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  1. Article ; Online: Use of business model potential in Dutch academic medical centres-A case study.

    Cardinaal, Ester M M / Truijens, Joey / Jeurissen, Patrick P T / Berden, Hubert

    PloS one

    2024  Volume 19, Issue 3, Page(s) e0297966

    Abstract: Academic Medical Centres (AMCs) are large organisations with a complex structure due to various intertwined missions and (public) roles that can be conflicting. This complexity makes it difficult to adapt to changing circumstances. The literature points ... ...

    Abstract Academic Medical Centres (AMCs) are large organisations with a complex structure due to various intertwined missions and (public) roles that can be conflicting. This complexity makes it difficult to adapt to changing circumstances. The literature points to the use of business models to address such challenges. A business model describes the resources, processes, and cost assumptions that an organisation makes in order to the delivery of a unique value proposition to a customer/patient. Do AMC business operations managers actually use business models to address challenges and operate in a way that enables AMCs to adapt to changing circumstances? This study explored whether the use of a business model is a starting point for bringing about change in AMC operations. A case study design was considered appropriate to explore the knowledge and experience of business models among business operations managers of Dutch AMCs. Through purposive sampling, participants were invited to participate in a questionnaire to provide in-depth and detailed information about the use of business models in AMCs. Our research showed that a business model can support the complex organisation of an AMC, but the design and use of business models varies. In general, respondents attribute more potential to the use of a business model than they experience in daily practice. The majority consider a business model to be suitable for bringing about change, but see it only sparingly used in their own AMC. This is the first study to provide some initial insights into the use of business models in Dutch AMCs. We can assume that improvements are possible in order to optimise the change potential of business models in AMCs worldwide. In order to successfully implement an innovative business model, the interpretation of the concept of a business model and the creation of a framework of preconditions should be taken into account. Healthcare providers, policy makers or researchers should explicitly identify the environment in which the model will operate. In particular, by identifying the level of readiness for change readiness at all levels of the organisation.
    MeSH term(s) Humans ; Academic Medical Centers ; Commerce ; Ethnicity ; Health Personnel
    Language English
    Publishing date 2024-03-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0297966
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Academic medical centres in the Netherlands: muddling through or radical change?

    Cardinaal, Ester M M / Tjan, Martijn J H / Jeurissen, Patrick P T / Berden, Hubert

    Frontiers in public health

    2024  Volume 11, Page(s) 1252977

    Abstract: Introduction: Academic medical centres (AMCs) are designed to perform multiple tasks within a single organisation. This institutional complexity gives rise to intricate governance challenges and promotes incrementalism and muddling.: Method: In this ... ...

    Abstract Introduction: Academic medical centres (AMCs) are designed to perform multiple tasks within a single organisation. This institutional complexity gives rise to intricate governance challenges and promotes incrementalism and muddling.
    Method: In this study, we hypothesised that radical change could provide a solution to the current incrementalism and we explored the conditions under which such changes could or could not be achieved.
    Results: We conducted unstructured interviews with various high-level stakeholders and identified issues that negatively affected the governance of Dutch AMCs, which include: 1) negative undercurrents and unspoken issues due to conflicts of interests, 2) organisational complexity due to relationships with a university and academic medical specialists, 3) lack of sufficient government direction, 4) competition between AMCs due to perverse systemic incentives, 5) different interests, focus, and organisational culture, 6) concentration of care, which does not always lead to enhanced quality and efficiency as the provision of less complex care is of utmost importance for education and research, 7) the infeasibility of public and regional functions of an AMC, 8) the inefficiency of managing three core tasks within the same organisation and, 9) healthcare market regulation.
    Discussion: Our hypothesis that radical change offers a solution to the current incrementalism in AMCs could not be adequately explored. Indeed, our exploration of the conditions under which radical change could potentially take place revealed that there are factors currently at play that make a substantive conversation between stakeholders about radical change difficult, if not impossible. The results also show that the government is in a position to take the lead and create conditions that foster mutual trust and common interests among AMCs, as well as between AMCs and other hospitals.
    MeSH term(s) Humans ; Netherlands ; Academic Medical Centers ; Hospitals
    Language English
    Publishing date 2024-01-04
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2023.1252977
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Passende zorg vereist passende sturing.

    Taminiau, Elsbeth F / Vrijhoeven, J E W / Berden, H J J M

    Nederlands tijdschrift voor geneeskunde

    2023  Volume 167

    Abstract: The accessibility and affordability of good quality health care is increasingly under pressure. 'Passende zorg' may support health care organisations and care providers in achieving the much needed transformation in health care. For 'Passende zorg' to be ...

