Knowledge bank

2021

15 years of market forces in healthcare
In 2006 began the ambitious reform of the Dutch healthcare system based on principles of regulated competition or market forces. Can we now - 15 years on - consider those reforms a success? What has 15 years of market forces done to the accessibility, quality and affordability of our healthcare system? The book 'The market reform in Dutch health care; Results, lessons and prospects' provides a thorough review.
Download the book via this website.

2018

Betaalbare zorg (Affordable care)
The insights from the knowledge program 'Celsus, academy for affordable care' were compiled in the eponymous book 'Betaalbare zorg (Affordable Care)' edited by Patrick Jeurissen, Hans Maarse and Marit Tanke.

This core publication is part of a series of books on healthcare affordability that appeared simultaneously. The other titles in this series are also on this page
Available via SDU

Beleid en besturing in de zorg (Policy and management in health care)
Hans Maarse
Available via SDU

Vijftig jaar kostenbeheersing in de zorg (Fifty years of cost control in health care)
Part I: 1966-1995
Karel-Peter Companje, Ton Kappelhof, Robert Mouton and Patrick Jeurissen
Availablevia S DU - (Part II see 2021)

Waardevolle zorg, Kwaliteit en doelmatigheid voor verpleegkundigen (Valuable care, Quality and efficiency for nurses)
Henny van Lienden and Hiske Calsbeek
Available via Koninklijke van Gorcum

Current education requires nurses to be able to argue their own actions using theoretical principles and results of scientific research (evidence-based nursing). Effectief Verplegen provides students with the arguments for solving or making manageable a number of common nursing problems. This book elaborates nursing problems that can occur in many different patients/caregivers, focusing on somatics. As in Volume 2, these are self-contained nursing problems and interventions, such as malnutrition, pain, sleep problems, etc. The book opens with an introduction to ebp, followed by the nursing problems worked out. Each chapter forms a completed whole, which can be studied separately. The chapter structure follows a fixed pattern: each chapter begins with a brief introduction, followed by case histories and a description of the problem area, nursing diagnostics and nursing interventions, and concludes with a knowledge review and a literature review.

Editors: Prof. Dr. Th. van Achterberg, Dr. G.J.J.W. Bours, Drs. A.M. Eliens.
Publisher: Kavanah, Dwingeloo
ISBN: 9789057401244
Year of publication: 2012

This book discusses nursing problems that may occur in various patient categories and are located in the psychosocial domain. These nursing problems are clustered into a number of nursing problem areas (see below). The book opens with an introduction, which discusses the state of evidence-based nursing and explains the significance of some commonly used classification systems and the EAP formula.
The introduction is followed by the elaborated nursing problems: each chapter forms a rounded whole (problem area), which can be studied separately.
The chapter structure follows a fixed pattern: each chapter starts with a short introduction, followed by case histories and a description of respectively the problem area, nursing diagnostics and nursing interventions, after which it concludes with a knowledge review and a literature review.

Editors: Prof. Dr. Th. van Achterberg, Dr. G.J.J.W. Bours, Dr. A.M. Elien.
Publisher: Kavanah, Dwingeloo
ISBN: 9789057401176
Year of publication: 2011

Parts 1 and 2 in this series cover common nursing problems in somatic and psychosocial care. These are nursing problems that can occur in many different patients (general care).
Effectief Verplegen 3 and Effectief Verplegen 4 differ from this. Parts 3 and 4 highlight nursing problems in specific groups of patients or caregivers (complex care). By choosing target groups instead of nursing problems as an entry point, it becomes possible to describe the entire care of a group. The chapters therefore cover problems in every area of human functioning. When describing the nursing problems for a target group, the particular problems of the group in question were chosen. For general problems that may also occur in these groups, reference has been made to Parts 1 and 2 where possible (e.g., pressure ulcers in Part 1 or compliance in Part 2).
This book is provided with a personal access code that allows users to consult additional information (such as the latest insights, measurement tools and a knowledge test) at www.verpleegproblemen.nl.

Editors: Prof. Dr. Th. van Achterberg, Dr. G.J.J.W. Bours, Drs. A.M. Eliens.

