The performance of primary health care organizations depends on interdependences with the local environment

2016 ◽  
Vol 30 (6) ◽  
pp. 836-854 ◽  
Author(s):  
Paul Lamarche ◽  
Lara Maillet
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Organizational Climate ◽  
Design Methodology ◽  
Health Care Organizations ◽  
Local Environment ◽  
Content Type ◽  
Primary Health ◽  
Optimal Execution ◽  
Do So

Purpose Improving the performance of health care organizations is now perceived as essential in order to better address the needs of the populations and respect their ability to pay for the services. There is no consensus on what is performance. It is increasingly considered as the optimal execution of four functions that every organization must achieve in order to survive and develop: reach goals; adapt to its environment; produce goods or services and maintain values; and a satisfying organizational climate. There is also no consensus on strategies to improve this performance. The paper aims to discuss these issues. Design/methodology/approach This paper intends to analyze the performance of primary health care organizations from the perspective of Kauffman’s model. It mainly aims to understand the often contradictory, paradoxical and unexpected results that emerge from studies on this topic. Findings To do so, the first section briefly presents Kauffman’s model and lays forward its principal components. The second section presents three studies on the performance of primary organizations and brings out the contradictory, paradoxical and unexpected results they obtained. The third section explains these results in the light of Kauffman’s model. Originality/value Kauffman’s model helps give meaning to the results of researches on performance of primary health care organizations that were qualified as paradoxical or unexpected. The performance of primary health care organizations then cannot be understood by only taking into account the characteristics of these organizations. The complexity of the environments in which they operate must simultaneously be taken into account. This paper brings original development of an integrated view of the performance of organizations, their own characteristics and those of the local environment in which they operated.

scholarly journals Lessons learnt from CBR practice at Hua Don Primary Health Care, Thailand

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Phaksachiphon Khanthong ◽  
Chatchadapon Chaiyasat ◽  
Chayada Danuwong
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Leader ◽  
Second Phase ◽  
Target Area ◽  
Content Type ◽  
Community Based Research ◽  
Primary Health ◽  
Lessons Learnt ◽  
Essential Skills

PurposeThe purpose of this study is to determine the capacity map of professional learning community (PLC) practicing community-based research (CBR) in Ubon Ratchathani Rajabhat University, Thailand, and the implementation of the lessons learnt from the process and essential skills at Hua Don Primary Health Care (PHC).Design/methodology/approachParticipatory action research (PAR) design was conducted in two phases, one on campus and the other in the PHC. For gathering and validating the data, the snowball sampling technique, focus group, in-depth interviews and the triangulation method were used.FindingsThe PLC capacity map from the first phase provided the essential skills of CBR and the second phase revealed lessons learnt from the implementation in the Hua Don PHC. The shortcut in researching a new target area by a collaboration of the community leader and village health volunteers was prominent. The results could be interpreted in creating collaboration in health care with a new community.Originality/valueThe capacity map is a practical guideline for a beginner or CBR novice researcher, and the lessons learnt help the implementation in the health field, particularly in PHC, succeed smoothly.

Evaluation of integrated antenatal care implementation in primary health care

2020 ◽  
Vol 28 (2) ◽  
pp. 99-117 ◽  
Author(s):  
Sandra Hakiem Afrizal ◽  
Achmad Nizar Hidayanto ◽  
Putu Wuri Handayani ◽  
Besral Besral ◽  
Evi Martha ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Antenatal Care ◽  
Local Governments ◽  
Health Workers ◽  
Practical Implication ◽  
Functional Integration ◽  
Content Type ◽  
Primary Health

