Oliver Groene

London School of Hygiene and Tropical Medicine | LSHTM · Department of Health Services Research and Policy

/st>To explore how European hospitals have implemented patient safety strategies (PSS) and evidence-based organization of care pathway (EBOP) recommendations and examine the extent to which implementation varies between countries and hospitals. /st>Mixed-method multilevel cross-sectional design in seven countries as part of the European Union-funde...

The English National Health Service published outcome information for individual surgeons for ten specialties in June, 2013. We looked at whether individual surgeons do sufficient numbers of procedures to be able to reliably identify those with poor performance. For some specialties, the number of procedures that a surgeon does each year is low and...

High performing hospitals attain excellence across multiple measures of performance and multiple departments. Studying high performing hospitals can be valuable if factors associated with high performance can be identified and applied. Factors leading to high performance are complex and an exclusive quantitative approach may fail to identify richly...

Since 2006 the Gesundes Kinzigtal (GK) model has demonstrated how a people-centred focus on population health management can lead to significant gains in achieving the Triple Aim of better population health, improved experience of care, and reduced per capita costs. Through a strong management organization, a sophisticated data management system, a...

Background: Outcomes for oesophagogastric cancer surgery are compared with the aim of benchmarking quality of care. Adjusting for patient characteristics is crucial to avoid biased comparisons between providers. The study objective was to develop a case-mix adjustment model for comparing 30- and 90-day mortality and anastomotic leakage rates after...

Background The Organisation for Economic Co-operation and Development (OECD) Patient-Reported Indicator Surveys (PaRIS) initiative aims to support countries in improving care for people living with chronic conditions by collecting information on how people experience the quality and performance of primary and (generalist) ambulatory care services....

The need to reorient health services towards health promotion is greater than ever. Health systems are overburdened by treating an ever-growing number of chronic patients, many of which seek care for problems that could partly be avoided or postponed through better health promotion implementation. Since its establishment, the International Network...

Healthcare professionals have first-hand experience with patients in clinical practice and the dynamics in the healthcare system, which can be of great value in the design, implementation, data analysis and dissemination of research study results. Primary care professionals are particularly important as they provide first contact, accessible, coord...

Introduction Adverse events in health care affect 8% to 12% of patients admitted to hospitals in the European Union (EU), with surgical adverse events being the most common types reported. Aim SAFEST project aims to enhance perioperative care quality and patient safety by establishing and implementing widely supported evidence-based perioperative...

Objective In view of the increasing number of people with (multiple) chronic conditions, the Organisation for Economic Co-operation and Development (OECD) initiated the International Survey of People Living with Chronic Conditions (PaRIS survey), which aims to provide insight in patient-reported outcomes and experiences of chronic care provided by...

Background The PaRIS survey, an initiative of the Organisation for Economic Co-operation and Development (OECD), aims to assess health systems performance in delivering primary care by measuring the care experiences and outcomes of people over 45 who used primary care services in the past six months. In addition, linked data from primary care pract...

Self‐management interventions (SMIs) may improve disease management in adults living with obesity. We formulated evidence‐based recommendations for SMIs within the context of the COMPAR‐EU project. The multidisciplinary panel selected critical outcomes based on the COMPAR‐EU core outcome set and established decision thresholds for each outcome. Rec...

Abschlussbericht der Evaluation des Programmes AGATHE

In the original publication [...]

Self-management interventions (SMIs) offer a promising approach to actively engage patients in the management of their chronic diseases. Within the scope of the COMPAR-EU project, our goal is to provide evidence-based recommendations for the utilisation and implementation of SMIs in the care of adult individuals with type 2 diabetes mellitus (T2DM)...

Self-management interventions (SMIs) may enhance heart failure (HF) outcomes and address challenges associated with disease management. This study aims to review randomized evidence and identify knowledge gaps in SMIs for adult HF patients. Within the COMPAR-EU project, from 2010 to 2018, we conducted searches in the databases MEDLINE, CINAHL, Emba...

Introduction: The translation of new digital solutions in different settings requires a preliminary analysis of contextual factors. The results might contribute to the development of strategies addressing barriers, for a successful implementation. ADLIFE is an EU funded project to improve the quality of life of older people with advanced chronic di...

Objective Integrated care and digital health technology interventions are promising approaches to coordinate services for people living with chronic conditions, across different care settings and providers. The EU-funded ADLIFE project intends to provide digitally integrated personalized care to improve and maintain patients’ health with advanced c...

