DTO-FTO trial: Small group quality improvement on prescribing and test ordering performance of general practitioners: a large scale implementation study in the South of the Netherlands

2012 ◽  
Author(s):  
J P Trietsch
Keyword(s):  
Quality Improvement ◽  
The Netherlands ◽  
Small Group ◽  
General Practitioners ◽  
Large Scale ◽  
Implementation Study ◽  
The South ◽  
Test Ordering

Laboratory Test Form Design Influences Test Ordering by General Practitioners in the Netherlands

Medical Care ◽  
1992 ◽  
Vol 30 (3) ◽  
pp. 189-198 ◽  
Author(s):  
Joost O.M. Zaat ◽  
Jacques Th.M. van Eijk ◽  
Harry A. Bonte
Keyword(s):  
The Netherlands ◽  
Laboratory Test ◽  
General Practitioners ◽  
Test Form ◽  
Form Design ◽  
Test Ordering

scholarly journals Effect of a price display intervention on laboratory test ordering behavior of general practitioners

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Dennis M. J. Muris ◽  
Max Molenaers ◽  
Trang Nguyen ◽  
Paul W. M. P. Bergmans ◽  
Bernadette A. C. van Acker ◽  
...  
Keyword(s):  
Primary Care ◽  
The Netherlands ◽  
Laboratory Test ◽  
General Practitioners ◽  
Laboratory Tests ◽  
Future Research ◽  
Post Intervention ◽  
Diagnostic Laboratory ◽  
The Mean ◽  
Test Ordering

Abstract Background Redundant use of diagnostic tests in primary care has shown to be a contributor to rising Dutch healthcare costs. A price display in the test ordering system of the electronic health records (EHRs) could potentially be a low-cost and easy to implement intervention to a decrease in test ordering rate in the primary care setting by creating more cost-awareness among general practitioners (GPs). The aim of this study was to assess the effect of a price display for diagnostic laboratory tests in the EHR on laboratory test ordering behavior of GPs in the Westelijke Mijnstreek region in the Netherlands. Methods A pre-post intervention study among 154 GPs working in 57 general practices was conducted from September 2019, until March 2020, in the Netherlands. The intervention consisted of displaying the costs of 22 laboratory tests at the time of ordering. The primary outcome was the mean test ordering rate per 1.000 patients per month, per general practice. Results Test ordering rates were on average rising prior to the intervention. The total mean monthly test order volume showed a non-statistically significant interruption in this rising trend after the intervention, with the mean monthly test ordering rate levelling out from 322.4 to 322.2 (P = 0.86). A subgroup analysis for solely individually priced tests showed a statistically significant decrease in mean monthly test ordering rate after implementation of the price display for the sum of all tests from 67.2 to 63.3 (P = 0.01), as well as for some of these tests individually (i.e. thrombocytes, ALAT, TSH, folic acid). Leucocytes, ESR, vitamin B12, anti-CCP and NT-proBNP also showed a decrease, albeit not statistically significant (P > 0.05). Conclusions Our study suggests that a price display intervention is a simple tool that can alter physicians order behavior and constrain the expanding use of laboratory tests. Future research might consider alternative study designs and a longer follow-up period. Furthermore, in future studies, the combination with a multitude of interventions, like educational programs and feedback strategies, should be studied, while potentially adverse events caused by reduced testing should also be taken into consideration.

Characterising essential breeding habitat for whales informs the development of large-scale Marine Protected Areas in the South Pacific

2016 ◽  
Vol 548 ◽  
pp. 263-275 ◽  
Author(s):  
RE Lindsay ◽  
R Constantine ◽  
J Robbins ◽  
DK Mattila ◽  
A Tagarino ◽  
...  
Keyword(s):  
Protected Areas ◽  
Marine Protected Areas ◽  
Large Scale ◽  
South Pacific ◽  
Breeding Habitat ◽  
The South

Bottlenecks in the Implementation of On-Site Wastewater Treatment Plants on a Large Scale in The Netherlands

1990 ◽  
Vol 22 (3-4) ◽  
pp. 291-298
Author(s):  
Frits A. Fastenau ◽  
Jaap H. J. M. van der Graaf ◽  
Gerard Martijnse
Keyword(s):  
Wastewater Treatment ◽  
The Netherlands ◽  
Large Scale ◽  
Wastewater Treatment Plants ◽  
Housing Stock ◽  
Research Work ◽  
Field Research ◽  
Domestic Wastewater ◽  
Research Programme ◽  
Definition Of

