increasing collaboration in health services management and
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Red Cross Blood Bank Foundation Bonaire 251016
Increasing Collaboration in Health
Services Management and Delivery
in the Dutch-Caribbean
Prof. dr. A.J. Duits
Red Cross Blood Bank Foundation Bonaire 251016
NOBEL PRIZE LITERATURE 2016 24051941
1964
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
PROGRESSION FREE:
83.2% vs 60.1%
After 1 year
Red Cross Blood Bank Foundation Bonaire 251016
Zika Infection May Bring Future Immunity: Study
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016 Red Cross Blood Bank Foundation ISBT 050916
Approved by the Inspectorate of Health
01-02-2016: 800 platelet units pooled
(pools of 4).
• Curacao
• Aruba
• Sint Maarten
• Bonaire
Hemovigilance:
• No adverse effects reported
• Neonatal/UV treatment
• Pediatric Tx
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
Dutch Caribbean
Red Cross Blood Bank Foundation Bonaire 251016
BES
CAS
AFTER 10-10-2010
Red Cross Blood Bank Foundation Bonaire 251016
Aruba: 100.000
Sint Maarten: 40.000
Curacao: 150.000
Bonaire: 17.000
ZIEKENHUIS:
FACILITEREND
OFICINA’S
WETGEVING
HONORARIUM:
FEEFORSERVICE
ONDERNEMERSRISICO
HUISARTSEN
ZIEKENHUIS:
GMSB/WERKGEVER
OFICINA’S
WETGEVING+BIG
+DECLARATIEWET
HONORARIUM:
BUDGET
GEEN
ONDERNEMERSRISICO
PRIMAIREENSECUNDAIREARBEIDSVOORWAARDEN
WERKOMSTANDIGHEDENENINFRASTRUCTUUR
MEDISCHESPECIALISTEN
HNO
WET
FINAN
CIEN
FTE
AGE
WORK
GMN
CHV
VMSC
MS
SEHOS
SVB
CBV
PAT
USONA
V
B
H
C
V
B
H
C
ADVENT
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
Increasing Collaboration in Health
Services Management and Delivery
in the Dutch-Caribbean
Sounds of Success
Red Cross Blood Bank Foundation Bonaire 251016
RED CROSS BLOOD BANK FOUNDATION
DONORS: 100% VOLUNTARY NON-REMUNERATED
BLOOD PRODUCTS: 100% LEUKOREDUCED
IDT: SEROLOGY (HIV, HCV, HTLV, SYPH, HBV)
NAT (HIV,HCV,HBV) WNV
QUALITY: GMP (EU/AABB)
Red Cross Blood Bank Foundation Bonaire 251016
SUSTAINABLE SMALL SCALE BLOOD BANKS
COMPLYING WITH EU QUALITY NORMS
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
Dutch Caribbean labile blood provision
Red Cross Blood Bank Foundation Bonaire 251016
PAHO TRAINING GEORGETOWN GUYANA 19-21/09/2016
Red Cross Blood Bank Foundation Bonaire 251016
PREVENTION OF TRANSMISSION
Red Cross Blood Bank Foundation Bonaire 251016
CHARACTERISTICS OF HIV INFECTED POPULATION IN CURAÇAO
Red Cross Blood Bank Foundation Bonaire 251016
"The HIV-1 Epidemic Amongst Men Having Sex
With Men in the Netherlands is Dispersed
Amongst a Large Number of Self-sustaining and
Persistent Transmission Clusters: A Combined
Mathematical and Phylogenetic Study on
Observational Data" (PMEDICINE-
D-14-01427R3) by Daniela Bezemer, Ph.D.; Anne Cori; Oliver Ratmann; Ard van Sighem; Gonneke Hermanides; Bas E. Dutilh; Luuk Gras; Nuno
Rodrigues Faria; Rob van den Hengel; Ashley Duits; Peter Reiss; Frank de Wolf; Christophe Fraser
Accepted for publication
Red Cross Blood Bank Foundation Bonaire 251016
HIV:
• SHM (Netherlands)
• SRKB/SEHOS (Curacao)
• FMD (Bonaire)
Treating physicians/infectiologists:
- SXM/Aruba/Bonaire/Curacao
- DATA sharing!
- Training personnel
Red Cross Blood Bank Foundation Bonaire 251016
Neurosurgery (Aruba and Curacao)
Intensive care (Bonaire and Aruba)
NICU (Curacao, Bonaire and Aruba)
Oncology (Curacao, Bonaire, Sint Maarten)
Rheumatology (Curacao, Bonaire)
Infectious Diseases (Curacao, Aruba, Bonaire)
Public Health (Curacao, Bonaire)
Red Cross Blood Bank Foundation Bonaire 251016
GLOBAL HEALTH: LOCAL PUBLIC HEALTH
• DISEASES
• MULTI-CULTURAL SOCIETY
Red Cross Blood Bank Foundation Bonaire 251016
Infectious disease monitoring
Globalization has intensified cross-border health threats, leading to a situation of health interdependence — the
notion that no nation or organization is able to address
single-handedly the health threats it face but instead
must rely to some degree on others to mount an effective
response.
