scholarly journals Clinical audit as a tool to optimize contracted private healthcare provision: Testing the waters in resource-deprived Greece

2019 ◽  
Vol 7 ◽  
pp. 205031211983873
Author(s):  
Kyriakos Souliotis ◽  
Christina Golna ◽  
Vasiliki Mantzana ◽  
Sotirios Papaspyropoulos ◽  
Anastasios Koutsovasilis ◽  
...  
Keyword(s):  
Social Insurance ◽  
Best Practice ◽  
Clinical Audit ◽  
Private Insurance ◽  
Healthcare Services ◽  
Evidence Based ◽  
Care Organization ◽  
Healthcare Provision ◽  
Private Healthcare

Background and Aims: Clinical audit is applied to optimize clinical practice and quality of healthcare services while controlling for money spent, critically in resource-deprived settings. This case study reports on the outcomes of a retrospective clinical audit on private hospitalizations, for which reimbursement had been pending by the Health Care Organization for Public Servants (OPAD) in Greece. This case study is the first effort by a social insurance organization in Greece to employ external clinical audit before settling contracted private healthcare charges. Methods: One thousand two hundred hospitalization records were reviewed retrospectively and a fully anonymized clinical audit summary report created for each one of them by a team of clinical audit experts, proposing evidence-based cuts in pending charges where medical services were deemed clinically unnecessary. These audit reports were then collated and analysed to test trends in overcharges among hospitalized insureds per reason for hospitalization. Results: The clinical audit report concluded that 17.4% of a total reimbursement claim of €12,387,702.18 should not be reimbursed, as it corresponded to unnecessary or not fully justifiable according to evidence-based, best practice, medical service provision. The majority of proposed cuts were related to charges for medical devices, which are borne directly by social insurance with no patient or private insurance co-payment. Conclusion: Clinical audit of hospital practice may be a key tool to optimize care provision, address supplier-induced demand and effectively manage costs for national health insurance, especially in circumstances of budgetary constraints, such as in austerity-stricken settings or developing national healthcare systems.

scholarly journals Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016626 ◽  
Author(s):  
Ross Bailie ◽  
Veronica Matthews ◽  
Sarah Larkins ◽  
Sandra Thompson ◽  
Paul Burgess ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Best Practice ◽  
Healthcare Services ◽  
Policy Support ◽  
Comparative Case Study ◽  
Indigenous Australians ◽  
Evidence Based ◽  
Continuous Quality

ObjectivesTo examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians.DesignMixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care.SettingIndigenous primary healthcare services across five states/territories of Australia.Participants175 Indigenous primary healthcare services.InterventionsA range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research.Primary and secondary outcome measures(i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines).ResultsProgressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities.ConclusionsHealth authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences.

Student-led fellowships: developing partnerships to identify best practice and promote change

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Ruth Matheson ◽  
Nicola Poole
Keyword(s):  
Student Voice ◽  
Best Practice ◽  
Evidence Based ◽  
Shared Understanding ◽  
Learning And Teaching ◽  
Challenges And Opportunities ◽  
Development Unit ◽  
Joint Ownership ◽  
Institutional Drivers

In 2011/2012 Cardiff Metropolitan University instigated a Student-Led Teaching Fellowship Scheme, which unlike other similar schemes sought to develop joint ownership between the University’s Learning and Teaching Development Unit (LTDU) and the Students’ Union (Cardiffmet SU), providing the opportunity for closer partnership working. Through establishing categories and criteria and developing an evidence-based nomination system the Fellowships have provided the opportunity to develop a shared understanding of both institutional drivers and pedagogic practice and have enabled a larger platform for the dissemination of best practice to both staff and students. In capturing the student voice it has been possible to recognise and evidence what students value and use this in a variety of ways to promote best practice. This case study seeks to demonstrate how the Student-led Teaching Fellowships have and can be used to instigate change within the institution together with identifying remaining challenges and opportunities for future development.

Risk Management in a Pandemic Crisis at a Global Non Profit Health Care Organization

2012 ◽  
Vol 1 (4) ◽  
pp. 1-17
Author(s):  
Drew Sugaretty
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Best Practice ◽  
Health Care Organization ◽  
Care Organization ◽  
Practice Model ◽  
Non Profit ◽  
Global Pandemic ◽  
Management Processes

This paper categorizes the risks experienced and voiced by subject matter experts at a pandemic crises event which unfortunately claimed almost 800 lives before it could be controlled. The project was a case study design using multiple methods. Qualitative data was collected by interviewing 22 front-line multicultural crisis practitioners. The unit of analysis was the constructed meaning of the uncertainty and risk management processes experienced by the participants, while they were attempting to control the global pandemic crisis associated with the Severe Acute Respiratory Syndrome outbreak during 2003. Several guiding constructs were researched from the literature review. NVIVO was used to analyze the interview transcripts to build a thematic model of constructed meanings. The result was a best-practice model constructed by the practitioners which they felt improved risk control during a significant global pandemic crisis event considering the lead mitigation agency was a nonprofit health care organization.

scholarly journals Diagnosis, Management and Return to Sport of a 16-year-old Patient with a Chiari I Malformation: A Case Report and Literature Review.

