Seven lessons from the field: Research on transformation of health systems for older adults

2020 ◽  
Vol 33 (5) ◽  
pp. 220-227
Author(s):  
Paul Stolee ◽  
Maggie MacNeil ◽  
Jacobi Elliott ◽  
Catherine Tong ◽  
Alison Kernoghan
Keyword(s):  
Older Adults ◽  
Health Systems ◽  
Family Caregiver ◽  
Field Research ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
System Transformation ◽  
Systems Research ◽  
Research Findings ◽  
Conducting Research

Research can play a key role in efforts to transform healthcare systems. Our group’s long-standing research program has been aimed at understanding how to support greater integration and coordination of healthcare services for older adults with complex conditions. Drawing on this experience, we outline seven “lessons from the field” that highlight research-related challenges that may hinder health system transformation. These challenges relate to conducting research in a complex and constantly changing system; co-design approaches that are simultaneously deemed essential yet too ambiguous to fund; patient, family caregiver, and citizen engagement; limited funding for health systems research; and lack of use of research findings. We hope that these reflections will help to inform an ongoing conversation about how these challenges might be overcome.

scholarly journals Innovation in healthcare services: notes on the limits of field research

2016 ◽  
Vol 32 (suppl 2) ◽  
Author(s):  
Laís Silveira Costa
Keyword(s):  
Population Aging ◽  
Field Research ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Public Healthcare ◽  
Social Changes ◽  
Public And Private ◽  
Disease Characteristics ◽  
Health And Disease ◽  
Current Article

Abstract: The contemporary context of population aging, itsthe population's different health and disease characteristics, and the growing incorporation of technologies by healthcare systems have highlighted the need to adjust the healthcare structure as a whole. The defense of a democratic and sustainable system reveals the importance of understanding how changes in healthcare take place. The current article aims to contribute to the understanding of innovation in healthcare services. The study's results indicate that the existence of certain knowledge gaps means that public policies tend to overlook a whole rangeseries of innovations normally associated with social changes, with a consequentwith an impact on human development, social cohesion, equality, and equity, allcentral issues that are central toin the field of collective public healthcare field. The article concludes that the lack of a mature theoretical framework negatively impacts the formulation of such policies, further aggravated in Brazil by growing differences in quality and access between population segments that depend on the public and private healthcare systems.

Building a learning health system using clinical registers: a non-technical introduction

2016 ◽  
Vol 30 (7) ◽  
pp. 1105-1118 ◽  
Author(s):  
John Ovretveit ◽  
Eugene Nelson ◽  
Brent James
Keyword(s):  
Health Systems ◽  
Computer Literacy ◽  
Patient Empowerment ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Digital Data ◽  
Content Type ◽  
Daily Work ◽  
Effective Use ◽  
Unpublished Research

Purpose The purpose of this paper is to describe how clinical registers were designed and used to serve multiple purposes in three health systems, in order to contribute practical experience for building learning healthcare systems. Design/methodology/approach Case description and comparison of the development and use of clinical registries, drawing on participants’ experience and published and unpublished research. Findings Clinical registers and new software systems enable fact-based decisions by patients, clinicians, and managers about better care, as well as new and more economical research. Designing systems to present the data for users’ daily work appears to be the key to effective use of the potential afforded by digital data. Research limitations/implications The case descriptions draw on the experience of the authors who were involved in the development of the registers, as well as on published and unpublished research. There is limited data about outcomes for patients or cost-effectiveness. Practical implications The cases show the significant investments which are needed to make effective use of clinical register data. There are limited skills to design and apply the digital systems to make the best use of the systems and to reduce their disadvantages. More use can be made of digital data for quality improvement, patient empowerment and support, and for research. Social implications Patients can use their data combined with other data to self-manage their chronic conditions. There are challenges in designing and using systems so that those with lower health and computer literacy and incomes also benefit from these systems, otherwise the digital revolution may increase health inequalities. Originality/value The paper shows three real examples of clinical registers which have been developed as part of their host health systems’ strategies to develop learning healthcare systems. The paper gives a simple non-technical introduction and overview for clinicians, managers, policy-advisors and improvers of what is possible and the challenges, and highlights the need to shape the design and implementation of digital infrastructures in healthcare services to serve users.

