Bed Blocking by Hospitalized Patients Awaiting Admission to Intramural Aftercare: A Case Study on Transfer Coordination.

: Elderly patients who require aftercare in an intramural care (IMC) facility may contribute to "bed blocking," which occurs when patients who are ready for discharge remain hospitalized longer than medically necessary. While most bed-blocking studies focus on capacity issues, this study also investigates the coordination process. In a regional hospital in the Netherlands, we examine the extent to which bed blocking occurs due to patients awaiting IMC, and how this issue can be characterized in terms of capacity and coordination challenges.

Change in Organizational Structure Influences Perceived Leadership in a Dutch Radiotherapy Center.

Purpose: Healthcare organizations face challenges in balancing efficiency and innovation, known as ambidexterity. Leadership plays an important role, with transformational leadership driving innovation and transactional leadership supporting efficiency. The dominant leadership framework is the Full-Range Leadership Theory (FRLT), which identifies three leadership behaviors: transformational, transactional, and passive avoidant.

Correction: Klemann et al. Quantifying the Resilience of a Healthcare System: Entropy and Network Science Perspectives. 2024, , 21.

In the original publication [...

The road to successful implementation of innovation in radiotherapy: A research-based implementation protocol.

Background And Purpose: Radiotherapy (RT) is rapidly advancing, yet only 50 % of innovations are implemented promptly. Despite the availability of Implementation Science (ImpSci) theories, models, and frameworks (TMFs), a theory-practice gap persists in effectively applying these insights in RT clinical practice. This study aims to develop a consensus-based implementation protocol for RT innovations using validated ImpSci knowledge.

Knowledge, attitudes and practices of women regarding breast and cervical cancer screening: a qualitative study in India.

In this study, we aimed to understand the factors that influence the use of breast and cervical cancer screening services in India. Purposive sampling was applied - and 64 participants with different characteristics based on their literacy, screening status, and rural or urban setting were classified into eight groups. The Knowledge, Attitudes and Practices (KAP) framework was used to conduct focus group discussions with each group.

Evaluating the Adoption of Evidence-Based Management Practices in Eye Hospitals.

Delivering sustainable, high-quality eye care requires a comprehensive understanding of patient conditions, clinical evidence, patients' preferences, demand patterns, quality supplies, outcomes, financial sustainability, and satisfaction metrics. Evidence-based management (EBM) offers a structured approach to align actions with evidence, enabling effective decision-making and better organizational outcomes. Evaluating current practices against EBM principles fosters awareness and promotes an EBM culture in eye hospitals, supporting improved and sustainable service delivery.

Medical liability claims in gynaecologic care: retrospective analysis of claims related to gynaecology in the Netherlands (2005-2022) - Is there a connection between treatment indication, phase of treatment and the risk of medical malpractice claims?

Background: An increased interest in medical liability claims has been noticed. Nevertheless, detailed data on subject of claims and possible factors that contribute to litigation and indemnity payments are scarce and relatively dated. Insight into these data may provide valuable information to prevent both incidents and malpractice claims.

Organizational Rigidity and Demands: A Qualitative Study on Nursing Work in Complex Organizations.

Background/objectives: The nursing work environment is a critical element in healthcare delivery and a strong predictor of both patient and nurse outcomes. Understanding the complexity and multifaceted nature of this environment is essential for improving nursing practices and optimizing healthcare systems. This study aimed to gain insights into the perceived characteristics of the nursing work environment, considering it as a complex and multifaceted system.

The Hidden Reserve of Nurses in The Netherlands: A Spatial Analysis.

Worldwide, nurse shortages constitute a problem, including in the Netherlands. Every region in the country has a shortage of all types of nurses. At the same time, there are large hidden reserves: persons who have been trained as a nurse but do not work in the healthcare sector.

Advances and Challenges in the Labor Markets for Healthcare Professionals.

A lack of nurses is a prevalent and persistent problem in many countries [...

Slack Is Needed to Solve the Shortage of Nurses.

Healthcare systems are facing a shortage of nurses. This article identifies some of the major causes of this and the issues that need to be solved. We take a perspective derived from queuing theory: the patient-nurse relationship is characterized by a scarcity of time and resources, requiring comprehensive coordination at all levels.

Quantifying the Resilience of a Healthcare System: Entropy and Network Science Perspectives.

In this study, we consider the human body and the healthcare system as two complex networks and use theories regarding entropy, requisite variety, and network centrality metrics with resilience to assess and quantify the strengths and weaknesses of healthcare systems. Entropy is used to quantify the uncertainty and variety regarding a patient's health state. The extent of the entropy defines the requisite variety a healthcare system should contain to be able to treat a patient safely and correctly.

