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Passchier E, Beck AJCC, Stuiver MM, Retèl VP, Navran A, van Harten WH, van den Brekel MWM, van der Molen L. Organization of head and neck cancer rehabilitation care: a national survey among healthcare professionals in Dutch head and neck cancer centers. Eur Arch Otorhinolaryngol 2024; 281:2575-2585. [PMID: 38324056 PMCID: PMC11023954 DOI: 10.1007/s00405-024-08488-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/16/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE Head and neck cancer (HNC) treatment often leads to physical and psychosocial impairments. Rehabilitation can overcome these limitations and improve quality of life. The aim of this study is to obtain an overview of rehabilitation care for HNC, and to investigate factors influencing rehabilitation provision, in Dutch HNC centers, and to some extent compare it to other countries. METHODS An online survey, covering five themes: organizational structure; rehabilitation interventions; financing; barriers and facilitators; satisfaction and future improvements, among HNC healthcare- and financial professionals of Dutch HNC centers. RESULTS Most centers (86%) applied some type of rehabilitation care, with variations in organizational structure. A speech language therapist, physiotherapist and dietitian were available in all centers, but other rehabilitation healthcare professionals in less than 60%. Facilitators for providing rehabilitation services included availability of a contact person, and positive attitude, motivation, and expertise of healthcare professionals. Barriers were lack of reimbursement, and patient related barriers including comorbidity, travel (time), low health literacy, limited financial capacity, and poor motivation. CONCLUSION Although all HNC centers included offer rehabilitation services, there is substantial practice variation, both nationally and internationally. Factors influencing rehabilitation are related to the motivation and expertise of the treatment team, but also to reimbursement aspects and patient related factors. More research is needed to investigate the extent to which practice variation impacts individual patient outcomes and how to integrate HNC rehabilitation into routine clinical pathways.
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Affiliation(s)
- Ellen Passchier
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Centre for Quality of Life, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Ann-Jean C C Beck
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Martijn M Stuiver
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Centre for Quality of Life, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Valesca P Retèl
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands
| | - Arash Navran
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands
| | - Michiel W M van den Brekel
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Institute of Phonetic Sciences ACLC, University of Amsterdam, Amsterdam, The Netherlands.
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Lisette van der Molen
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
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Rapin J, Pellet J, Mabire C, Gendron S, Dubois CA. How does nursing-sensitive indicator feedback with nursing or interprofessional teams work and shape nursing performance improvement systems? A rapid realist review. Syst Rev 2022; 11:177. [PMID: 36002846 PMCID: PMC9404638 DOI: 10.1186/s13643-022-02026-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 07/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Care quality varies between organizations and even units within an organization. Inadequate care can have harmful financial and social consequences, e.g. nosocomial infection, lengthened hospital stays or death. Experts recommend the implementation of nursing performance improvement systems to assess team performance and monitor patient outcomes as well as service efficiency. In practice, these systems provide nursing or interprofessional teams with nursing-sensitive indicator feedback. Feedback is essential since it commits teams to improve their practice, although it appears somewhat haphazard and, at times, overlooked. Research findings suggest that contextual dynamics, initial system performance and feedback modes interact in unknown ways. This rapid review aims to produce a theorization to explain what works in which contexts, and how feedback to nursing or interprofessional teams shape nursing performance improvement systems. METHODS Based on theory-driven realist methodology, with reference to an innovative combination of Actor-Network Theory and Critical Realist philosophy principles, this realist rapid review entailed an iterative procedure: 8766 documents in French and English, published between 2010 and 2018, were identified via 5 databases, and 23 were selected and analysed. Two expert panels (scientific and clinical) were consulted to improve the synthesis and systemic modelling of an original feedback theorization. RESULTS We identified three hypotheses, subdivided into twelve generative configurations to explain how feedback mobilizes nursing or interprofessional teams. Empirically founded and actionable, these propositions are supported by expert panels. Each configuration specifies contextualized mechanisms that explain feedback and team outcomes. Socially mediated mechanisms are particularly generative of action and agency. CONCLUSIONS This rapid realist review provides an informative theoretical proposition to embrace the complexity of nursing-sensitive indicator feedback with nursing or interdisciplinary teams. Building on general explanations previously observed, this review provides insight into a deep explanation of feedback mechanisms. SYSTEMATIC REVIEW REGISTRATION Prospero CRD42018110128 .
