Dunja Dreesens

161 Summary The body of knowledge in health care is vast and accumulating daily. To help healthcare professionals and patients handle and use this wealth of knowledge (something also dubbed ‘information overload’) when deciding about the patient’s care, so-called knowledge tools are developed. The aims of this thesis were firstly, tool types are no longer developed without a clear definition and use. Secondly, there exists a common terminology when referring to tool types. Thirdly, to make better use of the different knowledge sources available, and finally provide healthcare professionals and patients, and possibly other users such as policy advisors and insurers, with a set of pragmatic tools that cover their needs in knowledge translation and decision support. This resulted in the following research questions: - What tool types to translate knowledge and support (shared) decision-making are available to healthcare professionals (and patients) in the Netherlands? (Chapter 2) - How are these tool types defined and does consensus exist on the definitions across the healthcare domains in the Netherlands? (Chapters 2 and 3) - Which criteria do these tool types need to meet and which purposes do they serve so that healthcare professionals and patients consider them trustworthy and useful? (Chapter 4) - Do we consider all knowledge sources when developing tools, and what does that mean for tool development? (Chapter 5) - What are healthcare professionals’ needs using tools for knowledge translation and shared decision-making? (Chapter 6) Available tool types There exist different kinds of tool types that support knowledge translation and/or (shared) decision making. A scoping review among national organisations that develop and implement tools yielded 67 different tool types in the Netherlands. Of these tool types, many were ill- defined; meaning that there was no definition of the tool type (readily) available or the definition was (partially) incomplete: it contained no description of the tool type, its goal, and/nor who their intended target users were. In the pursuit of curtailing the information overload, we might have created an overload of tools and by ill defining them partially nullified the strived for use of knowledge and achieving optimal patient care. Defining tool types Therefore, a consensus procedure to limit the amount of tool types and to agree on the definition of the tool types was carried out at a national level in the Netherlands. Stakeholders from various domains in health care (curative care, long term care and public health) and with different expertise participated; patients, tool developers, healthcare professionals, policy advisors. In the end, consensus was reached on a core set of nine tool types and there was agreement on the definitions of five of these tools. These were: ‘summary’, ‘flowchart’, ‘clinical practice guideline’, ‘protocol’ and ‘patient decision aid’. Despite the participation of the stakeholders and some organisations already adopting the core set, the reached consensus was just a first step. It remains a challenge to adhere to the core set. A more concerted effort by the parties involved is needed. But also, because new tool types or seemingly new tool types Summary