Optimal service delivery for conservative therapies

Round Table Discussion 5

The chairperson will introduce the four members of the faculty. After his introduction of topic 1, the topics mentioned below will start with a small (maximal 90 seconds) pre-recorded video presented by a person considered to be an expert in that specific field. The topic is then open for discussion. The chairperson will invite first the faculty members to give their opinion/points of view. The chairperson challenges the audience to actively participate.


1.What is service delivery?
In relation to conservative treatment for pelvic floor dysfunctions.

2. Who are stakeholders and what is their specific role and relation to each other?
Video 1
Government, governmental institutions (such as NHS), insurance company, (university) hospital, first-line heath care providers, companies, patient organizations, patients, professional societies, all part of the health system.

3. What is ‘optimal’ related to conservative treatment for pelvic floor dysfunctions?
Video 2
Guidelines, recommendations, standards, multidisciplinary, patient-centered approach as much as needed as least as required, evidence-based, biopsychosocial/sociopsychosomatic, holistic assessment, treatment and after care/follow-up, use of valid diagnostic and outcome measures, conceptual health care related to the International Classification of Functions, Disability and Health, not only treating the health care problem itself (such as urinary incontinence) but its consequences locally (impairments/disorders), but also personally (limitations of the person) and socially (restriction in participation). Which factors are the most important related to optimal service delivery and is there a hierarchy?

4. How to organize optimal service delivery for conservative treatment?
Video 3
Explanation how optimal service delivery can contribute to if and to what extent conservative treatment is feasible for pelvic floor dysfunctions and restoration of the patient’s activities, mental reboots and quality of life. Healthcare workforce of all relevant health care providers (by professional societies), government(al institutions), health insurance companies) and patient involvement (by patient organizations) such as in the past the NHS organized for HIV. Importance of provider’s education/specialization, contribution of scientific evidence to optimal service delivery, infrastructure clinical practice.

5. Patient perspective and involvement, self-management
Video 4
Patients willingness to take greater charge of their care using digital tools and algorithms. In the light of (lack of) adherence, compliance with (home) exercise programs. Behavioral change of patients in that sense that their role in their treatment must be more active (activation contingent) and not passive (the health care provider must cure me….) (pain/discomfort contingent). Health care provider is coach, patient stakeholder own health.

6. Development of digital conservative management, artificial intelligence, and future of service delivery
Video 5
Patient-entered when assessing new technologies, patient as partner in this process. Conceptual (further)development of relevant mApps. Potential for digital healthcare technologies to improve accuracy of assessments and treatments. Attention for patient-clinician relationship using digital technologies. Attention for extensive education and training of the health care provider workforce and the public. Governmental responsibility to start this process, others? Companies? Sponsoring?

Summary and conclusions chairperson