[Preoperative geriatric screening in care path 'AAA'].

Aim: Determining the added value of preoperative geriatric screening (POGS) in the care path 'Infrarenal abdominal aortic aneurysm'.

Design: Retrospective observational study in a university hospital.

Method: For patients (>60 years) with non-acute aortic pathology, data on preoperative screening (including frailty measures) and treatment was automatically generated from medical records for the period 2018-2021 (42 months).

Design and Validation of a Questionnaire to Measure Interprofessional Collaborative Practice for Auditing Integrated Hospital Care: Empirical Research.

Introduction: Interprofessional teamwork is the key issue of delivering integrated hospital care; however, measuring interprofessional collaboration for auditing is fragmented. In this study, a questionnaire to measure InterProfessional collaborative Practice for Integrated Hospital care (IPPIH) has been developed and validated.

Methods: A four-step iterative process was conducted: (1) literature search to find suitable questionnaires; (2) semistructured stakeholder interviews (individual and in focus groups) to discuss the topics and questions (face validity), (3) pretesting the prototype of the questionnaire in two different integrated care pathways for feasibility, usability, and internal consistency, and (4) testing (content and construct validity and responsiveness) of the revised questionnaire in eight integrated care pathways; the validation and responsiveness was tested by means of exploratory factor analysis, calculation of Cronbach alpha, item analysis, and linear mixed model analysis.

Development of a maturity matrix to assess organizational readiness of community pharmacies for implementation of guideline recommendations in diabetes care.

Objectives: Pharmaceutical care for people with diabetes mellitus type 2 (DMT2) has been described in professional guidelines. To apply their recommendations, organizational changes are needed. We aimed to describe, for the first time, the development of a maturity matrix for community pharmacy teams (MM-CP) to assess organizational readiness in implementing the guideline recommendations on pharmaceutical DMT2 care.

The most efficient and effective BRCA1/2 testing strategy in epithelial ovarian cancer: Tumor-First or Germline-First?

Objective: Genetic testing in epithelial ovarian cancer (OC) is essential to identify a hereditary cause like a germline BRCA1/2 pathogenic variant (PV). An efficient strategy for genetic testing in OC is highly desired. We evaluated costs and effects of two strategies; (i) Tumor-First strategy, using a tumor DNA test as prescreen to germline testing, and (ii) Germline-First strategy, referring all patients to the clinical geneticist for germline testing.

Struggling with the governance of interprofessional elderly care in mandated collaboratives: a qualitative study.

Background: Governing interprofessional elderly care requires the commitment of many different organisations connected in mandated collaboratives. Research over a decade ago showed that the governance relied on clan-based mechanisms, while lacking formal rules and incentives for collaborations. Awareness and reflection were seen as first steps towards progression.

Supporting care engagement in primary care; the development of a maturity matrix.

Background: Care engagement or active patient involvement in healthcare contributes to the quality of primary care, but organisational preconditions in routine practice need to be aligned. A Maturity Matrix for Care Engagement to assess and discuss these preconditions in the general practice team was developed and tested on feasibility and acceptability in general practice.

Methods And Findings: A systematic user-centred approach was applied, starting with a scoping literature search to describe the domains on the horizontal axis of the maturity matrix.

Healthcare professionals' perspectives on implementation of universal tumor DNA testing in ovarian cancer patients: multidisciplinary focus groups.

Universal tumor DNA testing in epithelial ovarian cancer patients can function not only as an efficient prescreen for hereditary cancer testing, but may also guide treatment choices. This innovation, introduced as Tumor-First workflow, offers great opportunities, but ensuring optimal multidisciplinary collaboration is a challenge. We investigated factors that were relevant and important for large-scale implementation.

Uniform Registration Agreements on Cholesteatoma Care: A Nationwide Consensus Procedure.

Background: To coordinate and align the content for registration of cholesteatoma care.