PurposeThis study was aimed to evaluate the implementation of an integrated antenatal care (ANC) scheme through a retrospective document study using a checklist for measuring the adequacy of the cohort ANC register documented by midwives in an urban area and to describe the barriers for the midwives during the ANC record process.Design/methodology/approachAn exploratory descriptive study using a sequential mixed method was utilised where a quantitative method was employed by collecting secondary data of 150 entries of the cohort ANC register and followed by in-depth interviews among midwives and community health workers.FindingsThe results show that the cohort registry indicators for integrated care such as laboratory and management were poorly recorded. Several barriers were found and categorised during the implementation of the integrated ANC, namely (1) governance and strategy, (2) process of care, (3) organisation and management support.Research limitations/implicationsThe contribution of this present research is that it provides empirical data of the integrated ANC implementation in primary health care (PHC) which has the responsibility to deliver an integrated level of care for ANC using a cohort registry for pregnancy registration monitoring which facilitates the continuity and quality of care.Practical implicationsPractical implication of the finding is that functional integration such as the clinical information system to facilitate an efficient and effective approach during the implementation of integrated ANC in primary care should be considered to support the clinical, professional, organisational, system and normative integration.Originality/valueSince only limited studies have been conducted to assess the quality of the cohort ANC registry and to investigate the barriers against integrated ANC implementation in Indonesia, the research findings are valuable information for the national and local governments to improve the ANC service in Indonesia.

scholarly journals Integrating Physiotherapists into Primary Health Care Organizations: The Physiotherapists' Perspective

2018 ◽  
Vol 70 (2) ◽  
pp. 188-195 ◽  
Author(s):  
Sai Maharaj ◽  
Christine Chung ◽  
Inderdeep Dhugge ◽  
Maria Gayevski ◽  
Asya Muradyan ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Organizations ◽  
Primary Health

scholarly journals A Health Care Value Framework for Physical Therapy Primary Health Care Organizations

2020 ◽  
Vol 30 (1) ◽  
pp. 27-35
Author(s):  
Rutger Friso IJntema ◽  
Di-Janne Barten ◽  
Hans B. Duits ◽  
Brian V. Tjemkes ◽  
Cindy Veenhof
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Physical Therapy ◽  
Health Care Organizations ◽  
Primary Health ◽  
Health Care Value

scholarly journals Relevance of Improving Human Resource Management in the Organization of Primary Healthcare

2020 ◽  
Vol 4 (39) ◽  
pp. 31-39
Author(s):  
Gulzhan Mukhanova ◽  
◽  
Sultanbek Tultabaev ◽  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Resource Management ◽  
Human Resource Management ◽  
Human Resource ◽  
Health Care Organizations ◽  
Systems Approach ◽  
Primary Health ◽  
The Republic ◽  
Effective Use

The aim of this study: To determine the trajectory of improving human resource management as an element of operational management in the organization of primary health care. Methods. Within the framework of the study, a comparative analysis of statistical data on the provision of PHC doctors by regions for 2017-2019 was carried out according to the information system of the Ministry of Health of the Republic of Kazakhstan «Additional component of the per capita standard». Results. When analyzing the provision of health care organizations with general practitioners, district pediatricians, district therapists at the level of primary health care (PHC) in the republic, a dynamic decrease in the quantitative indicator of doctors providing PHC was revealed. And also noted a stable tension in the workload of a doctor in terms of the number of served (attached) population. Conclusions. Staff-oriented approaches, such as calculating the required number of staff or creating formulas and algorithms, provide only partial solutions. More comprehensive solutions are needed that will focus on effective multifactor human resource management. For the most effective use of human resources, health care organizations must expand a systems approach that takes into account organizational and institutional conditions

Towards quality primary health care: the dilemma of Community-Based Health Planning and Services (CHPS) in health service provision in Ghana

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Barnabas Addi ◽  
Benjamin Doe ◽  
Eric Oduro-Ofori
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Planning ◽  
Health Care Facilities ◽  
Health Needs ◽  
Community Based ◽  
Content Type ◽  
Primary Health ◽  
Care Facilities ◽  
Primary Health Care Facilities