scholarly journals 'Fieldwork' in the time of Covid-19

2021 ◽  
Author(s):  
Deborah Posel ◽  
Gladys Kigozi ◽  
joy owen ◽  
Kristina Riedel
Keyword(s):  
Social Sciences ◽  
Health Systems ◽  
Field Research ◽  
Health Systems Research ◽  
Human Interaction ◽  
Language Practice ◽  
Shared Experiences ◽  
Systems Research ◽  
Senior Researcher ◽  
Postgraduate Qualification

<div>How does an anthropologist, a linguist, and a health systems researcher collect data during COVID-19 when human interaction is limited? Speaking at the first webinar hosted by the Faculty of the Humanities on Fieldwork in the time of COVID-19, Prof Deborah Posel, Research Professor in Sociology, said, “Lockdown impacted social sciences just as much. For us it was a lockout from people, libraries, and field research.” </div><div><br></div><div>“The benefits (of the webinar) for Humanities research are obvious. Research in the Humanities differs a lot from research in other disciplines such as Natural Sciences; it happens in silos and not as a group focused,” said Prof Heidi Hudson, Dean of the Faculty of the Humanities. This webinar series will provide a platform to engage, but also for inter-departmental and inter-disciplinary research in the faculty. “Using this platform to engage and talk about our shared experiences will help bring researchers together and to reflect on our own experiences,” Prof Hudson said. </div><div><br></div><div>Academics from different departments in the faculty shared how the COVID-19 lockdown affected their research projects. They were Dr Gladys Kigozi, Senior Researcher in the <a href="https://www.ufs.ac.za/humanities/departments-and-divisions/centre-for-health-systems-research-development-home/postgraduate-qualification/master-of-health-system-studies" target="_blank">Centre for Health Systems Research and Development </a>(CHSR&D), Dr Kristina Riedel from the<a href="https://www.ufs.ac.za/humanities/departments-and-divisions/linguistics-and-language-practice-home/general/home" target="_blank"> Department of Linguistics and Language Practice</a>, and Prof Joy Owen from the <a href="https://www.ufs.ac.za/humanities/departments-and-divisions/anthropology-home" target="_blank">Department of Anthropology</a>. </div>

scholarly journals eHealth Literacy and Capability in the Context of the Pandemic Crisis

2022 ◽  
pp. 109-129
Author(s):  
Dimitrios Kokkinakis
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Scale Up ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Ageing Population ◽  
Ehealth Literacy ◽  
Complex Information ◽  
Health Promoting

AbstractThe rapidly increasing size of the ageing population, and in particular older adults living alone, requires the incorporation of eHealth into social and healthcare services, in order to choose the best way to manage their needs and demands for health and medical care. The purpose of this brief scoping study is to describe and identify an important dimension in this context, namely eHealth literacy (eHL) and its relation to health-promoting behaviours among older adults within the capability theoretical framework. The chapter examines some aspects of eHL and recent research highlighting the importance of eHL and the direct correlation between eHL and quality of life for older adults within the capability context. To make this more specific and explicit, this study takes into consideration outstanding circumstances, such as those caused by a pandemic crisis, namely the coronavirus disease 2019 (COVID-19). Since the COVID-19 pandemic has required urgent action and rapid containment, it offers a unique opportunity to test and evaluate the readiness of healthcare systems and to rapidly develop, scale up and enhance eHealth for the benefit of older people. However, this comes with a price, which is the necessity to quickly and effectively navigate complex information environments and manage behavioural changes and health.

scholarly journals Local ownership of health policy and systems research in low-income and middle-income countries: a missing element in the uptake debate

2019 ◽  
Vol 4 (4) ◽  
pp. e001523 ◽  
Author(s):  
Kudakwashe Paul Vanyoro ◽  
Kate Hawkins ◽  
Matthew Greenall ◽  
Helen Parry ◽  
Lynda Keeru
Keyword(s):  
Decision Making ◽  
Health Policy ◽  
Health Systems ◽  
Low Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Systems Research ◽  
Research Findings ◽  
Health Policy And Systems

