In search of the quickest way to disseminate health care innovations

RESEARCH QUESTION: Innovations in health care are slowly disseminated in The Netherlands and elsewhere. That's why the researchers defined their research question: What is the quickest way of disseminating health care innovations? RESEARCH METHOD: The design was a comparative, qualitative case study. The researchers invited a group of 52 authors to describe their 21 health care innovations. All case descriptions were published in a book of 261 pages [2]. RESULTS: Six types of innovations were distinguished. Most innovations simultaneously improved quality from the patient's point of view (18 out of 21 cases), professional pride (18/21) and speed of introduction (16/21). Clinical outcomes were better or comparable in 13 of the 21 cases. Brainstorm sessions took place with the innovators and the 22 experts on the quickest way to disseminate the innovations more widely in The Netherlands. These sessions looked for the critical success factors for the dissemination of the 21 projects and identified nine. The following factors were identified: 1. A clear distribution of responsibilities between professionals within the innovation (20/21) 2. Enough educational programs about the innovations for the professionals (18/21) 3. Adequate ICT support for the running of the innovations (15/21) 4. Suitable publicity for the innovations (12/21) 5. An adequate payment system for innovative care providers (7/21) 6. The right size of catchment's area for the innovations (6/21) 7. Enough professional freedom to adopt the innovation (5/21) 8. Fast managerial and public decision-making about the adoption of the innovation (3/21) 9. The embedding of the innovations in quality management assurance policy (1/21). DISCUSSION: The results of the study had some influence on the political health agenda in The Netherlands, leading to greater emphasis on innovations and quality of care

Estimation of greenhouse gas emission reductions based on vegetation changes after rewetting in Drentsche Aa brook valley

Contains fulltext : 218167.pdf (publisher's version ) (Open Access

Correction to: Durability of treatment effects of the sleep position trainer versus oral appliance therapy in positional OSA

The article “Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled trial”, written by Maurits H. T. de Ruiter, Linda B. L. Benoist, Nico de Vries, and Jan de Lange, was originally published electronically on the publisher’s internet portal SpringerLink on 15 September 2017 without open access. With the authors’ decision to opt for Open Choice the copyright of the article changed on October 2017 to © The Author(s) 2017 and the article is forthwith distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made

Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA

__Purpose:__ The Sleep Position Trainer (SPT) is a new option for treating patients with positional obstructive sleep apnea (POSA). This study investigated long-term efficacy, adherence, and quality of life during use of the SPT device compared with oral appliance therapy (OAT) in patients with POSA. __Methods:__ This prospective, multicenter trial randomized patients with mild to moderate POSA (apnea-hypopnea index [AHI] 5–30/h) to SPT or OAT. Polysomnography was performed at baseline and after 3 and 12 months’ follow-up. The primary endpoint was OSA severity; adherence, quality of life, and adverse events were also assessed. __Results:__ Ninety-nine patients were randomized and 58 completed the study (29 in each group). Median AHI in the SPT group decreased from 13.2/h at baseline to 7.1/h after 12 months; corresponding values in the OAT group were 13.4/h and 5.0/h, with no significant between-group difference. Improvements throughout the study were maintained at 12 months. Long-term median adherence was also similar in the two treatment groups; the proportion of patients who used their device for ≥ 4 h for 5 days in a week was 100% in the SPT group and 97.0% in the OAT group. __Conclusions:__ The efficacy of SPT therapy was maintained over 12 months and was comparable to that of OAT in patients with mild to moderate POSA. Adherence was relatively high, and similar in the two groups. Trial registration: _www.clinicaltrials.gov(NCT02045576).