Hanneke Merten

Amsterdam University Medical Center | VUmc · Department of Public and Occupational Health

Objective: Emergency department (ED) crowding is a worldwide problem and one of the main causes internationally is an increase in presentations by older patients with complex and chronic care needs. Although there has been a 4,3% reduction in total ED visits from 2016-2019 in the Netherlands, the EDs still experience crowding. National crowding re...

Background: Inappropriate bed occupancy due to delayed hospital discharge affects both physical and psychological wellbeing in patients and can disrupt patient flow. The Dutch healthcare system is facing ongoing pressure, especially during the current COVID-19 pandemic, intensifying the need for optimal use of hospital beds. The aim of this study...

Background Sleep is essential for recovery from illness. As a result, researchers have shown a growing interest in the sleep of hospitalized patients. Although many studies have been conducted over the past years, an up to date systematic review of the results is missing. Objective The objective of this systematic review was to assess sleep qualit...

Importance: Inadequate sleep negatively affects patients' physical health, mental well-being, and recovery. Nonpharmacologic interventions are recommended as first-choice treatment. However, studies evaluating the interventions are often of poor quality and show equivocal results. Objective: To assess whether the implementation of nonpharmacolog...

Background Sleep is vital for recovery during hospital stay. Many sleep-promoting interventions have been investigated in the past. Nurses seem to overestimate their patients sleep and their perspective is needed for these interventions to be successfully implemented. Objectives To assess the patient's and nurse's agreement on the patient's sleep...

Background Healthcare professionals are sometimes forced to adjust their work to varying conditions leading to discrepancies between hospital protocols and daily practice. We will examine the discrepancies between protocols, ‘Work As Imagined’ (WAI), and daily practice ‘Work As Done’ (WAD) to determine whether these adjustments are deliberate or ac...

Purpose Up to 22% of older patients who visit the emergency department (ED) have a return visit within 30 days. To achieve patient-centered care for this group at the ED it is important to involve the patient perspective and strive to provide the best possible experience. The aim of this study was to gain insight into the experiences and perspectiv...

Objectives: Unintended events (UEs) are prevalent in healthcare facilities, and learning from them is key to improve patient safety. The Prevention and Recovery Information System for Monitoring and Analysis (PRISMA)-method is a root cause analysis method used in healthcare facilities. The aims of this systematic review are to map the use of the P...

Objectives: Sleeping disorders are a common complaint in patients who suffer from an acute COVID-19 infection. Nonetheless, little is known about the severity of sleep disturbances in hospitalized COVID-19 patients, and whether these are caused by disease related symptoms, hospitalization, or the SARS-CoV-2 virus itself. Therefore, the aim of this...

Objective More older patients are presenting to the emergency department (ED). It is important to know why these patients present and if the ED is the best place for them to receive the care they need. The primary aim of this study was to identify organisational-related, technical-related, healthcare worker-related and patient-related factors leadi...

Background: Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was...

Patiënten van boven de zeventig jaar lopen meer risico op complicaties tijdens een ziekenhuisopname. Screening kan helpen om kwetsbare patiënten tijdig te herkennen. De landelijke richtlijnen hiervoor blijken vaak - in meer of mindere mate - te verschillen van de gang van zaken in de praktijk. Samen met Amsterdam Public Health (APH) research instit...

Patiënten van boven de zeventig lopen meer risico op complicaties tijdens een ziekenhuisopname. Screening kan helpen om kwetsbare patiënten tijdig te herkennen. De landelijke richtlijnen hiervoor blijken vaak - in meer of mindere mate - te verschillen van de gang van zaken in de praktijk. Samen met Amsterdam Public Health (APH) research institute o...

Patiënten van boven de zeventig lopen meer risico op complicaties tijdens een ziekenhuisopname. Screening kan helpen om kwetsbare patiënten tijdig te herkennen. De landelijke richtlijnen hiervoor blijken vaak - in meer of mindere mate - te verschillen van de gang van zaken in de praktijk. Samen met Amsterdam Public Health (APH) research institute o...

Patiënten van boven de zeventig lopen meer risico op complicaties tijdens een ziekenhuisopname. Screening kan helpen om kwetsbare patiënten tijdig te herkennen. De landelijke richtlijnen hiervoor blijken vaak - in meer of mindere mate - te verschillen van de gang van zaken in de praktijk. Samen met Amsterdam Public Health (APH) research institute o...

