'Together delivering the right care at the right place'- Nienke Huijbregts

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Nienke Huijbregts, manager Trauma Centre South-West of the Netherlands (incl Mobile Medical Team) gives an insight into how regionally cooperation in acute care is organised and what the influence of COVID-19 is.

Nienke is one of the speakers at the international Linnean webcast 'High Value Care and Corona: Uncertainty as the New Normal on October 28th. Register for the webcast here


The Health Care Coalition for Acute Care (in Dutch: ROAZ) – all ROAZ's together form the national acute care coalition – is committed to achieving and ensuring better cooperation in acute care in a regional context. Within the Executive Board, all healthcare providers of the network are represented: gp posts, general practitioners day care, ambulance services, hospitals, mental health institutions and nursing and nursing homes. Together they discuss integral issues.

What are you doing right now?

At the moment I arrange the consultations on COVID healthcare, such as administrative consultations; ROAZ's executive board and consultation with all hospital directors. In addition, team members consult with the tactical layer of all chain partners in the different sub-regions. We discuss how we can deliver COVID care and that this does not come at the expense of regular care. I am ultimately responsible for the staff office; we are currently working on 15 projects on chain alignment. As an example: we make a dashboard on the chain of acute care around Covid-19 such as the number of infections, the number of ambulance journeys related to Covid, the number of consultations at the gp posts, the number of hospital admissions and the number of infections in the care sector In addition, we are concerned with spreading COVID patients (sufficient bed capacity) through the National Coordination Centre Patients Distribution and the continuous monitoring of personal protective equipment (PPE). In addition, we have our regular activities, such as maintaining different networks, the trauma registration and the helicopter Emergency Medical Services (HEMS). COVID activities currently require 90% of my time.

How do you view value-based healthcare?

If you want to deliver value-based healthcare, you need to investigate what the patient wants, so that you can deliver tailored care. As a manager in acute care, I am less concerned at the patient level. We are looking at systemic issues at regional and national level. We puzzle out how to keep the system running organizationally and technically. This can mean that a patient is transported to Groningen. What this means for patients is determined by doctors. It is interesting to find out how we can involve the patient at the organizational level.

Do you have an inspiring example/ person?

How Diederik Gommers, IC-doctor and president of the Dutch Association for Intensive Care (NVIC), deals openly with all stakeholders, with politics, society and own supporters, I find very inspiring. To listen from your own expertise and to reach out to another. For example, he has turned Famke Louise's resistance into a joint campaign that will help to reach the younger population. A great example of how as you embrace your enemies, you move forward together.

What's your mission?

My mission is to provide the right care at the right place and, as far as I am concerned, the best healthcare for the patient. In COVID time, we take stock of COVID and non-COVID care. By making these trade-offs together on the right table, we can work together towards a better care system.

Do you have any tips?

Work well with your chain partners in times of crisis. It helps if you already know each other before the crisis. If you need to build a network, it will take you at least a month. In addition, the chair of the meetings must be the oil between all organizations. This can only be achieved if the chair puts the importance of the region first rather than the importance of his own organisation.

What do you think the future of care looks like?

The future of acute care will become more integral. GPs and hospitals will focus more on 1 1/2 line care. In addition, a further concentration will take place for high-complex care. This does raise issues of how you can continue to provide quality care in rural areas. Involving citizens and patients in this discussion is necessary.


Nienke Huijbregts| Manager Trauma Center Southwest Netherlands & Mobile Medical Team (MMT)| n.huijbregts@erasmusmc.nl

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