Clinical governance in the Irish health system – a review of progress

2014 ◽  
Vol 19 (4) ◽  
pp. 296-313 ◽  
Author(s):  
Eilish McAuliffe
Keyword(s):  
Health System ◽  
Clinical Governance ◽  
Healthcare Management ◽  
Reform Process ◽  
Content Type ◽  
Care Services ◽  
System A ◽  
Primary Care Services ◽  
Patient Groups ◽  
Why Questions

Purpose – The purpose of this paper is to explain the path that the Irish health system has taken towards achieving good clinical governance, exploring the historical influences on its’ development, some of the major initiatives that have been implemented and the obstacles that have been encountered. Design/methodology/approach – The paper draws on the author's experience researching and teaching in health systems and healthcare management. Findings – The paper offers some explanations for why earlier attempts failed to change the system as well as why recent attempts have met with more success. Greater efforts need to be made to progress clinical governance in the primary care services. In addition it is argued that there is a need to institute systems that enable learning form errors, to involve the public and patient groups and to invest in research that enables answers to the how and why questions that are so often neglected in the reform process. Originality/value – The paper discusses clinical governance in the Irish Health system and identifies some of the challenges yet to be addressed, many of which are common to clinical governance efforts in other jurisdictions.

scholarly journals The Primary Care Spend Model: a systems approach to measuring investment in primary care

2019 ◽  
Vol 4 (4) ◽  
pp. e001601 ◽  
Author(s):  
Robert Baillieu ◽  
Michael Kidd ◽  
Robert Phillips ◽  
Martin Roland ◽  
Michael Mueller ◽  
...  
Keyword(s):  
Primary Care ◽  
Health System ◽  
Systems Approach ◽  
Dynamic Assessment ◽  
International Health ◽  
Coordinated Care ◽  
Healthcare Budget ◽  
Care Services ◽  
Primary Care Services ◽  
Data Limitations

Increased investment in primary care is associated with lower healthcare costs and improved population health. The allocation of scarce resources should be driven by robust models that adequately describe primary care activities and spending within a health system, and allow comparisons within and across health systems. However, disparate definitions result in wide variations in estimates of spending on primary care. We propose a new model that allows for a dynamic assessment of primary care spending (PC Spend) within the context of a system’s total healthcare budget. The model articulates varied definitions of primary care through a tiered structure which includes overall spending on primary care services, spending on services delivered by primary care professionals and spending delivered by providers that can be characterised by the ‘4Cs’ (first contact, continuous, comprehensive and coordinated care). This unifying framework allows a more refined description of services to be included in any estimate of primary care spend and also supports measurement of primary care spending across nations of varying economic development, accommodating data limitations and international health system differences. It provides a goal for best accounting while also offering guidance, comparability and assessments of how primary care expenditures are associated with outcomes. Such a framework facilitates comparison through the creation of standard definitions and terms, and it also has the potential to foster new areas of research that facilitate robust policy analysis at the national and international levels.

scholarly journals Reduction of Neonatal Mortality Requires Strengthening of the Health System: A Situational Analysis of Neonatal Care Services in Ballabgarh

2017 ◽  
pp. fmw098
Author(s):  
Mudita Gosain ◽  
Akhil D. Goel ◽  
Pradeep Kharya ◽  
Ramesh Agarwal ◽  
Ritvik Amarchand ◽  
...  
Keyword(s):  
Health System ◽  
Neonatal Mortality ◽  
Neonatal Care ◽  
Situational Analysis ◽  
Care Services ◽  
System A

scholarly journals Using patient experience measures to evaluate the quality of medical and nursing care in the newly established PHC units (TOMYs), in Greece

2021 ◽  
Vol 14 (1) ◽  
pp. 49
Author(s):  
Olympia Konstantakopoulou ◽  
Daphne Kaitelidou ◽  
Petros Galanis ◽  
Olga Siskou ◽  
Charalambos Economou
Keyword(s):  
Health System ◽  
Patient Experience ◽  
Nursing Care ◽  
National Level ◽  
Local Health ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Social And Economic Development

Primary Health Care (PHC) is an integral part of both a country’s health system and of the overall social and economic development of the community. In Greece, in an effort to improve the provision of the PHC services on a national level, the Ministry of Health established the first Local Health Units (TOMYs) in December 2017. These new PHC units aimed to contribute to the provision of quality primary care services to citizens, while at the same time favoring the health system by improving the health of the population and helping to reduce health costs. Within this context, it is important for patients/PHC services’ recipients to be able to evaluate their experiences, as accumulated during their visits at these new health PHC structures. The aim of this paper was to evaluate the quality of medical and nursing care in the newly established PHC units (TOMYs) in Greece, using patient experience measures.

