Project 7: Human-Centered Networked Care in Hand-Wrist Orthopedics 

Recruiting organisation: Department of Public and Occupational Health at the Amsterdam University Medical Center, the Netherlands

Supervisors: Prof. Martine de Bruijne, Dr. Marijke Melles, Dr. Hanneke Merten, Dr. Gerard Kraan

Doctoral Candidate: Yutian (Tony) Sun

Secondments:  Reinier de Graaf HAGA Orthopedic Center in Delft, NL (3 months & 2 months); University of Applied Sciences and Arts Northwestern Switzerland (3 months); Department of Applied Ergonomics and Design, Faculty of Industrial Design Engineering, Delft University of Technology (3 months)

Summary

This PhD project aims to investigate communication and collaboration needs between hand-wrist orthopedic patients and healthcare providers. By leveraging Networked Care solutions, the research seeks to enhance patient involvement and interprofessional collaboration, ultimately optimizing treatment outcomes. The project will: 

  1. Identify the communication and collaboration needs of hand-wrist orthopedic patients during their care process. 
  1. Understand the needs and challenges faced by healthcare providers in treating patients and collaborating across teams. 
  1. Develop networked care solutions to improve communication and collaboration between patients and healthcare providers. 
  1. Evaluate the usability and effectiveness of the proposed solutions through prototyping and user testing. 

Background

Network thinking is gaining prominence in healthcare, with increasing recognition that collaboration and integration among care providers are essential in responding to the growing demands on healthcare services. In Europe and North America, integrated care has been a key policy priority across successive governments and global organizations such as the World Health Organization (WHO). 

Defining Integrated and Networked Care 

Networked Care is a healthcare delivery model that emphasizes collaboration and communication among various care providers, organizations, and patients to improve health outcomes. Unlike traditional care models that focus on optimizing efficiency within individual medical disciplines, Networked Care fosters coordinated, patient-centered approaches that span multiple settings. Digital technologies, including social media and dedicated applications, can enhance patient engagement and streamline communication among healthcare providers. 

Challenges in Hand-Wrist Orthopedic Care 

Hand and wrist injuries are prevalent in Dutch general practitioners’ offices and emergency departments, with many cases managed non-surgically and involving both clinical and psychosocial aspects. Common injuries include fractures, sprains, tendonitis, and trigger fingers. Previous research has highlighted several challenges for orthopedic patients and healthcare providers, including: 

  1. Misaligned Expectations and Lack of Awareness: Patients often have unrealistic expectations about surgical outcomes, leading to dissatisfaction and stress. Many patients are unaware of non-surgical treatment options, such as cognitive-behavioral therapy (CBT), due to poor accessibility and communication. 
  1. Complex Medical Information: Patients struggle to understand medical terminology and procedures, affecting their decision-making and overall satisfaction. 
  1. Lack of Personalized Care: A generic approach to patient care fails to consider individual characteristics, leading to less effective treatment and lower patient satisfaction. 
  1. Continuous Rehabilitation Support: There is insufficient communication between the surgical team, rehabilitation specialists, and primary care providers, impacting postoperative recovery. Healthcare providers also face challenges such as high workloads, limited consultation time, and inadequate ongoing communication with other caregivers. 

Approach

The research will be conducted through four interconnected studies using qualitative and design research methodologies. The first study will explore patient experiences, needs, and barriers through semi-structured interviews, observations, stakeholder mapping, and patient journey mapping. The second study will examine the work environment of healthcare providers, identifying challenges in patient treatment and interdisciplinary collaboration using service blueprints and design principles. The third study will co-design and prototype networked care solutions, involving both patients and providers to refine concepts through focus groups and feedback sessions. Finally, the fourth study will evaluate the usability and effectiveness of the developed solutions through user testing, contextual interviews, and heuristic evaluations. These studies will collectively contribute to the development of an evidence-based framework and practical tools for implementing networked care in hand-wrist orthopedics. 

Our research team

The Doctoral Candidate joined the Department of Public and Occupational Health at the Amsterdam University Medical Center and will collaborate closely with the Department of Human-Centered Design of the Faculty of Industrial Design Engineering at Delft University of Technology.

The Doctoral Candidate will complete four secondments during the studies. In the first year, a three month secondment at the Reinier de Graaf HAGA Orthopedic Center in Zoetermeer (NL) to gain insight in orthopedic care and opportunities for orthopaedic networked care. Next, at the end of the second year, a three month secondment follows at University of Applied Sciences and Arts Northwestern in Switzerland, to form a theoretical basis for the framework of networked care. In the third year, a three months secondment follows at the Department of Human-Centered Design of the Faculty of Industrial Design Engineering at Delft University of Technology (NL) to carry out human centered design of a prototype. Finally, at the end of the third year a two months secondments takes place at the Orthopedic center again to evaluate the prototype.

“Tools4Teams” is an EU-funded doctoral network, that investigates different instruments and tools to support teamwork in different parts of the healthcare system. Tools are technical as well as procedural. The network allows the various PhD candidates in a variety of European countries to meet and to learn with and from each other and the collective group of PhD supervisors. The consortium brings together the leading researchers on team processes in their various forms and applications. The network activities will support the mutual exchange of candidates and supervisors in unique ways, such as spring and winter schools and network wide meetings with academic and non-academic partners.