Student presentations Medical Delta Living Lab Better In Better Out: many opportunities to get patients fitter in treatment process

Going into surgery fit increases the chances of success and recovery. Ideally, this means that patients get plenty of exercise and eat healthy in the weeks leading up to their treatment. But how do you ensure that people who do not naturally do this follow this advice? Students from the Medical Delta Living Lab Better In Better Out investigated the possibilities. Last week they presented their findings at the Haaglanden Medical Centre in Leidschendam.

The students who conducted this research come from The Hague University of Applied Sciences, Leiden University of Applied Sciences, Rotterdam University of Applied Sciences and the Hotelschool The Hague. Because of the diverse backgrounds, including nursing, physiotherapy, nutrition and dietetics, sports management and hotel school, different perspectives were used.

Five-star experience

When leaving a hotel, the staff does its utmost to ensure a pleasant last contact. This determines to a large extent the feeling with which the customer leaves them and, not unimportantly, how the hotel is assessed. Why is this different for a hospital visit? Students at the hotel school concluded that empathy, involvement and the generation of trust should be higher on the agenda for discharge interviews in healthcare.
A more personal approach appears necessary so that information is tailored to the patient's needs - some need more information than others - and the patient is better involved in the moment of discharge. Trust in healthcare personnel also appears to be an area of concern. For example, the timing of discharge is sometimes determined by the fact that a bed is needed for another patient. "One patient told me that the care staff discussed this in the hallway. A few minutes later, the 'good news' came that the patient could leave the hospital," one of the students explained. "This kind of discussion does not give the patient a nice feeling at discharge." The five-star experience, which receives a lot of attention in hospitality, would therefore also have a lot of added value at discharge from the hospital.

Exercises could be more challenging, also for the elderly'

The patient himself is often passed over in determining the care path for recovery. This is one of the findings presented by physiotherapy students from Rotterdam University of Applied Sciences. They also told about their research from the Medical Delta Living Lab. This research is still at the beginning. The students presented their proposal for mapping the patient's experience during treatment. When defining the care pathway, the patient is considered from all angles to ensure optimal treatment, but the involvement of the patient is often low. As a result, specialists are often very enthusiastic about the treatment, but the patient himself is not. "I was talking to a patient I was treating to get fitter going into treatment. When I asked for her opinion, I was told that she found the exercises a bit patronizing," one physical therapist told me. "So exercises could be quite a bit more challenging, more in game form, even if the patient is a bit older."

Do's and don'ts when following lifestyle advice

Another research project from the Medical Delta Living Lab highlighted the bottlenecks in following lifestyle advice in colorectal cancer. Nursing students from The Hague University of Applied Sciences collected do's and don'ts from colorectal cancer patients and came up with three recommendations:

• Personalized advice; for example, patients receive advice without understanding the rationale behind it and they are often not given concrete alternatives, for example if it was advised not to eat red meat anymore.
• Better communication; the desired amount and type of information differs per patient. According to the students, this is often assessed on the spot by the care staff and the patient is insufficiently involved.
• More guidance on following advice. Bowel cancer patients benefit greatly from support from their immediate environment. In addition, better guidance after discharge can help to better follow advice. Wearables can help with this.

The student projects show that there is still a lot to gain when it comes to getting people who are entering treatment fitter. "Also in the coming academic year, several students will work on this," says Joost van der Sijp, Lecturer in Oncological Care and Living Lab Leader of Medical Delta Living Lab Better In Better Out. "Not only is it instructive for the students to work together with other disciplines, the research projects also provide very concrete solutions that healthcare professionals can work with."