“It would be great if the Knee Osteoarthritis Counseling Card from the Dutch Orthopedic Society (NOV) and the Dutch Patients Association also met the criteria of the Dutch College of General Practitioners (NHG),” says Gerda van der Weyle. And so the plan to renew this counseling card was born. “Together with relevant professional groups and patients, because we wanted to prevent 3 or more selection tables from having too soon. Then it becomes a mess for both the patient and the healthcare professional.”
A common goal
Gerda sought contact from NHG with the original owners, NOV and the Dutch Patients Union, and the Royal Dutch Society of Physiotherapy (KNGF) was also involved. All parties recognized the importance of a new selection schedule and were happy to participate in the review.
Worked for KNGF Mitchell Van Dormal: “Just like Gerda, I think it is important for all healthcare professionals to tell the same story. Certainly also in physiotherapy, where patients can be treated without the intervention of a GP. In addition, the physiotherapist must be aware of the options other treatment and to refer to the GP if necessary.Therefore I emphasize the goal of creating a single selection schedule that can be used practicably by various healthcare professionals.
Gerda van der Weele serves as Program Leader for Selection Schedules and Senior Scientific Officer in the NHG Guidelines Development Division. Among other things, it participates in the development and updating of selection schedules. Patients and healthcare professionals can use the selection table as an aid during conversation. In my time as a practicing physician, there were none. I think they are a real asset, they help in joint decision making. As a GP but also as a patient, I have experienced how important it is to know what options are available.
The range of interventions is broader than what you can offer as an individual healthcare professional. Not every healthcare professional has a clear picture of what is possible.
In order to arrive at a revised version, the current counseling card was taken as a starting point. What was out of date, what was missing, and is the information still in line with current guidelines? ‘So he said Mitchell For example, to add exercise therapy, says Gerda.
Mitchell He’s happy to explain: “The counseling card did mention lifestyle advice, but the exercise therapy was missing. That’s really something else. Especially people who’ve had osteoporosis – and therefore pain – for a while, they can’t always adjust their lifestyle on their own. Then it ends.” They get into a negative spiral where they become less active and the pain gets worse.By guiding and training patients as a physiotherapist, for example, on muscle strength and fitness, you can help them get out of this spiral.An important plus, already described in the guidelines that Everyone agreed to it.
Contact was made online and by phone. As the project leader and coordinator, Gerda was constantly sending emails to everyone involved. ‘Never 1 on 1, because I think it’s important for everyone to know what other project group members are thinking about something. This certainly contributed to the transparency and speed of the development process.
speak the same language
All the information was available and the professional groups had already been involved in developing the guidelines for each other, so the project group did not have any substantive discussions. “But the moment you are so stressed and to an extent, to a degree If you have to communicate, you can clash about the little things, says Gerda. Like expressing risk: do you provide numbers, percentages, or are you talking about ‘big’ or ‘small’ risks? Thuisarts.nl played an important role in the preparation, based on its experience in translating patient instructions.
Mitchell As a Senior Quality Policy Officer, van Doormaal is responsible for developing guidelines within the KNGF. While training and working as a physical therapist, he noticed that there was a huge gap between science and practice. “It is not always easy for many physiotherapists to turn scientific findings into concrete actions in practice.”
Our goal at KNGF is to translate scientific, complex, and sometimes abstract information into practice, using guidelines, among other things. Down to the level of the individual patient who is sitting in front of you in the treatment room.
By working together as healthcare professionals, you know how to find each other better and you both speak the same language much more. I see this as the biggest advance in recent years.
Not all subjects are suitable for developing a selection schedule with different occupational groups. “This approach and the method of communication worked, because there was a really good foundation,” he says. Mitchell. “If you want to create a new selection schedule around a topic where there is no agreement between the guidelines, that’s a different story.” Gerda knows this from experience. Then you first have to agree with the project group about the content and format. For which selection situation would you draw up a selection table, what is its use and necessity? This should be clear to everyone before you can proceed. Without a good foundation, as with osteoarthritis of the knee, it is a longer and more complex process.
The knee osteoarthritis selection schedule has been available online since September 2020 for both healthcare professionals and patients. “I only hear positive feedback,” says Mitchell. “What I love is that as a healthcare professional, you radiate that there is unity about it. We do it together, with one message to the patient, and it helps the patient make choices with the healthcare professional. This is also reflected in the integration with Thuisarts,” Gerda adds. .nl.” The selection table includes links to videos from Thuisarts.nl. A direct link to the selection table has been added to the guide for general practitioners. We are constantly looking at how to improve findability.
Within the NHG, Gerda is now looking at the situations of choice most suitable for developing such a (interdisciplinary) tool. It’s not that easy. The basic requirement is that there be evidence approved by the profession. There are already about 140 treatments available. We then look at whether there are several treatment options. With a simple choice, such as whether or not to use antibiotics to treat a UTI, the selection schedule is a very heavy tool. The subject must lend itself to joint decision-making.
But about 80 people still meet these conditions. There is no time and money to make a pick table for all of them. Together with general practitioners and patients, we are now studying whether we can come up with a priority list to work with in the coming years. Then we are also looking for cooperation with other professional groups. Same goal: today the patient with one healthcare professional, tomorrow with another. Whoever is with healthcare professionals should speak the same language.
Would you like to learn more about interdisciplinary collaboration in developing/reviewing selection schedules? Please contact Gerda van der Weele via [email protected]
editorial Milo Omens (Target group in the photo), Final editing SunMw
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