Health policy and systems researchers (HPSRs) in low-income and middle-income countries (LMICs) aim to influence health systems planning, costing, policy and implementation. Yet, there is still much that we do not know about the types of health systems evidence that are most compelling and impactful to policymakers and community groups, the factors that facilitate the research to decision-making process and the real-world challenges faced when translating research findings into practice in different contexts. Drawing on an analysis of HPSR from LMICs presented at the Fifth Global Symposium on Health Systems Research (HSR 2018), we argue that while there is a recognition in policy studies more broadly about the role of co-production, collective ownership and the value of localised HPSR in the evidence-to-policy discussion, ‘ownership’ of research at country level is a research uptake catalyst that needs to be further emphasised, particularly in the HPSR context. We consider embedded research, participatory or community-initiated research and emergent/responsive research processes, all of which are ‘owned’ by policymakers, healthcare practitioners/managers or community members. We embrace the view that ownership of HPSR by people directly affected by health problems connects research and decision-making in a tangible way, creating pathways to impact.

scholarly journals 'Fieldwork' in the time of Covid-19

2021 ◽  
Author(s):  
Deborah Posel ◽  
Gladys Kigozi ◽  
joy owen ◽  
Kristina Riedel
Keyword(s):  
Social Sciences ◽  
Health Systems ◽  
Field Research ◽  
Health Systems Research ◽  
Human Interaction ◽  
Language Practice ◽  
Shared Experiences ◽  
Systems Research ◽  
Senior Researcher ◽  
Postgraduate Qualification

<div>How does an anthropologist, a linguist, and a health systems researcher collect data during COVID-19 when human interaction is limited? Speaking at the first webinar hosted by the Faculty of the Humanities on Fieldwork in the time of COVID-19, Prof Deborah Posel, Research Professor in Sociology, said, “Lockdown impacted social sciences just as much. For us it was a lockout from people, libraries, and field research.” </div><div><br></div><div>“The benefits (of the webinar) for Humanities research are obvious. Research in the Humanities differs a lot from research in other disciplines such as Natural Sciences; it happens in silos and not as a group focused,” said Prof Heidi Hudson, Dean of the Faculty of the Humanities. This webinar series will provide a platform to engage, but also for inter-departmental and inter-disciplinary research in the faculty. “Using this platform to engage and talk about our shared experiences will help bring researchers together and to reflect on our own experiences,” Prof Hudson said. </div><div><br></div><div>Academics from different departments in the faculty shared how the COVID-19 lockdown affected their research projects. They were Dr Gladys Kigozi, Senior Researcher in the <a href="https://www.ufs.ac.za/humanities/departments-and-divisions/centre-for-health-systems-research-development-home/postgraduate-qualification/master-of-health-system-studies" target="_blank">Centre for Health Systems Research and Development </a>(CHSR&D), Dr Kristina Riedel from the<a href="https://www.ufs.ac.za/humanities/departments-and-divisions/linguistics-and-language-practice-home/general/home" target="_blank"> Department of Linguistics and Language Practice</a>, and Prof Joy Owen from the <a href="https://www.ufs.ac.za/humanities/departments-and-divisions/anthropology-home" target="_blank">Department of Anthropology</a>. </div>

scholarly journals 'Fieldwork' in the time of Covid-19

2021 ◽  
Author(s):  
Deborah Posel ◽  
Gladys Kigozi ◽  
joy owen ◽  
Kristina Riedel
Keyword(s):  
Social Sciences ◽  
Health Systems ◽  
Field Research ◽  
Health Systems Research ◽  
Human Interaction ◽  
Language Practice ◽  
Shared Experiences ◽  
Systems Research ◽  
Senior Researcher ◽  
Postgraduate Qualification

<div>How does an anthropologist, a linguist, and a health systems researcher collect data during COVID-19 when human interaction is limited? Speaking at the first webinar hosted by the Faculty of the Humanities on Fieldwork in the time of COVID-19, Prof Deborah Posel, Research Professor in Sociology, said, “Lockdown impacted social sciences just as much. For us it was a lockout from people, libraries, and field research.” </div><div><br></div><div>“The benefits (of the webinar) for Humanities research are obvious. Research in the Humanities differs a lot from research in other disciplines such as Natural Sciences; it happens in silos and not as a group focused,” said Prof Heidi Hudson, Dean of the Faculty of the Humanities. This webinar series will provide a platform to engage, but also for inter-departmental and inter-disciplinary research in the faculty. “Using this platform to engage and talk about our shared experiences will help bring researchers together and to reflect on our own experiences,” Prof Hudson said. </div><div><br></div><div>Academics from different departments in the faculty shared how the COVID-19 lockdown affected their research projects. They were Dr Gladys Kigozi, Senior Researcher in the <a href="https://www.ufs.ac.za/humanities/departments-and-divisions/centre-for-health-systems-research-development-home/postgraduate-qualification/master-of-health-system-studies" target="_blank">Centre for Health Systems Research and Development </a>(CHSR&D), Dr Kristina Riedel from the<a href="https://www.ufs.ac.za/humanities/departments-and-divisions/linguistics-and-language-practice-home/general/home" target="_blank"> Department of Linguistics and Language Practice</a>, and Prof Joy Owen from the <a href="https://www.ufs.ac.za/humanities/departments-and-divisions/anthropology-home" target="_blank">Department of Anthropology</a>. </div>

