Browsing by Author "Hoogeveen, M."

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The updated national research agenda 2021-2026 for prehospital emergency medical services in the Netherlands: a Delphi study
Vloet, L.C.M. ; Hesselink, G. ; Berben, S.A.A. ; Hoogeveen, M. ; Rood, P. ; Ebben, R.H.A.
2021, Article / Letter to editor (Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, (2021))
A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review
Ebben, R.H.A. ; Vloet, L.C.M. ; Speijers, RF ; Tonjes, NW ; Loef, J. ; Pelgrim, T. ; Hoogeveen, M. ; Berben, S.A.A.
2017, Article / Letter to editor (Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, vol. 25, (2017))Background: This systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyance rates, (2) characteristics of non-conveyed patients, (3) follow-up care after non-conveyance, (4) existing guidelines or protocols, and (5) influencing factors during the non-conveyance decision making process. Methods: We systematically searched MEDLINE, PubMed, CINAHL, EMBASE, and reference lists of included articles, in June 2016. We included all types of peer-reviewed designs on the five topics. Couples of two independent reviewers performed the selection process, the quality assessment, and data extraction. Results: We included 67 studies with low to moderate quality. Non-conveyance rates for general patient populations ranged from 3.7%-93.7%. Non-conveyed patients have a variety of initial complaints, common initial complaints are related to trauma and neurology. Furthermore, vulnerable patients groups as children and elderly are more represented in the non-conveyance population. Within 24 h-48 h after non-conveyance, 2.5%-6.1% of the patients have EMS representations, and 4.6-19.0% present themselves at the ED. Mortality rates vary from 0.2%-3. 5% after 24 h, up to 0.3%-6.1% after 72 h. Criteria to guide non-conveyance decisions are vital signs, ingestion of drugs/alcohol, and level of consciousness. A limited amount of non-conveyance guidelines or protocols is available for general and specific patient populations. Factors influencing the non-conveyance decision are related to the professional (competencies, experience, intuition), the patient (health status, refusal, wishes and best interest), the healthcare system (access to general practitioner/other healthcare facilities/patient information), and supportive tools (online medical control, high risk card). Conclusions: Non-conveyance rates for general and specific patient populations vary. Patients in the nonconveyance population present themselves with a variety of initial complaints and conditions, common initial complaints or conditions are related to trauma and neurology. After non-conveyance, a proportion of patients reenters the emergency healthcare system within 2 days. For ambulance professionals the non-conveyance decisionmaking process is complex and multifactorial. Competencies needed to perform non-conveyance are marginally described, and there is a limited amount of supportive tools is available for general and specific non-conveyance populations. This may compromise patient-safety.
A national research agenda for pre-hospital emergency medical services in the Netherlands: a Delphi-study
van de Glind, I ; Berben, S ; Zeegers, F. ; Poppen, H. ; Hoogeveen, M. ; Bolt, I ; van Grunsven, P ; Vloet, L
2016, Article / Letter to editor (Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, vol. 24, (2016))Background: In pre-hospital Emergency Medical Services (EMS) more research is needed to direct and underpin care delivery and inform policy. To target future research efforts, this study aimed to determine future research priorities with representatives of the EMS field. Methods: A four-round online Delphi survey was used to discuss different viewpoints and reach consensus on research priorities. A multidisciplinary panel of experts was recruited in the field of pre-hospital EMS and adjoining (scientific) professional organisations (n = 62). 48 research topics were presented in Delphi I, and the panel was asked to rate their importance on a 5-point scale. In Delphi II and III the panel selected their priority research topics, and arguments why and suggestions for research questions were collected and reported back. In Delphi IV appropriateness of the remaining topics and agreement within the expert panel was taken into account to make up the final list of research priorities. Results: The response on the Delphi-survey was high: 95 % (n = 59; Delphi I); 97 % (n = 60, Delphi II); 94 % (n = 58, Delphi III); 97 % (n = 60, Delphi IV). The panel reduced the number of research topics from 48 topics in Delphi I to 12 topics in Delphi III. A variety of arguments and suggestions for research questions were collected, giving insight in reasons why research on these topics in the near future is needed. Delphi IV showed an adequate level of agreement with respect to the 12 presented research topics. The following 9 topics were rated as appropriate for the national pre-hospital EMS research agenda: Non-conveyance to the hospital (ranked highest); Performance measures for quality of care; Hand over/registration/exchange of patient data; Care and task substitution; Triage; Assessment of acute neurologic signs & symptoms; Protocols and protocol adherence; Immobilisation; and Open/secure airway. Discussions: The research priorities identified in our study resemble those in other studies. However, the topic 'non-conveyance to the hospital' was determined as a priority in this study but not in other studies. Conclusions: The national pre-hospital EMS research agenda can focus future research efforts to improve the evidence base and clinical practice of pre-hospital emergency medical services. Dissemination and implementation of the research agenda deserves careful attention.

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