Self-management interventions (SMIs) may be promising in the treatment of Diabetes Mellitus Type 2 (T2DM). However, accurate comparisons of their relative effectiveness are challenging, partly due to a lack of clarity and detail regarding the intervention content being evaluated. This study summarizes intervention components and characteristics in...

Background Optimizing prescribing practices is important due to the substantial clinical and financial costs of polypharmacy and an increasingly aging population. Prior research shows the importance of social relationships in driving prescribing behaviour. Using social network analysis, we examine the relationship between a physician practices’ con...

This study, as part of the COMPAR-EU project, utilized a mixed-methods approach involving 37 individual, semi-structured interviews and one focus group with 7 participants to investigate the factors influencing the implementation and use of self-management interventions (SMIs) decision tools in clinical practice. The interviews and focus group disc...

Background: Self-management interventions (SMIs) are core components of high-quality care in type 2 diabetes mellitus (T2DM). We aimed to identify and summarise the scientific evidence exploring the perspectives of patients with T2DM and their informal caregivers on outcomes of SMIs, and the key themes to enhance T2DM patient-centred care. Method...

Background: Cooperation is a core feature of integrated healthcare systems and an important link in their value-creating mechanism. The premise is that providers who cooperate can promote more efficient use of health services while improving health outcomes. We studied the performance of an integrated healthcare system in improving regional cooper...

Objective: To reach consensus amongst stakeholders about the most important contextual factors (CFs) that may influence the successful implementation of (components of) self-management interventions (SMIs) for type 2 diabetes, obesity, COPD and heart failure. Methods: Building on our literature review that identified 31 CFs on different levels w...

Objectives: To conduct an evidence map on self-management interventions and patient-relevant outcomes for adults living with overweight/obesity. Methods: Following Arksey and O'Malley methodology, we searched in five electronical databases including randomized controlled trials (RCTs) on SMIs for overweight/obesity. We used the terms "self-manag...

The purpose of this study was to develop a prediction model to identify individuals and populations with a high risk of being hospitalized due to an ambulatory care-sensitive condition who might benefit from preventative actions or tailored treatment options to avoid subsequent hospital admission. A rate of 4.8% of all individuals observed had an a...

Citation: García-Lorenzo, B.; Gorostiza, A.; González, N.; Larrañaga, I.; Mateo-Abad, M.; Ortega-Gil, A.; Bloemeke, J.; Groene, O.; Vergara, I.; Mar, J.; et al. Abstract: Due to population ageing and medical advances, people with advanced chronic diseases (ACD) live longer. Such patients are even more likely to face either temporary or permanent re...

Objectives: To identify and describe the most relevant contextual factors (CFs) from the literature that influence the successful implementation of self-management interventions (SMIs) for patients living with type 2 diabetes mellitus, obesity, COPD and/or heart failure. Methods: We conducted a qualitative review of reviews. Four databases were...

Background: Evidence of integrated healthcare networks' effect on population health is scarce. Moreover, current designs for evaluating such networks have shortcomings that can result in misleading conclusions. Our paper evaluates Gesundes Kinzigtal, a best-practice integrated healthcare network, using an innovative design that enlightens the discu...

Our aim was to predict future high-cost patients with machine learning using healthcare claims data. We applied a random forest (RF), a gradient boosting machine (GBM), an artificial neural network (ANN) and a logistic regression (LR) to predict high-cost patients in the following year. Therefore, we exploited routinely collected sickness funds cla...

Background Interventions to reduce potentially risky hospitalizations among nursing home residents are highly relevant for patient safety and quality improvement. A catalog of nursing home-sensitive conditions (NHSCs) grounds the policy recommendations and interventions.Methods In two previous research phases, an expert panel developed a catalog of...

Background The global public health crisis of antibiotic resistance is being driven in part by over prescription of antibiotics. We aimed to assess the relative weight of patient expectations, clinical uncertainty, and past behaviour on hospital-based physicians’ antibiotic prescribing decisions. Methods A discrete choice experiment was administer...

The International Network of Health Promoting Hospitals and Health Services (HPH) was initiated by the World Health Organization as a settings approach toward reorienting health services. Over 600 members from 30 countries promote the integration of health promotion into the hospital/ health service setting. The International HPH Network developed...