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Affiliation(s)
- Joachim Rapin
- Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montréal, Québec, H3T 1A8, Canada. .,Lausanne University Hospital, rue du Bugnon 21, CH - 1011, Lausanne, Switzerland.
| | - Joanie Pellet
- Lausanne University Hospital, rue du Bugnon 21, CH - 1011, Lausanne, Switzerland.,Institute of Higher Education and Research in Healthcare - IUFRS, University of Lausanne, Biopôle 2 - Route de la Corniche 10, CH - 1010, Lausanne, Switzerland
| | - Cédric Mabire
- Lausanne University Hospital, rue du Bugnon 21, CH - 1011, Lausanne, Switzerland.,Institute of Higher Education and Research in Healthcare - IUFRS, University of Lausanne, Biopôle 2 - Route de la Corniche 10, CH - 1010, Lausanne, Switzerland
| | - Sylvie Gendron
- Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montréal, Québec, H3T 1A8, Canada
| | - Carl-Ardy Dubois
- École de Santé Publique de L'Université de Montréal, 7101 Avenue du Parc, Montréal, Québec, H3N 1X9, Canada
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Albers EAC, Fraterman I, Walraven I, Wilthagen E, Schagen SB, van der Ploeg IM, Wouters MWJM, van de Poll-Franse LV, de Ligt KM. Visualization formats of patient-reported outcome measures in clinical practice: a systematic review about preferences and interpretation accuracy. J Patient Rep Outcomes 2022; 6:18. [PMID: 35239055 PMCID: PMC8894516 DOI: 10.1186/s41687-022-00424-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The use of Patient-Reported Outcome Measures (PROMs) for individual patient management within clinical practice is becoming increasingly important. New evidence about graphic visualization formats for PROMs scores has become available. This systematic literature review evaluated evidence for graphic visualization formats of PROMs data in clinical practice for patients and clinicians, for both individual and group level PROMs data. METHODS Studies published between 2000 and 2020 were extracted from CINAHL, PubMed, PsychInfo, and Medline. Studies included patients ≥ 18 years old in daily clinical practice. Papers not available in English, without full-text access, or that did not specifically describe visualization of PROMs data were excluded. Outcomes were: visualization preferences; interpretation accuracy; guidance for clinical interpretation. RESULTS Twenty-five out of 789 papers were included for final analysis. Most frequently studied formats were: bar charts, line graphs, and pie charts. Patients preferred bar charts and line graphs as these were easy and quick for retrieving information about their PROMs scores over time. Clinicians' interpretation accuracy and preferences were similar among graphic visualization formats. Scores were most often compared with patients' own previous scores; to further guide clinical interpretation, scores were compared to norm population scores. Different 'add-ons' improved interpretability for patients and clinicians, e.g. using colors, descriptions of measurement scale directionality, descriptive labels, and brief definitions. CONCLUSION There was no predominant graphical visualization format approach in terms of preferences or interpretation accuracy for both patients and clinicians. Detailed clarification of graph content is essential.