Assessing migrants’ satisfaction from health care services in Cyprus: a nationwide study

2019 ◽  
Vol 16 (1) ◽  
pp. 108-118
Author(s):  
Christos Panagiotopoulos ◽  
Menelaos Apostolou ◽  
Agamemnonas Zachariades
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Health System ◽  
Health Professionals ◽  
Health Care Services ◽  
Service Providers ◽  
Health Concern ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care

Purpose As long as migration is recognized as a public health concern, policies exist to address migrants’ health, and provide comprehensive information on how public and private health care system operates, health rights and what their health care plan does or does not cover. Thereby, responding to patients’ expectations significantly affects overall satisfaction with health care services because this dimension is most strongly associated with patient satisfaction. The purpose of this paper is to constitute the first quantitative large-scale study (n=1,512) in Cyprus and Greece exploring the level of satisfaction among third-country nationals (TCN) in relation to their health care needs. Design/methodology/approach The questionnaire used in this study has been developed and measured (Cronbach α =0.7) in a similar study in Greece (Galanis et al., 2013) and it has been used by other studies too (Vozikis, 2015). Findings The authors can conclude that participants’ knowledge of the health system is not good as 70.2 percent that they do not have a good knowledge. The findings suggest that nearly one in two TCN faced problems in accessing clinics or communicating due to various factors. Practical implications The findings of this study provide the context for further exploration of different means to improve cultural awareness amongst health and social care professionals, including multicultural training of health and social service providers and medical pluralist approaches that may be closer to migrants’ cultural and health background. Overall, types of interventions to improve cultural competency included training/workshops/programs for health practitioners (e.g. doctors, nurses and community health workers), culturally specific/tailored education or programs for patients/clients, interpreter services, peer education, patient navigators and exchange programs (Truong, 2014). To the above, practices can also be added as multicultural education to all health professionals in order to develop enthusiasm and be able to acknowledge immigrants’ difficulties. Adding to the above recommendation, interdisciplinary education with allied health professionals (psychologists, social workers and nurses) may lead to a more holistic approach of this group’s needs, especially in the forthcoming health system where primary care will play a vital role. Social implications Access to the health system may lead to social inclusion of TCN in the local society and improve their quality of life. It is also important for TCN to feel that the current health system is aware of issues related to their social and cultural background; thus, it will make the health system and those who work look more friendly and approachable. Originality/value In an era of crisis and of great debate around a forthcoming National Health System, these findings indicate that healthcare providers in Cyprus will need to address several challenges in managing care for migrants. In order for that to happen, assessing patient satisfaction is thereby important in the process of quality evaluation, especially when dealing with population subgroups at higher risk of inequalities such as immigrants or ethnic minorities. Such studies help systems to develop by measuring their weaknesses and enhancing their strengths. Voicing clients/patients feedback is always helpful to minimize risks.

Telephone consultation in primary care

2018 ◽  
Vol 32 (2) ◽  
pp. 321-337 ◽  
Author(s):  
Francisco Gonzalez ◽  
Blanca Cimadevila ◽  
Julio Garcia-Comesaña ◽  
Susana Cerqueiro ◽  
Eladio Andion ◽  
...  
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Public Healthcare ◽  
Telephone Consultation ◽  
Content Type ◽  
Face To Face ◽  
Care Services ◽  
Primary Care Services ◽  
Gender And Age ◽  
Telephone Calls

