205 The care pathway for young children with hemophilia in the Netherlands 7 participated in the interactive co-design sessions. Per HTC between three and seven interactive co-design sessions and one to three validation sessions were necessary to develop the final version of the Metro Map. All co-design and validation sessions took place between August 23th 2022 and January 16th 2024 and lasted between 1 and 1,5 hours. Metro Map: Metro line and context Based on the available documentation of the care process and the interactive co-design sessions, four chronological phases were identified within the care pathway for patients with hemophilia; referral, diagnosis, treatment and followup. In addition to this chronological care pathway, three separate hemophilia care trajectories were identified that described the care processes in case of 1) bleeding episodes, 2) inhibitor development, and 3) planned medical interventions. These care pathways can occur at any moment during the chronological care pathway (see Additional file 1 to 5). Table 1: Specialization of the healthcare professionals participating in the pediatric team sessions. Pediatric hematologist Resident Nurse practitioner Nurse consultant Nurse Physical therapist Social worker HTC 1 2 - 1 1 3 1 1 HTC 2 4 1 1 1 - 1 1 HTC 3 2 - - 1 1 1 1 HTC 4 3 - 1 - - 1 1 HTC 5 2 1 1 - 5 2 1 Abbreviations: HTC, hemophilia treatment center Referral Across the HTCs, there are four different ways patients with a suspected bleeding disorder are referred to the pediatric HTC team. Patients are referred by the general practitioner, by a medical specialist from another hospital, by a medical specialist from the HTC, or by the emergency department of the HTC. Diagnostics After referral to the pediatric HTC team, the patient enters the diagnostic phase of the care pathway. This phase is similar across all five HTCs. Based on the referral documentation, the patient is first triaged based on the bleeding history, family history and previously performed laboratory tests. Subsequently, the patient is scheduled for a consultation at the outpatient clinic of the HTC. During this visit, additional blood tests are performed. The results of laboratory
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