Entropy Optimization by Redesigning Organization in Hospital Operations.

A redesign of hospitals (i.e., partitioning departments and delegating decision authority) may be needed to deal with variable demand.

How to Use Lean Thinking for the Optimization of Clinical Pathways: A Systematic Review and a Proposed Framework to Analyze Pathways on a System Level.

Lean Thinking and clinical pathways are commonly used concepts to improve healthcare. However, little is known on how to use Lean Thinking for the optimization of pathways or the quantification of both concepts. This study aims to create a framework to analyze pathways with Lean Thinking on a system level, by quantifying the seven wastes, flow and pull.

Comparison of cataract surgery outcomes between a secondary and a tertiary eye hospital in Tamil Nadu, India.

Purpose: To examine the difference in post-operative visual outcomes of cataract surgeries between a tertiary and secondary centre at Aravind Eye Hospitals in Tamil Nadu, India.

Methods: Our retrospective cross-sectional study analysed cataract surgeries at a secondary centre and its associated tertiary centre in 2021. Our main outcome measures were postoperative best corrected visual acuity (BCVA), spherical equivalent, and intraoperative and postoperative complications.

Impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes: a retrospective observational study at Aravind Eye Hospitals, India.

Objective: We aim to assess the effectiveness of a cataract surgery outcome monitoring tool used for continuous quality improvement. The objectives are to study: (1) the quality parameters, (2) the monitoring process followed and (3) the impact on outcomes.

Design And Procedures: In this retrospective observational study we evaluated a quality improvement (QI) method which has been practiced at the focal institution since 2012: internal benchmarking of cataract surgery outcomes (CATQA).

Causes for Medical Errors in Obstetrics and Gynaecology.

Quality strategies, interventions, and frameworks have been developed to facilitate a better understanding of healthcare systems. Reporting adverse events is one of these strategies. Gynaecology and obstetrics are one of the specialties with many adverse events.

The Intervention Selection Toolbox to improve patient-relevant outcomes: an implementation and qualitative evaluation study in colorectal cancer surgery.

Background: The concept of value-based healthcare is being used worldwide to improve healthcare. The Intervention Selection Toolbox was developed to bridge the gap of value-based healthcare, between insights in outcomes and actual quality improvement initiatives. In this study we aimed to evaluate the use of the Intervention Selection Toolbox in daily practice of a quality improvement team in a hospital setting.

Hospital Organizational Structure and Information Processing: An Entropy Perspective.

Organizational structure enables organizations to achieve their goals. The chosen organizational structure determines, to a large extent, the flow of information streams and the manner and extent to which roles, power, and responsibilities are delegated and coordinated to achieve the organization's goals. In this study, we applied information theory with entropy as the central concept to assess the effectiveness and costs of an organizational structure and its coordination processes.

Managing Outpatient Cycle Times in Hospitals Using Integrated Closed-Loop Approaches.

Long waiting times in outpatient clinics have multiple adverse effects on patients and their attendants, staff and hospital management. Several approaches practiced to manage the cycle time have been proposed. The purpose of this study was to evaluate the impact of implementing closed-loop based multiple approaches together.

Barriers to cervical cancer and breast cancer screening uptake in low- and middle-income countries: a systematic review.

There is an alarmingly high growth in breast and cervical cancers in low- and middle-income countries. Due to late presentation to doctors, there is a lower cure rate. The screening programmes in low- and middle-income countries are not comprehensive.

Trends and Developments in Medical Liability Claims in The Netherlands.

Recent data on number of claims, final judgement of claims and their costs are scarce. This study analyzes 15 years of malpractice claims in the Netherlands. All claims filed, and all claims closed by two insurance companies (which insure approximately 95% of all hospitals in the Netherlands) between 2007-2021 are included.

Mapping the extent, range and nature of research activity on value-based healthcare in the 15 years following its introduction (2006-2021): a scoping review.

Objectives: We aimed to systematically map the extent, range and nature of research activity on value-based healthcare (VBHC), and to identify research gaps.

Design: A scoping review with an additional cited reference search was conducted, guided by the Joanna Briggs Institute methodology.

Data Sources: The search was undertaken in PubMed, Embase and Web of Science.

Creating Coherence-Based Nurse Planning in the Perinatology Care System.

The combination of increasing demand and a shortage of nurses puts pressure on hospital care systems to use their current volume of resources more efficiently and effectively. This study focused on gaining insight into how nurses can be assigned to units in a perinatology care system to balance patient demand with the available nurses. Discrete event simulation was used to evaluate the what-if analysis of nurse flexibility strategies and care system configurations from a case study of the Perinatology Care System at Radboud University Medical Center in Nijmegen, the Netherlands.