Mirella M N Minkman

• Prof. Phd
• Professor at Vilans & Tilburg University-TIAS

Report of the National IAC commission (Innovation and Advisory Committee on Governance in Healthcare) in cooperation with dr. Sophie Bijloos and dr. Marilieke Engbers

Introduction: One of the challenging aspects of organizing integrated care is the complexity of organizing supervision of these networks. Supervision can be understood as parties explaining and justifying their conduct in reaction on other parties posing questions and passing judgement, potentially with consequences for the parties under supervisio...

Introduction: Effective collaboration between organisations, which is often essential for integrating care, is not only achieved by smooth governance structures or trust between partners. Values, which can be defined as “meaningful beliefs referring to desirable goals that motivate action” or simply ‘what we see as important’, also play a vital rol...

Background Previous research showed the potential of quality improvement programs in nursing home care. However, studies that quantitatively evaluate the effectiveness of quality of care improvement programs are scarce. In this study, we examine the results of a Dutch nation-wide programme that was established to support the implementation of the Q...

Background Organising integrated health services beyond domains in interorganizational networks, can be supported by conceptual models to overview the complexity. The Development Model for Integrated Care (DMIC) is a systematically developed generic model that has been applied to innovate and implement integrated care services in a large range of (...

Background The concepts of ‘ personalized medicine ’ and ‘ patient-orchestrated care ’ in Alzheimer's disease (AD) lack standard conceptualization, which presents challenges for collaborative and interdisciplinary care. Objective We explored the interpretations and perspectives of professionals involved in interdisciplinary work on a large-scale p...

Background The experiences and preferences of older patients regarding shared decision-making (SDM) for managing severe aortic stenosis (AS) and its impact on health outcomes are not well known. Objective The purpose of this study was to provide insight into the experiences, preferences, and needs for SDM of older patients with severe AS and the a...

Background Although the use of artificial intelligence (AI)–based technologies, such as AI-based decision support systems (AI-DSSs), can help sustain and improve the quality and efficiency of care, their deployment creates ethical and social challenges. In recent years, a growing prevalence of high-level guidelines and frameworks for responsible AI...

Objective: To explore the relationship between personal characteristics of older adults with multiple chronic conditions (MCCs) and perceived shared decision making (SDM) resp. decisional conflict. Methods: In a video-observational study (N = 213) data were collected on personal characteristics. The main outcomes were perceived level of SDM and dec...

Values are seen as important in both interorganizational networks and wicked problems. However, in both academia and practice the exact implications of these values remain unclear. In this article we examine the role of values in interorganizational networks dealing with wicked problems, by conducting a case study in a pregnancy and childbirth netw...

Een kennissynthese over het organiseren van integrale zorg in Nederland

BACKGROUND While use of artificial intelligence (AI)-based technologies such as decision-support systems (AI-DSSs) could help sustaining and improving the quality and efficiency of care, their deployment also creates ethical and social challenges. In recent years, there has been a growing prevalence of high-level guidelines and frameworks to provid...

BACKGROUND Emerging technologies like artificial intelligence (AI) require early-stage assessment of potential societal and ethical implications to increase their acceptability, desirability and sustainability. This paper explores and compares two of these assessment approaches: the responsible innovation framework originating from technology studi...

Background Emerging technologies such as artificial intelligence (AI) require an early-stage assessment of potential societal and ethical implications to increase their acceptability, desirability, and sustainability. This paper explores and compares 2 of these assessment approaches: the responsible innovation (RI) framework originating from techno...

Background: In the integrated care literature, functional aspects such as organisational forms, improving processes, funding issues and ICT challenges are dominant. However, although a lot has been written about these features, it is still difficult to understand why integrated care sometimes works, and sometimes does not. The scale-up of integrate...

1 – Summary: Are you curious about the development of integrated care and the scope of the evidence in the International Journal of Integrated Care (IJIC) over the past 10 years? And would you like to know how impact measurements and participation in research has changed over time, and help shape what the direction should be for the next decade? Th...

Short summary: Are you curious about how accountability in integrated care is developed and applied? How to organize accountability that suit these integrate care services is still work in progress and far from an end conclusion. Would you like to join this progress? Then come to our workshop. Why a workshop? There is still a way to go of developin...

