scholarly journals Regulation of health care professionals as a quality strategy

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Panteli ◽  
A Kreutzberg ◽  
C Reichebner ◽  
C Maier ◽  
F Destrebecq
Keyword(s):  
Health Services ◽  
Health System ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Professional Competence ◽  
Continuing Professional Development ◽  
Cost Effective ◽  
Patient Centered ◽  
System Input

Abstract Health professionals are both a health system input and an active component of the functions that the health system performs. As such, the performance of the health workforce is directly linked to the quality of health services. Regulation is essential to define a clear framework within which health professionals acquire and maintain the competence needed to provide health services that are of high quality, i.e. that are safe, effective and patient-centered. This presentation discusses the evidence on a sequence of strategies that regulate health professionals, looking at how they are currently deployed in Europe, how (cost-)effective they are, and what can be done to optimize their implementation. Adopting a comprehensive perspective ranging from the entry into training to life-long maintenance and demonstration of competence, the presentation brings together a) strategies to develop professional competence (including training structure and contents, curriculum development and the accreditation of institutions for health education); b) strategies that regulate the entry of physicians and nurses into their professions (e.g. licensing and registration); c) mechanisms to maintain competence (e.g. continuing professional development); and d) levers to address instances when fitness to practice comes into question.

scholarly journals Improving maternal health services through social accountability interventions in Nepal: an analytical review of existing literature

2020 ◽  
Vol 41 (1) ◽  
Author(s):  
Adweeti Nepal ◽  
Santa Kumar Dangol ◽  
Anke van der Kwaak
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health System ◽  
Maternal Health Services ◽  
Policy Formulation ◽  
Social Accountability ◽  
The Social ◽  
The Government ◽  
The Impact

Abstract Background The persistent quality gap in maternal health services in Nepal has resulted in poor maternal health outcomes. Accordingly, the Government of Nepal (GoN) has placed emphasis on responsive and accountable maternal health services and initiated social accountability interventions as a strategical approach simultaneously. This review critically explores the social accountability interventions in maternal health services in Nepal and its outcomes by analyzing existing evidence to contribute to the informed policy formulation process. Methods A literature review and desk study undertaken between December 2018 and May 2019. An adapted framework of social accountability by Lodenstein et al. was used for critical analysis of the existing literature between January 2000 and May 2019 from Nepal and other low-and-middle-income countries (LMICs) that have similar operational context to Nepal. The literature was searched and extracted from database such as PubMed and ScienceDirect, and web search engines such as Google Scholar using defined keywords. Results The study found various social accountability interventions that have been initiated by GoN and external development partners in maternal health services in Nepal. Evidence from Nepal and other LMICs showed that the social accountability interventions improved the quality of maternal health services by improving health system responsiveness, enhancing community ownership, addressing inequalities and enabling the community to influence the policy decision-making process. Strong gender norms, caste-hierarchy system, socio-political and economic context and weak enforceability mechanism in the health system are found to be the major contextual factors influencing community engagement in social accountability interventions in Nepal. Conclusions Social accountability interventions have potential to improve the quality of maternal health services in Nepal. The critical factor for successful outcomes in maternal health services is quality implementation of interventions. Similarly, continuous effort is needed from policymakers to strengthen monitoring and regulatory mechanism of the health system and decentralization process, to improve access to the information and to establish proper complaints and feedback system from the community to ensure the effectiveness and sustainability of the interventions. Furthermore, more study needs to be conducted to evaluate the impact of the existing social accountability interventions in improving maternal health services in Nepal.

Allied health: integral to transforming health

2016 ◽  
Vol 40 (2) ◽  
pp. 194 ◽  
Author(s):  
Lucylynn Lizarondo ◽  
Catherine Turnbull ◽  
Tracey Kroon ◽  
Karen Grimmer ◽  
Alison Bell ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
Patient Outcomes ◽  
Allied Health ◽  
Systems Of Care ◽  
Healthcare Services ◽  
Supporting Evidence ◽  
Allied Health Professionals ◽  
Health Practitioners

