Menno Vries improves care for stroke patients
Every year, 42,000 people in the Netherlands are admitted to hospital with a stroke (cerebral infarction). A large proportion of these patients feel insufficiently helped by our care system. Former physiotherapy student Menno Vries is concerned about the fate of these patients.
Text: Loes Vader
With his final thesis 'Connection intramural care to unmet care needs stroke patient', Menno Vries won the Jaco den Dekker Audience Award 2023, the prize for the best graduation thesis of the Royal Dutch Society for Physiotherapy. He graduated in February and now works in the Vogellanden rehabilitation centre in Zwolle. "It is very different from first-line physiotherapy, the physiotherapist around the corner so to speak. People at the centre are clinically admitted. Patients receive therapy here every day," Menno explains.
Patients face challenges that healthcare could have responded to better. "I often hear that people fall into a black hole at home. In the hospital or rehabilitation centre, they have received a lot of information and tools to help them deal with their limitations. Once they get home, they don't remember what they were told. Think of motor problems, cognitive problems, people can be overstimulated and no longer store the information properly, there can be speech problems and also psychological problems."
In the first year of his study programme, Menno did an internship at a primary care neurorehabilitation practice, where he came into contact with patients from this target group. "Patients who had already undergone the entire process of hospitalisation and care in a rehabilitation centre. I wanted to do something for them. This is a large group, about 42,000 people end up in hospital with a CVA (Cerebrovascular accident)."
Menno started an honours trajectory and did two research projects. Through the Brain Injury Patient Association, he distributed a survey about patients’ needs and healthcare demands, in which patients could leave their contact details. "I then interviewed those people. The results of these studies provided great insights, which I presented to practitioners for my final thesis. For example: patients would like their family or partner to be more involved in the treatment process. The practitioners then came up with their own ideas on how to increase the involvement of family and partners. By inviting the family to discuss the treatment plan or by allowing the family to come and visit more frequently. We are also thinking of walk-in consultation hours where both patients and family can ask questions. Feasible plans have been hatched. It's often about small changes that can make a huge difference."
In his thesis, Menno argues for a multidisciplinary, holistic approach to healthcare. A holistic view is based on the principle that everything is connected. The whole is a system in which everything is connected. "With a stroke, you may have to deal with many aspects. As a physiotherapist, I can't treat them on my own. Psychomotor therapists, occupational therapists, speech therapists... at de Vogellanden we also have activity therapists and music therapists. We all have one task: to get the patient home safely. We are all striving for that goal. And we have to do that together."
The jury was full of praise for Menno's thesis, but missed the specific physiotherapeutic aspect. "If we want to improve healthcare, we should start thinking in a much more multidisciplinary way instead of looking at it from just one discipline. All practitioners do a great job but coordinating our work, also with the patients, the partner and the family, the stroke knowledge network and primary care when the patient is back home, must be done in good harmony. There appears to be room for improvement there."
In his daily work, Menno is very attentive to how people return home from the rehabilitation centre. "The tricky thing is that people here are mainly concerned with the here and now. They want to rehabilitate right away and they'll see what happens when they get back home. While you actually want to stay ahead of the problems. What I do myself is write a short story about each treatment, so that they can read it at home. This is especially valuable for people with speech and cognitive problems. I also try to involve the partner and family in the treatment, so that they can think about challenges in the home situation."
Menno has been invited to talk to the board of the Vogellanden about how they can implement his research in the rehabilitation centre. "The first steps towards care that is better tailored to the patient have been taken. The board is open to it."
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