For better serving people's complex needs the subsequent movement to person‐centred integrated care, requires inter‐organisational cooperation and service provision by domain‐overarching networks and alliances. In the development to these networks, it is relevant to explore which accountability approaches are appropriate for local inter‐organisatio...

During the pre-design phase of supportive intelligent systems, interviews with future users, such as people with dementia, aim to explore the problems for which technology may present a solution. However, interviewing someone with dementia in this unstructured design phase is reported to be challenging resulting in systems that are not truly addres...

Jon Glasby and colleagues suggest short and long term measures to tackle the invisibility of adult social care

De zorgsector staat voor grote uitdagingen, met tekorten aan mensen en middelen, een groeiende vraag naar zorg en een bevolking die gewend is geraakt aan de vanzelfsprekendheid van goede zorg. Zorgprofessionals, -leidinggevenden en -bestuurders hebben de verantwoordelijkheid om een balans te vinden tussen vraag en aanbod. Zij moeten daarbij ook rek...

Background To evaluate the effects of a shared decision making (SDM) intervention for older adults with multiple chronic conditions (MCCs). Methods A pragmatic trial evaluated the effects of the SDMMCC intervention, existing of SDM training for nine geriatricians in two hospitals and a preparatory tool for patients. A prospective pre-intervention...

For better serving people’s complex needs the subsequent movement to person-centered integrated care, requires inter-organizational cooperation and service provision by domain-overarching networks and alliances. In the development to these networks, it is relevant to explore which accountability approaches are appropriate for local inter-organizati...

Introduction: The diverse nature of people's care needs requires collaboration between different organisations and sectors. One way of achieving such collaboration is through integrated care service networks. Decision-making is considered an important aspect of network governance and key to achieve further integration of care services. As integrat...

Engaging people with dementia in the design of technology is increasingly gaining more attention—and rightfully so. Yet to be sensitive and responsive to the variety of participants with dementia in different contexts and phases of a design process can be challenging. In this case-study, we applied retrospective reporting to elicit information on t...

Introduction: In addition to the functional aspects of healthcare integration, an understanding of its normative aspects is needed. This study explores the importance of values underpinning integrated, people-centred health services, and examines similarities and differences among the values prioritised by actors across Europe. Methods: Explorat...

Background: To evaluate the effects of a shared decision making (SDM) intervention for older adults with multiple chronic conditions (MCCs). Methods: A pragmatic trial evaluated the effects of the SDM training for geriatricians and a preparatory tool for patients. From two outpatient geriatric clinics 216 patients with MCCs participated. Researcher...

Conceptual frameworks are important for advancing systematic understanding in a field of research. Many conceptual models have been developed to study service integration, but few have addressed activation. Based on an outline of the literature on the integration of labour market services, we explored two complementary conceptual models from integr...

Aim To provide insight into the basic characteristics of decision making in the treatment of symptomatic severe aortic stenosis (SSAS) in Dutch heart centres with specific emphasis on the evaluation of frailty, cognition, nutritional status and physical functioning/functionality in (instrumental) activities of daily living [(I)ADL]. Methods A ques...

Accountability in health services is necessary for legitimacy, transparency, financial and managerial justification. To achieve the best possible outcomes for people at an affordable cost, healthcare services are continuously evolving. One development is the movement to person-centred integrated care to better serve people’s individual needs. This...

In the development process of integrated care many impeding factors occur. Our premise is, that many of these barriers are related to the differences in values or perspectives. This article aims to clarify what an important challenge is for the further development of integrated care and for integrated care research. Professionals and managers in in...

Objective To provide insight into professionals’ perceptions of and experiences with shared decision-making (SDM) in the treatment of symptomatic patients with severe aortic stenosis (AS). Methods A semistructured interview study was performed in the heart centres of academic and large teaching hospitals in the Netherlands between June and Decembe...

Background and Objectives Artificial intelligence (AI) is widely positioned to become a key element of intelligent technologies used in the long-term care (LTC) for older adults. The increasing relevance and adoption of AI has encouraged debate over the societal and ethical implications of introducing and scaling AI. This scoping review investigate...

Background Client-centred care serves as the foundation for healthcare policy. Indeed, various instruments for assessing clients’ experiences of care and support are increasingly used to provide insights into the quality, and client-centred nature, of the care and support provided, which, in turn, aids the development of subsequent improvements. Th...

