Institutional ethnography as a unique tool for improving health systems

2019 ◽  
Vol 32 (3) ◽  
pp. 143-147 ◽  
Author(s):  
Emily Rowland ◽  
Myuri Manogaran ◽  
Ivy Lynn Bourgeault
Keyword(s):  
Health System ◽  
Neonatal Intensive Care ◽  
Institutional Ethnography ◽  
Deep Understanding ◽  
Patient Experiences ◽  
Social Contexts ◽  
Neonatal Intensive Care Units ◽  
System Reform ◽  
Internal Structures ◽  
The Social

Qualitative research in the health system has made tremendous developments in the last decade to better understand patient experiences. What is often overlooked, are the influences that the internal structures, policies and people have on the individuals that use health services. Institutional ethnography is a qualitative approach that aims to capture the social organization of "everyday life" at various system levels. An institutional ethnographic framework was applied to two research studies exploring how families experience care in neonatal intensive care units. Data were collected to develop a deep understanding of the social contexts that exist within institutional boundaries. This paper provides evidence that how care is organized and delivered can significantly influence patient experiences, perceptions and ultimately health outcomes. Adopting institutional ethnographic techniques as a common research method is a valuable tool for health leaders seeking to understand and develop recommendations for health system reform.

scholarly journals Pharmaceutical policy reform in Canada: lessons from history

2018 ◽  
Vol 13 (3-4) ◽  
pp. 299-322 ◽  
Author(s):  
Katherine Boothe
Keyword(s):  
Health System ◽  
Private Insurance ◽  
Universal Coverage ◽  
New Drugs ◽  
System Reform ◽  
The Social ◽  
Broad Public Health ◽  
Potential Methods ◽  
Integrated Health Services

AbstractCanada is the only country with a broad public health system that does not include universal, nationwide coverage for pharmaceuticals. This omission causes real hardship to those Canadians who are not well-served by the existing patchwork of limited provincial plans and private insurance. It also represents significant forgone benefits in terms of governments’ ability to negotiate drug prices, make expensive new drugs available to patients on an equitable basis, and provide integrated health services regardless of therapy type or location. This paper examines Canada’s historical failure to adopt universal pharmaceutical insurance on a national basis, with particular emphasis on the role of public and elite ideas about its supposed lack of affordability. This legacy provides novel lessons about the barriers to reform and potential methods for overcoming them. The paper argues that reform is most likely to be successful if it explicitly addresses entrenched ideas about pharmacare’s affordability and its place in the health system. Reform is also more likely to achieve universal coverage if it is radical, addressing various components of an effective pharmaceutical program simultaneously. In this case, an incremental approach is likely to fail because it will not allow governments to contain costs and realize the social benefits that come along with a universal program, and because it means forgoing the current promising conditions for achieving real change.

scholarly journals ‘Unknowing’ and mental health system reform in Palestine

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Zeina Amro ◽  
Hanna Kienzler
Keyword(s):  
Mental Health ◽  
Health System ◽  
International Development ◽  
Mental Health System ◽  
Scientific Evidence ◽  
Social Contexts ◽  
International Standards ◽  
System Reform ◽  
Health Providers ◽  
Health System Reform

In this Think Piece we argue that mental health system reforms are not mainly driven by scientific evidence and international standards, but rather by concrete political constellations, national and international development agendas, local and global socioeconomic contexts, and the interactions between differently positioned actors. We further argue that these forces gain their influence not by being openly discussed, but precisely because they are rendered invisible and turned into what Geissler (2013) calls ‘unknown knowns’. To illustrate these complex processes, we present a case study that examines how mental health system reform processes in the West Bank are shaped by the Israeli occupation, particular political events, and unequal power relations between international and local institutional actors. Furthermore, we present critical reflections by mental health providers related to these processes, and their visions for a more sustainable mental health system. We end with an appeal to aid providers to stop characterising their work with abstract catchphrases such as ‘evidence-based’ or ‘best practice’, and call on them to be transparent about how political, economic, and social contexts shape their work on the ground.

scholarly journals Review of Biomedical Applications of Contactless Imaging of Neonates Using Infrared Thermography and Beyond

2018 ◽  
Vol 1 (4) ◽  
pp. 39 ◽  
Author(s):  
Abbas AlZubaidi ◽  
Yahya Ethawi ◽  
Georg Schmölzer ◽  
Sherif Sherif ◽  
Michael Narvey ◽  
...  
Keyword(s):  
Infrared Thermography ◽  
Neonatal Intensive Care ◽  
Near Infrared ◽  
Daily Basis ◽  
Neonatal Intensive Care Units ◽  
Data Generation ◽  
Skin Breakdown ◽  
Internal Structures ◽  
Monitoring Procedure ◽  
Visible Light Imaging

The sick preterm infant monitoring is an intriguing job that medical staff in Neonatal Intensive Care Units (NICU) must deal with on a daily basis. As a standards monitoring procedure, preterm infants are monitored via sensors and electrodes that are firmly attached to their fragile and delicate skin and connected to processing monitors. However, an alternative exists in contactless imaging to record such physiological signals (we call it as Physio-Markers), detecting superficial changes and internal structures activities which can be used independently of, or aligned with, conventional monitors. Countless advantages can be gained from unobtrusive monitoring not limited to: (1) quick data generation; (2) decreasing physical and direct contact with skin, which reduces skin breakdown and minimizes risk of infection; and (3) reduction of electrodes and probes connected to clinical monitors and attached to the skin, which allows greater body surface-area for better care. This review is an attempt to build a solid ground for and to provide a clear perspective of the potential clinical applications of technologies inside NICUs that use contactless imaging modalities such as Visible Light Imaging (VLI), Near Infrared Spectroscopy (NIRS), and Infrared Thermography (IRT).

The Social Contexts of Racial Discrimination in Sentencing

1986 ◽  
Vol 33 (3) ◽  
pp. 236-251 ◽  
Author(s):  
Martha A. Myers ◽  
Susette M. Talarico
Keyword(s):  
Racial Discrimination ◽  
Social Contexts ◽  
The Social

YENİDOĞAN YOĞUN BAKIM ÜNİTELERİNDE İŞ KAZALARI RİSKLERİ VE NEDENLERİNE YÖNELİK BİR ARAŞTIRMA

2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Haluk Tanrıverdi ◽  
Orhan Akova ◽  
Nurcan Türkoğlu Latifoğlu
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Physical Environment ◽  
Neonatal Intensive Care ◽  
Organizational Factors ◽  
Occupational Accidents ◽  
Neonatal Intensive Care Units ◽  
Work Related ◽  
Physical Conditions ◽  
The Relationship

This study aims to demonstrate the relationship between the qualifications of neonatal intensive care units of hospitals (physical conditions, standard applications, employee qualifications and use of personal protective equipment) and work related causes and risks, employee related causes and risks when occupational accidents occur. Accordingly, a survey was prepared and was made among 105 nurses working in 3 public and 3 private hospital's neonatal intensive care units, in the January of 2010. The survey consists of questions about the qualifications of neonatal intensive care units, work related causes and risks, and employee related causes and risks. From the regression analysis conducted, it has been found that confirmed hypotheses in several studies in the literature were not significant in this study. The sub-dimensions in which relationships has been found show that the improvement of the physical environment in workplace, the improvement of the employee qualifications and standard applications can reduce the rate of occupational accidents. According to the results of this study management should take care of the organizational factors besides to improvement of the physical environment in workplace, the improvement of the employee qualifications and standard applications.

Sign in / Sign up

Export Citation Format

Share Document