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37
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Introduction
Additional affiliations
March 2012 - present
Publications
Publications (37)
In dit geblindeerde case-controlonderzoek lieten we 15 triagegesprekken op een HAP waarin een acuut coronair syndroom werd gemist en 120 vergelijkbare triagegesprekken zonder catastrofale afloop beoordelen door een panel van ervaren huisartsen, onafhankelijk van elkaar en geblindeerd voor de uitkomst. De interbeoordelaarsbetrouwbaarheid binnen het...
Objectives:
Serious adverse events at out-of-hours services in primary care (OHS-PC) are rare, and the most often concern is missed acute coronary syndrome (ACS). Previous studies on serious adverse events mainly concern root cause analyses, which highlighted errors in the telephone triage process but are hampered by hindsight bias. This study com...
Background Especially in elderly with polypharmacy, medication can do harm. Clinical pharmacists integrated in primary care teams might improve quality of pharmaceutical care. Objective To assess the effect of non-dispensing clinical pharmacists integrated in primary care teams on general practitioners’ prescribing quality. Setting This study was c...
Objective:
The HEART score is a clinical decision support tool for physicians to stratify the risk of major adverse cardiac events (MACE) in patients presenting with chest pain at the emergency department (ED). The score includes 5 elements, including troponin level. Our aim was to compare safety and efficiency of the HEART scores calculated by us...
Objective:
To evaluate the process of clinical medication review for elderly patients with polypharmacy performed by non-dispensing pharmacists embedded in general practice. The aim was to identify the number and type of drug therapy problems and to assess how and to what extent drug therapy problems were actually solved.
Method:
An observationa...
Aims:
To evaluate the effect of non-dispensing pharmacists (NDPs) integrated in general practice on medication-related hospitalisations, drug burden index and costs in patients at high risk of medication problems (being 65 years or older and using five or more chronic medications).
Methods:
This was a multicentre, non-randomised, controlled inte...
Background: Care transitions between general practice and hospital are hazardous regarding patient safety. For developing an improvement strategy adjusted to local settings, understanding of type and potential causes of transitional safety incidents (TSIs) is needed.
Objectives: To provide a broad overview of the nature of TSIs reported by patients...
Objective
Inadequate information transfer during transitions in healthcare is a major patient safety issue. Aim of this study was to pilot a review of medical records to identify transitional safety incidents (TSIs) for use in a large intervention study and assess its reliability and validity.
Design
A retrospective medical record review study.
S...
Objective:
This study describes the development and validation of the Transitional Risk and Incident Questionnaire (TRIQ), which measures transitional patient safety from the patients' perspective.
Methods:
The TRIQ questionnaire was developed based on literature review, tested in the target group using a think-aloud procedure, and validated by...
Background
Patients are at risk for harm when treated simultaneously by healthcare providers from different healthcare organisations. To assess current practice and improvements of transitional patient safety, valid measurement tools are needed.
Aim and methods
To identify and appraise all measurement tools and outcomes that measure aspects of tra...
BACKGROUND:
Patients are at risk for harm when treated simultaneously by healthcare providers from different healthcare organisations. To assess current practice and improvements of transitional patient safety, valid measurement tools are needed.
AIM AND METHODS:
To identify and appraise all measurement tools and outcomes that measure aspects of t...
In- and exclusion criteria.
(DOCX)
Validity assessment: Characteristics included studies.
SP: Spain; NL: the Netherlands; USA: United States of America; AUS: Australia; CAN: Canada; HOS: hospital; PCP: Primary care provider, NA = not applicable, NR = not reported, GP = general practitioner.
* PCAS:79%, PCAT-S:91%, CPCI:99%, VANOCCS:64+54%.
¥ PCAS:342, PCAT-S:392, CPCI:427, VANOCCS:2...
Outcome inventory: Complete data extraction and references.
ADE = Adverse drug event; AE = Adverse event; DOC-questionnaire = Doctors’ Opinions on Collaboration-questionnaire; ED = Emergency department; GP = General practitioner; HCP = Healthcare professional; PCP = Primary care physician; RCT = Randomised controlled trial.
(DOCX)
Outcome inventory: Used outcomes from healthcare professionals’ and patients’ perspectives inventoried in 191 publications that measured transitional patient safety: Which are used and how often.
As some publications measured more than one outcome or one outcome from both the perspective of the healthcare professional and the patient, the added num...
Background:
The 1-hour rule-out high-sensitive cardiac troponin T protocol (hs-cTnT), in which a serial troponin measurement is performed 1 hour after the first to assess the possibility of acute coronary syndrome (ACS), has been implemented in the European guidelines in 2015. Our aim was to assess the safety of this protocol in low-risk patients...
Background
An increasing number of transitions due to substitution of care of more complex patients urges insight in and improvement of transitional medication safety. While lack of documentation of prescription changes and/or lack of information exchange between settings likely cause adverse drug events, frequency of occurrence of these causes is...
Background:
The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown.
Objective:
To measure the effect of use of the HEART score...
Objective
Cardiac guidelines recommend that the decision to perform coronary angiography (CA) in patients with Non-ST-Elevation Acute Coronary Syndrome (NST-ACS) is based on multiple factors. It is, however, unknown how cardiologists weigh these factors in their decision-making. The aim was to investigate the importance of different clinical charac...
Background:
The performance of the GRACE, HEART and TIMI scores were compared in predicting the probability of major adverse cardiac events (MACE) in chest pain patients presenting at the emergency department (ED), in particular their ability to identify patients at low risk.
Methods:
Chest pain patients presenting at the ED in nine Dutch hospit...
Objective To investigate which risk score (TIMI score or HEART score) identifies the largest population of low-risk patients at the emergency department (ED). Furthermore, we retrospectively calculated the corresponding expected decrease in medical consumption if these patients would have been discharged from the ED.
Methods We performed analyses i...
Background:
Despite the availability of high-sensitive troponin (hs-cTnT), there is still room for improvement in the diagnostic assessment of patients suspected of acute coronary syndrome (ACS). Apart from serial biomarker testing, which is time-consuming, novel biomarkers like copeptin have been proposed to expedite the early diagnosis of suspec...
Introduction Cardiologists face the difficult task of rapidly distinguishing cardiac-related chest pain from other conditions, and to thoroughly consider whether invasive diagnostic procedures or treatments are indicated. The use of cardiac risk-scoring instruments has been recommended in international cardiac guidelines. However, it is unknown to...
Chest pain remains a diagnostic challenge: physicians do not want to miss an acute coronary syndrome (ACS), but, they also wish to avoid unnecessary additional diagnostic procedures. In approximately 75% of the patients presenting with chest pain at the emergency department (ED) there is no underlying cardiac cause. Therefore, diagnostic strategies...
Background:
The focus of the diagnostic process in chest pain patients at the emergency department is to identify both low and high risk patients for an acute coronary syndrome (ACS). The HEART score was designed to facilitate this process. This study is a prospective validation of the HEART score.
Methods:
A total of 2440 unselected patients pr...
Background:
To improve early diagnostic and therapeutic decision making, we designed the HEART score for chest pain patients in the emergency department (ED). HEART is an acronym of its components: History, ECG, Age, Risk factors and Troponin. Currently, many chest pain patients undergo exercise testing on the consecutive days after presentation....
