210 Chapter 7 professionals about the medical procedure and/or providing instructions to the patient, caregivers and nursing staff of the admitting ward on how to administer treatment. On the day of the surgery, medication is administered and a blood withdrawal is performed to check the factor levels before the surgical or dental procedure is initiated. At HTC 3 a sufficient factor level needs to be confirmed before the surgery can start. This is not a requirement in HTC 1, HTC 2, HTC 4 or HTC 5. In these HTCs, surgery will start and additional treatment is administered during surgery if necessary. During the post-surgical period, treatment is administered and a blood withdrawal is performed daily to check the factor levels as long as the patient receives medication. Depending on the HTC, the pediatric hematologist, resident, physiotherapist, nurse practitioner and/or nurse consultant visit the patient daily to check on their progress. A post-operative consultation takes place after approximately six weeks at the outpatient clinic of the HTC to check for inhibitor development. This post-operative consult occurs at all HTCs except at HTC 4. Metro Map: Information discussed and educational materials provided during consultations Two layers of the Metro Map are related to information provision. These layers depict which information is discussed between the healthcare professionals, the patient and caregivers, and which information or educational materials is provided by the healthcare professionals during each step within the metro line. We found that throughout the entire care pathway all HTCs discuss the same overarching topics. These topics include 1) education on coagulation and hemophilia, 2) when and how to contact the HTC, 3) how to recognize a bleeding episode and what to do in case of a bleeding episode, 4) treatment options, 5) treatment plan, and 6) lifestyle recommendations that the patient is advised to follow. Additionally, during specific phases further information is provided on treatment options and the consequences of bleeding episodes and inhibitor development. Which specific information is discussed and provided by the healthcare professional during the various steps within the care pathway differs. For example, during the diagnostic phase healthcare professionals at HTC 2 discuss the possibility and desirability of a SOS strap for the car seatbelt in case of car accidents. This SOS strap is not discussed by the healthcare
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