    Title translation Low-value care requires adequate financial constraints: preconditions to render low-value care as an effective instrument in health care transformation.
    Abstract The accessibility and affordability of good quality health care is increasingly under pressure. 'Passende zorg' may support health care organisations and care providers in achieving the much needed transformation in health care. For 'Passende zorg' to be an effective instrument, adequate financial conditions are a prerequisite. In this paper, we point at the importance of firm embedding of 'Passende zorg' in a hospital's business operations to yield effect.
    MeSH term(s) Humans ; Low-Value Care ; Commerce ; Quality of Health Care
    Language Dutch
    Publishing date 2023-11-28
    Publishing country Netherlands
    Document type English Abstract ; Journal Article
    ZDB-ID 82073-8
    ISSN 1876-8784 ; 0028-2162
    ISSN (online) 1876-8784
    ISSN 0028-2162
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Van voldoen aan volumenormen naar leren van zorguitkomsten.

    Mesman, Roos / Berden, H J J M / Westert, Gert P

    Nederlands tijdschrift voor geneeskunde

    2022  Volume 166

    Abstract: The authors provide an update of an article about volume standards that was published in this journal in 2013. A systematic literature review uncovered trends in volume-outcomes research (2014-2021): studies focused on outcomes after concentration of ... ...

    Title translation From compliance with volume standards to learning from healthcare outcomes.
    Abstract The authors provide an update of an article about volume standards that was published in this journal in 2013. A systematic literature review uncovered trends in volume-outcomes research (2014-2021): studies focused on outcomes after concentration of care in the Netherlands, attempted to define volume thresholds and assessed whether experience in a specific operation can influence outcomes in similar procedures. Available research still does not shed much light on the mechanisms underlying the volume-outcome relationship. Nevertheless, professional associations look beyond volume and include multiple indicators of quality of care in their national quality standards. Professionals have also increasingly collaborated in regional networks where they share, compare and learn from outcomes. Three preconditions to enhance these efforts in "learning networks" are: the availability of reliable information about treatments and outcomes, adequate knowledge and support in selecting meaningful interventions, and lastly, an ambitious, collective goal which garners support from financiers and government bodies.
    MeSH term(s) Delivery of Health Care ; Humans ; Netherlands ; Outcome Assessment, Health Care
    Language Dutch
    Publishing date 2022-06-09
    Publishing country Netherlands
    Document type Journal Article ; Systematic Review
    ZDB-ID 82073-8
    ISSN 1876-8784 ; 0028-2162
    ISSN (online) 1876-8784
    ISSN 0028-2162
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: De zorgplannen van Rutte IV.

    Berden, H Bart J J M / Westert, Gert P / Jeurissen, Patrick P T

    Nederlands tijdschrift voor geneeskunde

    2022  Volume 166

    Abstract: The Rutte IV administration can and will spend much less on healthcare than its predecessor. A difficult task. Providing less low-value care, that is healthcare with no or little benefit for the patient given the alternatives, by physicians is one way to ...

    Title translation Plans of the Rutte IV administration: more control by the government, less personnel, lower budget.
    Abstract The Rutte IV administration can and will spend much less on healthcare than its predecessor. A difficult task. Providing less low-value care, that is healthcare with no or little benefit for the patient given the alternatives, by physicians is one way to improve quality and reduce costs. Less low-value care will therefore play a crucial role in the plans of the Rutte IV administration. Low-value care is attractive on paper, but radical implementation will lead to new dilemmas. The government must therefore be prepared to make and manage more choices itself. Besides tension on professional autonomy, there is also the risk of (even) more administrative burdens for healthcare professionals, which has a bad effect on captivating and retaining healthcare professionals. How to keep the intrinsic motivation of professionals intact within the paradigm of appropriate care could well become the real dilemma for the new administration of Mark Rutte.
    MeSH term(s) Budgets ; Delivery of Health Care ; Government ; Health Personnel ; Humans ; Physicians
    Language Dutch
    Publishing date 2022-04-14
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 82073-8
    ISSN 1876-8784 ; 0028-2162
    ISSN (online) 1876-8784
    ISSN 0028-2162
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Reimbursement of care does not equal the distribution of hospital resources: an explorative case study on a missing link among Dutch hospitals.

    van Leeuwen, L V L / Mesman, R / Berden, H J J M / Jeurissen, P P T

    BMC health services research

    2023  Volume 23, Issue 1, Page(s) 1007

    Abstract: Background: Affordability and accessibility of hospital care are under pressure. Research on hospital care financing focuses primarily on incentives in the financial system outside the hospital. It is notable that little is known about (incentives in) ... ...