Toward Identifying Mild Cognitive Impairment in Hispanic and African American Adults

2017 ◽  
Vol 2 (2) ◽  
pp. 110-116
Author(s):  
Valarie B. Fleming ◽  
Joyce L. Harris
Keyword(s):  
Older Adults ◽  
African American ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Healthcare Access ◽  
Communication Disorders ◽  
Healthcare Systems ◽  
Prevention Education ◽  
Education Management ◽  
African American Adults

Across the breadth of acquired neurogenic communication disorders, mild cognitive impairment (MCI) may go undetected, underreported, and untreated. In addition to stigma and distrust of healthcare systems, other barriers contribute to decreased identification, healthcare access, and service utilization for Hispanic and African American adults with MCI. Speech-language pathologists (SLPs) have significant roles in prevention, education, management, and support of older adults, the population must susceptible to MCI.

Political Science Research in the Middle East and North Africa

2018 ◽  
Keyword(s):  
Middle East ◽  
Research Methods ◽  
North Africa ◽  
Quantitative Research ◽  
Real Life ◽  
Field Research ◽  
Science Research ◽  
Lessons Learned ◽  
Conducting Research ◽  
Personal Accounts

Based on personal accounts of their experiences conducting qualitative and quantitative research in the countries of the Middle East and North Africa, the contributors to this volume share the real-life obstacles they have encountered in applying research methods in practice and the possible solutions to overcome them. The volume is an important companion book to more standard methods books, which focus on the “how to” of methods but are often devoid of any real discussion of the practicalities, challenges, and common mistakes of fieldwork. The volume is divided into three parts, highlighting the challenges of (1) specific contexts, including conducting research in areas of violence; (2) a range of research methods, including interviewing, process-tracing, ethnography, experimental research, and the use of online media; and (3) the ethics of field research. In sharing their lessons learned, the contributors raise issues of concern to both junior and experienced researchers, particularly those of the Global South but also to those researching the Global North.

scholarly journals Exploring the role of gender and women in the political economy of health in armed conflict: a narrative review

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Kristen Meagher ◽  
Bothaina Attal ◽  
Preeti Patel
Keyword(s):  
Political Economy ◽  
Health Systems ◽  
Armed Conflict ◽  
Narrative Review ◽  
Health Systems Strengthening ◽  
The Political ◽  
Systems Research ◽  
Political Economy Of Health ◽  
And Gender

Abstract Background The ripple effects of protracted armed conflicts include: significant gender-specific barriers to accessing essential services such as health, education, water and sanitation and broader macroeconomic challenges such as increased poverty rates, higher debt burdens, and deteriorating employment prospects. These factors influence the wider social and political determinants of health for women and a gendered analysis of the political economy of health in conflict may support strengthening health systems during conflict. This will in turn lead to equality and equity across not only health, but broader sectors and systems, that contribute to sustainable peace building. Methods The methodology employed is a multidisciplinary narrative review of the published and grey literature on women and gender in the political economy of health in conflict. Results The existing literature that contributes to the emerging area on the political economy of health in conflict has overlooked gender and specifically the role of women as a critical component. Gender analysis is incorporated into existing post-conflict health systems research, but this does not extend to countries actively affected by armed conflict and humanitarian crises. The analysis also tends to ignore the socially constructed patriarchal systems, power relations and gender norms that often lead to vastly different health system needs, experiences and health outcomes. Conclusions Detailed case studies on the gendered political economy of health in countries impacted by complex protracted conflict will support efforts to improve health equity and understanding of gender relations that support health systems strengthening.

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