Publisher: Kavanah, Dwingeloo
ISBN: 9789057401183
Year of publication: 2012

Effective communication is one of the most important competencies of the general practitioner. Yet this subfield sometimes remains underexposed in (continuing) education and is - wrongly - taken for granted. Optimal communication can make consultation and practice much more effective and enjoyable.

'Handboek effectieve communicatie in de huisartsenpraktijk'. Authors: Dielissen, P.W. / Jagt, E.J. van der / Timmerman, A.A. With contributions by W. Dekkers, S. Naber, P. Giesen (IQ Health).

Publisher: Prelum
ISBN:9789085621478
Year of publication: 2016

Implementation in healthcare is enjoying growing interest from science and practice. The book ‘Implementatie: Effectieve verbetering van de patiëntenzorg’ ('Implementation: Effective Improvement of Patient Care') edited by Michel Wensing and Richard Grol has for many years offered a practical and scientifically based overview of the knowledge in this field. It is widely used in education.

Recently, the eighth, revised edition was published, on which several scientists from the Radboudumc collaborated. The book covers clinical guidelines, implementation strategies, quality indicators, patient safety, patient empowerment, and process evaluation, among other topics. The new edition contains much new knowledge that has become available internationally in recent years.

Learn more at the BSL Web site.

The book Coaching Peer Learning in Healthcare by Marjo Maas and Anjo Markhorst was recently released. A Peer Learning (PL) Group is a group of professionals working together on professionalization, quality improvement and innovation. Central is learning from each other based on issues from practice or science. In this book, the authors focus primarily on coaching PL groups working toward good and responsible healthcare.

A critical reflection on current healthcare practice and the search together for alternative or new ways of doing things form the common thread. The authors of this book are experienced PL coaches in healthcare and trainers of PL coaches. They have compiled this book based on the available literature on learning and professionalization, their experience as trainers and their observational research using video recordings of PL sessions.

Coaching Peer Learning in Healthcare is intended for healthcare professionals who have experience with, or interest in, coaching professional learning groups. This book gives the (potential) coach tools to facilitate the process of Peer Learning and to act appropriately when it is necessary to adjust the process.

Marjo Maas is affiliated as senior lecturer at the Academy of Paramedical Studies of the HAN and as researcher at Radboudumc, IQ Health department. Anjo Markhorst is owner of Alinea Consult, organizational coach and researcher at Radboudumc, IQ Health department.

This book was created with support from the Stichting Keurmerk Fysiotherapie. Click here for more info:

 https://www.2010uitgevers.nl/product/het-coachen-van-peer-learning-in-de-gezondheidszorg/

New book, I Can See You. The healing power of empathy
The book with this title was recently released, edited by Prof. Dr. Maria van den Muijsenbergh and Dr. Hub Wollersheim. Dr. Wollersheim worked as a researcher and teacher at IQ Health until his retirement. At a time when polarization and individualism prevail, this book offers an essential look at the importance of empathy and humanity. It explores how declining empathy affects our relationships and social structures.
Through a series of essays by experts from various fields, including philosophy, medical science and technology, this book illuminates the multifaceted nature of empathy. It examines the impact of an empathetic attitude in the doctor-patient relationship, and how this translates to broader social and political issues.

Every year in healthcare, many valuable new insights, technologies, programs or best practices become available. Unfortunately, many of these innovations do not find their way into practice. Why is that? And how can effective improvement of patient care be achieved? In this - thoroughly revised - edition of Implementation: effectively improving patient care, you will find up-to-date information on implementing a variety of changes. The process of innovation in practice is carefully analyzed and discussed using a practical, step-by-step model. A large number of scientific findings and practical examples are presented to explain the model. In Implementation: effectively improving patient care, the emphasis is on improving the actions of physicians, paramedics and nurses and the teams in which they work. The patient is central to this effort. It is a practical book for healthcare providers, executives, quality officers, managers, policy makers and researchers involved in optimizing patient care in the Netherlands. Richard Grol is Emeritus Professor of Quality of Care at the Universities of Nijmegen and Maastricht, Michel Wensing is Professor of Implementation Science at Radboud University Nijmegen.

Editors: Richard Grol and Michel Wensing.
Publisher: Reed business, Amsterdam
ISBN: 9789035233966
Year of publication: 2011

Strategies for successfully updating and improving health care organizations of all kinds. 

