What systems participants know about access and service entry and why managers should listen

2017 ◽  
Vol 41 (4) ◽  
pp. 449
Author(s):  
Rohena Duncombe
Keyword(s):  
Health Services ◽  
Community Health ◽  
Participatory Design ◽  
Service Providers ◽  
Local Level ◽  
Academic Research ◽  
Research Literature ◽  
Local Health ◽  
Policy Makers ◽  
Health Counselling

Objective The present study looked at the views of people directly involved in the entry process for community health counselling using the frame of the health access literature. The concurrence of system participants’ views with the access literature highlights access issues, particularly for people who are vulnerable or disadvantaged. The paper privileges the voices of the system participants, inviting local health services to consider using participatory design to improve access at the entry point. Methods People involved in the entry process for community health counselling explored the question, ‘What, for you, are the features of a good intake system?’ They also commented on themes identified during pilot interviews. These were thematically analysed for each participant group by the researcher to develop a voice for each stakeholder group. Results People accessing the service could be vulnerable and the entry process failed to take that into account. People directly involved in the counselling service entry system, system participants, consisted of: professionals referring in, people seeking services and reception staff taking first enquiries. They shared substantially the same concerns as each other. The responses from these system participants are consistent with the international literature on access and entry into health services. Conclusion Participatory service design could improve primary healthcare service entry at the local level. Canvassing the experiences of system participants is important for delivering services to those who have the least access and, in that way, could contribute to health equity. What is known about the topic? People with the highest health needs receive the fewest services. Health inequality is increasing. What does this paper add? System participants can provide advice consistent with the academic research literature that is useful for improving service entry at the local level. What are the implications for practitioners? Participatory design can inform policy makers and service providers. Entry systems could acknowledge the potential vulnerability or disadvantage of people approaching the service.

Exploring the Spheres of Crowdfunding

2016 ◽  
pp. 190-209
Author(s):  
Bernard Owens Imarhiagbe
Keyword(s):  
Service Providers ◽  
Early Stage ◽  
Academic Research ◽  
Relevant Information ◽  
Research Literature ◽  
Policy Framework ◽  
Policy Statement ◽  
The World Bank ◽  
The Subject ◽  
The Uk

This chapter reviews research and policy literatures on the spheres of crowdfunding. It identifies reward-based, donation-based, equity-based and credit-based crowdfunding with a view to collate relevant information to support crowdfunding knowledgebase and further research. As crowdfunding is a new concept in research literature, it is increasing in popularity in social media, business and research communities. Academic research in crowdfunding is limited and the subject is still evolving as a way of access to finance for seed capital, entrepreneurial projects and other early stage projects. Advanced countries in Europe and North America have recognised the relevance of crowdfunding in varying proportion from one country to another for project fundraising. However, the World Bank confirmed that developing countries are at different stages of recognition of crowdfunding in their policy framework. Although the UK financial regulator, Financial Conduct Authority, has produced a policy statement for crowdfunding and approved some service providers such as crowdfunding platforms, it is still interacting with stakeholders and providing guidance to potential entrepreneurs on the operational models. Crowdfunding is a way of raising small amounts of money from different contributors over the internet for different types of projects. There are huge management implications in the spheres of crowdfunding.

Exploring the Spheres of Crowdfunding

2020 ◽  
pp. 1547-1566
Author(s):  
Bernard Owens Imarhiagbe
Keyword(s):  
Service Providers ◽  
Early Stage ◽  
Academic Research ◽  
Relevant Information ◽  
Research Literature ◽  
Policy Framework ◽  
Policy Statement ◽  
The World Bank ◽  
The Subject ◽  
The Uk

