Organization of outcome-based quality improvement in Dutch heart centres

Veghel, Dennis van; Daeter, Edgar J.; Bax, Matthijs; Amoroso, Giovanni; Blaauw, Yuri; Camaro, Cyril; Cummins, Paul; Halfwerk, F.R.; Hamer, Inez J. Wijdh-den; Jong, Jonas S S G de; Stooker, Wim; Wees, Philip J. van der; Nat, P. B. van der

doi:10.1093/ehjqcco/qcz021

Cited by 16 publications

(33 citation statements)

References 16 publications

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“…In the Netherlands, the Netherland Heart Registration (NHR) monitors outcomes of interventions in cardiovascular disease that matter most to patients. Annual reports confirm the high standards of care in the Netherlands and show only minor variations [20]. Outcomes of patients not receiving intervention and patient satisfaction are not yet monitored, resulting in an incomplete overview of the quality of decision-making in the heart team.…”

Section: Patient Safety and Outcome Measurementmentioning

confidence: 90%

Heart teams in the Netherlands: From teamwork to data‑driven decision-making

Wierda¹,

Veghel

Hirsch

et al. 2020

Neth Heart J

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For all patients with cardiovascular disease requiring an intervention, this is a major life event. The heart team concept is one of the most exciting and effective team modalities to ensure cost-effective application of invasive cardiovascular care. It optimises patient selection in a complex decision-making process and identifies risk/benefit ratios of different interventions. Informed consent and patient safety should be at the centre of these decisions. To deal with increased load of medical data in the future, artificial intelligence could enable objective and effective interpretation of medical imaging and decision support. This technical support is indispensable to meet current patient and societal demands for informed consent, shared decision-making, outcome improvement and safety. The heart team should be restructured with clear leadership, accountability, and process and outcome measurement of interventions. In this way, the heart team concept in the Netherlands will be ready for the future.

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Section: Patient Safety and Outcome Measurementmentioning

confidence: 90%

Heart teams in the Netherlands: From teamwork to data‑driven decision-making

Wierda¹,

Veghel

Hirsch

et al. 2020

Neth Heart J

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“…It is well known that, putting innovative care according to VBHC principles into practice, a major change for the healthcare staff and patients involved is expected. [3][4][5][6][7][8] Organising care centred around the patient challenges multidisciplinary professionals from different organisational units to collaborate and coordinate their tasks as well as to share responsibility for continuous healthcare improvement. These are major changes in daily practice that require extensive implementation effort.…”

Section: Open Accessmentioning

confidence: 99%

“…As literature shows, the implementation of VBHC is difficult. [3][4][5][6][7][8] Besides, it appears largely unclear how to use PROMs with respect to SDM and the expectations of physicians in that regard. 3 6 For implementation to be successful, an understanding of the barriers and facilitators experienced by physicians and nurses is needed.…”

Section: Open Accessmentioning

confidence: 99%

Lessons learned on the experienced facilitators and barriers of implementing a tailored VBHC model in a Dutch university hospital from a perspective of physicians and nurses

et al. 2022

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ObjectiveThis study aims to obtain insight into experienced facilitators and barriers of implementing a tailored value-based healthcare (VBHC) model in a Dutch university hospital from a perspective of physicians and nurses.MethodA descriptive qualitative study with 12 physicians, nurses and managers of seven different care pathways who were involved in the implementation of a tailored VBHC methodology was conducted. Thematic content analysis was used to analyse the data guided by all factors of the Consolidated Framework for Implementation Research (CFIR).FindingsThe method designed for the implementation of a tailored VBHC methodology was appointed as a structured guide for the process. Throughout the implementation process, leadership and team dynamics were considered as important for the implementation to succeed. Also, sharing experiences with other value teams and the cooperation with external Information Technology (IT) teams in the hospital was mentioned as desirable. The involvement of patients, that is part of the VBHC methodology, was considered useful in the decision-making and improvement of the care process because it gave better insights in topics that are important for patients. The time-consuming nature of the implementation process was named as barrier to the VBHC methodology. On top of that, the shaping of the involvement of patients and the ongoing changes in departments were established as difficult. Finally, working with the Electronic Health Records and acquiring the necessary digital skills were considered to be often forgotten and, thus, hindering implementation.ConclusionClinical Healthcare organisations implementing a tailored VBHC methodology will benefit from the use of a structured implementation methodology, a well-led strong team and cooperation with (external) teams and patients. However, shaping patient involvement, alignment with other departments and attention to digitisation were seen as a most important concerns in implementation and require further attention.

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“…Last but not least and perhaps more importantly, the typical Dutch spirit of consultation and collaboration has led to structured multidisciplinary decision-making, planning, execution and evaluation involving medical specialists with various backgrounds and expertise ensuring balanced treatment stratification via the heart-team [23]. Given the outstanding infrastructure in the Netherlands, such as the nationwide prospective registry that was created under the auspices of the Netherlands Society of Cardiology and Cardio-Thoracic Surgery to improve quality of care by monitoring patient demographics and clinical outcomes (BHN-registratie), clinical programs are incorporated into clinical-scientific ones [24]. The TAVI Care and Cure is an example of this [25].…”

Section: Tavi In the Netherlandsmentioning

confidence: 99%