scholarly journals Improvisation during a crisis: hidden innovation in healthcare systems

BMJ Leader ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 185-188 ◽  
Author(s):  
Rene Wiedner ◽  
Charlotte Croft ◽  
Gerry McGivern
Keyword(s):  
Healthcare Professionals ◽  
Social Care ◽  
Economic Recession ◽  
Healthcare Systems ◽  
Service Area ◽  
Critical Situation ◽  
Health And Social Care ◽  
The World ◽  
Care Systems ◽  
Key Drivers

BackgroundCrises, such as the COVID-19 pandemic, risk overwhelming health and social care systems. As part of their responses to a critical situation, healthcare professionals necessarily improvise. Some of these local improvisations have the potential to contribute to important innovations for health and social care systems with relevance beyond the particular service area and crisis in which they were developed.FindingsThis paper explores some key drivers of improvised innovation that may arise in response to a crisis. We highlight how services that are not considered immediate priorities may also emerge as especially fertile areas in this respect.ConclusionHealth managers and policymakers should monitor crisis-induced improvisations to counteract the potential deterioration of non-prioritised services and to identify and share useful innovations. This will be crucial as health and social care systems around the world recover from the COVID-19 pandemic and head into another potential crisis: a global economic recession.

The challenge of integration

2017 ◽  
Author(s):  
Alan Cribb
Keyword(s):  
Health Policy ◽  
Health Systems ◽  
Social Care ◽  
Healthcare Systems ◽  
Division Of Labour ◽  
Health And Social Care ◽  
Care Systems ◽  
Central Device ◽  
The Way

This chapter analyses the increasingly influential idea that healthcare systems, or health and social care systems more broadly, need to be better integrated—that both services and the experiences of individuals need to be less ‘fractured’ and that this depends upon attending to the overall architecture of systems. In order to approach the integration agenda, it is worth acknowledging the ‘problem’ that gives rise to it. The agenda is closely bound up with divisions and boundaries that are both necessary and a source of difficulties. The way in which health systems seek to provide diverse goods is through a division of labour that structures both services and roles. Yet the necessary division of labour inevitably and notoriously creates problems. Perhaps the central device through which health policy addresses and manages this tension—between differentiated provision and consolidated needs—is by supporting both specialism and generalism.

A system-wide transformation towards integrated care in the Basque Country: A realist evaluation

2018 ◽  
Vol 21 (3) ◽  
pp. 98-108 ◽  
Author(s):  
Maider Urtaran-Laresgoiti ◽  
Arturo Álvarez-Rosete ◽  
Roberto Nuño-Solinís
Keyword(s):  
Health System ◽  
Social Care ◽  
Basque Country ◽  
Economic Recession ◽  
Realist Evaluation ◽  
System Transformation ◽  
Structured Interviews ◽  
Long Run ◽  
Health And Social Care ◽  
Care Systems

Introduction In 2010, in a context of severe economic recession, the Basque Government launched the Strategy to tackle the challenge of chronicity in the Basque Country to transform the Basque health system to cope with the challenges of chronicity, ageing, health system fragmentation and sustainability in the long run. Methods A realist evaluation has been conducted, and through a combination of research methods, information has been analysed to identify context, mechanisms and outcomes. The research provides a snapshot of the experience of a system-wide, complex health system transformation, which aims to identify ‘what has worked, for whom and under what circumstances’. Twenty-two semi-structured interviews held between June 2015 and December 2016, allowed us to obtain both retrospective and real-time accounts on the transformation phenomenon. Results Research pointed out that system-wide transformation requires time, effort, leadership, vision and narrative, as well as commitment, inclusiveness, collaborative decision-making processes with local implementers, ‘muddling through’ and constant learning. Key levers to shake and shift the health and social care systems towards closer alignment, coordination and integration to meet the needs of people include promoting collaborative relationships between health professionals to ensure care continuity, developing new staff roles, investing in integrated electronic health records, stratifying the population by risk and facilitating bottom-up innovation. Discussion Research has shown that system-wide changes in health and social care have been viable in the Basque Health System, although the interplay between context, mechanisms and outcomes is more complex than expected, leading to many unexpected factors, patterns and relationships.

scholarly journals Carer Empowerment Is Key to Reduce Dementia Care Inequalities in the Middle East

2021 ◽  
Vol 18 (8) ◽  
pp. 4378
Author(s):  
Syed Fahad Javaid ◽  
Aishah Al-Zahmi ◽  
Munir Abbas
Keyword(s):  
Middle East ◽  
Social Care ◽  
Evidence Based ◽  
Political Factors ◽  
Knowledge Based ◽  
Care And Support ◽  
Health And Social Care ◽  
Care Systems ◽  
Spiritual Perspectives ◽  
Do So