Health care is always evolving and improving. However, the rapid speed of medical advancement can make the adoption of new technologies and practices a challenging process – particularly in large organizations and complex networks. Any projected impact upon quality and outcomes of care must be carefully evaluated so that changes may be implemented in the most efficacious and efficient manner possible.

Improving Patient Care equips professionals and policymakers with the knowledge required to successfully optimize health care practice. By integrating scientific evidence and practical experience, the text presents a cohesive and proven model for practice change and innovation, complete with analysis of innovation, target group and setting; selection and application of strategies; and evaluation of process, outcomes and costs.

This new third edition also includes:

• Newly written chapters on clinical performance feedback, patient engagement, patient safety, evaluation designs, and methods for process evaluation
• Increased emphasis on the role of contextual influences in implementation and improvement
• New research examples from across the world and updated scientific literature throughout

Designed to help promote safer and more efficient, patient-centered care and better outcomes, Improving Patient Care is an essential resource for healthcare providers, quality assessors, and students of health services research, health management, and health policy.

Editors: Michel Wensing, Richard Grol, Jeremy Grimshaw

More information can be found on the website of Wiley.

"Quality of care is determined by many factors, including the (personal and professional) qualities of professionals such as doctors and nurses. Those qualities include the personal qualities to be able to do your job ethically as a professional - virtues. This book includes a chapter on the virtues of doctors, the virtues of nurses and two "profiles" of healthcare professionals. One is Prof. Dr. Baziel van Engelen, a neurologist at the Radboudumc. The book combines two of IQ Health's research themes: 'professional development' and 'ethics.'"

According to virtue ethics, good action comes from attitudes you develop as you go through life, such as courage, justice and integrity. If you have character, you pursue such virtues. They make your own life and the lives of those around you good, even when you are at work.

'Those who are virtuous provide virtuosic custom.'

What virtues matter in professional practices such as education, healthcare, law and business, and how do you develop them? This book brings together answers to those questions and short interviews with professionals such as Robbert Dijkgraaf, Femke Cools and Jos de Blok. As an introduction, Paul van Tongeren wrote a brief history of virtue ethics.

Edited by Wouter Sanderse and Jos Kole
ISVW publishers NUR: 730 / ISBN: 978-94-91693-62-5

A new edition of the book Kwaliteit en veiligheid in patiëntenzorg (Quality and Safety in Patient Care) has been released. The book has now been made expressly suitable for nurses as well.
In health care education, increasing attention is being paid to quality improvement and the prevention of unsafety in patient care. The increased attention to quality of care is evident, for example, in the recent Framework Plan. The 2020 Framework Plan for Physician Education is based on the (updated) CanMEDS framework. Whereas in 2009 about half of the competencies were related to quality and safety, professional behavior and ethical moral thinking and acting, in 2020 this is more than three quarters. Moreover, many competencies are more explicitly elaborated toward patient safety, continuity of care, working on virtues and professional behavior, reflective capacity and lifelong learning, interprofessional collaboration, collaborative decision making and co-producing care. These topics are covered extensively in this textbook.
Quality and safety are such a high priority because of the important consequences for patients and society. But what exactly does it mean to provide quality and safe care in a transparent manner? What role does the healthcare organization play, and how can the physician, nurse or paramedic individually contribute to safe patient care? How are calamities prevented? But also: how to adequately deal with a mistake made and how to learn from it?
Quality and Safety in Patient Care clarifies what quality of care is and what are conditions for quality improvement. The various dimensions such as professional, organizational and patient-centered quality are discussed, as well as research on quality improvement and implementation in practice. Despite the pursuit of optimal patient care, incidents always continue to occur. A separate chapter is therefore devoted to how to deal with a calamity, keeping in mind patient, organization and one's own feelings and functioning. The possibilities of quality improvement are illustrated in this book with numerous examples from clinical practice.
Quality and Safety in Patient Care is written by leading Dutch quality researchers and improvers, -professionals and healthcare providers, who have already made many contributions to actual improvement of patient care. With this book they offer every (future) healthcare professional the knowledge and tools to pursue optimal patient care and to reflect on their own role in it.

