108 Lessons Learned in Health Service Delivery to Victims of Slow-Onset Disaster

The emergence of skeletal prosthetic attachments leaves governmental organizations facing the challenge of implementing equitable policies that support the provision of bone-anchored prostheses (BAPs). In 2013, the Queensland Artificial Limb Service (QALS) started a five-year research project focusing on health service delivery and economic evaluation of BAPs. This paper reflects on the QALS experience, particularly the lessons learned. QALS’ jurisdiction and drivers are presented first, followed by the impact of outcomes, barriers, and facilitators, as well as future developments of this work. The 21 publications produced during this project (e.g., reimbursement policy, role of prosthetists, continuous improvement procedure, quality of life, preliminary cost-utilities) were summarized. Literature on past, current, and upcoming developments of BAP was reviewed to discuss the practical implications of this work. A primary outcome of this project was a policy developed by QALS supporting up to 22 h of labor for the provision of BAP care. The indicative incremental cost-utility ratio for transfemoral and transtibial BAPs was approximately AUD$17,000 and AUD$12,000, respectively, per quality-adjusted life-year compared to socket prostheses. This project was challenged by 17 barriers (e.g., limited resources, inconsistency of care pathways, design of preliminary cost-utility analyses) but eased by 18 facilitators (e.g., action research plan, customized database, use of free repositories). In conclusion, we concluded that lower limb BAP might be an acceptable alternative to socket prostheses from an Australian government prosthetic care perspective. Hopefully, this work will inform promoters of prosthetic innovations committed to making bionic solutions widely accessible to a growing population of individuals suffering from limb loss worldwide. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36210/28330 How To Cite: Berg D, Frossard L. Health service delivery and economic evaluation of limb lower bone-anchored prostheses: A summary of the Queensland artificial limb service’s experience. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.12. https://doi.org/10.33137/cpoj.v4i2.36210 Corresponding Author: Laurent Frossard, PhD, Professor of BionicsYourResearchProject Pty Ltd, Brisbane, Australia.E-Mail: [email protected] number: https://orcid.org/0000-0002-0248-9589

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Combating health care fragmentation through integrated health service delivery networks in the Americas: lessons learned

Journal of Integrated Care ◽

10.1108/14769011111176707 ◽

2011 ◽

Vol 19 (5) ◽

pp. 5-16 ◽

Cited By ~ 30

Author(s):

Hernán Montenegro ◽

Reynaldo Holder ◽

Caroline Ramagem ◽

Soledad Urrutia ◽

Ricardo Fabrega ◽

...

Keyword(s):

Health Care ◽

Health Service ◽

Service Delivery ◽

Health Service Delivery ◽

Lessons Learned ◽

Integrated Health ◽

Delivery Networks ◽

Care Fragmentation

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Comprehensive approach for strengthening the management of regional referral hospitals in Tanzania

Journal of Hospital Administration ◽

10.5430/jha.v9n5p1 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1

Author(s):

Hisahiro Ishijima ◽

Masashi Teshima ◽

Yasuko Kasahara ◽

Noriyuki Miyamoto ◽

Fares Masaule ◽

...

Keyword(s):

Health Service ◽

Service Delivery ◽

Hospital Management ◽

Monitoring And Evaluation ◽

Health Service Delivery ◽

Lessons Learned ◽

Basic Knowledge ◽

Management Tools ◽

Healthcare Facilities ◽

Referral Hospitals

Hospital managers in Tanzania have always been expected to manage and deliver quality services to patients under resource constrained situation. In the organizational structure of regional referral hospitals (RRHs) in Tanzania, including, clinicians with very limited knowledge of and skills in management hold over 80% of the managerial positions. The Ministry of Health, Community Development, Gender, Elderly and Children of Tanzania has identified the strengthening of management at RRHs as a key to improving efficiency and effectiveness in health service delivery. The ministry launched a five-year project for strengthening hospital management in RRHs in collaboration with the Japan International Cooperation Agency. The project provided a series of training courses for capacitating RRH management Team (RRHMT), and developed and introduced several planning, monitoring, and evaluation tools. This study was conducted to identify the positive factors and approaches for strengthening management of RRHs. Necessary information and data were collected through the intervention and analyzed to measure the effectiveness of the interventions. RRHMT members obtained basic knowledge of and skills for hospital management through the project interventions with those deferent management tools to improve the completion of their hospital management tasks. Based on the findings, it can be concluded that the interventions were effective in strengthening the managerial capacity of RRHMTs. The study also confirmed that the strategy to improve hospital management was on the right track for improving health service delivery in efficient and effective manners. The lessons learned from the project can be adjusted for the management of lower healthcare facilities.

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