Value creation in a learning community: an interprofessional partnership between nursing home care, education and students.

OBJECTIVES: To assess the value created in a learning community - comprised of different professionals and nursing students - at a nursing home. METHODS: A case study approach was used. Data were collected between 2019 and 2021 through self-reports, observations and stories (interviews, diaries). RESULTS: The template analysis revealed nine transcending themes, six associated with preexisting value-creation cycles (expected, immediate, potential, applied, realized and transformative value) and three other relevant themes: contextual, factors and value-creation initiators. CONCLUSIONS: A nursing home learning community comprised of diverse professionals in partnership with nursing students shows a variety of value creation and seems to potentially leverage interprofessional and lifelong learning activities, on top of formal nursing education. It is recommended to integrate the value-creation cycles into the processes of learning communities to promote collective decision-making. Research on both the final level of students involved and having residents participate in the learning community would be worthwhile.

Participatory Action Research as a Driver for Health Promotion and Prevention: A Co-creation Process Between Professionals and Citizens in a Deprived Neighbourhood in the Hague.

Introduction: Ignited by the persistent health inequalities many cities and neighbourhoods, the 'Healthy and Happy The Hague' network in the Netherlands wanted to gain insight in how prevention and health promotion could become successful in one deprived neighbourhood, Moerwijk. Methods: The cycle of Look-Think-Act of Participatory Action Research was used in which both citizens and professionals got involved from the start. Besides interviews, field notes were analysed, visualised and discussed in several rounds of focus groups. Results: Thematic analysis yielded seven themes: Healthy Eating and Exercise, Healthy Money, Healthy Mind, Healthy Relationships, Growing up healthy, Healthy Environment and Healthy Collaboration. During sessions around combination of themes, eight initiatives were co-created by citizens and professionals together, improving the feeling of ownership and interconnectedness. Discussion and conclusion: This PAR sheds a light on the mismatch between the system world's solutions for individuals and the living world's needs for solutions for the collective. Findings provides a better insight into the social, political, and cultural mechanisms and processes that influence clustering and interaction of health conditions. PAR is a promising process of citizens and professionals working together is an excellent way to learn about the conditions under which people experience health inequalities, and how to combat these inequalities.

The Impact of Community Learning During a Participatory Nursing Research Project.

BACKGROUND: Community learning is one approach to promote research competencies and to involve nurses and nursing students in research. This study examines the impact of community learning according to participants-both those inside and outside the community-in a joint nursing research project at a hospital. METHOD: A qualitative design was selected using a participatory approach. Data were collected through semistructured interviews, reflections, conversations, and patient input during 2 academic years. RESULTS: Thematic analysis showed 11 themes, which were organized into three clusters: realization, transformation, and influencing factors. Participants perceived changes in practice and described how their perspectives have changed on care, education, and research. Reconsiderations led to some new or revised strategies, and influencing factors were associated with the contemporary context, degree of involvement, and design/facilitation. CONCLUSION: The impact of community learning emerged and extended beyond community boundaries, and the indicated influencing factors must be taken into account. [J Contin Educ Nurs. 2023;54(3):131-144.].

Collaboration to combat COVID-19: policy responses and best practices in local integrated care settings.

PURPOSE: This illustrative case study describes and evaluates drivers of effective inter-organizational collaboration to mitigate the impact and spread of COVID-19 among homeless people in two cities in the Netherlands. The aims of this study are: (1) to explore the strategic and operational policy responses in two local integrated care settings at the start of the crisis, (2) to identify best policy practices and lessons learned. The authors interpret and evaluate the findings by combining insights from the population health management (PHM) and collaborative governance literature. DESIGN/METHODOLOGY/APPROACH: The authors describe and illustrate the experiences of two Dutch municipalities, Rotterdam and The Hague, in the early policy responses to sudden operational challenges around the impact of COVID-19 on homeless people as experienced by local decision-makers, medical doctors and clients. FINDINGS: The authors show that best policy practices revolve around (1) using data and risk stratification methods for identifying and targeting populations at-risk in local policy making, and (2) having an inter-organizational data sharing architecture in place ex ante. These two factors were clear prerequisites for tailor-made policy responses for newly-defined groups at risk with the existing and well-documented vulnerable population, and executing crisis-induced tasks efficiently. ORIGINALITY/VALUE: This paper is among the first to illustrate the potential of combining collaborative governance and PHM perspectives to identify key drivers of effective local governance responses to a healthcare crisis in an integrated care setting.

[Patient involvement during crises]. / Patiëntbetrokkenheid tijdens crisisbesluitvorming: Lessen voor de toekomst op basis van COVID-19.

Patient involvement is an important topic in health care. Client councils are one way through which patients are involved in decision-making. However, we know little about their role during crises, and what we can learn from these experiences. We argue that there was little patient involvement in the top-down and centralized decision-making during the COVID-19 crisis. Furthermore, many decisions were taken in interorganizational networks, where patient involvement is rare. Based on these findings, we argue that health care organizations and client councils should rethink what effective patient involvement looks like during crises and in interorganizational networks.

What Should Clinicians Tell Patients about Placebo and Nocebo Effects? Practical Considerations Based on Expert Consensus.

INTRODUCTION: Clinical and laboratory studies demonstrate that placebo and nocebo effects influence various symptoms and conditions after the administration of both inert and active treatments. OBJECTIVE: There is an increasing need for up-to-date recommendations on how to inform patients about placebo and nocebo effects in clinical practice and train clinicians how to disclose this information. METHODS: Based on previous clinical recommendations concerning placebo and nocebo effects, a 3-step, invitation-only Delphi study was conducted among an interdisciplinary group of internationally recognized experts. The study consisted of open- and closed-ended survey questions followed by a final expert meeting. The surveys were subdivided into 3 parts: (1) informing patients about placebo effects, (2) informing patients about nocebo effects, and (3) training clinicians how to communicate this information to the patients. RESULTS: There was consensus that communicating general information about placebo and nocebo effects to patients (e.g., explaining their role in treatment) could be beneficial, but that such information needs to be adjusted to match the specific clinical context (e.g., condition and treatment). Experts also agreed that training clinicians to communicate about placebo and nocebo effects should be a regular and integrated part of medical education that makes use of multiple formats, including face-to-face and online modalities. CONCLUSIONS: The current 3-step Delphi study provides consensus-based recommendations and practical considerations for disclosures about placebo and nocebo effects in clinical practice. Future research is needed on how to optimally tailor information to specific clinical conditions and patients' needs, and on developing standardized disclosure training modules for clinicians.