Methods: Systematic Delphi consensus procedure, consisting three rounds: two written sessions followed by a face-to-face meeting. Before this procedure, input on important patient outcomes was obtained.

Development of a framework with tools to support the selection and implementation of patient-reported outcome measures.

Background: Patient reported outcomes (PROs) provide information on a patient's health status coming directly from the patient. Measuring PROs with patient reported outcome measures (PROMs) has gained wide interest in clinical practice for individual patient care, as well as in quality improvement, and for providing transparency of outcomes to stakeholders through public reporting. However, current knowledge of selecting and implementing PROMs for these purposes is scattered, and not readily available for clinicians and quality managers in healthcare organizations.

The differences between three performance measures on dental restorations, clinical success, survival and failure: A matter of perspective.

Objectives: The aim of this retrospective methodology study was to investigate the influence of using different definitions for restoration failure and inclusion criteria on restoration longevity expressed in AFR.

Methods: EPF from fifteen general dental practices were used for collecting the data for this study. From the EPF, 321,749 composite restorations placed in 52,245 patients by forty-seven GDPs between January 2000 and December 2011 were included.

Variation in Integrated Head and Neck Cancer Care: Impact of Patient and Hospital Characteristics.

Monitoring and effectively improving oncologic integrated care requires dashboard information based on quality registrations. The dashboard includes evidence-based quality indicators (QIs) that measure quality of care. This study aimed to assess the quality of current integrated head and neck cancer care with QIs, the variation between Dutch hospitals, and the influence of patient and hospital characteristics.

Minimally Invasive Intervention for Primary Caries Lesions: Are Dentists Implementing This Concept?

Contemporary minimally invasive treatment concepts for restorative treatment of primary caries lesions include both delayed intervention and smaller-sized preparations restricted to removal of carious tissue. The aim of this study was to investigate whether these concepts have resulted in a trend towards a more conservative choice made by dentists regarding treatment thresholds and restorative techniques. The results from previously conducted, precoded questionnaires developed by Espelid and Tveit, as well as from a recent Dutch questionnaire, were collected and analysed.

The implementation of a quality system in the Dutch GP specialty training: barriers and facilitators; a qualitative study.

Background: Quality assurance programs in medical education are introduced to gain insight into the quality of such programs and to trigger improvements. Although of utmost importance, research on the implementation of such programs is scarce. The Dutch General Practice (GP) specialty training institutes used an implementation strategy to implement a quality system (QS), and we aimed to study the success of this strategy and to learn about additional facilitators and barriers.

The development of a collective quality system: challenges and lessons learned; a qualitative study.

Background: The ongoing professionalization of medical education means that quality systems (QSs) aimed at improving medical education also continuously have to improve. The aim of this paper is to describe the development of a collective QS for eight Dutch General Practitioner (GP) specialty training institutes to provide insights into the considerations that are involved in developing a QS in medical education.

Methods: Experts in the field of GP education and quality assurance developed the QS.

Feedback preferences of patients, professionals and health insurers in integrated head and neck cancer care.

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.

Data extraction from electronic health records (EHRs) for quality measurement of the physical therapy process: comparison between EHR data and survey data.

Background: With the emergence of the electronic health records (EHRs) as a pervasive healthcare information technology, new opportunities and challenges for use of clinical data for quality measurements arise with respect to data quality, data availability and comparability. The objective of this study is to test whether data extracted from electronic health records (EHRs) was of comparable quality as survey data for the calculation of quality indicators.

Methods: Data from surveys describing patient cases and filled out by physiotherapists in 2009-2010 were used to calculate scores on eight quality indicators (QIs) to measure the quality of physiotherapy care.

Patient experiences with family medicine: a longitudinal study after the Dutch health care reforms in 2006.

Background: In 2006 The Dutch Health Care system changed to a market oriented system. The GP remuneration changed from ± 2/3 capitation patients and 1/3 private patients before 2006 to a mixed payment scheme. From 2006 onward every patient was insured and the GP received partly capitation, partly fees for consultations and for specific services.