Dementia represents a significant problem in the Middle East. Sociocultural and political factors that shape conceptions of health and care tend to stifle research and the dissemination of knowledge throughout the Middle East. These socio-political challenges concerning engagement with individuals living with dementia and their carers include language barriers, stigmatization, logistical constraints, lack of informal support outside of hospitals, and over-dependence on clinicians for dementia information. There is an urgent need in the Middle East to increase care and support for adults with dementia and their carers, enhance research efforts and improve the dissemination of information related to dementia in the region. One possible way to do so is to begin to promote a knowledge-based culture throughout the Middle East. This can be achieved by aligning traditional deterministic and spiritual perspectives of mental health with more Western, scientific, and evidence-based models. We suggest employing practical, multidimensional approaches to deal with the stated challenges, both at individual and societal levels. Doing so will improve knowledge of dementia and allow health and social care systems in the Middle East to begin to address a growing problem.

scholarly journals Maudsley International: improving mental health and well-being around the world

2018 ◽  
Vol 15 (3) ◽  
pp. 49-51 ◽  
Author(s):  
Nick Bouras ◽  
Silvia Davey ◽  
Tracey Power ◽  
Jonathan Rolfe ◽  
Tom Craig ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Care ◽  
Well Being ◽  
Building Capacity ◽  
The Past ◽  
Health And Social Care ◽  
The World ◽  
Set Up ◽  
Health And Well Being ◽  
And Training

Maudsley International was set up to help improve people's mental health and well-being around the world. A variety of programmes have been developed by Maudsley International over the past 10 years, for planning and implementing services; building capacity; and training and evaluation to support organisations and individuals, professionals and managers to train and develop health and social care provisions. Maudsley International's model is based on collaboration, sharing expertise and cultural understanding with international partners.

Health and Social Care Systems

2020 ◽  
pp. 49-66
Author(s):  
Anna Coleman ◽  
Jolanta Shields ◽  
Tim Gilling
Keyword(s):  
Social Care ◽  
Health And Social Care ◽  
Care Systems

scholarly journals Maternal mortality in the developing world: why do mothers really die?

2008 ◽  
Vol 1 (1) ◽  
pp. 2-6 ◽  
Author(s):  
Gwyneth Lewis
Keyword(s):  
Maternal Mortality ◽  
Death Certificate ◽  
Social Care ◽  
World Health ◽  
Depth Information ◽  
Health Organizations ◽  
Political Will ◽  
Cultural Attitudes ◽  
Health And Social Care ◽  
The World

Every year some eight million women suffer preventable or remediable pregnancy-related complications and over half a million will die unnecessarily. Most of these deaths could be averted at little or no extra cost, even where resources are limited, but in order to take action, and develop and implement changes to maternity services to save mothers and newborns lives, a change in cultural attitudes and political will, as well as improvements in the provision of health and social care, is required. Further, to aid programme planners, more in-depth information than that which may already be available through national statistics on maternal mortality rates or death certificate data is urgently needed. What is required is an in-depth understanding of the clinical, social, cultural or any other underlying factors which lead to mothers' deaths. Such information can be obtained by using any of the five methodologies outlined in the World Health Organizations programme and philosophy for maternal death or disability reviews, ‘Beyond the Numbers’, briefly described here and which are now being introduced in a number of countries around the world.

scholarly journals Reducing the Risk of Cognitive Decline and Dementia: WHO Recommendations

2022 ◽  
Vol 12 ◽  
Author(s):  
Neerja Chowdhary ◽  
Corrado Barbui ◽  
Kaarin J. Anstey ◽  
Miia Kivipelto ◽  
Mariagnese Barbera ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Risk Reduction ◽  
Social Care ◽  
Guideline Development ◽  
Action Plan ◽  
World Health Organisation ◽  
World Health ◽  
Public Health Response ◽  
Health And Social Care ◽  
The World

With population ageing worldwide, dementia poses one of the greatest global challenges for health and social care in the 21st century. In 2019, around 55 million people were affected by dementia, with the majority living in low- and middle-income countries. Dementia leads to increased costs for governments, communities, families and individuals. Dementia is overwhelming for the family and caregivers of the person with dementia, who are the cornerstone of care and support systems throughout the world. To assist countries in addressing the global burden of dementia, the World Health Organisation (WHO) developed the Global Action Plan on the Public Health Response to Dementia 2017–2025. It proposes actions to be taken by governments, civil society, and other global and regional partners across seven action areas, one of which is dementia risk reduction. This paper is based on WHO Guidelines on risk reduction of cognitive decline and dementia and presents recommendations on evidence-based, multisectoral interventions for reducing dementia risks, considerations for their implementation and policy actions. These global evidence-informed recommendations were developed by WHO, following a rigorous guideline development methodology and involved a panel of academicians and clinicians with multidisciplinary expertise and representing geographical diversity. The recommendations are considered under three broad headings: lifestyle and behaviour interventions, interventions for physical health conditions and specific interventions. By supporting health and social care professionals, particularly by improving their capacity to provide gender and culturally appropriate interventions to the general population, the risk of developing dementia can be potentially reduced, or its progression delayed.