Health, social, and community care agencies are undergoing rapid changes in response to the COVID-19 pandemic, arguably offering a “window of opportunity” for health system transformation. What is required is theoretical guidance to help determine whether rapid system responses are likely to be sustained as part of broader transformation efforts. W...

Introduction: In the Netherlands multiple single, cross sector and cross governance level policy reforms were introduced to improve health and social care and decrease fragmentation. In addition to legislative and funding measures, the governmental strategy was to set up long-lasting improvement programs and supported by applied research. Descrip...

Personalized-care and 'taking control' are well-known phrases in the field of (child) healthcare in many countries. Given the shift in healthcare to person-centred-care and the role and responsibilities of persons themselves, attention is needed for what we mean with 'taking control'. Childcare is special because when we talk about clients, we are...

Persons with Parkinsons Disease (PwPDs) require accessible, long-term, multi-disciplinary, person-centered treatment. Building care networks has been shown as a useful tool to improve outcomes for PwPDs and care providers. In France and Germany, a growing number of regional integrated care concepts for PwPDs have emerged. However, they differ in th...

Background: To help enhance the quality of integrated stroke care delivery, regional stroke services networks in the Netherlands participated in a self-assessment study in 2012, 2015 and 2019. Methods: Coordinators of the regional stroke services networks filled out an online self-assessment questionnaire in 2012, 2015 and 2019. The questionnair...

Purpose: The purpose of this paper is to synthesize the existing evidence on leadership that best matches nursing home care, with a focus on behaviors, effects and influencing factors. Design/methodology/approach: A narrative review was performed in three steps: the establishment of scope, systematic search in five databases and assessment and a...

Background The aim of this study was to describe barriers and facilitators for shared decision making (SDM) as experienced by older patients with multiple chronic conditions (MCCs), informal caregivers and health professionals. Methods A structured literature search was conducted with 5 databases. Two reviewers independently assessed studies for e...

Hoofdstuk 14: De toekomst van de zorg. Nadenken over voor- en nadelen van schaalvergroting en integraliteit van zorg

As integrated care is recognized as crucial to meet the challenges of chronic conditions such as Parkinson's disease (PD), integrated care networks have emerged internationally and throughout Germany. One of these networks is the Parkinson Network Eastern Saxony (PANOS). PANOS aims to deliver timely and equal care to PD patients with a collaborativ...

Purpose The development of a national model has led municipalities in the Netherlands to implement integrated care for childhood overweight and obesity. To monitor how this approach is being implemented locally, an appropriate tool is required. This study presents a “Tool to monitor the local implementation of Integrated Care for Childhood Overweig...

Technologies can support people with dementia to live an independent life at home. These supportive technologies have a variety of purposes, such as support in day-to-day activities and safety. There are also technologies with a focus on engaging in meaningful activities, supporting communication, information, and screening. Iterative co-design wit...

Introduction: Although person-centredness is a key principle of integrated care, successfully embedding and improving person-centred care for older people remains a challenge. In the context of a cross-European project on integrated care for older people living at home, the objective of this paper is to provide insight at an overarching level, int...

De governance van netwerkzorg ontrafeld 1 De governance van netwerkzorg ontrafeld VERDER Waarom 'samen sturen' belangrijk én ingewikkeld is

Background: In order to organize person-centered health services for a growing number of people with multiple complex health and social care needs, a shift from fragmented to integrated health services delivery has to take place. For the organization of governance in integrated health services, it is important to better understand the underlying fa...

Background: Shared decision making (SDM) contributes to personalized decisions that fit the personal preferences of patients when choosing a treatment for a condition. However, older adults frequently face multiple chronic conditions (MCC). Therefore, implementing SDM requires special features. The aim of this paper is to describe the development...

This review provides an overview of the status of shared decision making (SDM) in older patients regarding treatment of symptomatic severe aortic stenosis (SSAS). The databases Embase, Medline Ovid, Cinahl and Cochrane Dare were searched for relevant studies from January 2002 to May 2018 regarding perspectives of professionals, patients and caregiv...

For organising person entered care, an important issue is how to deal with scale. This addresses what to organise on what level (in the neighbourhood, local, in the region, or national). With the increasing complexity of organising integrated care in networks, scale issues are an ingredient of integrated care governance. However, there is a lack of...

Integrated care programmes are increasingly being put in place to provide care to older people living at home. However, knowledge about further improving integrated care is limited. In fourteen integrated care sites in Europe, plans to improve existing ways of working were designed, implemented and evaluated to enlarge the understanding of what wor...