    Abstract Background: Affordability and accessibility of hospital care are under pressure. Research on hospital care financing focuses primarily on incentives in the financial system outside the hospital. It is notable that little is known about (incentives in) internal funding in hospitals. Therefore, our study focuses on the budget allocation in hospitals: the distribution model. Based on our hypothesis that the reimbursement and distribution models in hospitals might interact, we gain knowledge about-, and insight into, the interaction of different reimbursement and distribution models used in Dutch hospitals, and how they affect the financial output of hospital care.
    Methods: An online survey with 22 questions was conducted among financial senior management as an expert group in 49 Dutch hospitals.
    Results: Ultimately, 38 of 49 approached experts fully completed the survey, which amounts to 78% of the hospitals we approached and 60% of all Dutch hospitals. The results on the reimbursement model indicate price * volume with adjusted prices above a maximum cap as the most common dominant contract type. On the internal distribution model, 75-80% of the experts reported incremental budgeting as the dominant budgeting method. Results on the interaction between the reimbursement and the distribution model show that both general and specific changes in contract agreements are only partially incorporated in hospital budgets. In 28 out of 31 hospitals with self-employed medical specialists, a relation is reported between the reimbursement model and the contracts with the Medical Consultant Group(s) in which the medical specialists are united.
    Conclusions: Our results in Dutch setting indicate a limited interaction between the reimbursement model and the distribution model. This lack of congruence between both models might limit the desired effects of incentives in contractual agreements aimed at the financial output. This applies to different reimbursement and distribution models. Further research into the various interactions and incentives, as visualized in our conceptual framework, could result in evidence-based advice for achieving affordable and accessible hospital care.
    MeSH term(s) Humans ; Budgets ; Consultants ; Ethnicity ; Hospitals ; Knowledge
    Language English
    Publishing date 2023-09-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-023-09649-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Academic medical centres in the Netherlands

    Ester M. M. Cardinaal / Martijn J. H. Tjan / Patrick P. T. Jeurissen / Hubert Berden

    Frontiers in Public Health, Vol

    muddling through or radical change?

    2024  Volume 11

    Abstract: IntroductionAcademic medical centres (AMCs) are designed to perform multiple tasks within a single organisation. This institutional complexity gives rise to intricate governance challenges and promotes incrementalism and muddling.MethodIn this study, we ... ...

    Abstract IntroductionAcademic medical centres (AMCs) are designed to perform multiple tasks within a single organisation. This institutional complexity gives rise to intricate governance challenges and promotes incrementalism and muddling.MethodIn this study, we hypothesised that radical change could provide a solution to the current incrementalism and we explored the conditions under which such changes could or could not be achieved.ResultsWe conducted unstructured interviews with various high-level stakeholders and identified issues that negatively affected the governance of Dutch AMCs, which include: 1) negative undercurrents and unspoken issues due to conflicts of interests, 2) organisational complexity due to relationships with a university and academic medical specialists, 3) lack of sufficient government direction, 4) competition between AMCs due to perverse systemic incentives, 5) different interests, focus, and organisational culture, 6) concentration of care, which does not always lead to enhanced quality and efficiency as the provision of less complex care is of utmost importance for education and research, 7) the infeasibility of public and regional functions of an AMC, 8) the inefficiency of managing three core tasks within the same organisation and, 9) healthcare market regulation.DiscussionOur hypothesis that radical change offers a solution to the current incrementalism in AMCs could not be adequately explored. Indeed, our exploration of the conditions under which radical change could potentially take place revealed that there are factors currently at play that make a substantive conversation between stakeholders about radical change difficult, if not impossible. The results also show that the government is in a position to take the lead and create conditions that foster mutual trust and common interests among AMCs, as well as between AMCs and other hospitals.
    Keywords academic medical centre ; organisation ; institutional complexity ; radical change ; governance ; incrementalism ; Public aspects of medicine ; RA1-1270
    Subject code 320
    Language English
    Publishing date 2024-01-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: An

    Houthuijs, Kas J / Berden, Giel / Engelke, Udo F H / Gautam, Vasuk / Wishart, David S / Wevers, Ron A / Martens, Jonathan / Oomens, Jos

    Analytical chemistry

    2023  Volume 95, Issue 23, Page(s) 8998–9005

    Abstract: Infrared ion spectroscopy (IRIS) continues to see increasing use as an analytical tool for small-molecule identification in conjunction with mass spectrometry (MS). The IR spectrum of ... ...