2021 ◽  
Author(s):  
MaKenna L. Turk ◽  
Kelly Schmidt ◽  
Melanie L. McGrath
Keyword(s):  
Case Report ◽  
Best Practice ◽  
Return To Sport ◽  
Chiari I Malformation ◽  
Athletic Trainer ◽  
Evidence Based ◽  
Practice Recommendations ◽  
Chiari I ◽  
Access To Medical Care

This CASE report presents a 16-year-old female volleyball, basketball and track & field athlete who was diagnosed with a Chiari I Malformation following a concussion. Surgical decompression was recommended and performed 3 months following her initial diagnosis. This patient presented unique challenges due to her age, desire to return-to-sport, and the lack of access to medical care due to living in a rural area. There are few evidence-based best-practice recommendations for the management and return-to-sport of Chiari I Malformation patients, particularly for post-surgical Chiari I Malformation cases. This case study discusses the treatment and return-to-sport process for the patient, and also provides a comprehensive review of the published literature on patients attempting to return-to-sport following Chiari I Malformation diagnosis. Additionally, this case report suggests and explores the utilization of an athletic trainer to reconcile various barriers in management and return-to-sport evident in this case and the reviewed literature.

Healthcare Strategic Planning as Part of National and Regional Development in the Israeli Galilee: A Case Study of the Planning Process

2009 ◽  
Vol 38 (3) ◽  
pp. 43-50 ◽  
Author(s):  
Ronit Peled ◽  
Jerry Schenirer
Keyword(s):  
Strategic Planning ◽  
Regional Development ◽  
Planning Process ◽  
Healthcare Services ◽  
Healthcare Provision ◽  
Mortality And Morbidity ◽  
Health And Wellbeing ◽  
Local Residents

This article describes a systematic process of geographic and strategic planning for healthcare services as a part of a regional development plan in the Israeli Galilee. The planning process consisted of three stages: (a) assessment of needs, demand and existing resources; (b) prioritisation of initiatives; and (c) scheduling of theoretical priorities. For many years the region has suffered from inequities and inequalities regarding the availability and accessibility of a regional healthcare system, resulting in high mortality and morbidity rates and low quality of life. The aim of the healthcare strategic plan was to suggest initiatives and actions to be taken in order to improve healthcare provision and the health and wellbeing of local residents.

scholarly journals Evidence-Based Practice Approach Over Three Visits in the Management of a Patient with Tibio-Femoral Osteoarthritis: A Case Study

2009 ◽  
Author(s):  
Sjaan Gomersall ◽  
Maureen McEvoy
Keyword(s):  
Best Practice ◽  
Evidence Based Practice ◽  
Research Question ◽  
Osteoarthritis Of The Knee ◽  
Evidence Based ◽  
Future Health ◽  
Physiotherapy Student ◽  
Future Health Care ◽  
Practice Approach

Supervised training is essential for developing an evidence-based practice (EBP) approach for future health care clinicians. While the skills associated with asking a research question, accessing databases for best research evidence (BRE), and appraising this evidence can be taught in the classroom, the day-to-day application into patient management needs to be taught, and there is a lack of best practice models for this. This case study of a patient with osteoarthritis of the knee demonstrates over a series of three clinic visits how EBP can be used as a framework for guiding assessment and management from the perspective of a final year physiotherapy student.

scholarly journals Remote primary care consultations for people living with dementia during the COVID-19 pandemic: experiences of people living with dementia and their carers

2021 ◽  
pp. BJGP.2020.1094 ◽  
Author(s):  
Remco Tuijt ◽  
Greta Rait ◽  
Rachael Frost ◽  
Jane Wilcock ◽  
Jill Manthorpe ◽  
...  
Keyword(s):  
Primary Care ◽  
Best Practice ◽  
Qualitative Interviews ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Healthcare Settings ◽  
Healthcare Needs ◽  
Remote Healthcare ◽  
Remote Consultations

