University Medical Center Utrecht
Julius Center for Health Sciences and
Primary Care
Unit Health Care Innovations
RECENT DEVELOPMENTS AND INNOVATIONS IN THE DUTCH HEALTH SERVICES
A five days course for leading doctors, nurses and other health professionals about Dutch solutions to promote quality of care, to control costs and to answer the growing needs of chronic patients
A course for health managers, directors and executives in the health services in Europe, North America, Australia, Japan and other parts of the world
Monday November 24, 16.00h till Friday, 28, 12.00h at the University Medical Center Utrecht
Are you not able to attend this course? Is this not the right course for you? Please, forward this brochure to a colleague.
Julius Center for Health Sciences
and Primary Care
UMC Utrecht
P.O.box 85.500
3508 GA Utrecht
The Netherlands
Mail:
Phone 003188 756 88 82
Why this course?
The Dutch health services are world known because of fourteen themes on which they differ from systems in other developed countries.
The University Medical Center Utrecht (UMC Utrecht) wants to share its knowledge and experiences about these themes with leading health professionals all over the world. That’s why we offer them in five days a fourteen themes overview. We do that with the best speakers from The Netherlands in a modern, interactive teaching setting with workshops, patient oriented education and site visits.
We distinguish five general themes which are important for all health professionals and managers in health services. Nine themes relate to special groups of patients and public health problems. Together, the fourteen remarkable themes of the Dutch health services are:
General themes
1. Competition
Since 2006, Dutch health insurers compete for insurants, doctors compete for patients and hospitals compete for contracts with insurers. This competition takes place in a regulated market. Many American politicians and other Very Important Persons (VIP) visit Holland to learn about it. We think you are also a VIP. That’s why we organized this course in which we tell about theory and practice of competition in the Dutch way.
2. A strong primary health care
Since centuries the Dutch General Practitioners (GP’s) are family doctors and gatekeeper before a patient enters a hospital. They have mostly a longstanding relation with their patients. The last years the GP’s work more and more in multidisciplinary settings with practice nurses, psychologists, pharmacists and physical therapists. One thousand multidisciplinary health centers are in preparation. Spend a few days in the world of primary health care in The Netherlands: participate in this course.
3. Transparent hospitals and other institutes
Fourty key performance indicators hospitals publish obligatory every year on their websites. Mass media make a sport of these indicators and elect annually the hospital of the year. Other institutes as primary care organisations, psychiatric hospitals and nursing homes have comparable indicators. How are these indicators selected and constructed? What is their influence on health professionals and managers? These answers are given during the course.
4. Strong patient unions
Since the eighties The Netherlands developed 200 patient organizations with about 600.000 members together. For nearly each disease a patient union exists. What is their influence on knowledge and quality of life of patients? Do this unions have influence on doctors, hospitals and insurance companies? The UMC Utrecht did a survey amongst all patient unions. We are happy to share our research findings with you during the course and to bring you in contacts with one or more of these unions.
5. Dissemination and implementation of successful experiments
Since 1994 a Dutch state agency (ZonMw) is responsible for the financing of health service research. However, this institute stimulates also the sharing of know how and the implementation of successful experiments. What are the implementation techniques? And have these techniques success? These questions are discussed during the course.
Specific themes
6. Centers for youth and family
The Dutch youth is very healthy and happy. However, we see four growing health problems amongst Dutch majorities and ethnic minorities:
1. a growing overweight under children; 2. a growing number of children especially boys with ADHD and autism; 3. a growing number of children especially girls with depressed feelings;
4. an increase of violence at home and sexual abuse of children. From the UMC Utrecht we asked for attention of policy makers. Nowadays a special Minister for Youth tries to set up multidisciplinary centers for youth and family all over the country. Their focus is on early detection of the mentioned health problems and on early interventions. Share our knowledge and experiences with children. Participate in the course.
7. Safe hospitals
In comparison to the neighbouring countries Holland has less outbreaks of hospital infections, e.g. MRSA outbreaks, than neighbouring countries. That is because the Dutch hospitals have a strict patient safety management system. How does this function in theory? And in practice? Import this knowledge to your own country by participating in this course.
8. Integration of emergency services of ambulances, GP’s and hospitals
In Holland, patients who need acute care outside office hours have three options: calling for an ambulance, visiting an out-of-duty center for general practitioners or going to an emergency department. Last years these three are integrating because their services are overlapping: these serve same types of patients. How far are the integrated centers for emergent care? How do they function in theory and in practice? Enthusiast pioneering doctors and managers like to show you the results of this recent integration.
9. Integrated care programs for chronic patients
Dutch primary care organizations and hospitals run four to eight integrated care programs together for instance for patients with diabetes, COPD, heart failure, stroke, cancer in terminal phase and hip or other joint operations. These programs, also mentioned clinical pathways exist since 1995. Nowadays they are more and more facilitated by health information technology and principle of health operations management. What you can learn from these integrated care programs, is part of the course.
10.Disease management in mental health services
Since the nineties, in Holland many ambulatory mental health organizations and psychiatric hospitals merged. As a result thirty organisations now exist with an average of staff of more than 1000 professionals. They now all work with disease management programs per mental disorder, for instance for patients with depression, schizophrenic disorders, anxiety disorders and so on. What protocols are the base of these programs? Do the programs promote the recovery speed of the patients, the quality of care and the efficiency of care delivery? Answers on these questions are given in this course.
11.One access to long term care
Since 1998 all home care organisations, residential homes and nursing homes have the same access agency for patients: the national needs assessment agency (CIZ). These agencies use the International Classification of Functions (ICF) to assess the care needs of clients. They work independent from the suppliers of long term care. What is the influence of these agencies on demand orientation, waiting lists, bureaucracy and equal access for each citizen? We discuss these questions in the course after explaining how the agencies work in theory and in reality.
