SIMONS, Pascale; Benders, Jos; Marneffe, Wim; Pijls-Johannesma, Madelon; Vandijck, Dominique
For change programs to succeed, it is vital to have a detailed understanding of employees’ views regarding the program, especially when the proposed changes are potentially contested. Gaining insight into employee perceptions helps managers to decide how to proceed. We conducted two workshops in a radiotherapy institute to assess the benefits and drawbacks, as well as their underlying causes, of a proposed lean change program. Managers’ views on the workshops’ usefulness were charted.
Two workshops were organized in which employees predicted positive and negative effects of a lean program. The workshops combined a structured brainstorm (KJ-technique) and an evaluation of the...
BERGS, Jochen; Verelst, Sandra; Gillet, Jean-Bernard; VANDIJCK, Dominique
Introduction: Triage aims to categorize patients based on their clinical need and the available departmental resources. To accomplish this goal, one needs to ensure that the implemented triage system is reliable and that staff use it correctly. Therefore this study assessed the ability of Belgium nurses to apply the Emergency Severity Index (ESI), version 4, to hypothetical case scenarios after an educational intervention. Methods: An ESI educational intervention was implemented in accordance with the ESI manual. Using paper case scenarios, nurses' interrater agreement was assessed by comparing triage nurse ESI levels with the reference answers noted in the implementation manual....
BERVOETS, Liene; MEWIS, Alex; MASSA, Guy
It is hypothesized that the shape of the glucose curve during an oral glucose tolerance test is an early indicator of the risk for developing type 2 diabetes mellitus. In this study, we aimed to examine the shape of plasma glucose response curves and study their relationship with insulin sensitivity, insulin secretion and components of the metabolic syndrome in end-pubertal obese girls. Eighty one end-pubertal obese girls (median (range) age: 14.4 (11.2 ??? 18.0) years; BMI: 34.6 (25.4???50.8) kg/m??) who underwent a 2-hour oral glucose tolerance test were classified according to the shape of the glucose curve. Four shape types...
Effects of a lean management transition were extensively evaluated in a radiotherapy setting, with a special focus on quality, safety and efficiency of care. A radiotherapy institute was followed from 2010 to 2014 in their journey towards a lean healthcare organization. The studied organization combined specific interventions (lean tools), which addressed the clinical processes with a generic approach focusing on the organizations' structure and cultural elements. Effects were evaluated using a mixed method approach. Quantitative results were interpreted with qualitative data from structured interviews. Positive effects on waiting (process) times, reported safety incidents, safety & improvement culture, job satisfaction, absenteeism,...
SCHOUTEN, Bojoura; HELLINGS, Johan; Vankrunkelsven, Patrick; VAN HOOF, Elke
SIMONS, Pascale; Houben, Ruud; Vlayen, Annemie; Hellings, Johan; Pijls-Johannesma, Madelon; Marneffe, Wim; Vandijck, Dominique
The importance of a safety culture to maximize safety is no longer questioned. However, achieving sustainable culture improvements are less evident. Evidence is growing for a multifaceted approach, where multiple safety interventions are combined. Lean management is such an integral approach to improve safety, quality and efficiency and therefore, could be expected to improve the safety culture. This paper presents the effects of lean management activities on the patient safety culture in a radiotherapy institute.
Patient safety culture was evaluated over a three year period using triangulation of methodologies. Two surveys were distributed three times, workshops were performed twice, data from...
Bergs, Jochen; Hellings, Johan; CLEEMPUT, Irina; SIMONS, Pascale; ZUREL, Ozhan; VERTRIEST, Sonja; VANDIJCK, Dominique
Surgical safety checklists aim to improve patient safety by prompting the attention of the surgical team towards critical steps during the operation. The checklist's items are aimed to improve compliance with proven interventions, and to facilitate multidisciplinary communication and teamwork. Based on the current literature, corroborated by systematic reviews and meta-analysis, surgical safety checklists have a positive impact on communication and reduce postoperative complications including mortality. However, despite their effectiveness, the implementation of these checklists is not straightforward. Several determinants leading to behaviour were checklists are checked but not properly executed have been highlighted. As surgical safety checklists are in...
VANDIJCK, Dominique; BERGS, Jochen
MARQUET, Kristel; CLAES, Neree; DE TROY, Elke; KOX, Gaby; DROOGMANS, Martijn; SCHROOTEN, Ward; WEEKERS; VLAYEN, Annemie; VANDERSTEEN, Marjan; VLEUGELS, Arthur
MARQUET, Kristel; CLAES, Neree; DE TROY, Elke; KOX, Gaby; DROOGMANS, Martijn; VLEUGELS, Arthur
VANDERSTEEGEN, Tom; MARNEFFE, Wim; CLEEMPUT, Irina; VEREECK, Lode
Around the world, governments are faced with spiralling health care expenditures. This raises the need for further insight in the determinants of these expenditures. Existing literature focuses primarily on income, ageing, health care financing and supply variables. This paper includes medical malpractice system characteristics as determinants of health spending in OECD countries. Estimates from our regression models suggest that no-fault schemes for medical injuries with decoupling of deterrence and compensation reduce health expenditures per capita by 0.11%. Furthermore, countries that introduced a no-fault system without decoupling of deterrence and compensation are found to have higher (+0.06%) health care spending.