Inappropriate prescription of antibiotics remains a major contributor to the global antimicrobial resistance crisis despite clear linkages between antibiotic utilization and resistance spread. This study aims to better understand the simultaneous and independent effect of previous prescription behavior, patient expectation, and clinical uncertainty...

Hintergrund und Stand (inter)nationaler Forschung: Die Vermeidung von Krankenhauseinweisungen aus dem Pflegeheim wird – auch hinsichtlich der Qualität der Versorgung – international diskutiert [1], [2]. Durch Anpassung der ambulanten Versorgung kann ein Teil dieser Krankenhauseinweisungen vermieden werden. Fragestellung und Zielsetzung: Welche str...

Introduction In view of growing populations with chronic conditions, many countries are redesigning their health systems. However, little information is available about how health systems perform from the perspective of people living with chronic conditions. The Organisation for Economic Co-operation and Development (OECD) Member States therefore m...

Background Governments across the World Health Organization (WHO) European Region have prioritised dashboards for reporting COVID-19 data. The ubiquitous use of dashboards for public reporting is a novel phenomenon. Objective This study explores the development of COVID-19 dashboards during the first year of the pandemic and identifies common barr...

Objectives: We evaluate the impact of the COVID-19 pandemic on unplanned hospitalization rates for patients without COVID-19, including their length of stay, and in-hospital mortality, overall, and for acute myocardial infarction (AMI), stroke, and heart failure in the Tuscany region of Italy. Methods: We carried out a population-based controlled i...

Background: Hospitalizations of nursing home residents are associated with various health risks. Previous research indicates that, to some extent, hospitalizations of this vulnerable population may be inappropriate and even avoidable. This study aimed to develop a consensus list of hospital discharge diagnoses considered to be nursing home-sensitiv...

Objective To develop and test the validity and reliability of a tool measuring patient experiences with patient safety in ambulatory care that is suitable for routine use in general practitioner and specialist practices. Design Instrument development was based on a literature review, a 3-round Delphi survey with a multidisciplinary expert panel an...

The topic of patient involvement (PI) is gaining increasing importance in health services research, health policy and service delivery (Mockford et al. 2012). In the US, the Patient-Centered Outcomes Research Institute (PCORI) was established three years ago specifically to bolster research focusing more on patients’ needs. PCORI funded research re...

Background: Hospitalizations of nursing home residents are associated with various health risks. Previous research indicates that, to some extent, hospitalizations of this vulnerable population may be inappropriate and even avoidable. This study aimed to develop a consensus list of hospital discharge diagnoses considered to be nursing home-sensitiv...

Objective Routine measurement of patient safety from the patients’ perspective receives increasing attention as an important component of safety measurement systems. The aim of this study was to examine patients’ experience with patient safety in ambulatory care and the results’ implications for routine patient safety measurement in ambulatory care...

Background: Governments across the WHO European Region prioritized dashboards for reporting COVID-19 data. The ubiquitous use of dashboards for public reporting is novel. This study explores the development of COVID-19 dashboards during the pandemic's first year and common barriers, enablers and lessons from the experiences of teams responsible for...

Background The commitment of hospital managers plays a key role in decisions regarding investments in quality improvement (QI) and the implementation of quality improvement systems (QIS). With regard to the concept of social capital, successful cooperation and coordination among hospital management board members is strongly influenced by commonly s...

Context The literature on self‐management interventions (SMIs) is growing exponentially, but it is characterized by heterogeneous reporting that limits comparability across studies and interventions. Building an SMI taxonomy is the first step towards creating a common language for stakeholders to drive research in this area and promote patient self...

Background The guiding principle of many health care reforms is to overcome fragmentation of service delivery and work towards integrated healthcare systems. Even though the value of integration is well recognized, capturing its drivers and its impact as part of health system performance assessment is challenging. The main reason is that current as...

Background: The COVID-19 pandemic is a complex global public health crisis presenting clinical, organisational and system-wide challenges. Different research perspectives on health are needed in order to manage and monitor this crisis. Performance intelligence is an approach that emphasises the need for different research perspectives in supporting...

Objective Interventions informed by behavioral economics have the potential to change behaviors governed by underlying cognitive biases. This has been explored extensively for various use in healthcare including changing patient behavior and, more recently, physician behavior. We aimed to systematically review the literature on the use and effectiv...

