scholarly journals A Realist Case Study of a Regional Hospital’s Response to Improve Emergency Department Access in the Context of Australian Health Care Reforms

2016 ◽  
Vol 3 ◽  
pp. 233339281663110 ◽  
Author(s):  
Sandeep Reddy ◽  
Timothy A. Carey ◽  
John Wakerman
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Reforms ◽  
Australian Health

scholarly journals Quality improvement primer part 2: executing a quality improvement project in the emergency department

CJEM ◽  
2017 ◽  
Vol 20 (4) ◽  
pp. 532-538 ◽  
Author(s):  
Lucas B. Chartier ◽  
Antonia S. Stang ◽  
Samuel Vaillancourt ◽  
Amy H. Y. Cheng
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Emergency Medicine ◽  
Quality Improvement ◽  
Improvement Project ◽  
Emergency Department Setting ◽  
Pdsa Cycle ◽  
Time To Antibiotics ◽  
Final Article

ABSTRACTThe topics of quality improvement (QI) and patient safety have become important themes in health care in recent years, particularly in the emergency department setting, which is a frequent point of contact with the health care system for patients. In the first of three articles in this series meant as a QI primer for emergency medicine clinicians, we introduced the strategic planning required to develop an effective QI project using a fictional case study as an example. In this second article we continue with our example of improving time to antibiotics for patients with sepsis, and introduce the Model for Improvement. We will review what makes a good aim statement, the various categories of measures that can be tracked during a QI project, and the relative merits and challenges of potential change concepts and ideas. We will also present the Model for Improvement’s rapid-cycle change methodology, the Plan-Do-Study-Act (PDSA) cycle. The final article in this series will focus on the evaluation and sustainability of QI projects.

scholarly journals The Politics of Health Care Reforms in Kenya and their Failure

2016 ◽  
Vol 2016 (1) ◽  
Author(s):  
Daniel Künzler
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Social Policy ◽  
Current Literature ◽  
Theoretical Explanation ◽  
Policy Reforms ◽  
Health Care Reforms ◽  
Health Reforms ◽  
Free Health Care

The current literature on the politics of social policy has two major shortcomings: health care reforms are undertheoretized and research on Anglophone Africa tends to neglect health reforms. To tackle this, a case study on Kenya presents (failed) re-forms such as universal or categorical free health care or the introduction of health insurance and the expansion of its coverage. The case study clearly shows that there is no single theoretical explanation of social policy reforms or their failure. Rather, there are different combination of factors at work in Kenya.

A Case Study of the Emergence of Data Analytics in Health Care

2012 ◽  
Vol 14 (4) ◽  
pp. 56-62 ◽  
Author(s):  
Au Vo ◽  
Rahul Bhaskar
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Technology Implementation ◽  
Data Analytics ◽  
Health Care Reforms ◽  
Profound Impact ◽  
Almost All ◽  
The Impact ◽  
Rapid Transformation

In the era of health care reforms, the executives and CEO of the SBC Company are faced with many questions. They wonder about the impact of these changes on their market share. They also wanted to determine the impact on prices they can charge for their services. The changes in the ways the health care will be bought were causing a rapid transformation in the behavior of the consumers. The executives determined that they need to focus on specific areas to keep abreast of all the changes. These will have a profound impact on the information technology implementation across the company. For example, the need for analyzing a large amount of data and data in real time was becoming acute among many departments; there was a need for different skillsets in the employees in almost all the departments across the company. These changes across the industry were presenting new and unique challenges to the executive team.

Caught in the “Traps of Managed Competition”? Examples of Russian Health Care Reforms from St. Petersburg and the Leningrad Region

1997 ◽  
Vol 27 (4) ◽  
pp. 661-686 ◽  
Author(s):  
Sarah Curtis ◽  
Natasha Petukhova ◽  
Galina Sezonova ◽  
Nadia Netsenko
Keyword(s):  
Health Care ◽  
Health Service ◽  
Service Systems ◽  
Leningrad Region ◽  
Managed Competition ◽  
Health Care Reforms ◽  
Future Policy ◽  
The City ◽  
Different Parts

Elements of a “managed market” for health services have been introduced into the Russian health care system, which under the Soviet regime was run as a comprehensive state-managed system. The authors examine the recent development of health service reforms in a case study of the city of St. Petersburg and the surrounding Leningrad region. Evidence from key informants and a local survey of service users shows how alternative models of the managed market are being introduced in different parts of the study area. A critical review of the market-oriented strategies for reform emerging in the case study suggests that such reforms carry risks associated with the “traps of managed competition.” Future policy for health service systems in Russia must take these risks more fully into account.

A Systematic Review of the Impact of Healthcare Reforms on Access to Emergency Department and Elective Surgery Services

2017 ◽  
Vol 48 (1) ◽  
pp. 81-105 ◽  
Author(s):  
Sandeep Reddy ◽  
Peter Jones ◽  
Harsha Shanthanna ◽  
Raechel Damarell ◽  
John Wakerman
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Emergency Department ◽  
United Kingdom ◽  
Elective Surgery ◽  
Grey Literature ◽  
Unintended Consequences ◽  
Health Care Reforms ◽  
The United Kingdom ◽  
The Impact

This systematic review sought to identify whether health care reforms led to improvement in the emergency department (ED) length of stay (LOS) and elective surgery (ES) access in Australia, Canada, New Zealand, and the United Kingdom. The review was registered in the PROSPERO database (CRD42015016343), and nine databases were searched for peer-reviewed, English-language reports published between 1994 and 2014. We also searched relevant “grey” literature and websites. Included studies were checked for cited and citing papers. Primary studies corresponding to national and provincial ED and ES reforms in the four countries were considered. Only studies from Australia and the United Kingdom were eventually included, as no studies from the other two countries met the inclusion criteria. The reviewers involved in the study extracted the data independently using standardized forms. Studies were assessed for quality, and a narrative synthesis approach was taken to analyze the extracted data. The introduction of health care reforms in the form of time-based ED and ES targets led to improvement in ED LOS and ES access. However, the introduction of targets resulted in unintended consequences, such as increased pressure on clinicians and, in certain instances, manipulation of performance data.

scholarly journals Medi(c)ation Work in the Emergency Department: Making Standardized Practice Work

2018 ◽  
Vol 8 (2) ◽  
pp. e2298 ◽  
Author(s):  
Ursula Reichenpfader ◽  
Anette Wickström ◽  
Per Nilsen ◽  
Madeleine Abrandt Dahlgren ◽  
Siw Carlfjord
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Medication Review ◽  
Work Organizations ◽  
Local Adaptations ◽  
Medication Therapy ◽  
Practical Capacity ◽  
Standardized Practice ◽  
Constructing Meaning

Medication review, the systematic examination of an individual patient’s medicines in order to improve medication therapy, has been advocated as an important patient safety measure. Despite widespread use, little is known about how medication review is conducted when implemented in routine health care. Drawing from an ethnographic case study in a Swedish emergency department and using a practice-based approach, we examine how medication review is practically accomplished and how knowledge is mobilized in everyday practice. We show how physicians construct and negotiate medication safety through situated practices and thereby generate knowledge through mundane activities. We illustrate the centrality of practitioners’ collective reflexive work when co-constructing meaning and argue here that practitioners’ local adaptations can serve as important prerequisites to make “standardized” practice function in everyday work. Organizations need to build a practical capacity to support practitioners’ work-based learning in messy and time-pressured  health care  settings.

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