scholarly journals Aiming for quality: a global compass for national learning systems

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Diana Sarakbi ◽  
Nana Mensah-Abrampah ◽  
Melissa Kleine-Bingham ◽  
Shams B. Syed

Abstract Introduction Transforming a health system into a learning one is increasingly recognized as necessary to support the implementation of a national strategic direction on quality with a focus on frontline experience. The approach to a learning system that bridges the gap between practice and policy requires active exploration. Methods This scoping review adapted the methodological framework for scoping studies from Arksey and O’Malley. The central research question focused on common themes for learning to improve the quality of health services at all levels of the national health system, from government policy to point-of-care delivery. Results A total of 3507 records were screened, resulting in 101 articles on strategic learning across the health system: health professional level (19%), health organizational level (15%), subnational/national level (26%), multiple levels (35%), and global level (6%). Thirty-five of these articles focused on learning systems at multiple levels of the health system. A national learning system requires attention at the organizational, subnational, and national levels guided by the needs of patients, families, and the community. The compass of the national learning system is centred on four cross-cutting themes across the health system: alignment of priorities, systemwide collaboration, transparency and accountability, and knowledge sharing of real-world evidence generated at the point of care. Conclusion This paper proposes an approach for building a national learning system to improve the quality of health services. Future research is needed to validate the application of these guiding principles and make improvements based on the findings.

Author(s):  
Fatih Altan ◽  
Aykut Ekiyor ◽  
Demet Unalan

Health services include the services provided to prevent the occurrence of diseases and disabilities, to ensure that the sick and disabled are restored to their former health, and to those who cannot regain their health, to adapt to the environment. As an essential element of the health system, health services appear as an important factor in raising the health level of the society. Reforms in health systems worldwide have been carried out to increase the health level of the community and improve the quality of health services. Satisfaction is one of the critical determinants of quality in health services. It is possible to mention many factors that affect satisfaction in health services. However, in the literature, it is emphasized that health personnel-patient interaction, trust in a health institution, the fee of service received, physical facilities of the health institution, and nutrition services affect satisfaction.


2005 ◽  
Vol 21 (3) ◽  
pp. 173-181
Author(s):  
Francisco Gil ◽  
Jesús Sanz ◽  
María Paz García-Vera ◽  
José M. León ◽  
Silvia Medina ◽  
...  

Abstract. The quality of health services depends on the contribution of all the professionals involved in the system, including certain groups, usually forgotten and underrated, such as the health-transport technicians (HTT). With the aim of improving this group's performance, an intervention program, focusing on the development of the workers' technical and social skills, was designed in a collective of enterprises. Information about the first stage of this program, consisting of the assessment of these workers' social skills, is offered in this study. A specific questionnaire was developed: The Health-Transport Technicians Social Skills Questionnaire (HTT-SSQ), made up of three scales (assertive, passive, and aggressive behavior). It was administered to a large sample (N = 530) from the above-mentioned association. The psychometric properties of the questionnaire were analyzed, with quite satisfactory indexes of internal consistency and factor validity, and the group's deficiencies (excess or deficit) were evaluated.


Author(s):  
Claudia Rokx ◽  
John Giles ◽  
Elan Satriawan ◽  
Puti Marzoeki ◽  
Pandu Harimurti

2020 ◽  
Vol 41 (1) ◽  
Author(s):  
Adweeti Nepal ◽  
Santa Kumar Dangol ◽  
Anke van der Kwaak

Abstract Background The persistent quality gap in maternal health services in Nepal has resulted in poor maternal health outcomes. Accordingly, the Government of Nepal (GoN) has placed emphasis on responsive and accountable maternal health services and initiated social accountability interventions as a strategical approach simultaneously. This review critically explores the social accountability interventions in maternal health services in Nepal and its outcomes by analyzing existing evidence to contribute to the informed policy formulation process. Methods A literature review and desk study undertaken between December 2018 and May 2019. An adapted framework of social accountability by Lodenstein et al. was used for critical analysis of the existing literature between January 2000 and May 2019 from Nepal and other low-and-middle-income countries (LMICs) that have similar operational context to Nepal. The literature was searched and extracted from database such as PubMed and ScienceDirect, and web search engines such as Google Scholar using defined keywords. Results The study found various social accountability interventions that have been initiated by GoN and external development partners in maternal health services in Nepal. Evidence from Nepal and other LMICs showed that the social accountability interventions improved the quality of maternal health services by improving health system responsiveness, enhancing community ownership, addressing inequalities and enabling the community to influence the policy decision-making process. Strong gender norms, caste-hierarchy system, socio-political and economic context and weak enforceability mechanism in the health system are found to be the major contextual factors influencing community engagement in social accountability interventions in Nepal. Conclusions Social accountability interventions have potential to improve the quality of maternal health services in Nepal. The critical factor for successful outcomes in maternal health services is quality implementation of interventions. Similarly, continuous effort is needed from policymakers to strengthen monitoring and regulatory mechanism of the health system and decentralization process, to improve access to the information and to establish proper complaints and feedback system from the community to ensure the effectiveness and sustainability of the interventions. Furthermore, more study needs to be conducted to evaluate the impact of the existing social accountability interventions in improving maternal health services in Nepal.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Keely Jordan ◽  
Todd P. Lewis ◽  
Bayard Roberts