Zusammenfassung Hintergrund Studien aus unterschiedlichen Ländern haben gezeigt, dass eine kleine Zahl von Versicherten (Hochkostenversicherte) einen großen Teil der Leistungsausgaben im Gesundheitssektor verursacht. Gleichzeitig wird davon ausgegangen, dass ein Teil dieser Hochkosten durch besseres Management dieser Personengruppe reduziert werde...

Zusammenfassung Hintergrund Der Innovationsausschuss beim Gemeinsamen Bundesausschuss (G-BA) fördert das Projekt „INTEGRAL–10-Jahres-Evaluation der populationsbezogenen Integrierten Versorgung Gesundes Kinzigtal“ (IVGK) (Förderkennzeichen 01VSF16002). Basis der Evaluation soll ein mit Routinedaten erfassbares Indikatorenset sein, mit dem zum einen...

Low health literacy is associated with poorer health and quality of life. An open question is whether a regional integrated healthcare system whose management strives to enable and empower its members with regard to health issues can contribute to a higher level of health literacy in the population. Against this background, in a cross-sectional stu...

Zusammenfassung Über Register können Fragestellungen zur Gesundheitsversorgung im Alltag untersucht werden. Sie sind daher eine wesentliche Methode der Versorgungsforschung. Das Deutsche Netzwerk Versorgungsforschung (DNVF) fördert die Qualität von Registern durch einen wissenschaftlichen Austausch, durch Fortbildungsangebote sowie durch Empfehlung...

Introduction Population ageing and increasing chronic illness burden have sparked interest in innovative care models. While self-management interventions (SMIs) are drawing increasing attention, evidence of their efficacy is mostly based on pairwise meta-analysis, generally derived from randomised controlled trials comparing interventions versus a...

The German and other health systems focus in their remuneration system on the volume of services provided to patients and not the value they generate. Consequently, there is little incentive for prevention or health-promotion that would help to maintain or regain health. On the contrary, this payment framework leads to gaps in the exchange of infor...

With this paper, we initiate the Supplement on Deepening our Understanding of Quality in Australia (DUQuA). DUQuA is an at-scale, cross-sectional research programme examining the quality activities in 32 large hospitals across Australia. It is based on, with suitable modifications and extensions, the Deepening our Understanding of Quality improveme...

Background: The purpose of our study was to develop and psychometrically test a German-language survey instrument that measures patient enablement generically and in greater detail than previous instruments. Methods: A multidisciplinary team developed 13 items to capture individual aspects of patient enablement (PEN-13). A pre-test with 26 subje...

Background The EU-funded Marie Curie project HEALTHPROS aims to foster a new generation of “Healthcare Performance Intelligence Professionals” through a cohesive stream of 13 doctoral projects (www.healthpros-h2020.eu). Over 48 months, researchers will investigate key levers of healthcare improvement in 7 different countries, using methods drawn fr...

Accreditation, certification and supervision are quality strategies that intend to encourage the compliance of health care organizations with published standards through external assessment. The idea is that health care organizations will increase compliance with standards in advance of a planned external inspection. Despite several common characte...

Hintergrund: Für das vom Innovationsausschuss beim Gemeinsamen Bundesausschuss geförderte Projekt „INTEGRAL“ – „10-Jahres-Evaluation der populationsbezogenen Integrierten Versorgung Gesundes Kinzigtal“ (Förderkennzeichen 01VSF16002) wurde innerhalb eines Teilprojektes ein Qualitätsindikatoren-Set (QI-Set) entwickelt. Mittels anonymisierten AOK-Rout...

What are the characteristics of the strategy? Accreditation, certification and supervision are quality strategies that intend to encourage the compliance of healthcare organizations with published standards through external assessment. The idea is that healthcare organizations will increase compliance with standards in advance of a planned externa...

Health systems face significant challenges in moving towards integrated care. Despite long time policy pressures and the existence of best practice models at international level, integrated care frequently remains limited to pilot projects. There are multiple reasons why pilot projects are not scaled up. First, the internal validity of the findings...

Executive summary Background / Purpose of the review The NSW Health Integrated Care Strategy is focused on transforming healthcare delivery to improve health outcomes, patient experience and efficiency. Implementing integrated care involves changes at system, organisation, professional, clinical and consumer levels. The strategy recognises a broade...

Abstract Background Implementation of clinical health promotion (CHP) aiming at better health gain is slow despite its effect. CHP focuses on potentially modifiable lifestyle risks such as smoking, alcohol, diet, and physical inactivity. An operational program was created to improve implementation. It included patients, staff, and the organization,...