Editors: Hub Wollersheim, Trudy van der Weijden, Cordula Wagner, Kees Ahaus, Jaap Hamming and Hester Vermeulen.

Quality of care is under pressure from high demand, complexity and high costs. The idea of 'appropriate care' helps address these issues. The updated edition of this book provides insight into theories (head), it encourages self-reflection (heart) and contains practical tips (hands). The book helps to deepen knowledge, and also to develop one's own view on quality of care. For (future) healthcare professionals who not only want to know what good care is, but also want to understand how they can really make a difference.

IQ Health colleagues Marlies Hulscher, Rosella Hermens, Hiske Calsbeek and Hester Vermeulen helped make this updated edition possible. The book can be ordered via:

BSL Shop | Kwaliteit en veiligheid in patiëntenzorg

On May 25, 2021, Kok Boekencentrum published the volume Leven met Euthanasie (Living with Euthanasia), by Theo Boer, Stef Groenewoud (health scientist and ethicist at IQ Health) and Wouter de Jonge. The book is a compilation of over forty stories of experience from people who are (or have been) involved in euthanasia in some way.
Approximately one in twenty deaths in the Netherlands involves euthanasia. In response to unplannable and unwanted suffering, people choose this planned death. But what does the "good death" mean for directly involved loved ones? How do they experience it? Living with Euthanasia provides an impressive, poignant look into the stories of 43 next of kin.

Medical Practice Variations © 2016

Editors: Johnson, Ana, Stukel, Thérèse A. (Eds.)

• Raises critical concerns about the quality, equity and efficiency of international health care resources  
• Raises critical concerns about the quality, equity and efficiency of international health care resources
• Synthesizes current research on variations in healthcare utilization, delivery and outcomes
• Outlines established concepts & frameworks involved in researching medical practice variations
• Examines systemic questions about healthcare spending, decision-making and service disparities

Medical Practice Variations Part of the series Health Services Research pp 113-122

Medical Practice Variations in Primary Care
Gert P. Westert Affiliated with Health Services Research, Scientific Institute for Quality of Healthcare (IQ Health), Radboud University Nijmegen Medical Centre Email author 

• Judith D. de Jong Affiliated with Health Care System and Governance, NIVEL (Netherlands Institute for Health Services Research)
• Philip da Silva Affiliated with NHS Right Care

In daily care, nurses, like other healthcare professionals, have many questions. What does a patient want to achieve? What are we going to work on? What are the effects of the care? Does treatment need to be adjusted?

The third, revised edition of the book Meten in de praktijk (Measuring in Practice) is now accessible to nurses. The book includes a roadmap for using measurement tools in health care.

Measuring clarifies and objectifies these issues. This benefits the healthcare professional, the patient and their loved ones, both in determining the diagnosis, predicting the course of recovery, and also jointly determining the goal and evaluating a treatment.

Hester Vermeulen, professor of nursing science at IQ Health, has been added to the editorial team. As a result, the nursing perspective is now well represented herein. Nurses regularly use measurement tools in all settings. Using a step-by-step plan, nurses can now also learn how to systematically and critically search for, select, and interpret the appropriate measurement instrument and integrate its outcomes into the treatment process.

So in this third edition, there is more focus on interpreting and using the results in the care process. In addition, it collaborates with the website https://meetinstrumentenzorg.nl/, making the measurement tools and user information freely available.

The book is now also accessible to nurses. Furthermore, it is intended for all healthcare professionals, students and teachers of healthcare courses in higher education. In addition, it is a useful guide for professionals and quality staff working in healthcare.

The editorial board members are Sandra Beurskens, Roland van Peppen, Raymond Swinkels, Hester Vermeulen and Harriët Wittink. The book can be ordered by: https://www.bsl.nl/shop/meten-in-de-praktijk-9789036824583.html

A new international book was released in 2020: "Occupational therapy for older people," in Dutch "Ergotherapie bij ouderen."  The book describes occupational therapy interventions with older people in primary care, intensive care, rehabilitation, nursing home, palliative care and future perspectives.
The editors of this book are IQ Health professor Maud Graff, Christian Pozzi, Alessandro Lanzoni and Alessandro Morandi. The book was published by Springer International Publishers, 2020.