12.Flexible long term care
Twenty years ago only two options existed for frail elderly: they either stayed at home or they lived permanently in a nursing home. Nowadays many intermediate forms became available: nursing homes without walls, case management, respite care and a regulation with budget holding clients. Do these new Dutch solutions postpone a permanent admission to a 24 hour facility? Are partners and children of frail elderly able to continu their informal care during a longer period thanks to this intermediate arrangements? We discuss that in the course.
13.Professional addiction care
Holland has in comparison to other European countries less soft and hard drugs users per 10.000 inhabitants. This year, the methadone programs were modernised and individualized. Most of the treatment is now evidence based. Are you interested? The lecturers in the course are very eager to tell you about their successes and also pitfalls.
14.Legislation on medical end of live decisions
In previous years Holland got the name as a country where
euthanasia is allowed. Nowadays, we have a strict ethical system
about medical decisions concerning the end of live of patients.
This system includes euthanasia but also (non-) resuscitation
decisions, the treatment with morphine and decisions about
sedation. Are you involved in your own practice or institute with
these medical decisions? Do you like to broaden your scope?
Participate in the course.
Are you the right person for this course?
Our ideal course participants have at least five years experiences as doctor, nurse or other kind of health professional. Participants may also function as manager, director, board member or policy maker. They understand medical terminology affluent and economic terminology adequate. They know the system in which they work quite well. So they can reflect about the difference between their own country and Holland.
They are eager to innovate the setting in which they work. They are critical about the Dutch innovations but eager to learn about them.
They understand English quite well. They are able to discuss the subject matters of the course in small groups and to raise questions to lecturers.
The course has a minimum of fifteen and a maximum of 75 participants. The first days of the course the above mentioned five general themes are discussed. The last two days you have your individual learning traject following in more detail four of the nine specific themes. If you like to combine the course with a traineeship of a couple of days in an institute we will try to help you. For this extra service we ask a small fee.
What is the lecturing program?
By mail and in advance we send you about twenty pages with fact sheets about the course and the fourteen themes. We expect that you read them ultimately during your flight to Holland or on the morning of Monday November 24. If we have more than 15 participants course members sometimes will be divided in subgroups.
The schedule will be as follows:
Monday 24 November
16.00h introduction to each other and to the course
17.00 quiz about the facts sheets: which participant knows most of the fact sheets knowledge?
19.00h opening dinner
Tuesday 25 November
This day consists of five plenary sessions of 75 minutes. In each session one general theme (see above) is discussed. A Dutch expert introduces the theme during about 30 or 40 minutes. The remaining time is for discussion and questions. At the end of the day a walking tour is planned through the buildings of the University Medical Center Utrecht. The evening is free. The city of Utrecht has many nice and payable restaurants.
Wednesday 26 and Thursday 27 November
These two days site visits are offered around the nine specific themes. Each site visit has the following format: 1. An expert introduces the specific theme. 2. A walk through the facility where you are. If nothing can be seen around the theme, in this section patient cases are discussed in groups of two or three persons. 3. reflection: what do the participants do with the Dutch experiences? Are the shown innovations useful and implementable in their own country? The Dutch expert or a member of the course staff leads this discussion.
Each site visit takes place in the environment of Utrecht and takes three hours. Course participants select four site visits out of nine. They create their own learning traject. They subcribe in advance for their site visits.
If less than five course members have subscribed for a specific site visit, it will be cancelled. We will inform you in advance, giving you an alternative choice or the option to withdraw as participant.
The evening of November 26 is free. On the evening of November 27 a closing dinner is planned.
Friday 28 November, 900 -1200h
Participants are subdivided in groups of the same profession or from the same country to rethink all experiences of the last three days. Course faculty is available to answer remaining questions. Later in the morning a discussion takes place about leadership, clinical leadership and innovative management. At the end an evaluation of the course takes place.
Who are the organizers of this course?
Responsible for this course are prof. Guus Schrijvers and dr. Henk van der Steeg. Since 1987, Schrijvers is professor of public health and health economist. Within the UMC Utrecht he is involved in public health education to medical students. He manages the Unit for health care innovations within the UMC Utrecht. A staff of thirty professionals evaluate innovations in the field of integrated care, disease management and emergency care. Henk van der Steeg is medical doctor and worked many years as gynaecologist and hospital director. Now he is senior lecturer within the Unit for health care innovations. Both have a long standing experience in post graduate courses in management of quality of care, financial matters and innovative management.
In last years, Schrijvers and Van der Steeg developed this course as a part of a 18 days course, the European Health Executive Program (EHE Program). This course is given by the Universities of Durham (UK), Stockholm, Budapest, Berlin and Utrecht. Because of the success of the Utrecht part we offer in cooperation with our EHEP partners this special five days course. In January 2009, a new edition of the EHE Program starts. Are in you interested in this course? Please, send an email to EHEP course organizer Marie Johnson in Durham. She can be reached via her email address:
In 2000 Schrijvers started the International Journal of Integrated Care (IJIC). Now, he is editor-in-chief of this digital, peer reviewed journal. Annually, this journal organizes congresses together with the International Network of Integrated Care (INIC). Partly, the marketing of this five days course is done through this journal and network. Parts of this course are based on the experiences with these congresses. Are you interested in IJIC? Surf to www.ijic.org Are you interested in INIC? Surf to www.integratedcarenetwork.org Join the congress on integrated primary health care in Southampton, 15 – 17 September 2008. See the last mentioned website.