Abstract Background There is a growing concern that the quality of health systems in humanitarian crises and the care they provide has received little attention. To help better understand current practice and research on health system quality, this paper aimed to examine the evidence on the quality of health systems in humanitarian settings. Methods This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The context of interest was populations affected by humanitarian crisis in low- and middle- income countries (LMICs). We included studies where the intervention of interest, health services for populations affected by crisis, was provided by the formal health system. Our outcome of interest was the quality of the health system. We included primary research studies, from a combination of information sources, published in English between January 2000 and January 2019 using quantitative and qualitative methods. We used the High Quality Health Systems Framework to analyze the included studies by quality domain and sub-domain. Results We identified 2285 articles through our search, of which 163 were eligible for full-text review, and 55 articles were eligible for inclusion in our systematic review. Poor diagnosis, inadequate patient referrals, and inappropriate treatment of illness were commonly cited barriers to quality care. There was a strong focus placed on the foundations of a health system with emphasis on the workforce and tools, but a limited focus on the health impacts of health systems. The review also suggests some barriers to high quality health systems that are specific to humanitarian settings such as language barriers for refugees in their host country, discontinued care for migrant populations with chronic conditions, and fears around provider safety. Conclusion The review highlights a large gap in the measurement of quality both at the point of care and at the health system level. There is a need for further work particularly on health system measurement strategies, accountability mechanisms, and patient-centered approaches in humanitarian settings.


2016 ◽  
Vol 40 (2) ◽  
pp. 194 ◽  
Author(s):  
Lucylynn Lizarondo ◽  
Catherine Turnbull ◽  
Tracey Kroon ◽  
Karen Grimmer ◽  
Alison Bell ◽  
...  

Objective South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system. In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to various healthcare challenges. A recent opinion piece proposed 10 clinician-driven strategies to assist in maximising value and sustainability of healthcare in Australia. The present study aimed to seek the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health. Methods A survey of allied health practitioners was undertaken to capture their perspectives on the 10 clinician-driven strategies for maximising value and sustainability of healthcare in Australia. Survey findings were then layered with evidence from the literature. Results Highly relevant across allied health are the strategies of discontinuation of low value practices, targeting clinical interventions to those getting greatest benefit, active involvement of patients in shared decision making and self-management and advocating for integrated systems of care. Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the ‘maximum value for spend’ of the increasingly scarce health dollar. What is known about the topic? In medicine, clinician-driven strategies have been proposed to minimise inappropriate and costly care and maximise highly appropriate and less expensive care. These strategies were developed based on clinical experiences and with supporting evidence from scientific studies. What does this paper add? Major changes to the health system are required to slow down the growth in healthcare expenditure. This paper describes opportunities in which allied health practitioners can implement similar strategies not only to improve the quality of patient outcomes, but also to offer cost-effective solutions for a sustainable healthcare. What are the implications for practitioners? Allied health practitioners can provide solutions to healthcare challenges and assist in the transformation of healthcare in Australia. However, for this to happen, there should be concerted efforts to increase recognition of and support for the use of allied health services.


2021 ◽  
Vol 8 (5) ◽  
pp. 1077
Author(s):  
Joko Purwanto ◽  
Renny Renny

<p class="BodyCxSpFirst">Pemanfaatan teknologi informasi sangat penting bagi rumah sakit, karena berpengaruh pula terhadap kualitas pelayanan kesehatan yang secara manual diubah menjadi digital dengan menggunakan teknologi informasi.Dalam penelitian ini penulis menggunakan metodologi <em>Nine step</em> sebagai acuan dalam merancang suatu <em>data warehouse</em><em>,</em> untuk pemodelan menggunakan skema konstelasi fakta dengan 3 tabel fakta dan 11 tabel dimensi. Perbedaan penelitian ini dengan penelitian sebelumnya terletak pada sumber data yang diekstrak langsung dari <em>database</em> SIMRS yang digunakan rumah sakit, sehingga tidak ada ekstraksi data secara manual.Penelitian ini bertujuan untuk menghasilkan desain data warehouse berbasis Online Analytical Processing (OLAP) sebagai sarana penunjang kualitas pelayanan kesehatan rumah sakit. OLAP yang dihasilkan akan berupa desain data warehouse dengan berbagai dimensi yang akan menghasilkan tampilan informasi berupa Chart maupun Grafik sehingga informasinya mudah dibaca dan dipahami oleh berbagai pihak.</p><p class="BodyCxSpFirst"> </p><p class="BodyCxSpFirst"><em><strong>Abtract</strong></em></p><p class="BodyCxSpFirst"><em>The use of information technology is very important for hospitals, because it also affects the quality of health services, which manualy changed to digital using information technology. In this study, the authors used the Nine step methodology as a reference in designing a data warehouse for modeling using a fact constellation schema with 3 fact tables and 11 dimension tables. the different in this study from previous research is that the data source was taken directly from the SIMRS database used by the hospital, so there is no manual data extraction.</em><em>The aim of this research is to be able to produce a Data Warehouse design based on Online Analytical Processing (OLAP) as a means of supporting the quality of hospital health services. The resulting OLAP will be a data warehouse design with various dimensions will produce the displays information in the form of a graph or chart so that the information is easy to read and understand by various parties.</em></p><p class="BodyCxSpLast"><em> </em></p><p class="BodyCxSpFirst"><em><strong><br /></strong></em></p>


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