Red Cross Blood Bank Foundation Bonaire 251016
GP medical center/Surveillance center
INNOVATIVE EARLY WARNING SYSTEM
Red Cross Blood Bank Foundation Bonaire 251016
Education
• Residents
• Interns
• Nurses
• Medical
Specialists
• Medical
professionals
TEACHING HOSPITAL UMCG AFFILIATE
Curacao, Aruba,
Bonaire,
Sint Maarten
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
Increasing Collaboration in Health
Services Management and Delivery
in the Dutch-Caribbean
Under construction/design
Red Cross Blood Bank Foundation Bonaire 251016
HEALTHCARE SERVICES
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
CURAÇAO HEALTH CARE SYSTEM
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
BES
CAS
The Hague
Red Cross Blood Bank Foundation Bonaire 251016
BEFORE 10-10-2010:
• Healthcare: island
responsibility
AFTER 10-10-2010:
• CAS: Healthcare: island
responsibility
• BES: Healthcare: Holland responsibility
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
CARIBBEAN PERSPECTIVE
Red Cross Blood Bank Foundation Bonaire 251016
ESSENTIAL = TRUST
• OPEN COMMUNICATION
• SHARING RELEVANT DATA/INFORMATION
• SHARED VISION
• LESSONS LEARNED SUCCESSFULL COLLABORATIONS
Red Cross Blood Bank Foundation Bonaire 251016
Transport knowledge and skills
Not patients!
Redundancy and backup
Red Cross Blood Bank Foundation Bonaire 251016
Shared
infrastructure:
Volume, quality
and costs
• Dedicated
facilities
• Single Island
Hospital
location
EP
Red Cross Blood Bank Foundation Bonaire 251016
FACILITIES:
• Redundant • Cooperation in teams!
• Patient population
• Costs
• Volume
• Availability
CP
Red Cross Blood Bank Foundation Bonaire 251016
CP/EP
Red Cross Blood Bank Foundation Bonaire 251016
MYTHS DEBUNKED
Red Cross Blood Bank Foundation Bonaire 251016
Relationship between volume and quality in
healthcare
2012
Red Cross Blood Bank Foundation Bonaire 251016
Policy of collaborative efforts should focus on
quality optimization of organization and
delivery of healthcare and not focus
unilaterally on a so-called sufficient quantity of
patients
Increasing Collaboration in Health Services
Management and Delivery in the Dutch-Caribbean
For high-risk complicated surgical
interventions volume-quality rate influenced
by:
• surgical expertise
• Support by the hospital organization
• Multidisciplinary collaboration
Red Cross Blood Bank Foundation Bonaire 251016
Increasing Collaboration in Health Services
Management and Delivery in the Dutch-Caribbean
Other factors:
• Diagnostic and supporting service teams
• Staff composition
• Information system supporting pre- and postoperative processes
Other crucial factor:
* Obtaining and maintaining expertise of medical professionals
Red Cross Blood Bank Foundation Bonaire 251016
Volume-quality debate:
• Different evaluation criteria from different perspectives
• Society perspective
• Organizational perspective
• Professional’ perspective
• Patient’ perspective
Increasing Collaboration in Health Services
Management and Delivery in the Dutch-Caribbean
Red Cross Blood Bank Foundation Bonaire 251016
Society perspective:
- Volume initiatives contribute to quality, accessibility
and affordability healthcare
Organizational perspective:
- Efficient organization of healthcare, strategic
positioning, collaboration and competition
Professional perspective:
- Sufficient expertise
- Multidisciplinary collaboration
- Career development
Patient perspective:
- Individual results
- Freedom of choice
- Geographical accessible care
Increasing Collaboration in Health Services
Management and Delivery in the Dutch-Caribbean
LEAST DISCUSSED!
Red Cross Blood Bank Foundation Bonaire 251016
Increasing Collaboration in Health Services
Management and Delivery in the Dutch-Caribbean
Results: hernia, obstetrics, bariatric surgery, breast cancer and
hemophilia
*organizational and professional perspective
Red Cross Blood Bank Foundation Bonaire 251016
YOUR MONEY OR
YOUR LIFE
Red Cross Blood Bank Foundation Bonaire 251016
ZZ
MK
Red Cross Blood Bank Foundation Bonaire 251016
COLLABORATION IN HEALTH SERVICES
• SHARED RESPONSIBILITY • SHARED OPPORTUNITY
• SCIENTISTS/PROFESSIONALS/INSTITUTES
COLLABORATE
• GOVERNMENTS/ SHOULD FURTHER FACILITATE
(IMPROVEMENT)
4 perspectives:
• Society
• Organizational
• Professional
• Patient
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
HEALTHY LIFESTYLE: CURACAO & BONAIRE
INFECTIOUS DISEASES:
CURACAO & ARUBA
CLINICAL GENETICS:
CURACAO & ARUBA
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
Red Cross Blood Bank Foundation Bonaire 251016
EPO: 50x more expensive!
Red Cross Blood Bank Foundation Bonaire 251016
YOUR MONEY OR
YOUR LIFE
Red Cross Blood Bank Foundation Bonaire 251016
Increasing Collaboration in Health
Services Management and Delivery
in the Dutch-Caribbean
Prof. dr. A.J. Duits
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