A patient-centred healthcare network for orthopaedic hand and wrist care

Abstract

This thesis is initiated by the Reinier Haga Orthopaedic Centre (RHOC) and shows the creation of a patient-centred healthcare network for orthopaedic hand and wrist care. A healthcare network can be defined as a group of interconnected stakeholders that directly or indirectly influence the patient’s care. In this project, the involved stakeholders are people undergoing treatment for their hand and wrist and healthcare providers from seven disciplines; orthopaedic surgeons, hand therapists, general practitioners, plaster technicians, orthopaedic instrument makers, rheumatologists and rehabilitation physicians. A literature review and a user research study sketch the context and underlying problem. The context is shaped by ongoing developments that cause an increase in the care demand, an increase in healthcare costs, empowered patients and digitalisation. This asks for care that is efficient and gives patients more control. Currently, both are lacking in orthopaedic hand and wrist care. The user research, which consists of interviews with the stakeholders, shows that patients are not feeling involved, and inefficient guidelines and lack of cooperation prevent an efficient treatment process. The hand and wrist is a speciality within the medical field of orthopaedics. It entails a wide range of care disciplines that could benefit a well-connected network, which is currently missing. This prevents effective cooperation, which research showed would lead to more efficient and improved care, fewer treatment sessions and a reduction in costs (Ypinga, 2018). The developed design aims to create more involvement of the stakeholders in the orthopaedic hand and wrist care and active participation of the patient. This design is developed through ideation using the “How-Tos” method, which resulted in three ideas that three healthcare providers reviewed. This approach gave insight into the aspects that were perceived as most relevant by them. These were: an overview of the whole treatment, which helps in contacting other healthcare providers, holistic treatment and patient involvement. In addition, allowing patients to set a goal for their treatment allows for more control and better treatment. With this input, the concept of WegWijs is developed and evaluated with patients. WegWijs means to be wise, informed and in control in healthcare. It provides all the stakeholders with the knowledge needed to create a holistic and patient-centred care process by providing an overview of the treatment process and the involved parties. The patient actively shapes their treatment by formulating a treatment goal and cocreating their treatment plan with the doctor. The care providers remain actively involved throughout the process and in close contact with each other, creating a well-connected healthcare network. Two patients and two healthcare providers validated these aspects. The established implementation strategy outlines the required steps that include the co-creation of new protocols and the execution of a pilot. However, further research is needed to develop this concept and implement it in the RHOC, and eventually in the wider healthcare system.