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Affiliation(s)
- Elaine A C Albers
- Department of Psychosocial Research, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Itske Fraterman
- Department of Psychosocial Research, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Iris Walraven
- Department of Psychosocial Research, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department for Health Evidence, Radboudumc, Nijmegen, The Netherlands
| | - Erica Wilthagen
- Library and Scientific Information Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sanne B Schagen
- Department of Psychosocial Research, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Iris M van der Ploeg
- Department of Surgical Oncology, Antoni Van Leeuwenhoek, Amsterdam, The Netherlands
| | - Michel W J M Wouters
- Department of Surgical Oncology, Antoni Van Leeuwenhoek, Amsterdam, The Netherlands.,Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Psychosocial Research, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands.,Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Kelly M de Ligt
- Department of Psychosocial Research, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Hancock SL, Ryan OF, Marion V, Kramer S, Kelly P, Breen S, Cadilhac DA. Feedback of patient-reported outcomes to healthcare professionals for comparing health service performance: a scoping review. BMJ Open 2020; 10:e038190. [PMID: 33234623 PMCID: PMC7684821 DOI: 10.1136/bmjopen-2020-038190] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Patient-reported outcomes (PROs) provide self-reported patient assessments of their quality of life, daily functioning, and symptom severity after experiencing an illness and having contact with the health system. Feeding back summarised PROs data, aggregated at the health-service level, to healthcare professionals may inform clinical practice and quality improvement efforts. However, little is known about the best methods for providing these summarised data in a way that is meaningful for this audience. Therefore, the aim of this scoping review was to summarise the emerging approaches to PROs data for 'service-level' feedback to healthcare professionals. SETTING Healthcare professionals receiving PROs data feedback at the health-service level. DATA SOURCES Databases selected for the search were Embase, Ovid Medline, Scopus, Web of Science and targeted web searching. The main search terms included: 'patient-reported outcome measures', 'patient-reported outcomes', 'patient-centred care', 'value-based care', 'quality improvement' and 'feedback'. Studies included were those that were published in English between January 2009 and June 2019. PRIMARY AND SECONDARY OUTCOME MEASURES Data were extracted on the feedback methods of PROs to patients or healthcare providers. A standardised template was used to extract information from included documents and academic publications. Risk of bias was assessed using Joanna Briggs Institute Levels of Evidence for Effectiveness. RESULTS Overall, 3480 articles were identified after de-duplication. Of these, 19 academic publications and 22 documents from the grey literature were included in the final review. Guiding principles for data display methods and graphical formats were identified. Seven major factors that may influence PRO data interpretation and use by healthcare professionals were also identified. CONCLUSION While a single best format or approach to feedback PROs data to healthcare professionals was not identified, numerous guiding principles emerged to inform the field.
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Affiliation(s)
- Shaun L Hancock
- Public Health and Health Services Research Group, Stroke Theme, Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia
| | - Olivia F Ryan
- Public Health and Health Services Research Group, Stroke Theme, Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia
| | - Violet Marion
- Public Health and Health Services Research Group, Stroke Theme, Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia
| | - Sharon Kramer
- AVERT Early Rehabilitation Research, Stroke Theme, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
- School of Nursing and Midwifery, Faculty of Health Centre for Quality and Patient Safety Research-Alfred Health Partnership, Deakin University, Burwood, Victoria, Australia
| | - Paulette Kelly
- Health Services Data, Customer Support Branch, Corporate Services, Department of Health and Human Services, Victorian government, Melbourne, Victoria, Australia
| | - Sibilah Breen
- Public Health and Health Services Research Group, Stroke Theme, Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia
| | - Dominique A Cadilhac
- Public Health and Health Services Research Group, Stroke Theme, Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia
- Medicine, Monash University, Clayton, Victoria, Australia
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5
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Groene O. Improving the capacity for learning and improvement in health care. Int J Qual Health Care 2018; 30:159-160. [PMID: 29596637 DOI: 10.1093/intqhc/mzy064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 03/20/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Oliver Groene
- OptiMedis AG, Research & Development, Germany.,London School of Hygiene and Tropical Medicine, Department of Health Services Research and Policy, 15-17 Tavistock Place, London WC1H 9SH, UK