Aim Use of tele-health programs and wearable sensors that allow patients to monitor their own vital signs have been expanded in response to COVID-19. We aimed to explore the utility of patient-held data during presentation as medical emergencies. Methods We undertook a systematic scoping review of two groups of studies: studies using non-invasive...

Background: In line with demographic changes, there is an increase in ED presentations and unplanned return presentations by older patients (≥70 years). It is important to know why these patients return to the ED shortly after their initial presentation. Therefore, the aim of this study was to provide insight into the root causes and potential pre...

Objectives: Acute care crowding is a global issue, jeopardizing patient safety. An important cause of crowding is the growing number of older, vulnerable, and complex patients. This group is at higher risk of experiencing (preventable) adverse events (AEs) than younger patients.This study aimed to identify the incidence, preventability, nature, an...

Background: With the ageing population, there is a stronger focus on supporting older people to live independently as long as possible. One of the important factors to take into consideration for independent living older adults is frailty. This manuscript aims to provide insight into the relation between the different domains of frailty (physical,...

Background Changes in Dutch policy towards long-term care led to the Dutch Health and Youth Care Inspectorate testing a regulatory framework focusing on care networks around older adults living independently. This regulatory activity involved all care providers and the older adults themselves. Methods Semi-structured interviews with the older adul...

Background Emergency department (ED) crowding is common and associated with increased costs and negative patient outcomes. The aim of this study was to conduct an in-depth analysis to identify the root causes of an ED length of stay (ED-LOS) of more than six hours. Methods An observational retrospective record review study was conducted to analyse...

Patient characteristics and information from the EPR from all patients (n = 568) visiting the ED during the selected one-week period. (SAV)

The growth in the numbers of older adults needing long-term care has resulted in rising costs which have forced the Dutch government to change its long-term care system. Now, the local authorities have greater responsibility for supporting older adults and in prolonging independent living with increased support provided by the social network. Howev...

Background: The proportion of older people needing acute care is rapidly growing, thereby posing an increased burden on the acute care chain. The aim of this study is to gain more insight into the obstacles and potential improvement opportunities of the acute care process for older patients arriving at the hospital. Methods: Semi-structured inte...

Insight into risks concerning older adults living independently from their own perspective and their care provider’s perspective is essential to address issues that may threaten their independent living. The most often mentioned perceived risks by older adults and their care providers in different regions in the Netherlands were: loneliness, falls,...

Objectives: Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority consensus to determine contributing factors that co...

Background: Policy makers struggle with unplanned readmissions as a quality indicator since integrating preventability in such indicators is difficult. Most studies on the preventability of readmissions questioned physicians whether they consider a given readmission to be preventable, from which conclusions on factors predicting preventable readm...

This are the results of a pan European survey to assess the degree of consensus between physicians regarding the preventability and predictability of readmissions. An online survey based on eight case scenarios was distributed to physicians in Europe. For four cases, participants were requested to assess whether they expected the patients to be rea...

Background: An unplanned ICU admission of an inpatient is a serious adverse event (SAE). So far, no in depth-study has been performed to systematically analyse the root causes of unplanned ICU-admissions. The primary aim of this study was to identify the healthcare worker-, organisational-, technical,- disease- and patient- related causes that con...

ICU admissions. (SAV)

Data collection sheet unplanned ICU admissions. (DOC)

Overview root causes. (DOCX)

Objectives To minimise adverse events in healthcare, various large-scale incident reporting and learning systems have been developed worldwide. Nevertheless, learning from patient safety incidents is going slowly. Local, unit-based reporting systems can help to get faster and more detailed insight into unit-specific safety issues. The aim of our st...

Importance: Unplanned readmissions within 30days are a common phenomenon in everyday practice and lead to increasing costs. Although many studies aiming to analyze the probable causes leading to unplanned readmissions have been performed, an in depth-study analyzing the human (healthcare worker)-, organizational-, technical-, disease- and patient-...

