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Outcomes and costs in specialized burn care:Adapting the Quality Cost Indicator (QCI) model for burn care
No full textThe Quality Cost Indicator (QCI) model supports value-based health care at the institutional level, by calculating disease-specific health outcomes per unit cost over time. The aim of this study was to adapt the QCI model for specialized burn care (the BC-QCI model) and explore its utilization using real-world data. Burn care outcome indicators were selected through an iterative process with multiple stakeholders. Threshold values were established per outcome indicator and average total healthcare costs were calculated. A cohort of adult burn patients (n = 1449) admitted for at least one day and/or had undergone surgery in Dutch burn centers between 2020 and 2023 was used, with a follow-up period of 12 months. The proportion of patients who achieved textbook outcome (i.e., having achieved all the outcome indicators), the average total costs per patient, and QCI values were calculated. Of all patients, 54% achieved all five outcome indicators (i.e., length of stay, wound infections, other complications, discharge destination, and predicted mortality). The most successful outcome indicator was 'predicted mortality' (passed by 99% of the population), the least successful outcome indicator was 'length of stay' (62%). The patients who failed to achieve one or more outcome indicators (46%) had significantly higher average total costs compared to the patients who achieved textbook outcome (54%) (€50,134 [€47,810-€52,850] vs. €11,721 [€11,096-€12,429]). The BC-QCI model is a solid foundation to provide insights into the outcomes and costs for specialized burn care at the institutional level.</p
A meaningful and vibrant work environment
Get PDFBackground and aim. Research highlights that poor workspace variety, poor zoning, and limited personalization can reduce comfort, privacy, and focus in hybrid environments. This study aims to anticipate these challenges and to develop and evaluate participatory design interventions for user-centred, efficient workplaces.Methods and data. This study adopted qualitative techniques, and was structured around a case study at an office in the Netherlands. The work environment was studied through needs assessments with interviews. Design interventions were subsequently explored in participatory focus groups, utilizing 3D scale models and 2D visualizations to facilitate collaborative input. Finally, these interventions were evaluated with end-users to determine their effectiveness in enhancing the hybrid work environment, focusing on comfort, functionality, and engagement.Results. The study revealed a lack in workplace diversity which compromised comfort and privacy. Additionally, the absence of clear zoning disrupted focused work and reduced workplace efficiency. There was also a lack of elements that foster personalization, identity, and positive experience, making the work environment less inviting and less inspiring for employees.Originality. By presenting solutions in direct interaction with users, valuable insights for facility management (FM) were gained into the supposed effectiveness of interventions in office design, organizational needs, and individual preferences.Practical implications. The use of 3D scale models and 2D visualizations can help FM to enhance the integration of organizational needs and user experiences, while simultaneously fostering employee engagement and a sense of ownership.<br/