Setting up clinical trials is a complicated business, and one of the more difficult questions is how many patients and centres to include in multi-centre trials.
Statistician Steven Teerensta from Radboud University Medical Center and Mirjam Moerbeek from Utrecht University have published the book 'Power Analysis of Trials with Multilevel Data' with Chapman and Hall  explaining exactly what the issues are and giving guidelines to researchers.

Nurses are critical to delivering quality care. By demonstrating leadership, they influence quality, safety, effectiveness and person-centeredness of care. After all, nurses influence key outcome measures such as reduced malnutrition, infection, pain, anxiety and increased participation, adherence and self-management.  Nurses influence their own development and professionalism as well as that of students and colleagues on their team or the organization.
The editors of this book, including three colleagues from Radboudumc, IQ Health, invite nurses to explore and make the topic of nursing leadership their own. In this book, they ask many questions in between, let them reflect on their own practice situations or give short assignments on leadership. Because leadership, like nursing, is a "practice," in other words, you have to do it, practice, learn and try.
This book is intended for all ambitious nurses who, in a variety of roles and functions, are engaged in the professionalization of their profession and serve as boosters. More specifically: nurses following a program to become nurse leaders, nurse advisory boards, nurse specialists in training, students in the final phase of undergraduate education.
Editors and authors: Hester Vermeulen, Monique van Dijk, Maud Heinen, Gerda Holleman, Anita Huis, Erwin Ista, Pieterbas Lalleman, Catharina van Oostveen and Marjolein Schouten.

To support nurses and caregivers with signaling and prevention of healthcare-associated infections, a new guideline has recently been issued. This guideline was developed by Dr. Anita Huis (senior researcher IQ Health) and her colleague Nynke Bos (junior researcher at IQ Health). The goal is for a team to gain insight into how it handles infection prevention measures and what can be improved. The guideline, implementation guide and hygiene chart can be found on the V&VN site.
Read more on the V&VN website.

The Maturity Matrix is a method for evaluating the level of development in a general practice. During the administration, each practice staff member is asked to complete the list individually and independently.

A consultant then leads a discussion to reach agreement among the practice staff. A discussion then takes place about improvement priorities and plans in the practice.

The international version of the Maturity Matrix was developed between 2005 and 2007 by the European association for quality in general practice (EquiP) and IQ Health in a partnership with Cardiff University.

See also:
Elwyn G et al . Facilitating organizational development using a group-based formative assessment and benchmarking method: design and implementation of the International Family Practice Maturity Matrix. Qual Saf Health Care. 2010;19(6):e48.

For more information, please contact Jolanda van Haren.

The IQ consensus tool supports groups in reaching consensus. It is based on the Modified RAND Delphi Method and combines the measures highest tertile, median, and score on top-3 to arrive at a score "selection," "discussion," or "no selection.

The tool consists of several components:

• An (online) questionnaire, in which respondents must score on a 9-point Likert scale and indicate a top-3 and can add any comments;
• An Access program in which all relevant data can be entered;
• A summary of the scoring results, indicating for each indicator whether the indicator scores "selection," "discussion," or "no selection. This document can serve for discussion.
• An overview of the comments per indicator.
• An overview of the scores per individual respondent.

For more information, please contact Drs. Janine Liefers.

The bottleneck questionnaire is a tool for identifying bottlenecks for change. The questionnaire can be used in both improvement projects and research.
From the application of the questionnaire described in the book 'Room for Change? Bottlenecks and opportunities for improvement in patient care' described in the book 'Space for change? This variation further underscores the importance of good bottleneck analysis in improving patient care.

The world is changing. A movement is visible in which the starting point is not the care system of the care provider, but the context of the patient as a person. Patients are also increasingly able to access tools that allow them to direct the care process from their intention.

The personal care net is an example of this. MijnZorgnet is owned by the Radboudumc and managed by IQ Health. It is an Internet place owned by the patient where there is the possibility to store, share and discuss information about your health.

The information can include diaries written by the patient, uploaded files of medical information and modular third-party applications such as forms, decision aids for shared decision-making and questionnaires. Patients can invite people they consider relevant to their health to join their personal care network. These could include family doctors, medical specialists and physical therapists, as well as family members or friends. Members of a care team have access to the personal data and can communicate about it. All activities in the personal care net are logged. In this way, the patient can see who has visited and when.