Background: COVID-19 has accelerated remote healthcare provision in primary care, with changes potentially permanent. The implementation of remote provision of healthcare needs to hear from vulnerable populations, such as people living with dementia. Aim: To understand the remote healthcare experiences of patients living with dementia and their family carers during the COVID-19 pandemic. Design and setting: Qualitative interviews with community-based patients living with dementia and their carers during early months (May-August 2020) of the COVID-19 pandemic in England. Methods: Semi-structured interviews were conducted remotely by telephone or video call with 30 patients living with dementia and 31 carers. Data were analysed using thematic analysis. Results: Three main themes were derived relating to: 1) proactive care at the onset of COVID-19 restrictions, 2) avoidance of healthcare settings and services, and 3) difficulties with remote healthcare encounters. People living with dementia and their carers felt check-up calls were reassuring but limited in scope and content. Some avoided healthcare services, wishing to minimise COVID-19 risk, reduce NHS burden, or encountering technological barriers. Difficulties in remote consultations included lack of prompts to remember problems, dealing with new emerging problems, rescheduling/missed calls, and inclusion of the person with dementia’s voice. Conclusion: While remote consultations could be effective, pro-active calls could be more structured around needs, and consideration should be given to replace non-verbal prompts to describe problems, particularly for new health concerns. In continuing remote consultations, it is important to facilitate engagement with patients living with dementia and their carers to ensure best practice.

scholarly journals Applications of lean in human resources management in healthcare

2021 ◽  
Author(s):  
Gulfer Bektas ◽  
Fikri Kiper
Keyword(s):  
Human Resources ◽  
Human Resources Management ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Healthcare Industry ◽  
Lean Thinking ◽  
Resources Management ◽  
Private Healthcare ◽  
Reduced Costs

Recent challenges brought by the coronavirus disease-2019 pandemic have underscored the importance of coping with pressures on the workforce in healthcare around the world and have emphasised the continuing need to improve quality and operation efficiency of healthcare services even in such dire circumstances. Over the years, lean thinking has gained recognition in the healthcare industry, where lean has been associated with benefits, such as improved healthcare delivery quality, reduced costs and increased effectiveness of the healthcare delivery processes. Lean thinking has also been analysed in human resources with benefits, such as increased job satisfaction and perceived job autonomy. The current narrative review was planned to analyse and discuss the application and implementation of lean strategies with a particular focus on human resource management in healthcare. The review is complemented by a case study in a private healthcare group in Turkey, ---Continue

Public and Private Healthcare in Slovenia in Relation to Choice and Accessibility of Services

2013 ◽  
Vol 3 (3) ◽  
pp. 1-14 ◽  
Author(s):  
Matic Kavčič ◽  
Majda Pahor
Keyword(s):  
Public Sector ◽  
Evolutionary Process ◽  
Secondary Data ◽  
Healthcare Services ◽  
Background Information ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Public And Private ◽  
The Public ◽  
Private Healthcare

This article starts with background information on the Slovenian healthcare system and the description of the evolutionary process and privatisation reforms that bring a mix of public and private healthcare services. The authors' aim is to conceptualise existing modes of public and private healthcare provision and discuss possible implications for user choice and accessibility of services. A descriptive and exploratory case study approach was employed. Literature and document analysis was complemented by secondary data and semi-structured interviews. The results demonstrate four modes of healthcare services in relation to public-private delivery. The ‘public non-profit' type refers to publicly financed and delivered services. The ‘private within public' type addresses services provided within and by the public sector for patients who pay out-of-pocket. The ‘private for public' type deals with services provided by private entities with concessions. The ‘private for-profit' type refers to completely private provision (without concession) of self-pay services. The strengths and weaknesses of each mode with respect to choice, space-time accessibility, financial accessibility and quality of services are critically discussed. The results of the study show that private healthcare services significantly complement and compete with public sector. In addition, there is a risk that uncontrolled mixing of public and private modes of practice may bring about unethical behaviour and corruption.

Risk Management in a Pandemic Crisis at a Global Non Profit Health Care Organization

2013 ◽  
pp. 1253-1270
Author(s):  
Drew Sugaretty
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Best Practice ◽  
Health Care Organization ◽  
Care Organization ◽  
Subject Matter Experts ◽  
Non Profit ◽  
Global Pandemic ◽  
Management Processes

This article categorizes the risks experienced and voiced by subject matter experts at a pandemic crises event which unfortunately claimed almost 800 lives before it could be controlled. The project was a case study design using multiple methods. Qualitative data was collected by interviewing 22 front-line multicultural crisis practitioners. The unit of analysis was the constructed meaning of the uncertainty and risk management processes experienced by the participants, while they were attempting to control the global pandemic crisis associated with the Severe Acute Respiratory Syndrome outbreak during 2003. Several guiding constructs were researched from the literature review. NVIVO was used to analyze the interview transcripts to build a thematic model of constructed meanings. The result was a best-practice model constructed by the practitioners which they felt improved risk control during a significant global pandemic crisis event considering the lead mitigation agency was a nonprofit health care organization.

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