The fitter you are when undergoing surgery, the higher your chances of success and recovery. Ideally, this means that patients should exercise a lot and follow a healthy diet in the weeks leading up to their treatment. But how do you get people who don't naturally do this to follow this advice? Students from the Medical Delta Living Lab Better In Better Out researched the options. Last July, they presented their findings at the Haaglanden Medical Centre in Leidschendam.
The research was conducted by students from The Hague University of Applied Sciences, Leiden University of Applied Sciences, Rotterdam University of Applied Sciences and The Hague Hotel Management School. With a diversity of backgrounds, including nursing, physiotherapy, nutrition and dietetics, sports management and the hotel school, a variety of perspectives were used.
When a guest leaves a hotel, the staff will do their best to ensure they leave feeling happy. This determines to a large extent the way in which the client feels when they leave and, also important, how they rate the hotel. Why would this be any different when visiting a hospital? Students at the hotel school concluded that empathy, commitment and building trust should be higher priorities in discharge meetings in healthcare.
A more personalised approach is needed so that information is adapted to the patient's needs - some people need more information than others - and to better involve the patient at the time of their discharge. Trust in care staff also seems to be an issue. For example, the time of discharge is sometimes determined by the need for a bed for another patient.
“A patient told me that the care staff discussed this in the hallway. A few minutes later, the ‘good news’ was delivered that the patient was allowed to leave the hospital”, says a student. “This kind of talk does not give the patient a good impression when they are discharged. The five-star experience, which receives a great deal of attention in the hospitality industry, would therefore also have great added value during discharge from a hospital”.
Exercises could be more challenging, including for elders
The patient is often overlooked when determining the care pathway to recovery. This is one of the findings presented by physiotherapy students at Rotterdam University of Applied Sciences. They also 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 patient involvement is often low. As a result, specialists are often very enthusiastic about the treatment, but the actual patient is not. “I was talking to a patient I was treating to encourage her to become fitter for treatment. When I asked for her opinion, I was told that she found the exercises a bit patronising”, a physiotherapist told me. “Exercises could be more challenging, more game-like, even if the patient is older”.
Do's and don'ts for following lifestyle advice
Another research project from the Medical Delta Living Lab highlighted the bottlenecks in following lifestyle advice for bowel cancer. Nursing students from The Hague University of Applied Sciences collected do's and don'ts from colon cancer patients and came up with three recommendations:
- Personalised advice; for example, patients are given advice without understanding the rationale behind it and they are often not given specific alternatives, for example, if they were advised not to eat red meat
- Better communication; the desired amount and type of information differs from patient to patient. According to the students, this is often assessed on the spot by the care staff and the patient is not sufficiently involved.
- More guidance on following advice. Bowel cancer patients benefit greatly from support from their immediate environment. In addition, better post-discharge counselling can help to better follow advice. Wearables can help.
The student projects demonstrate that there is still plenty to gain when it comes to making people fitter before treatment. “In the coming academic year, several students will also be working on this”, explains Joost van der Sijp, Lecturer in Oncological Care and Living Lab Leader of Medical Delta Living Lab Better In Better Out. “It's not only educational for the students to work together with other disciplines, the research projects also provide very specific solutions that healthcare professionals can use.