This chapter reviews research and policy literatures on the spheres of crowdfunding. It identifies reward-based, donation-based, equity-based and credit-based crowdfunding with a view to collate relevant information to support crowdfunding knowledgebase and further research. As crowdfunding is a new concept in research literature, it is increasing in popularity in social media, business and research communities. Academic research in crowdfunding is limited and the subject is still evolving as a way of access to finance for seed capital, entrepreneurial projects and other early stage projects. Advanced countries in Europe and North America have recognised the relevance of crowdfunding in varying proportion from one country to another for project fundraising. However, the World Bank confirmed that developing countries are at different stages of recognition of crowdfunding in their policy framework. Although the UK financial regulator, Financial Conduct Authority, has produced a policy statement for crowdfunding and approved some service providers such as crowdfunding platforms, it is still interacting with stakeholders and providing guidance to potential entrepreneurs on the operational models. Crowdfunding is a way of raising small amounts of money from different contributors over the internet for different types of projects. There are huge management implications in the spheres of crowdfunding.

Evaluating models of working at the interface between mental health services and primary care

1997 ◽  
Vol 170 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Linda Gask ◽  
Bonnie Sibbald ◽  
Francis Creed
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Services ◽  
Service Providers ◽  
Psychiatric Nurses ◽  
Local Health ◽  
Care Services ◽  
Secondary Health Care

BackgroundThis paper examines the feasibility of evaluating innovative models of working at the interface between primary care and secondary mental health services.MethodMethodological problems relevant to evaluation of innovative models of working at the interface are discussed.ResultsAlthough there is some evidence that neurotic disorders can be more cost-effectively treated in primary care, many general practitioners (GPs), and possibly some patients, prefer referral to community mental health teams and community psychiatric nurses, which are provided by the secondary health care services. Since the latter are provided with the intention of improving serious mental illness their involvement in the care of neurotic illness can lead to tensions between GPs, local health authorities and service providers. There is little evidence to suggest that psychiatrists working in health centres using the ‘shifted out-patient’ model have eased this problem. By contrast the ‘consultation-liaison’ (C-L) model has a number of theoretical advantages; referrals to secondary care should be limited to those most in need of this level of expertise and GP management skills should improve, so leading to better quality of care for patients who are not referred.ConclusionStudies comparing the different models of service delivery are required to address the tensions that have arisen following changes in government policy. Further work is also needed to develop the necessary research tools.

scholarly journals Increasing autonomy in publically owned services

2015 ◽  
Vol 29 (6) ◽  
pp. 778-794
Author(s):  
Ailsa Cameron ◽  
Pauline Allen ◽  
Lorraine Williams ◽  
Mary Alison Durand ◽  
Will Bartlett ◽  
...  
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Community Health ◽  
Design Methodology ◽  
Community Health Services ◽  
Policy Makers ◽  
Content Type ◽  
Organisational Form ◽  
Foundation Trusts ◽  
Improve Service Delivery

Purpose – The purpose of this paper is to explore government efforts to enhance the autonomy of community health services (CHS) in England through the creation of Foundation Trusts status. It considers why some CHS elected to become nascent Community Foundation Trusts (CFTs) while others had not and what advantages they thought increased levels of autonomy offered. Design/methodology/approach – Data are drawn from the evaluation of the Department of Health’s CFT pilot programme. Participants were purposively selected from pilot sites, as well as from comparator non-pilot organisations. A total of 44 staff from 14 organisations were interviewed. Findings – The data reveals that regardless of the different pathways that organisations were on, they all shared the same goal, a desire for greater autonomy, but specifically within the NHS. Additionally, irrespective of their organisational form most organisations were considering an almost identical set of initiatives as a means to improve service delivery and productivity. Research limitations/implications – Despite the expectations of policy makers no CFTs were established during the course of the study, so it is not possible to find out what the effect of such changes were. Nevertheless, the authors were able to investigate the attitudes of all the providers of CHS to the plans to increase their managerial autonomy, whether simply by separating from PCTs or by becoming CFTs. Originality/value – As no CFTs have yet been formed, this study provides the only evidence to date about increasing autonomy for CHS in England.

