Five-year sustainability of a de-implementation strategy to reduce inappropriate use of catheters: a multicentre, mixed-methods study.

Background: The use of peripheral intravenous catheters (PIVCs) contributes to healthcare-associated infections. In 2017, we implemented a multifaceted de-implementation strategy that successfully reduced the inappropriate use of catheters in seven hospitals in the Netherlands (RICAT-1 study). Five years later, we investigated the sustainability of this strategy and the contributing factors.

Stakeholders' perspectives on capturing societal cost savings from a quality improvement initiative: A qualitative study.

Background: Besides improving the quality of care, quality improvement initiatives often also intend to produce cost savings. An example is prehabilitation, which can reduce complication rates and the length of stay in the hospital. However, the process from utilization reductions to actual societal cost savings remains uncertain in practice.

Web-based interventions in the clinical encounter in fertility care: a scoping review.

There has been a huge increase in the development of new e-health initiatives, including interventions supporting the interaction between patients and healthcare professionals - the clinical encounter. This interaction can influence clinical decision making during a patient's workup or treatment process. This scoping review was designed (i) to display the current landscape of web-based interventions to support the clinical encounter, and (ii) to critically appraise their composition.

Low-value chronic prescription of acid reducing medication among Dutch general practitioners: impact of a patient education intervention.

Background: Dyspepsia is a commonly encountered clinical condition in Dutch general practice, which is often treated through the prescription of acid-reducing medication (ARM). However, recent studies indicate that the majority of chronic ARM users lack an indication for their use and that their long-term use is associated with adverse outcomes. We developed a patient-focussed educational intervention aiming to reduce low-value (chronic) use of ARM.

The relation between usage of an eHealth intervention for stress urinary incontinence and treatment outcomes: an observational study.

Background: Stress urinary incontinence (SUI), though a prevalent condition among women, is undertreated in primary care. EHealth with pelvic floor muscle training is an evidence-based alternative to care-as-usual. It is unknown, however, how eHealth usage is related to treatment outcome, and this knowledge is required for general practitioners to implement eHealth in their practice.

Trends in low-value GP care during the COVID-19 pandemic: a retrospective cohort study.

Background: Several studies showed that during the pandemic patients have refrained from visiting their general practitioner (GP). This resulted in medical care being delayed, postponed or completely forgone. The provision of low-value care, i.

Non-indicated vitamin B- and D-testing among Dutch hospital clinicians: a cross-sectional analysis in data registries.

Objectives: To assess the extent of non-indicated vitamin B- and D-testing among Dutch clinicians and its variation among hospitals.

Design: Cross-sectional study using registration data from 2015 to 2019.

Participants: Patients aged between 18 and 70 years who received a vitamin B- or D-test.

The implementation of a multidisciplinary, electronic health record embedded care pathway to improve structured data recording and decrease electronic health record burden.

Introduction: Theoretically, the added value of electronic health records (EHRs) is extensive. Reusable data capture in EHRs could lead to major improvements in quality measurement, scientific research, and decision support. To achieve these goals, structured and standardized recording of healthcare data is a prerequisite.

Development and validation of automated electronic health record data reuse for a multidisciplinary quality dashboard.

Objective: To describe the development and validation of automated electronic health record data reuse for a multidisciplinary quality dashboard.

Materials And Methods: Comparative study analyzing a manually extracted and an automatically extracted dataset with 262 patients treated for HNC cancer in a tertiary oncology center in the Netherlands in 2020. The primary outcome measures were the percentage of agreement on data elements required for calculating quality indicators and the difference between indicators results calculated using manually collected and indicators that used automatically extracted data.

What are Effective Strategies to Reduce Low-Value Care? An Analysis of 121 Randomized Deimplementation Studies.

Background: Low-value care is healthcare leading to no or little clinical benefit for the patient. The best (combinations of) interventions to reduce low-value care are unclear.

Purpose: To provide an overview of randomized controlled trials (RCTs) evaluating deimplementation strategies, to quantify the effectiveness and describe different combinations of strategies.

Evaluation of a remote monitoring app in head and neck cancer follow-up care.

Background: A remote monitoring app was developed for head and neck cancer (HNC) follow-up during the SARS-CoV-2 pandemic. This mixed-methods study provides insight in the usability and patients' experiences with the app to develop recommendations for future use.

Methods: Patients were invited to participate if they were treated for HNC, used the app at least once and were in clinical follow-up.

Low-value wound care: Are nurses and physicians choosing wisely? A mixed methods study.

Background: Choosing Wisely is an international movement that stimulates conversations about unnecessary care. The campaign created five recommendations including a statement that less wound care is sometimes better.

Aims: The study aims to evaluate nurses' and physicians' adherence to the Choosing Wisely recommendations for acute wound care in the Netherlands and the barriers and facilitators to improve this.

Exploring patients' perceptions of low-value care: An interview study.

Objective: Clinicians consider patients' expectations and demands as a major driver of low-value care. However, little is known about the patients' perspective. We aimed to explore patients' perceptions of low-value care.

[Trends in number of vitamin B12- and D-determinations in the Netherlands].

Objective: To gain insight into the volume of vitamin B12- and D-determinations over time.

Design: A retrospective cohort study.

Method: Using declaration data of around 3.

Usage of a Web-Based eHealth Intervention for Women With Stress Urinary Incontinence: Mixed Methods Study.

Background: Stress urinary incontinence (SUI) is highly prevalent among women and has an impact on physical and mental well-being. eHealth with pelvic floor muscle training (PFMT) has shown to be effective in reducing complaints. The usage and nonusage attrition of eHealth for SUI is unknown, but knowledge about users and their usage patterns is crucial for implementation purposes.

Development of the SPREAD framework to support the scaling of de-implementation strategies: a mixed-methods study.

Objective: We aimed to increase the understanding of the scaling of de-implementation strategies by identifying the determinants of the process and developing a determinant framework.

Design And Methods: This study has a mixed-methods design. First, we performed an integrative review to build a literature-based framework describing the determinants of the scaling of healthcare innovations and interventions.

Importance of Patient Involvement in Creating Content for eHealth Interventions: Qualitative Case Report in Orthopedics.

Background: In many industries, collaboration with end users is a standard practice when developing or improving a product or service. This process aims for a much better understanding of who the end user is and how the product or service could be of added value to them. Although patient (end user) involvement in the development of eHealth apps is increasing, this involvement has mainly focused on the design, functionalities, usability, and readability of its content thus far.

Quantifying the Electronic Health Record Burden in Head and Neck Cancer Care.

Background: Although the main task of health care providers is to provide patient care, studies show that increasing amounts of time are spent on documentation.

Objective: To quantify the time and effort spent on the electronic health record (EHR) in head and neck cancer care.

Methods: Cross-sectional time-motion study.

Identifying and prioritizing do-not-do recommendations in Dutch primary care.

Background: Low-value care provides minimal or no benefit for the patient, wastes resources, and can cause harm. Explicit do-not-do recommendations in clinical guidelines are a first step in reducing low-value care. The aim of this study was to identify and prioritize do-not-do recommendations in general practice guidelines with priority for implementation.

The Impact of Structured and Standardized Documentation on Documentation Quality; a Multicenter, Retrospective Study.

The reuse of healthcare data for various purposes will become increasingly important in the future. To enable the reuse of clinical data, structured and standardized documentation is conditional. However, the primary purpose of clinical documentation is to support high-quality patient care.