Objective South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system. In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to various healthcare challenges. A recent opinion piece proposed 10 clinician-driven strategies to assist in maximising value and sustainability of healthcare in Australia. The present study aimed to seek the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health. Methods A survey of allied health practitioners was undertaken to capture their perspectives on the 10 clinician-driven strategies for maximising value and sustainability of healthcare in Australia. Survey findings were then layered with evidence from the literature. Results Highly relevant across allied health are the strategies of discontinuation of low value practices, targeting clinical interventions to those getting greatest benefit, active involvement of patients in shared decision making and self-management and advocating for integrated systems of care. Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the ‘maximum value for spend’ of the increasingly scarce health dollar. What is known about the topic? In medicine, clinician-driven strategies have been proposed to minimise inappropriate and costly care and maximise highly appropriate and less expensive care. These strategies were developed based on clinical experiences and with supporting evidence from scientific studies. What does this paper add? Major changes to the health system are required to slow down the growth in healthcare expenditure. This paper describes opportunities in which allied health practitioners can implement similar strategies not only to improve the quality of patient outcomes, but also to offer cost-effective solutions for a sustainable healthcare. What are the implications for practitioners? Allied health practitioners can provide solutions to healthcare challenges and assist in the transformation of healthcare in Australia. However, for this to happen, there should be concerted efforts to increase recognition of and support for the use of allied health services.

scholarly journals Assessing Apps for Patients with Genitourinary Tumors Using the Mobile Application Rating Scale (MARS): Systematic Search in App Stores and Content Analysis (Preprint)

2019 ◽  
Author(s):  
Miguel Ángel Amor-García ◽  
Roberto Collado-Borrell ◽  
Vicente Escudero-Vilaplana ◽  
Alejandra Melgarejo-Ortuño ◽  
Ana Herranz-Alonso ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Mobile Application ◽  
Rating Scale ◽  
Cross Sectional ◽  
Cancer Symptoms ◽  
Genitourinary Cancers

BACKGROUND The large number of available cancer apps and their impact on the population necessitates a transparent, objective, and comprehensive evaluation by app experts, health care professionals, and users. To date, there have been no analyses or classifications of apps for patients with genitourinary cancers, which are among the most prevalent types of cancer. OBJECTIVE The objective of our study was to analyze the quality of apps for patients diagnosed with genitourinary cancers using the Mobile Application Rating Scale (MARS) and identify high-quality apps. METHODS We performed an observational cross-sectional descriptive study of all smartphone apps for patients diagnosed with genitourinary cancers available on iOS and Android platforms. In July 2019, we searched for all available apps for patients with genitourinary cancers (bladder, prostate, cervical, uterine, endometrial, kidney, testicular, and vulvar) or their caregivers. Apps were downloaded and evaluated, and the general characteristics were entered into a database. The evaluation was performed by 2 independent researchers using the MARS questionnaire, which rates 23 evaluation criteria clustered in 5 domains (Engagement, Functionality, Esthetics, Information, and Subjective Quality) on a scale from 1 to 5. RESULTS In total, 46 apps were analyzed. Of these, 31 (67%) were available on Android, 6 (13%) on iOS, and 9 (20%) on both platforms. The apps were free in 89% of cases (41/46), and 61% (28/46) had been updated in the previous year. The apps were intended for prostate cancer in 30% of cases (14/46) and cervical cancer in 17% (8/46). The apps were mainly informative (63%, 29/46), preventive (24%, 11/46), and diagnostic (13%, 6/46). Only 7/46 apps (15%) were developed by health care organizations. The mean MARS score for the overall quality of the 46 apps was 2.98 (SD 0.77), with a maximum of 4.63 and a minimum of 1.95. Functionality scores were quite similar for most of the apps, with the greatest differences in Engagement and Esthetics, which showed acceptable scores in one-third of the apps. The 5 apps with the highest MARS score were the following: “Bladder cancer manager,” “Kidney cancer manager,” “My prostate cancer manager,” “Target Ovarian Cancer Symptoms Diary,” and “My Cancer Coach.” We observed statistically significant differences in the MARS score between the operating systems and the developer types (<i>P</i>&lt;.001 and <i>P</i>=.01, respectively), but not for cost (<i>P</i>=.62). CONCLUSIONS MARS is a helpful methodology to decide which apps can be prescribed to patients and to identify which features should be addressed to improve these tools. Most of the apps designed for patients with genitourinary cancers only try to provide data about the disease, without coherent interactivity. The participation of health professionals in the development of these apps is low; nevertheless, we observed that both the participation of health professionals and regular updates were correlated with quality.

scholarly journals Harmonization of European and Russian standards of evaluation of the quality of delivery of health care in educational organizations