The Reasons behind the (Non)Use of Feedback Reports for Quality Improvement in Physical Therapy: A Mixed-Method Study.

Objectives: To explain the use of feedback reports for quality improvements by the reasons to participate in quality measuring projects and to identify barriers and facilitators.

Design: Mixed methods design.

Methods: In 2009-2011 a national audit and feedback system for physical therapy (Qualiphy) was initiated in the Netherlands.

Medication management strategy for older people with polypharmacy in general practice: a qualitative study on prescribing behaviour in primary care.

Background: For older patients with polypharmacy, medication management is a process of careful deliberation that needs periodic adjustment based on treatment effects and changing conditions. Because of the heterogeneity of the patient group, and limited applicability of current guidelines, it is difficult for GPs to build up a routine.

Aim: To gain insight into GPs' medication management strategies for patients with polypharmacy, and to explore the GPs' perspectives and needs on decision-making support to facilitate this medication management.

Inter-practice variation in polypharmacy prevalence amongst older patients in primary care.

Purpose: Complex medication management in older people with multiple chronic conditions can introduce practice variation in polypharmacy prevalence. This study aimed to determine the inter-practice variation in polypharmacy prevalence and examine how this variation was influenced by patient and practice characteristics.

Methods: This cohort study included 45,731 patients aged 55 years and older with at least one prescribed medication from 126 general practices that participated in NIVEL Primary Care Database in the Netherlands.

Case-mix adjustment for diabetes indicators: a systematic review.

Objectives: Case-mix adjustment is generally considered indispensable for fair comparison of healthcare performance. Inaccurate results are also unfair to patients as they are ineffective for improving quality. However, little is known about what factors should be adjusted for.

Quality of chronic kidney disease management in primary care: a retrospective study.

Background: Early detection and appropriate management of chronic kidney disease (CKD) in primary care are essential to reduce morbidity and mortality.

Aim: To assess the quality of care (QoC) of CKD in primary healthcare in relation to patient and practice characteristics in order to tailor improvement strategies.

Design And Setting: Retrospective study using data between 2008 and 2011 from 47 general practices (207 469 patients of whom 162 562 were adults).

Longevity of direct restorations in Dutch dental practices. Descriptive study out of a practice based research network.

Objectives: The aim of this retrospective practice-based study was to investigate the longevity of direct restorations placed by a group of general dental practitioners (GDPs) and to explore the effect of practice/operator, patient, and tooth/restoration related factors on restoration survival.

Methods: Electronic Patient Files of 24 general dental practices were used for collecting the data for this study. From the patient files, longevity of 359,548 composite, amalgam, glass-ionomer and compomer placed in 75,556 patients by 67 GDPs between 1996 and 2011 were analyzed.

Implementation strategies to enhance management of heavy alcohol consumption in primary health care: a meta-analysis.

Background And Aims: Screening and brief interventions (SBI) delivered in primary health care (PHC) are cost-effective in decreasing alcohol consumption; however, they are underused. This study aims to identify implementation strategies that focus on SBI uptake and measure impact on: (1) heavy drinking and (2) delivery of SBI in PHC.

Methods: Meta-analysis was conducted of controlled trials of SBI implementation strategies in PHC to reduce heavy drinking.

Dutch influenza vaccination rate drops for fifth consecutive year.

Aim: To determine the prevalence and trend of the influenza vaccination-rate of the overall target population in the period 2008-2013, with a specific focus on groups at risk such as patients with cardiovascular diseases, lung diseases, diabetes and aged 60 years and older.

Methods: In an observational longitudinal study electronic medical records data from the Dutch representative network of general practices, LINH, were analyzed. For each influenza vaccination season, 2008-2013, the number of vaccinated and unvaccinated patients at risk are compared by chi-square tests (χ(2)) for linear trends, linear-by-linear association.