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6
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van Overveld LFJ, Takes RP, Vijn TW, Braspenning JCC, de Boer JP, Brouns JJA, Bun RJ, van Dijk BAC, Dortmans JAWF, Dronkers EAC, van Es RJJ, Hoebers FJP, Kropveld A, Langendijk JA, Langeveld TPM, Oosting SF, Verschuur HP, de Visscher JGAM, van Weert S, Merkx MAW, Smeele LE, Hermens RPMG. Feedback preferences of patients, professionals and health insurers in integrated head and neck cancer care. Health Expect 2017; 20:1275-1288. [PMID: 28618147 PMCID: PMC5689243 DOI: 10.1111/hex.12567] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2017] [Indexed: 12/31/2022] Open
Abstract
Background Audit and feedback on professional practice and health care outcomes are the most often used interventions to change behaviour of professionals and improve quality of health care. However, limited information is available regarding preferred feedback for patients, professionals and health insurers. Objective Investigate the (differences in) preferences of receiving feedback between stakeholders, using the Dutch Head and Neck Audit as an example. Methods A total of 37 patients, medical specialists, allied health professionals and health insurers were interviewed using semi‐structured interviews. Questions focussed on: “Why,” “On what aspects” and “How” do you prefer to receive feedback on professional practice and health care outcomes? Results All stakeholders mentioned that feedback can improve health care by creating awareness, enabling self‐reflection and reflection on peers or colleagues, and by benchmarking to others. Patients prefer feedback on the actual professional practice that matches the health care received, whereas medical specialists and health insurers are interested mainly in health care outcomes. All stakeholders largely prefer a bar graph. Patients prefer a pie chart for patient‐reported outcomes and experiences, while Kaplan‐Meier survival curves are preferred by medical specialists. Feedback should be simple with firstly an overview, and 1‐4 times a year sent by e‐mail. Finally, patients and health professionals are cautious with regard to transparency of audit data. Conclusions This exploratory study shows how feedback preferences differ between stakeholders. Therefore, tailored reports are recommended. Using this information, effects of audit and feedback can be improved by adapting the feedback format and contents to the preferences of stakeholders.
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Affiliation(s)
- Lydia F J van Overveld
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The Netherlands
| | - Robert P Takes
- Department of Otolaryngology, Head and Neck surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Thomas W Vijn
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The Netherlands
| | - Jozé C C Braspenning
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The Netherlands.,The Netherlands Federation of University Medical Centres, NFU, Utrecht, The Netherlands
| | - Jan P de Boer
- Department of Medical Oncology, Antoni van Leeuwenhoek Nederlands Kanker Instituut, Amsterdam, The Netherlands
| | - John J A Brouns
- Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Arnhem, The Netherlands
| | - Rolf J Bun
- Department of Oral and Maxillofacial Surgery, Medical Centre Alkmaar, Alkmaar, The Netherlands
| | - Boukje A C van Dijk
- Department of Research, Comprehensive Cancer Organization the Netherlands (IKNL), Utrecht, The Netherlands.,Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Judith A W F Dortmans
- Department of Radiation Oncology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Emilie A C Dronkers
- Department of Otorhinolaryngology, Head and Neck surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Robert J J van Es
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, Utrecht, The Netherlands
| | - Frank J P Hoebers
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Arvid Kropveld
- Department of Otolaryngology, Head and Neck surgery, Elisabeth-TweeSteden ziekenhuis Tilburg, Tilburg, The Netherlands
| | - Johannes A Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ton P M Langeveld
- Department of Otorhinolaryngology, Head and Neck surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Sjoukje F Oosting
- Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Hendrik P Verschuur
- Department of Otolaryngology, Head and Neck surgery, MC Haaglanden-Bronovo, The Hague, The Netherlands
| | - Jan G A M de Visscher
- Department of Oral and Maxillofacial Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Stijn van Weert
- Department of Otolaryngology, Head and Neck surgery, VU University Medical Centre, Amsterdam, The Netherlands
| | - Matthias A W Merkx
- Department of Oral and Maxillofacial Surgery, Radboud university Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Ludi E Smeele
- Department of Head and Neck Surgery and Oncology, Antoni van Leeuwenhoek Nederlands Kanker Instituut, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Academisch Medisch Centrum, Amsterdam Zuid-Oost, The Netherlands
| | - Rosella P M G Hermens
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The Netherlands
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