scholarly journals Nine Lessons Learned From the COVID-19 Pandemic for Improving Hospital Care and Health Care Delivery

2021 ◽  
Author(s):  
Eric K. Wei ◽  
Theodore Long ◽  
Mitchell H. Katz
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Hospital Care ◽  
Care Delivery ◽  
Lessons Learned

Are Communities Willing to Transition Into Learning Health Care Communities? A Community-Based Participatory Evaluation of Stakeholders’ Receptivity

2021 ◽  
pp. 104973232199864
Author(s):  
Nabil Natafgi ◽  
Olayinka Ladeji ◽  
Yoon Duk Hong ◽  
Jacqueline Caldwell ◽  
C. Daniel Mullins
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Lessons Learned ◽  
Community Members ◽  
Community Based ◽  
Care Community ◽  
Care Experience ◽  
National Initiative

This article aims to determine receptivity for advancing the Learning Healthcare System (LHS) model to a novel evidence-based health care delivery framework—Learning Health Care Community (LHCC)—in Baltimore, as a model for a national initiative. Using community-based participatory, qualitative approach, we conducted 16 in-depth interviews and 15 focus groups with 94 participants. Two independent coders thematically analyzed the transcripts. Participants included community members (38%), health care professionals (29%), patients (26%), and other stakeholders (7%). The majority considered LHCC to be a viable model for improving the health care experience, outlining certain parameters for success such as the inclusion of home visits, presentation of research evidence, and incorporation of social determinants and patients’ input. Lessons learned and challenges discussed by participants can help health systems and communities explore the LHCC aspiration to align health care delivery with an engaged, empowered, and informed community.

Modularising outpatient care delivery: A mixed methods case study at a Finnish University Hospital

2018 ◽  
Vol 31 (4) ◽  
pp. 195-204 ◽  
Author(s):  
Katariina Silander ◽  
Paulus Torkki ◽  
Antti Peltokorpi ◽  
Aino Lepäntalo ◽  
Maija Tarkkanen ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Delivery ◽  
Outpatient Care ◽  
Hospital Care ◽  
Care Delivery ◽  
University Hospital ◽  
Care Providers ◽  
Mixed Methods Case Study

Background Modularisation is a potential means to develop health care delivery by combining standardisation and customisation. However, little is known about the effects of modularisation on hospital care. The objective was to analyse how modularisation may change and support health care delivery in specialised hospital care. Methods A mixed methods case study methodology was applied using both qualitative and quantitative data, including interviews, field notes, documents, service usage data, bed count and personnel resource data. Data from a reference hospital’s unit were used to understand the context and development of care delivery in general. Results The following outcome themes were identified from the interviews: balance between demand and supply; support in shift from inpatient to outpatient care; shorter treatment times and improved management of service production. Modularisation supported the shift from inpatient towards outpatient care. Changes in resource efficiency measures were both positive and negative; the number of patients per personnel decreased, while the number of visits per personnel and the bed utilisation rate increased. Conclusions Modularisation may support health care providers in classifying patients and delivering services according to patients’ needs. However, as the findings are based on a single university hospital case study, more research is needed.

Empirical exploration of brilliance in health care: perceptions of health professionals

2017 ◽  
Vol 41 (3) ◽  
pp. 336 ◽  
Author(s):  
Leila Karimi ◽  
Ann Dadich ◽  
Liz Fulop ◽  
Sandra G. Leggat ◽  
Jiri Rada ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Management Practices ◽  
Health Management ◽  
Care Delivery ◽  
Lessons Learned ◽  
Lexical Analysis ◽  
Professional Perspective

Objective The aim of the present study was to develop a positive organisational scholarship in health care approach to health management, informed by health managers and health professionals’ experiences of brilliance in health care delivery. Methods A sample of postgraduate students with professional and/or management experience within a health service was invited to share their experiences of brilliant health services via online discussions and a survey running on the SurveyMonkey platform. A lexical analysis of student contributions was conducted using the individual as the unit of analysis. Results Using lexical analysis, the examination of themes in the concept map, the relationships between themes and the relationships between concepts identified ‘care’ as the most important concept in recognising brilliance in health care, followed by the concepts of ‘staff’ and ‘patient’. Conclusions The research presents empirical material to support the emergence of an evidence-based health professional perspective of brilliance in health management. The findings support other studies that have drawn on both quantitative and qualitative materials to explore brilliance in health care. Pockets of brilliance have been previously identified as catalysts for changing health care systems. Both quality, seen as driven from the outside, and excellence, driven from within individuals, are necessary to produce brilliance. What is known about the topic? The quest for brilliance in health care is not easy but essential to reinvigorating and energising health professionals to pursue the highest possible standards of health care delivery. What does this paper add? Using an innovative methodology, the present study identified the key drivers that health care professionals believe are vital to moving in the direction of identifying brilliant performance. What are the implications for practitioners? This work presents evidence on the perceptions of leadership and management practices associated with brilliant health management. Lessons learned from exceptionally well-delivered services contain different templates for change than those dealing with failures, errors, misconduct and the resulting negativity.

scholarly journals Scaling virtual health at the epicentre of coronavirus disease 2019: A case study from NYU Langone Health

2020 ◽  
pp. 1357633X2094139
Author(s):  
Jason Sherwin ◽  
Katharine Lawrence ◽  
Veronica Gragnano ◽  
Paul A Testa
Keyword(s):  
Health Care ◽  
At Risk ◽  
Health Systems ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Lessons Learned ◽  
Virtual Care ◽  
Health Enterprise

The coronavirus disease 2019 (COVID-19) pandemic has accelerated the drive of health-care delivery towards virtual-care platforms. While the potential of virtual care is significant, there are challenges to the implementation and scalability of virtual care as a platform, and health-care organisations are at risk of building and deploying non-strategic, costly or unsustainable virtual-health systems. In this article, we share the NYU Langone Health enterprise approach to building and scaling an integrated virtual-health platform prior to and during the COVID-19 pandemic, and offer lessons learned and recommendations for health systems that need to undertake or are currently undertaking the transition to virtual-care delivery.