More than 95 % of the total housing stock in the Netherlands is connected to central sewerage systems and in most cases the wastewater is treated biologically. As connection to central sewerage systems has reached its economic limits, interest in on-site treatment of the domestic wastewater of the remaining premises is increasing. A large scale research programme into on-site wastewater treatment up to population equivalents of 200 persons has therefore been initiated by the Dutch Ministry of Housing, Physical Planning and Environment. Intensive field-research work did establish that the technological features of most on-site biological treatment systems were satisfactory. A large scale implementation of these systems is however obstructed in different extents by problems of an organisational, financial and/or juridical nature and management difficulties. At present research is carried out to identify these bottlenecks and to analyse possible solutions. Some preliminary results are given which involve the following ‘bottlenecks':-legislation: absence of co-ordination and absence of a definition of ‘surface water';-absence of subsidies;-ownership: divisions in task-setting of Municipalities and Waterboards; divisions involved with cost-sharing;-inspection; operational control and maintenance; organisation of management;-discharge permits;-pollution levy;-sludge disposal. Final decisions and practical elaboration of policies towards on-site treatment will have to be formulated in a broad discussion with all the authorities and interest groups involved.

MODELING THE SOUTH ATLANTIC OCEAN FROM MEDIUM TO HIGH RESOLUTION

2014 ◽  
Vol 31 (2) ◽  
Author(s):  
Mariela Gabioux ◽  
Vladimir Santos da Costa ◽  
Joao Marcos Azevedo Correia de Souza ◽  
Bruna Faria de Oliveira ◽  
Afonso De Moraes Paiva
Keyword(s):  
High Resolution ◽  
Atlantic Ocean ◽  
Large Scale ◽  
South Atlantic ◽  
Surface Relaxation ◽  
The South ◽  
Small Surface ◽  
Basic Model ◽  
Basic Set ◽  
Set Up

Results of the basic model configuration of the REMO project, a Brazilian approach towards operational oceanography, are discussed. This configuration consists basically of a high-resolution eddy-resolving, 1/12 degree model for the Metarea V, nested in a medium-resolution eddy-permitting, 1/4 degree model of the Atlantic Ocean. These simulations performed with HYCOM model, aim for: a) creating a basic set-up for implementation of assimilation techniques leading to ocean prediction; b) the development of hydrodynamics bases for environmental studies; c) providing boundary conditions for regional domains with increased resolution. The 1/4 degree simulation was able to simulate realistic equatorial and south Atlantic large scale circulation, both the wind-driven and the thermohaline components. The high resolution simulation was able to generate mesoscale and represent well the variability pattern within the Metarea V domain. The BC mean transport values were well represented in the southwestern region (between Vitória-Trinidade sea mount and 29S), in contrast to higher latitudes (higher than 30S) where it was slightly underestimated. Important issues for the simulation of the South Atlantic with high resolution are discussed, like the ideal place for boundaries, improvements in the bathymetric representation and the control of bias SST, by the introducing of a small surface relaxation. In order to make a preliminary assessment of the model behavior when submitted to data assimilation, the Cooper & Haines (1996) method was used to extrapolate SSH anomalies fields to deeper layers every 7 days, with encouraging results.

scholarly journals Social Media in and Around a Temporary Large-Scale Refugee Shelter in the Netherlands

2021 ◽  
Vol 7 (2) ◽  
pp. 205630512110249
Author(s):  
Peer Smets ◽  
Younes Younes ◽  
Marinka Dohmen ◽  
Kees Boersma ◽  
Lenie Brouwer
Keyword(s):  
Social Media ◽  
The Netherlands ◽  
Crisis Communication ◽  
Asylum Seekers ◽  
Large Scale ◽  
State Policies ◽  
Refugee Crisis ◽  
Top Down ◽  
And Migration

During the 2015 refugee crisis in Europe, temporary refugee shelters arose in the Netherlands to shelter the large influx of asylum seekers. The largest shelter was located in the eastern part of the country. This shelter, where tents housed nearly 3,000 asylum seekers, was managed with a firm top-down approach. However, many residents of the shelter—mainly Syrians and Eritreans—developed horizontal relations with the local receiving society, using social media to establish contact and exchange services and goods. This case study shows how various types of crisis communication played a role and how the different worlds came together. Connectivity is discussed in relation to inclusion, based on resilient (non-)humanitarian approaches that link society with social media. Moreover, we argue that the refugee crisis can be better understood by looking through the lens of connectivity, practices, and migration infrastructure instead of focusing only on state policies.

Sign in / Sign up

Export Citation Format

Share Document