VANDIJCK, Dominique; Moreno, C.; Starkel, P.; Van Damme, P.; Van Vlierberghe, H.; Hindman, S. J.; Razavi, H.; Laleman, W.
Background and study aims : Chronic hepatitis C virus (HCV) infection is a serious global health problem affecting 150 million individuals worldwide. Although infection rates are decreasing, an aging population with progressing disease is expected to result in increased burden of advanced stage disease with high associated costs. This analysis describes the current and projected future economic impact of HCV sequelae in Belgium. Methods : A previously described and validated model was populated with Belgian inputs and calibrated to project the current and future health and economic burden of HCV. Monte Carlo and sensitivity analyses were run to quantify uncertainty....
Van Damme, P.; Laleman, W.; St??rkel, P.; Van Vlierberghe, H.; VANDIJCK, Dominique; Hindman, S. J.; Razavi, H.; Moreno, C.
Background : The burden of hepatitis C virus (HCV) infection is significant and is increasing with the aging population. The results of a modeling study that included Belgium, along with many other countries, was published in April 2014. An in depth discussion surrounding the epidemiology of HCV in Belgium will be presented here. Methods : A systematic literature review was conducted to assess the historical and current clinical burden of HCV in Belgium. Two expert panels were convened to discuss the strengths and limitations surrounding the available data and to generate consensus regarding the best estimates for total number of...
Starkel, P.; VANDIJCK, Dominique; Laleman, W.; Van Damme, P.; Moreno, C.; Hindman, S.; Razavi, H.; Van Vlierberghe, H.
Background : Novel direct antiviral agents (DAAs) will become available soon with higher sustained viral response (SVR), fewer side-effects and higher compliance. Our aim was to evaluate different realistic strategies to control the projected increase in HCV-related disease burden in Belgium. Methods : Based on literature review, expert opinions and historical assumptions, HCV-disease progression and mortality in Belgium was modeled to 2030. Strategies exploring the impact of increased treatment, treatment delay, and treatment restrictions were developed. Results : Although the overall HCV prevalence is decreasing in Belgium, the burden of advanced stage HCV, including cirrhosis and hepatocellular carcinoma (HCC), is...
VANDIJCK, Dominique; St??rkel, P.
Degroote, S.; Vogelaers, D.; Koeck, R.; Borms, R.; De Meulemeester, L.; VANDIJCK, Dominique
Objectives: As HIV is currently a chronic and manageable disease, an increasing amount of people living with HIV (PLHIV) are (again) active on the labour market. Since research on this topic is scarce, this study aimed to explore experiences of PLHIV in the workplace, especially concerning disclosure and adherence to antiretroviral therapy. Methods: A questionnaire was developed and validated in collaboration with Sensoa (Flemish expertise centre for sexual health) and participants were recruited using flyers and announcements on websites. Results: A total of 54 PLHIV completed the questionnaire, among whom 50 (92.6%) males. Half of the participants did not disclose...
Simons, Pascale; Houben, Ruud; Benders, Jos; Pijls-Johannesma, Madelon; Vandijck, Dominique; Marneffe, Wim; Backes, Huub; Groothuis, Siebren
To realize safe radiotherapy treatment, processes must be stabilized. Standard operating procedures (SOP’s) were expected to stabilize the treatment process and perceived task importance would increase sustainability in compliance. This paper presents the effects on compliance to safety related tasks of a process redesign based on lean principles.
Compliance to patient safety tasks was measured by video recording of actual radiation treatment, before (T0), directly after (T1) and 1.5 years after (T2) a process redesign. Additionally, technologists were surveyed on perceived task importance and reported incidents were collected for three half-year periods between 2007 and 2009.
Compliance to four out...
BERGS, Jochen; Verelst, Sandra; Gillet, Jean-Bernard; Deboutte, Peter; Vandoren, Cindy; VANDIJCK, Dominique
Blot, Koen; BERGS, Jochen; Vogelaers, Dirk; Blot, Stijn; VANDIJCK, Dominique
This systematic review and meta-analysis examines the impact of quality improvement interventions on central line???associated bloodstream infections in adult intensive care units. Studies were identified through Medline and manual searches (1995???June 2012). Random-effects meta-analysis obtained pooled odds ratios (ORs) and 95% confidence intervals (CIs). Meta-regression assessed the impact of bundle/checklist interventions and high baseline rates on intervention effect. Forty-one before???after studies identified an infection rate decrease (OR, 0.39 [95% CI, .33???.46]; P < .001). This effect was more pronounced for trials implementing a bundle or checklist approach (P = .03). Furthermore, meta-analysis of 6 interrupted time series studies revealed an...
Verelst, Sandra; Pierloot, Sarah; Desruelles, Didier; Gillet, Jean-Bernard; BERGS, Jochen
Emergency department (ED) crowding is a major international concern that affects patients and providers.
We describe the characteristics of patients who had an unscheduled related return visit to the ED and investigate its relation to ED crowding.
Retrospective medical record review of all unscheduled related ED return visits by patients older than 16 years of age over a 1-year period. The top quartile of ED occupancy rates was defined as ED crowding.
Eight hundred thirty-seven patients (1.9%) made an unscheduled related return visit. Length of stay (LOS) at the ED for the index visit and the LOS for the return visit (5...