Identification and authentication on MijnZorgnet is via DigiD for patients and BIG validation for healthcare providers. After creating a profile, patients can set up their personal care net and get started.

For more information, please contact Prof. Jan Kremer.

The Excel application POINT 1.0 (Presentation of the Opportunity Costs of Introduction of New (Medical) Technologies 1.0) was developed as part of the project "Verdringseffecten binnen het Nederlandse zorgstelsel", commissioned by Zorginstituut Nederland. This project investigated the loss of value when introducing new healthcare interventions. Empirical research calculated how much producing a QALY in hospital care costs and how these opportunity costs were distributed across hospital care 2. This was calculated using an econometric model that relates changes in health outcomes to changes in hospital spending for the years 2012 to 2014.

POINT 1.0 uses the results of this report to visualize displacement effects at a glance. Filling in a limited set of data on a new medical technology shows whether the innovation is cost-effective, and if not, what the price reduction would have to be for the innovation to be cost-effective. The necessary data should all be available by default with a pharmacoeconomic file as submitted to ZIN. Medical technologies that have not taken that path but where a Dutch cost-effectiveness analysis is available usually also have the necessary information. In addition to the total displacement, the loss of value is also shown per disease state. This manual shows how the Excel application works and which parameters can be set or input.

Open POINT 1.0
Go to the user manual of POINT 1.0
Go to the final report on which POINT 1.0 is based
An illustration using the case study Orkambi

This questionnaire is designed to evaluate the process of interprofessional collaboration.
The questionnaire was developed by IQ Health in cooperation with Hogeschool Zuyd (Wim Goossens & Jerome van Dongen). The ReflectionScan (RISS-2020) can be used for both existing and newly formed teams.

Download Reflectiescan (RISS-2020)

Informal care is often very satisfying, but it can also be demanding at times. Informal caregivers who provide intensive care for long periods of time are at risk of becoming overburdened. It is important for caregivers, nurses and nursing specialists to be able to act in time to identify, prevent or alleviate overburdening.

IQ Health, in cooperation with the University Medical Center (UMC) Utrecht and the Hogeschool van Arnhem en Nijmegen (HAN), has developed a guideline on Informal Care. By using the guideline, young, working and elderly informal caregivers will be recognized earlier and (threatening) overburdening will be detected earlier. Informal caregivers will feel more heard and empowered in dealing with the care for their loved one.

The guideline was developed by Dr. Maud Heinen, Dr. José Peeters, Dr. Nicole Vullings, Prof. Dr. Hester Vermeulen and Prof. Dr. Maud Graff.

• The guideline can be found on the website of V&VN
• Read an additional introduction to ithere
• Report practice test guideline Informal care
• Infographic Informal caregiver
• Infographic Care professional

Nationwide, the call ''Pay a little attention to each other'' is heard in this time of the coronavirus. Togetherness and caring are not only desirable and necessary in situations of crisis.

For (care) questions and needs of residents, strong neighborhood networks are vital. The project "A strong neighborhood network: citizens, professionals and education SAMEN!" has resulted in an online toolbox. Citizens and professionals are given tools to build, organize and perpetuate a strong neighborhood network.

This toolbox came out of the project 'A strong neighborhood network: citizens, professionals and education SAMEN! In this project 2 living labs and 5 practical projects are involved.

This is a cooperation project between KOH, HAN University of Applied Sciences (lectorate Organization of Care and Services) and Radboudumc (departments IQ Health and Primary Care). The research was funded by the Ministry of Health, Welfare and Sport.

See website: Successful collaboration in neighborhood networks

Read also 'Collaborating with citizens. How to do it'.

This is a questionnaire for measuring team climate. This questionnaire is based on a theory of team climate and consists of 4 dimensions ('Experienced safety for participation', 'Support for innovation', 'Vision' and 'Task orientation') and 13 subscales.

IQ Health has translated and validated the TCI for the Dutch situation.
IQ Health can provide support in administering the questionnaire and prepare a report.

For more information, please visit www.teamclimateinventory.nl

Contact person: Jolanda van Haren