2019 ◽  
Vol 19 (3) ◽  
pp. 157-162
Author(s):  
V. R. Kuchma ◽  
Svetlana B. Sokolova
Keyword(s):  
Health Care ◽  
Health Services ◽  
Medical Care ◽  
Health Care Workers ◽  
Health Professionals ◽  
School Health ◽  
Educational Institutions ◽  
Medical Aid ◽  
Care Workers

Harmonization of European and Russian standards of the quality of the delivery of school health services and competencies for school health professionals allowed to justify the concept of the evaluation of the quality of the delivery of medical help to students in educational institutions. The concept does not prescribe a concrete methodfor the organizing school health services, unified process of the activity of health professionals. The concept consists of 7 groups of indices of quality and competences of health care workers. Quality criteria include the presence of a regulatory framework, indices of benevolence towards children, social equity and access to health care for students, requirements for premises, equipment of medical rooms in schools, cooperation with the administration and teachers of schools, parents and children, the medical community, the requirements for health care workers, a minimum list of services, covering both population and individual needs of students, the secure storage, the management and use ofpersonal medical data of children and adolescents. The competences of the staff of medical units are determined by provided medical services and technologies of the work. Properly medical competences of workers of medical care units for the delivery of medical aid to students are contributed by willingness to ensure the rights of children in the process of health care delivery in the educational organization, skills in the field of communication, sharing of information with children, parents and teachers, cooperation with colleagues, planning and coordination of the organization of medical care, the provision of sanitary epidemiological well-being of students, informational-elucidative activity for shaping of healthy lifestyle, research activity. Concept is the basis of the algorithm of the evaluation of the quality of the delivery of medical aid to students and quality assessment technology as well by medical organizations and institutions, as in the form of an independent audit of the quality of the delivery of medical aid to students in educational institutions.

Quality

2020 ◽  
pp. 166-183
Author(s):  
Julie Sin
Keyword(s):  
Health Services ◽  
Health System ◽  
Services Quality ◽  
Quality Care ◽  
System Level ◽  
Quality Of Services ◽  
Provider Perspective ◽  
Multidimensional Concept

This chapter looks at the topic of health services quality from a commissioning and whole population perspective. Quality is noted to be a multidimensional concept and dimensions of quality are considered. The role of the commissioner in maintaining and improving quality of services is explored, and this is seen within a wider backdrop of a health system with commissioner and provider functions (if there are such distinctions in the system). Commissioners need to know whether they are securing quality care for their population for the money spent. They also need an understanding of how this dovetails with the provider perspective on this topic. Commissioners also need to be able to articulate what they wish to assess in practice under the guise of quality. Finally, at a system level there are also bearings on how to compile and interpret a picture of a population’s health if needed.

scholarly journals Intimate partner violence among health professionals: distribution by autonomous communities in Spain

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Juan Manuel Carmona-Torres ◽  
Beatriz Recio-Andrade ◽  
María Aurora Rodríguez-Borrego
Keyword(s):  
Intimate Partner Violence ◽  
Health System ◽  
National Health ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Partner Violence ◽  
National Health System ◽  
Intimate Partner ◽  
Autonomous Communities ◽  
Spanish National Health System

Abstract OBJECTIVE To determine the prevalence of intimate partner violence among health care professionals who work in the Spanish National Health System, according to the autonomous communities of Spain. METHOD This was a descriptive cross-sectional multicenter study conducted with male and female health professionals (doctors, nurses, and nursing aides) in the different autonomous communities that are part of the Spanish National Health System. The following instruments were employed: among women, an intimate partner violence screening questionnaire; and among men, a questionnaire that screened for violence in the family environment. RESULTS A total of 1,039 health professionals participated in the study. Of these, 26% had suffered some type of abuse. Among the men, this prevalence was 2.7%, while among the women, it was 33.8%. There were differences in the prevalence of intimate partner violence among different autonomous communities, with the highest percentages in the Canary Islands. In terms of profession, 19.5% of the doctors had been exposed to intimate partner violence, while this percentage was 31% and 48.6% for nurses and nursing professionals, respectively. CONCLUSION The results indicate the presence of intimate partner violence among healthcare personnel in most of the autonomous communities of Spain. The data demonstrate the need to implement action plans, both to support victims and to mitigate the problem.

scholarly journals Reconceptualising specialisation: integrating refugee health in primary care