scholarly journals Exploring the role of the Care and Health Information Exchange (CHIE) in clinical decision-making: a realist evaluation

2020 ◽  
Author(s):  
Philip Scott ◽  
Elisavet Andrikopoulou ◽  
Haythem Nakkas ◽  
Paul Roderick
Keyword(s):  
Decision Making ◽  
Health Information ◽  
Information Exchange ◽  
Healthcare Professionals ◽  
Clinical Decision Making ◽  
Social Care ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
Health And Social Care ◽  
The Impact

Background: The overall evidence for the impact of electronic information systems on cost, quality and safety of healthcare remains contested. Whilst it seems intuitively obvious that having more data about a patient will improve care, the mechanisms by which information availability is translated into better decision-making are not well understood. Furthermore, there is the risk of data overload creating a negative outcome. There are situations where a key information summary can be more useful than a rich record. The Care and Health Information Exchange (CHIE) is a shared electronic health record for Hampshire and the Isle of Wight that combines key information from hospital, general practice, community care and social services. Its purpose is to provide clinical and care professionals with complete, accurate and up-to-date information when caring for patients. CHIE is used by GP out-of-hours services, acute hospital doctors, ambulance service, GPs and others in caring for patients. Research questions: The fundamental question was How does awareness of CHIE or usage of CHIE affect clinical decision-making? The secondary questions were What are the latent benefits of CHIE in frontline NHS operations? and What is the potential of CHIE to have an impact on major NHS cost pressures? The NHS funders decided to focus on acute medical inpatient admissions as the initial scope, given the high costs associated with hospital stays and the patient complexities (and therefore information requirements) often associated with unscheduled admissions. Methods: Semi-structured interviews with healthcare professionals to explore their experience about the utility of CHIE in their clinical scenario, whether and how it has affected their decision-making practices and the barriers and facilitators for their use of CHIE. The Framework Method was used for qualitative analysis, supported by the software tool Atlas.ti. Results: 21 healthcare professionals were interviewed. Three main functions were identified as useful: extensive medication prescribing history, information sharing between primary, secondary and social care and access to laboratory test results. We inferred two positive cognitive mechanisms: knowledge confidence and collaboration assurance, and three negative ones: consent anxiety, search anxiety and data mistrust. Conclusions: CHIE gives clinicians the bigger picture to understand the patient's health and social care history and circumstances so as to make confident and informed decisions. CHIE is very beneficial for medicines reconciliation on admission, especially for patients that are unable to speak or act for themselves or who cannot remember their precise medication or allergies. We found no clear evidence that CHIE has a significant impact on admission or discharge decisions. We propose the use of recommender systems to help clinicians navigate such large volumes of patient data, which will only grow as additional data is collected.

scholarly journals Háziorvosok és idősellátás egy kérdőíves kutatás tükrében

2018 ◽  
Vol 159 (8) ◽  
pp. 312-319
Author(s):  
Anett Mária Tróbert ◽  
Zsuzsanna Széman
Keyword(s):  
Health Care ◽  
General Practitioners ◽  
Social Care ◽  
The Elderly ◽  
Care Process ◽  
Efficient Operation ◽  
Health And Social Care ◽  
Care Systems ◽  
Care System

Abstract: According to statistical data, the number of healthy life years is not increasing in proportion with the longer average life expectancy. In the ageing societies, the long-term care systems are increasingly overburdened; cost-efficient operation and the related coordination of services is one of the key questions for their sustainability. The present separation of the health care and social care systems causes numerous difficulties. One aim of the online research by questionnaire was to survey the attitude of general practitioners – who play a very important part in care for the elderly – towards their elder patients, the patients’ family members, and social workers providing eldercare. The other aim was to gather information on shortcomings experienced by doctors in the care system and on what possibilities general practitioners see for the improvement of eldercare. Semi-structured questionnaires were applied and analysed by descriptive and content methodology. The questionnaires were sent out to 5060 addresses around the country: a total of 145 were returned filled in. The respondents made many recommendations for the improvement of eldercare in the categories of development of social services, family support, development of health services, and societal cooperation. The areas in need of development named by the general practitioners are closely interrelated: the reform of social care would support the health care system and vice versa. More effective operation of the health and social care systems would ease the burdens of families, and at the same time encourage more active participation of families in the care process. And the systematic education of society and communities is a long-term investment that would strengthen a positive attitude towards old age and a value-oriented view of the ageing process that is one of the basic conditions for successful social integration of the elderly. Orv Hetil. 2018; 159(8): 312–319.

Sign in / Sign up

Export Citation Format

Share Document