Purpose The purpose of this paper is to describe and analyze a teleconsultation modality based on a simple telephone call, using either landline or mobile phone, made available to more than two million people. Telecommunication systems are an increasingly common feature in modern healthcare. However, making teleconsultations available to the entire population covered by a public health system is a challenging goal. Design/methodology/approach This retrospective longitudinal observational study analyzed how this modality was used at the primary care level in Galicia, a region in the Northwest of Spain, in 2014 and 2015, focusing on demand, gender and age preferences, rural vs urban population and efficiency. Findings Of 28,472,852 consultations requested in this period, 9.0 percent were telephone consultations. Women requested more telephone consultations (9.9 percent of total consultations) than men (7.7 percent of total consultations). The highest demand occurred for the over 85 age group for both men and women. In both years, 2014 and 2015, the number of telephone consultations per inhabitant was higher in urban (0.53 and 0.69) than in rural areas (0.34 and 0.47). In 10.9 percent of cases, the telephone consultations required further face-to-face consultation. Originality/value Conventional voice telephone calls can efficiently replace conventional face-to-face consultations in primary healthcare in roughly 10 percent of cases. Women are more likely than men to use primary care services in both face-to-face and telephone consultation modalities. Public healthcare systems should consider implementing telephone consultations to deliver their services.

scholarly journals Critical Care in the Military Health System: A Survey-Based Summary of Critical Care Services

2018 ◽  
Vol 183 (11-12) ◽  
pp. e471-e477 ◽  
Author(s):  
Jason J Nam ◽  
Christopher J Colombo ◽  
Cristin A Mount ◽  
Elizabeth A Mann-Salinas ◽  
Ferdinand Bacomo ◽  
...  
Keyword(s):  
Critical Care ◽  
Health System ◽  
Military Health System ◽  
Military Health ◽  
Care Services ◽  
System A ◽  
The Military

Completing the Health System through Personal Care Benefits

1973 ◽  
Vol 4 (2) ◽  
pp. 157-165 ◽  
Author(s):  
Robert Morris
Keyword(s):  
Health System ◽  
The Elderly ◽  
Personal Care ◽  
Care Services ◽  
System A ◽  
Incomplete System ◽  
Disabled Elderly ◽  
The Disabled ◽  
Adequate Provision ◽  
Expenditure Pattern

Discussion about policy and programming for the elderly and disabled is frequently built around the cycle of prevention, treatment, and rehabilitation which leads to an incomplete system of health care for this population. Lack of adequate provision for the special maintenance required for the disabled elderly produces undesirable consequences in the prevailing medical system. A system of personal care benefits and personal care services is proposed as a means for completing the health system for more effective functioning. Approaches for structure and for stable, assured funding for such personal care support services are proposed which draw upon the principles of capitation prepayment. A change in the expenditure pattern of present appropriations is suggested as an alternative to additional expenditures.

Analyzing the performance of health technologies distribution models in primary care services

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Elisabetta Garagiola ◽  
Alessandro Creazza ◽  
Emanuele Porazzi
Keyword(s):  
Primary Care ◽  
Current Distribution ◽  
Distribution Model ◽  
Local Health ◽  
Distribution Models ◽  
Content Type ◽  
Health Technologies ◽  
Care Services ◽  
Primary Care Services ◽  
Quantitative Performance

Purpose Due to the evolution of the health-care scenario and the growing role of the primary care setting, the distribution processes of health technologies will be more and more in demand in the near future. This paper aims to investigate this theme, analyzing the performance, strengths and weaknesses of the current distribution practices, with the ultimate overarching aim to improve the provision of the primary care services. Design/methodology/approach The research framework is twofold. First, a tool to monitor the economic/quantitative performance of the distribution models was designed; second, the tool was applied to measure the performance of distribution models of absorbent devices for incontinence adopted by Local Health Authorities (LHA) in Lombardy Region (Italy). Quantitative data were collected by LHAs (from 2012 to 2016) and compared through data-benchmarking. Qualitative data from interviews and focus groups complemented the outcomes. Findings Two main distribution models were investigated: distribution through pharmacies and home delivery. Results show that there is no winning/preferable model in terms of economic/quantitative performance and service quality level, but a counterbalanced combination of strengths and weaknesses exists. Moving from the highlighted weaknesses and building on the strengths, an alternate distribution model is proposed for testing. Originality/value The present study approaches the theme of primary care services with a holistic approach, filling a literature gap. It also provides practitioners with a tool of performance analysis and management and real data, applicable also in international contexts. The collected real-world data also gives insights on the area of the quality of care, with particular reference to the patients’ experience. As a lesson learned, policymakers and the National Healthcare Service should re-think their current distribution models/practices in the light of the highlighted criticisms and opportunities for improvement.

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