Obtaining and Using Client Feedback in Community Health Services

1998 ◽  
Vol 4 (4) ◽  
pp. 105
Author(s):  
Gwyneth Jolley ◽  
Libby Kalucy ◽  
Joanne McNamara
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Service Providers ◽  
South Australia ◽  
Organisational Change ◽  
Community Health Services ◽  
Service Planning ◽  
Power Sharing ◽  
Client Feedback

Client feedback is an important component of two primary health care strategies: participation and evaluation. Workers need feedback from clients to ensure that their practice meets the criterion of providing affordable, accessible and appropriate services to enhance the health of their communities. Telephone interviews were conducted with thirty staff and thirty clients from women's and community health services in South Australia, to identify current practice in obtaining and using feedback from users of one-to-one services and group health promotion and community development activities. Factors which encourage feedback to be given and used include: trust and effective communications between all stakeholders; and supportive organisational philosophies, culture and practices. Client feedback is more likely to be used when given in written form. Collection and use of feedback are discouraged by inappropriate methods and timing, rapid organisational change, and clients' lack of awareness of, or confidence in, giving feedback about the services they receive. Verbal feedback, although preferred by many clients, is less likely to be recorded and used in service planning and evaluation. Client feedback is a valuable tool to reinforce the notion of partnership and power sharing between clients and health care workers. Staff at all levels should be engaged in obtaining feedback and the information gained should be disseminated throughout the agency in order to improve the quality and effectiveness of services. The challenge is now for service providers and users to adopt new, and support currently successful, ways of obtaining and using feedback so that service providers and users are engaged in working in partnership to ensure the needs of the community are best met.

scholarly journals Rethinking Service Systems and Public Policy: A Transformative Refugee Service Experience Framework

2020 ◽  
pp. 074391562096281
Author(s):  
Silke Boenigk ◽  
Raymond Fisk ◽  
Sertan Kabadayi ◽  
Linda Alkire ◽  
Lilliemay Cheung ◽  
...  
Keyword(s):  
Public Policy ◽  
Nonprofit Organizations ◽  
Service Providers ◽  
Service System ◽  
Well Being ◽  
Research Literature ◽  
Service Systems ◽  
Policy Makers ◽  
Service Experience ◽  
Research Questions

The global refugee crisis is a complex humanitarian problem. Service researchers can assist in solving this crisis because refugees are immersed in complex human service systems. Drawing on marketing, sociology, transformative service, and consumer research literature, this study develops a Transformative Refugee Service Experience Framework to enable researchers, service actors, and public policy makers to navigate the challenges faced throughout a refugee’s service journey. The primary dimensions of this framework encompass the spectrum from hostile to hospitable refugee service systems and the resulting suffering or well-being in refugees’ experiences. The authors conceptualize this at three refugee service journey phases (entry, transition, and exit) and at three refugee service system levels (macro, meso, and micro) of analysis. The framework is supported by brief examples from a range of service-related refugee contexts as well as a Web Appendix with additional cases. Moreover, the authors derive a comprehensive research agenda from the framework, with detailed research questions for public policy and (service) marketing researchers. Managerial directions are provided to increase awareness of refugee service problems; stimulate productive interactions; and improve collaboration among public and nonprofit organizations, private service providers, and refugees. Finally, this work provides a vision for creating hospitable refugee service systems.

scholarly journals Decentralization Process in Portugal: impact in the health care system

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Sequeira ◽  
G Quinaz Romana ◽  
A Campos Fernandes ◽  
M Pinho ◽  
E Freire Rodrigues ◽  
...  
Keyword(s):  
Health Services ◽  
Local Governments ◽  
Local Level ◽  
National Level ◽  
Population Characteristics ◽  
Healthy Lifestyles ◽  
Local Health ◽  
Preliminary Results ◽  
Quality Costs ◽  
Quality Life