2020 ◽  
Vol 26 (6) ◽  
pp. 452 ◽  
Author(s):  
Donata Sackey ◽  
Meryl Jones ◽  
Rebecca Farley
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Health System ◽  
Health Professionals ◽  
Care Patient ◽  
Refugee Health ◽  
Health Networks ◽  
Geographic Coverage ◽  
Unmet Health Needs ◽  
High Degree

People from a refugee background have significant unmet health needs including complex physical and psycho-social presentations. They can experience low trust, unfamiliarity with the health system and reliance on family and friends to access care. To address these needs, Australia has specialised refugee health services in each state and territory. The majority of these services transition patients to primary care, but this transition, although necessary, is difficult. Most primary care and specialised health professionals share a high degree of commitment to refugee patients; however, despite best efforts, there are gaps. More integrated health services can start to address gaps and promote continuity of care. A previous study has described 10 principles that are associated with successful integration; this paper references five of those principles (continuum of care, patient focus, geographic coverage, information systems and governance) to describe and map out the outcomes of an integrated model of care designed to deliver specialist refugee health in primary care. The Co-location Model is a partnership between a refugee health service, Primary Health Networks, a settlement agency and general practices. It has the potential to deliver benefits for patients, greater satisfaction for health professionals and gains for the health system.

Volunteers and the Care of the Terminal Patient

1985 ◽  
Vol 15 (3) ◽  
pp. 237-244 ◽  
Author(s):  
Chwee Lye Chng ◽  
Michael Kirby Ramsey
Keyword(s):  
Quality Of Life ◽  
Health Services ◽  
Health Professionals ◽  
Terminal Care ◽  
Training Programs ◽  
Personal Characteristics ◽  
Supportive Role ◽  
Care Facilities ◽  
Demand For Health

In a time of shrinking funds and growing demand for health services, volunteers are indispensable. Civic minded people from all walks of life, when properly trained, can play an important supportive role to health professionals in terminal care facilities. Beside enhancing the quality of life of patients, volunteers may also help educate professionals to cope with death and bereavement. More specifically, the article examines the different roles of the volunteer: companion/friend, advocate, and educator. It also draws a profile of the volunteer, lists qualifications and personal characteristics, offers suggestions on where to work, and discusses special training programs to prepare volunteers for work with the dying.

scholarly journals Providing care to long-term mechanically ventilated patients in Germany – Current situation and needs for action from the perspective of health professionals / Die Versorgung langzeitbeatmeter Patienten in Deutschland – Aktuelle Situation und Handlungsbedarfe aus der Sicht von Gesundheitsberufsangehörigen

2020 ◽  
Vol 7 (1) ◽  
pp. 53-65
Author(s):  
Yvonne Lehmann ◽  
Susanne Stark ◽  
Michael Ewers
Keyword(s):  
Health Professionals ◽  
Invasive Mechanical Ventilation ◽  
Life Quality ◽  
Control Mechanisms ◽  
Health Providers ◽  
Patient Centered ◽  
Patient Pathways ◽  
Number Of Patients

AbstractBackgroundThe number of patients depending on long-term invasive mechanical ventilation (IMV) has been increasing for several years. Anecdotal reports indicate heterogeneous health structures, opaque patient pathways, nontransparent and sometimes questionable practices in individual areas of care, inadequate quality standards and control mechanisms in Germany. However, there is hardly any empirical data on this topic.AimTo report findings from a qualitative study conducted as part of a complex research project to assess the appropriateness of care provided to IMV patients in Germany.MethodsThirteen semi-structured expert interviews were conducted with 22 health professionals providing care for IMV patients. The data analysis was conducted with MAXQDA according to the framework by Meuser and Nagel.ResultsInterviewees emphasized similar healthcare deficits. They considered health providers to be nontransparent and influenced by secondary interests. Quality of care is reported to be jeopardized by shortage of trained staff. Warranty of self-determination and participatory decision-making is not a matter of fact. Clarifying issues of sustaining life, quality of life and shaping the end of life is often ignored. The professionals are familiar with the patient pathways, allocation processes and responsibilities described in existing guidelines, but criticize the fact that they are not sufficiently binding. Accordingly, patient pathways are frequently individual results of experience-based, informal networking, and often left to chance.ConclusionsThe results point to a considerable need for action to reach an appropriate, integrated, patient-centered level of care for long-term IMV patients and ensure its quality.

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