In shared decision making, the exploration of preferred personal health outcomes is important. Patient-reported outcome measures (PROMs) provide input for discussions between patients and healthcare professionals. The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS) PROM is a multidimensional questionnaire on the physical a...

Shared decision making (SDM) in older patients is more complex when multiple chronic conditions (MCC) have to be taken into account. The aim of this research is to explore the effect of the evidence based implementation intervention SDMMCC on (1) the preferred and perceived participation (2) decisional conflict and (3) actual SDM during consultatio...

Shared decision making (SDM) contributes to personalised decisions that fit the personal preferences of patients. However, older adults frequently face multiple chronic conditions (MCC). Therefore, implementing SDM requires special features. The aim of this paper is to describe the development of an intervention to improve SDM in older adults with...

Background: Integrated health and social care initiatives are being developed in many countries and settings. This development has been guided by substantial knowledge about integrated care interventions, ingredients and building blocks. In practice, integrated care initiatives are still looking for ways to further align collaboration and define de...

Introduction: Quality, accessibility and affordability in Dutch healthcare are system-goals in which the secretaries of the ministry of Healthcare, Welfare and Sports are accountable. These system-goals serve a public interest and they have to be accounted for. This only happens if the allied institutes, professionals and citizens take responsibili...

Objective: To develop a valid and reliable tool to measure triadic decision making between older adults with multiple chronic conditions (MCC), their informal caregivers and geriatricians. Methods: Video observational study with cross-sectional assessment of interaction during medical consultations between geriatricians (n = 10), patients (n = 1...

Although there are promising benefits of supportive technology in dementia care, use of these technologies is still limited. It is challenging for researchers and developers in this field to actively involve people with dementia in development. This review updates and builds on existing knowledge by including a contemporary and relevant perspective...

Background The Scaling Integrated Care in Context (SCIROCCO) tool has been developed to facilitate knowledge transfer and learning about the implementation and scaling-up of integrated care in European regions. To adequately test the functionality of the tool in assessing the maturity for integrated care within regions, this study evaluated its str...

BACKGROUND As a result of advances in diagnostic testing in the field of Alzheimer’s Disease (AD), patients are diagnosed in earlier stages of the disease; for example in the stage of mild cognitive impairment (MCI). This poses novel challenges for the clinician during the diagnostic work-up with regard to diagnostic testing itself (which tests), b...

Background: As a result of advances in diagnostic testing in the field of Alzheimer disease (AD), patients are diagnosed in earlier stages of the disease, for example, in the stage of mild cognitive impairment (MCI). This poses novel challenges for a clinician during the diagnostic workup with regard to diagnostic testing itself, namely, which tes...

Introduction Although substantial generic knowledge about integrated care has been developed, better understanding of the factors that drive behaviour, decision-making, collaboration and governance processes in integrated care networks is needed to take integrated care forward. To gain more insight into these topics and to understand integrated car...

Evaluation Wlz Long-term Care Act 2015

Introduction To meet the needs of vulnerable people, the integration of services across different sectors is important. This paper presents a preliminary review of service integration across sectors in Europe. Examples of service integration between social services, health, employment and/or education were studied. A further aim of the study was to...

Objectives: For older persons with two or more chronic diseases (multiple chronic conditions) insight into what they perceive as important in their lives is essential when discussing preferences in the shared decision making process. The aims of this study were to 1) investigate the personal views on the ageing process communicated by older persons...

Due to improved living conditions and better health care, life expectancy is expanding very rapidly in many countries (Colombo et al., Help wanted? Providing and paying for long-term care, OECD Health Policy Studies, Paris, 2011). Overall, we consider this as a blessing. But this blessing is to some extent ambiguous. Many people also extend their l...

Research report of the Evaluation of the Long term care act in the elderly care and care for people with disabilities. The research was performed in a co-production between KPMG and Vilans, in assignment for the Netherlands Institute for Social Research/ Ministry of Health Welfare and Sports.

Background Since recent years Dutch diabetes care has increasingly focused on improving the quality of care by introducing the concept of care groups (in Dutch: ‘zorggroepen’), care pathways and improving cooperation with involved care professionals and patients. This study examined how participating actors in care groups assess the development of...

Inventariserend onderzoek naar de mogelijkheden van vluchtelingen in de langdurende zorg