Abstract Problem Different countries have incorporated models of decentralization in their health reforms to achieve efficiency, by increasing the training of local governments, responsibility and gains in areas such as quality, costs and equity. In Portugal, the 21st government program established the autonomy of local authorities and the democratic decentralization of public administration. Accordingly, a decentralization law was approved and local governments have now a crucial role on health policies. Description of the Problem For this framework, a situational diagnosis and an intersectoral approach to policies are needed. This is an observational, analytical and cross-sectional study developed at council level in two Portuguese municipalities. This study aims to: Adjust responses to health needs at the local level; Set priorities by taking into account installed capacity and responses to populations; Promote the articulation between entities; Strengthen the focus on health promotion and healthy lifestyles; Strengthen health interventions in educational communities; Promote the creation of programs at local level, in conjunction with the national level, to reduce inequalities. Results The preliminary results in health, social and economic indicators show that this framework, while taking in consideration population characteristics, allows the development of local strategies regarding health services coverage, health services type and medication. At council level, the preliminary results also show a lack of data on healthy lifestyles and social indicators. Lessons The implementation of a decentralization process involves a broad range of requirements such as a situational diagnosis, strategies development and a periodic update of quality life and health indicators. Those are needed to assess council level priorities, which allow the development of public policies and interventions, in line with population characteristics, to tackle health inequalities and inequities. Key messages Performance improvement of health system is linked to the implementation of local citizen centred policies. These are actions which promote quality of life through health-friendly ecosystems. The local health intervention has contributed to promote inequalities reduction, increasing equity and dynamize new frameworks of organization with individual and community participation.

scholarly journals Gaining knowledge of Ontario’s community mental health and addictions system: linking community-based health services data with administrative health data in Toronto, Ontario, Canada

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Paul Kurdyak ◽  
Abigail Amartey ◽  
Julie Yang ◽  
Daniel Liadsky ◽  
Rachel Solomon ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Service ◽  
Health Services ◽  
Community Health ◽  
Community Health Services ◽  
Health Data ◽  
Local Health ◽  
Community Based ◽  
Administrative Health Data

IntroductionIn most developed countries, a significant amount of mental health and addictions care occurs in community settings. Data reflecting populations served by community-based mental health and addictions providers and the types of services provided are not available, resulting in an incomplete reflection of the entire mental health and addictions system within existing administrative data. Objectives and ApproachThe Community Business Intelligence (CBI) initiative is a data collection project that captures information on adults receiving community-based mental health, addictions, and support services in Toronto Central Local Health Integration Network (LHIN), located in Ontario, Canada. Leveraging administrative health data and data linkage capacity at the Institute for Clinical Evaluative Sciences (ICES), along with engagement of external stakeholders knowledgeable of CBI and the community health sector, we linked the 2015/16 CBI dataset to administrative health data. Demographic characteristics, health-service utilization, primary care attachment, and 30-day emergency department (ED) revisits were calculated for individuals accessing community health services. ResultsThere was an 80.8% linkage rate, of which 36.9% linked deterministically via health card number, while 43.9% linked probabilistically. After study exclusions, 37,688 individuals in the CBI dataset used community health services between April 2015 and March 2016. Compared to Toronto Central LHIN, a greater proportion in the CBI dataset were female, older than 65 years of age, and living in a low income neighbourhood. Furthermore, 95.5%of individuals had at least one outpatient physician visit, 51.3%had at least one ED visit, and 21.7%had at least one hospitalization in the past year. Few individuals in the CBI dataset were without primary care attachment (4.5%); however, a larger proportion had a 30-day ED revisit, particularly those receiving community addictions services (19%). Conclusion/ImplicationsThe availability of community health services data in the CBI dataset and its successful linkage to the administrative health data held at ICES identified health service intersections and outcomes that were previously unknown. This linkage project demonstrates a successful framework for sector-wide performance measurement to address a critical infrastructure gap.

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