    Abstract Infrared ion spectroscopy (IRIS) continues to see increasing use as an analytical tool for small-molecule identification in conjunction with mass spectrometry (MS). The IR spectrum of an
    MeSH term(s) Humans ; Metabolomics/methods ; Mass Spectrometry/methods ; Metabolome ; Gene Library ; Ions
    Chemical Substances Ions
    Language English
    Publishing date 2023-06-01
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1508-8
    ISSN 1520-6882 ; 0003-2700
    ISSN (online) 1520-6882
    ISSN 0003-2700
    DOI 10.1021/acs.analchem.3c01078
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Characterization of elusive rhamnosyl dioxanium ions and their application in complex oligosaccharide synthesis.

    Moons, Peter H / Ter Braak, Floor / de Kleijne, Frank F J / Bijleveld, Bart / Corver, Sybren J R / Houthuijs, Kas J / Almizori, Hero R / Berden, Giel / Martens, Jonathan / Oomens, Jos / White, Paul B / Boltje, Thomas J

    Nature communications

    2024  Volume 15, Issue 1, Page(s) 2257

    Abstract: Attaining complete anomeric control is still one of the biggest challenges in carbohydrate chemistry. Glycosyl cations such as oxocarbenium and dioxanium ions are key intermediates of glycosylation reactions. Characterizing these highly-reactive ... ...

    Abstract Attaining complete anomeric control is still one of the biggest challenges in carbohydrate chemistry. Glycosyl cations such as oxocarbenium and dioxanium ions are key intermediates of glycosylation reactions. Characterizing these highly-reactive intermediates and understanding their glycosylation mechanisms are essential to the stereoselective synthesis of complex carbohydrates. Although C-2 acyl neighbouring-group participation has been well-studied, the reactive intermediates in more remote participation remain elusive and are challenging to study. Herein, we report a workflow that is utilized to characterize rhamnosyl 1,3-bridged dioxanium ions derived from C-3 p-anisoyl esterified donors. First, we use a combination of quantum-chemical calculations and infrared ion spectroscopy to determine the structure of the cationic glycosylation intermediate in the gas-phase. In addition, we establish the structure and exchange kinetics of highly-reactive, low-abundance species in the solution-phase using chemical exchange saturation transfer, exchange spectroscopy, correlation spectroscopy, heteronuclear single-quantum correlation, and heteronuclear multiple-bond correlation nuclear magnetic resonance spectroscopy. Finally, we apply C-3 acyl neighbouring-group participation to the synthesis of complex bacterial oligosaccharides. This combined approach of finding answers to fundamental physical-chemical questions and their application in organic synthesis provides a robust basis for elucidating highly-reactive intermediates in glycosylation reactions.
    Language English
    Publishing date 2024-03-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-024-46522-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Anomeric Triflates versus Dioxanium Ions: Different Product-Forming Intermediates from 3-Acyl Benzylidene Mannosyl and Glucosyl Donors.

    Remmerswaal, Wouter A / Elferink, Hidde / Houthuijs, Kas J / Hansen, Thomas / Ter Braak, Floor / Berden, Giel / van der Vorm, Stefan / Martens, Jonathan / Oomens, Jos / van der Marel, Gijsbert A / Boltje, Thomas J / Codée, Jeroen D C

    The Journal of organic chemistry

    2024  Volume 89, Issue 3, Page(s) 1618–1625

    Abstract: Minimal structural differences in the structure of glycosyl donors can have a tremendous impact on their reactivity and the stereochemical outcome of their glycosylation reactions. Here, we used a combination of systematic glycosylation reactions, the ... ...

    Abstract Minimal structural differences in the structure of glycosyl donors can have a tremendous impact on their reactivity and the stereochemical outcome of their glycosylation reactions. Here, we used a combination of systematic glycosylation reactions, the characterization of potential reactive intermediates, and in-depth computational studies to study the disparate behavior of glycosylation systems involving benzylidene glucosyl and mannosyl donors. While these systems have been studied extensively, no satisfactory explanations are available for the differences observed between the 3-
    Language English
    Publishing date 2024-01-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 123490-0
    ISSN 1520-6904 ; 0022-3263
    ISSN (online) 1520-6904
    ISSN 0022-3263
    DOI 10.1021/acs.joc.3c02262
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