The Cardiovascular Intensive Care Unit—An Evolving Model for Health Care Delivery

2016 ◽  
Vol 32 (2) ◽  
pp. 116-123 ◽  
Author(s):  
John Loughran ◽  
Tauqir Puthawala ◽  
Brad S. Sutton ◽  
Lorrel E. Brown ◽  
Peter J. Pronovost ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Care Delivery ◽  
General Medicine ◽  
Physical Space ◽  
Lessons Learned ◽  
Care Providers

Prior to the advent of the coronary care unit (CCU), patients having an acute myocardial infarction (AMI) were managed on the general medicine wards with reported mortality rates of greater than 30%. The first CCUs are believed to be responsible for reducing mortality attributed to AMI by as much as 40%. This drastic improvement can be attributed to both advances in medical technology and in the process of health care delivery. Evolving considerably since the 1960s, the CCU is now more appropriately labeled as a cardiac intensive care unit (CICU) and represents a comprehensive system designed for the care of patients with an array of advanced cardiovascular disease, an entity that reaches far beyond its early association with AMI. Grouping of patients by diagnosis to a common physical space, dedicated teams of health care providers, as well as the development and implementation of evidence-based treatment algorithms have resulted in the delivery of safer, more efficient care, and most importantly better patient outcomes. The CICU serves as a platform for an integrated, team-based patient care delivery system that addresses a broad spectrum of patient needs. Lessons learned from this model can be broadly applied to address the urgent need to improve outcomes and efficiency in a variety of health care settings.

scholarly journals Creating Effectiveness Principles for Principles-Focused Developmental Evaluations in Health-Care Initiatives: Lessons Learned from Three Cases in British Colombia

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Ihoghosa Iyamu ◽  
Mai Berger ◽  
Erika Ono ◽  
Amy Salmon
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Health Care Delivery ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Care Delivery ◽  
Lessons Learned ◽  
Complex Adaptive ◽  
British Colombia ◽  
Method Of Evaluation

Principles-focused developmental evaluation is an emergent method of evaluation that is increasingly achieving relevance in initiatives seeking to transform health-care delivery within complex-adaptive systems. Creating meaningful eff ectiveness principles is considered a crucial first step in setting up such evaluations. In this article, we describe four practical steps that we applied in defi ning eff ectiveness principles to align with Patton’s GUIDE criteria. To illustrate our approach, this article features three principles-focused developmental evaluations implemented in British Columbia, highlighting lessons learned through the process of creating eff ectiveness principles.

scholarly journals Rapid Implementation of a Complex, Multimodal Technology Response to COVID-19 at an Integrated Community-Based Health Care System

2020 ◽  
Vol 11 (05) ◽  
pp. 825-838
Author(s):  
Andrew J. Knighton ◽  
Pallavi Ranade-Kharkar ◽  
Kimberly D. Brunisholz ◽  
Douglas Wolfe ◽  
Lauren Allen ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Tracking System ◽  
Health Care Systems ◽  
Care Quality ◽  
Lessons Learned ◽  
Leadership Role ◽  
Surge Capacity ◽  
Care Systems

Abstract Background The rapid spread of severe acute respiratory syndrome coronavirus-2 or SARS-CoV-2 necessitated a scaled treatment response to the novel coronavirus disease 2019 (COVID-19). Objective This study aimed to characterize the design and rapid implementation of a complex, multimodal, technology response to COVID-19 led by the Intermountain Healthcare's (Intermountain's) Care Transformation Information Systems (CTIS) organization to build pandemic surge capacity. Methods Intermountain has active community-spread cases of COVID-19 that are increasing. We used the Centers for Disease Control and Prevention Pandemic Intervals Framework (the Framework) to characterize CTIS leadership's multimodal technology response to COVID-19 at Intermountain. We provide results on implementation feasibility and sustainability of health information technology (HIT) interventions as of June 30, 2020, characterize lessons learned and identify persistent barriers to sustained deployment. Results We characterize the CTIS organization's multimodal technology response to COVID-19 in five relevant areas of the Framework enabling (1) incident management, (2) surveillance, (3) laboratory testing, (4) community mitigation, and (5) medical care and countermeasures. We are seeing increased use of traditionally slow-to-adopt technologies that create additional surge capacity while sustaining patient safety and care quality. CTIS leadership recognized early that a multimodal technology intervention could enable additional surge capacity for health care delivery systems with a broad geographic and service scope. A statewide central tracking system to coordinate capacity planning and management response is needed. Order interoperability between health care systems remains a barrier to an integrated response. Conclusion The rate of future pandemics is estimated to increase. The pandemic response of health care systems, like Intermountain, offers a blueprint for the leadership role that HIT organizations can play in mainstream care delivery, enabling a nimbler, virtual health care delivery system that is more responsive to current and future needs.

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