PurposeOver the past two decades, Community-Based Health Planning and Services (CHPS) has been a pragmatic strategy towards universal Primary Health Care (PHC) in Ghana. However, the ability and capacity of these facilities to deliver quality primary health care remain an illusion as they are still crumbling in myriad challenges. These challenges are translated to the poor-quality services provision and low community utilization of CHPS facilities. The study presents a comparative analysis of three communities in the Kassena-Nankana East Municipality, Ghana.Design/methodology/approachUsing a mixed-method research design, the study gathered and analysed data from 110 households, three community health officers (CHOs) and three community leaders using semi-structured questionnaires and interview guides.FindingsThe findings indicated that the facilities do not have the requisite inputs such as drugs and supplies, logistics, appropriate health personnel, good infrastructure, funding support necessary to deliver quality and appropriate healthcare services that meet the health needs of the communities. For the CHPS to realize their full potentials as PHC facilities, it is required that the needed inputs such as logistics, drugs and appropriate staff are in place to facilitate the activities of CHOs.Research limitations/implicationsDue to the limited number of participants and selection of the study communities, the results may generalization. Also, the researchers acknowledged the inability to interview the district level health officials and the Kassena-Nankana Municipal Assembly during the field visits. This could have provided in-depth knowledge on the findings of this research as well as the validation of the results from the communities' perspective. Several attempts were made to contact and interview district-level authorities which proven futile due to the unavailability of targeted respondents. This resulted in limiting the studies at the community level. However, this limitation does not disprove the findings of this study.Practical implicationsThe article implications for planning primary health care strategies include a keen assessment of community health needs and institutional management of primary health care facilities, equip PHC facilities with adequate resources such as drugs and appropriate staffing to provide the health needs of the communities.Originality/valueThe paper fulfils the gap in the literature by providing empirical data on how the challenges of primary health care facilities affected the provision of high quality service and how this can affect community’s use of the facilities.

MANAGEMENT OF PATIENT COMPLAINTS IN PRIMARY HEALTH CARE ORGANIZATIONS TO IMPROVE THE QUALITY OF MEDICAL CARE (LITERATURE REVIEW)

2021 ◽  
pp. 65-70
Author(s):  
Ж.А. Амантаева ◽  
Л.К. Кошербаева
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Organizations ◽  
Medical Services ◽  
Management Information ◽  
Patient Complaints ◽  
Primary Health ◽  
National League ◽  
Quality Of Medical Care

В данной статье представлен научно-литературный обзор факторов, влияющих на возникновение жалоб потребителей медицинских услуг и их управление. Приведена информация о том, в каком объеме поступают медицинские жалобы, в национальную лигу потребителей. В статье приведены в качестве примера жалобы потребителей медицинских услуг не только в Казахстане, но и зарубежом. This article presents a scientific and literary review of the factors that influence the occurrence of complaints of consumers of medical services and their management. Information is provided on the extent to which medical complaints are received by the national league of Consumers. The article provides an example of complaints from consumers of medical services not only in Kazakhstan, but also abroad.

Impacts of continuous quality improvement in Aboriginal and Torres Strait islander primary health care in Australia

2018 ◽  
Vol 32 (4) ◽  
pp. 545-571 ◽  
Author(s):  
Beverly Sibthorpe ◽  
Karen Gardner ◽  
Mier Chan ◽  
Michelle Dowden ◽  
Ginny Sargent ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Service Systems ◽  
Client Outcomes ◽  
Content Type ◽  
Care Services ◽  
Continuous Quality ◽  
Primary Health ◽  
Primary Health Care Services