Samenwerking in de eerstelijnszorg en in het lokale zorgsysteem meer algemeen heeft een hoge prioriteit, maar is verre van vanzelfsprekend. Er zijn plekken in het land waar succesvolle samenwerking van de grond is gekomen. Toch blijkt het ook daar vaak lastig om die samenwerking te borgen en/of uit te bouwen. In dit licht hebben onderzoekers van he...

Objectives: Hip fracture patients of 65 years and older are a complex patient group who often suffer from complications and difficult rehabilitation with disappointing results. It is unknown to what extent suboptimal hospital care contributes to these poor outcomes. This study reports on the scale, preventability, causes and prevention strategies...

Hospital readmissions are increasingly used as a quality indicator. Patients with cancer have an increased risk of readmission. The purpose of this study was to develop an in depth understanding of the causes of readmissions in patients undergoing cancer treatment using PRISMA methodology and was subsequently used to identify any potentially preven...

Introduction: The Dutch healthcare inspectorate (IGZ) supervises the quality and safety of healthcare in the Netherlands. Owing to the growing population of (community dwelling) older adults and changes in the Dutch healthcare system, the IGZ is exploring new methods to effectively supervise care networks that exist around frail older adults. The...

Background Hospital readmissions are increasingly used as a quality indicator with a belief that they are a marker of poor care has led to financial penalties in the United Kingdom and United States. Risk scoring systems, such as LACE and HOSPITAL, have been proposed as tools for identifying patients at high risk of readmission but have not been va...

Background: Hospital readmissions are increasingly used as a quality indicator. Patients with cancer have an increased risk of readmission. The purpose of this study was to develop an in depth understanding of the causes of readmissions in patients undergoing cancer treatment using PRISMA methodology and was subsequently used to identify any potent...

Objective: to gain insight into the scale, nature, preventability and causes of adverse events in hospitalised older patients. Design: a three-stage retrospective, structured, medical record review study of 7,917 records of patients admitted in 21 Dutch hospitals in 2004. Main outcome measures: incidence, preventability, clinical process categ...

We need to know the scale and underlying causes of surgical adverse events (AEs) in order to improve the safety of care in surgical units. However, there is little recent data. Previous record review studies that reported on surgical AEs in detail are now more than ten years old. Since then surgical technology and quality assurance have changed rap...

The clinical environment in which health care providers have to work everyday is highly complex; this increases the risk for the occurrence of unintended events. The aim of this randomised controlled trial is to improve patient safety for a vulnerable group of patients that have to go through a complex care chain, namely elderly hip fracture patien...

Several studies have shown that the rate of unintended harm is higher in surgical than in non-surgical care. To improve patient safety in surgery, information about the underlying causes is needed. This observational study examined the nature, causes and consequences of unintended events in surgical units, and the completeness of event reporting. T...

Op verpleeghuisafdelingen met meer en beter opgeleid personeel is de zorg beter. Demente bewoners hebber er minder pijn, de sfeer is er beter en de omgeving veiliger. Krapte Verpleeghuizen kampen al jaren met een gebrek aan goed opgeleid personeel en krappe budgetten. Toch is in Nederland nooit eerder onderzocht in hoeverre er een verband bestaat...

Door de toename van het aantal mensen met diabetes is de vraag ontstaan hoe men in de toekomst adequate zorg aan deze groep kan blijven bieden. De diabetesverpleegkundige binnen een multidisciplinaire zorggroep (de diabeteszorggroep) zou hierbij een rol kunnen spelen, waarbij taakherschikking tot de mogelijkheden behoort. In opdracht van de stuurgr...

In vervolg op het onderzoek naar onbedoelde schade in de Nederlandse ziekenhuizen dat in april 2007 op initiatief van de Orde verscheen, is een studie uitgevoerd naar de oorzaken van incidenten en onbedoelde schade. Op 30 afdelingen in 21 ziekenhuizen (spoedeisende hulp, chirurgie en interne geneeskunde) zijn incidenten systematisch verzameld en ge...

Operaties vanwege een gebroken heup zijn berucht vanwege de vele complicaties en hoge sterfte. Van de bijna 18.000 patiënten per jaar overlijdt één op de drie in het eerste jaar na opname. Een overdrachtsinstrument, een patiëntveiligheidskaart en een informatieboekje voor patiënten lijken slechts deels effectief om hierin verbetering te brengen. H...