PurposeContinuous quality improvement (CQI) programmes have been taken up widely by indigenous primary health care services in Australia, but as yet there has not been a systematic assessment of their focus and achievements. A scoping review of the literature from studies of CQI in indigenous primary health care services was undertaken to explore impacts on service systems, care and client outcomes with the aim of providing guidance on future evaluation efforts. The paper aims to discuss these issues,Design/methodology/approachSearches were conducted in MEDLINE, CINAHL and the Cochrane Database of Systematic Reviews to December 2016 and handsearching of key websites and publications. Studies of CQI programs or activities in Indigenous primary health care services which demonstrated some combination of CQI characteristics, as described by Rubenstein (2013) were included. A two-stage approach to analysis was undertaken. Stage 1 identified the range and scope of literature, and Stage 2 investigated impacts to service systems, care and client outcomes. The Framework for Performance Assessment in Primary Health Care was used to frame the Stage 2 analysis.FindingsThe majority of Aboriginal community controlled health services have been involved in CQI but there are gaps in knowledge about uptake in general practice and government clinics. There are as many baseline studies as studies on impacts over time. Of the 14 studies included for further analysis, 6 reported on impacts on service systems; all 14 reported on impacts on care and 6 on client outcomes. Changes to services systems are variable and studies of impacts on care and client outcomes show promising though uneven improvements. There are no economic studies or studies addressing community engagement in CQI activities.Research limitations/implicationsTo supplement existing limited knowledge about which service system change strategies are effective and sustainable for which problems in which settings, there needs to be investment in research and development. Research needs to be grounded in the realities of service delivery and contribute to the development of CQI capacity at the service level. Knowledge translation needs to be built into implementation to ensure maximum benefit to those endeavouring on a daily basis to constantly reflect on and improve the quality of the care they deliver to clients, and to the stewardship structures supporting services at regional, state/territory and national levels.Practical implicationsImproved approaches, methods, data capture and reporting arrangements are needed to enhance existing activity and to ensure maximum benefit to services endeavouring to reflect on and improve quality of care and to the stewardship structure supporting services at regional, state/territory and national levels.Originality/valueAlthough there is a growing body of research evidence about CQI both nationally and internationally, and considerable investment by the federal government in Australia to support CQI as part of routine practice, there has not been a systematic assessment of the achievements of CQI in Indigenous primary health care services. Many unanswered questions remain about the extent of uptake, implementation and impacts. This is a barrier to future investment and regional and local programme design, monitoring and evaluation. The authors conducted a scoping review to address these questions. From this, the authors draw conclusions about the state of knowledge in Australia with a view to informing how future CQI research and evaluation might be intensified.

TLC vs Simvastatin vs Simvastatin and TLC in hypercholesterolemia

2016 ◽  
Vol 46 (3) ◽  
pp. 344-362 ◽  
Author(s):  
Jian Pei Kong ◽  
Azlee Bin Ayub ◽  
Rawa Ak Bau
Keyword(s):  
Health Care ◽  
Weight Loss ◽  
Primary Health Care ◽  
Care Setting ◽  
Health Care Setting ◽  
The Other ◽  
Lipid Lowering ◽  
Content Type ◽  
Primary Health Care Setting ◽  
Primary Health

Purpose National Health and Morbidity Survey of Malaysia 2011 revealed that hypercholesterolemia (35.1 per cent, 6.2 million) was the primary leading causes of cardiovascular disease in Malaysia. Currently, three established recommended approaches such as therapeutic lifestyle change (TLC) diet, pharmacotherapy (simvastatin) and TLC + simvastatin are available to the public but, to our knowledge, have never been compared in Malaysia Primary Health Care setting. Hence, this paper aims to compare the lipid lowering effects of these three approaches in a primary health care clinic. Design/methodology/approach This randomized trial enrolled 180 patients with hypercholesterolemia who met adult treatment panel III (ATP III) criteria. All participants were randomized to TLC diet, simvastatin (10-20 mg/d) or TLC + simvastatin diets. The TLC group was enrolled in a 12-week multidisciplinary lifestyle program that involved monthly 45 minutes to hour meetings. The simvastatin group received medication, and traditional counseling was conducted by registered medical officer. Another group was enrolled into TLC + simvastain treatment. The primary outcome measure was the percentage change in low-density lipoprotein-cholesterol. Secondary measures were changes in weight loss, blood pressure and dietary changes. Assessments were repeated at three-month interval. Findings Lifestyle changes combined with simvastatin had a better lipid lowering effect compared to the other two treatments. However, TLC had a better weight and blood pressure reduction compared to the other two treatments. Nevertheless, TLC group showed reduction proportions similar to standard therapy with simvastatin or TLC + simvastatin. TLC has proven as an alternative approach to hyperlipidemia for a subset of patients unwilling or unable to take statins especially in a community-based, primary health care setting. Research limitations/implications Weight loss was not recorded for simvastatin participants, and this was the major drawback of this study, and there was no comparable weight loss reduction with other groups. Originality/value In Malaysia, the efficacy of hypocholesterolemic therapies among patients who are receiving the most common lipid-lowering drug, simvastatin, in primary health care setting has not been clearly defined. There is also a lack of research on the efficacy of TLC conducted by registered dietitian in a primary health care setting in Malaysia.

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