scholarly journals Improving the quality of care in health systems: towards better strategies

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jennifer Dixon
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
New Technologies ◽  
Critical Mass ◽  
National Level ◽  
Short Term ◽  
The Future ◽  
Over Time

AbstractImproving the quality of health care across a nation is complex and hard. Countries often rely on multiple single national level programmes to make progress. But the key is to use a framework to develop a balanced overall strategy, and evaluate the main elements continuously and over time. Achieving that requires having a critical mass of leaders who collectively can see the bigger picture now, envision a roadmap for the future to chart an intelligent course, and course correct regularly. This is a long-term agenda requiring commitment, careful stewardship, different perspectives, trust, and the building of knowledge and experience over time. It is also almost completely at odds with much current policymaking which is short term, reactive and demands hard results. Many countries are making progress. But the rapid introduction of new types of care during the COVID 19 pandemic, such as online and digital, the use of new technologies which could soon revolutionalise the way care is delivered, experienced and evaluated, and the huge pressures on spending on health care in future mean we will have to do better. Achieving system-wide quality of care requires having a critical mass of leaders who collectively can see the bigger picture now, envision a roadmap for the future to chart a balanced intelligent course. For the Israeli health system, the recent IJHPR article by Dreiher et al. will help, but it will be important, in the future, to analyse how Israel measures up on the framework outlined above. This ideally would be supplemented with a survey of key leaders for their assessment, and both would be a regular (say 5 yearly) exercise and would help inform future strategies.

scholarly journals COVID-19 pandemic. Effects of stress

2020 ◽  
Vol 1 (2) ◽  
pp. 16-24
Author(s):  
Elena S. Akarachkova ◽  
◽  
Anton A. Beliaev ◽  
Dmitrii V. Blinov ◽  
Evgenii V. Bugorskii ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Preventive Health Care ◽  
Preventive Health ◽  
World Health ◽  
Social Stability ◽  
Short Term ◽  
Health Organization

World Health Organization declared COVID-19 outbreak a pandemic on March 11, 2020. Fear of illness, self-isolation/quarantine, and reduced quality of life dramatically increased the prevalence of stress-related disorders in the population. Therefore, it is necessary to implement the preventive health-care measures aimed at short-term and long-term COVID-19 pandemic consequences reduction and promotion of social stability.

scholarly journals Is physiological glucocorticoid replacement important in children?

2016 ◽  
Vol 102 (2) ◽  
pp. 199-205 ◽  
Author(s):  
John Porter ◽  
Joanne Blair ◽  
Richard J Ross
Keyword(s):  
Circadian Rhythm ◽  
Adrenal Insufficiency ◽  
New Technologies ◽  
Poor Quality ◽  
Short Term ◽  
Once Daily ◽  
Low Concentrations ◽  
Diabetes And Obesity

Cortisol has a distinct circadian rhythm with low concentrations at night, rising in the early hours of the morning, peaking on waking and declining over the day to low concentrations in the evening. Loss of this circadian rhythm, as seen in jetlag and shift work, is associated with fatigue in the short term and diabetes and obesity in the medium to long term. Patients with adrenal insufficiency on current glucocorticoid replacement with hydrocortisone have unphysiological cortisol concentrations being low on waking and high after each dose of hydrocortisone. Patients with adrenal insufficiency complain of fatigue, a poor quality of life and there is evidence of poor health outcomes including obesity potentially related to glucocorticoid replacement. New technologies are being developed that deliver more physiological glucocorticoid replacement including hydrocortisone by subcutaneous pump, Plenadren, a once-daily modified-release hydrocortisone and Chronocort, a delayed and sustained absorption hydrocortisone formulation that replicates the overnight profile of cortisol. In this review, we summarise the evidence regarding physiological glucocorticoid replacement with a focus on relevance to paediatrics.

scholarly journals Can the craze for patient safety hinder a more holistic care of the person in the health care system?

2018 ◽  
Vol 8 (12) ◽  
pp. 9
Author(s):  
Mamane Abdoulaye Samri ◽  
Daphney St-Germain
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Quality Of Care ◽  
Health System ◽  
Continuous Improvement ◽  
Clinical Governance ◽  
Decision Makers ◽  
Holistic Care

Background and objective: Since the publication of a report by the Institute of Medicine on the mortality associated with adverse events in the hospital, patient safety has become one of the essential objectives of the health care system. However, this movement tends to obscure the fundamental link between safety and quality of care in the health system. The study was aimed to demonstrate that the only focus on patient safety concept overshadow the more holistic care of the person and the population in the health care system.Methods: Documentary research in the Pubmed database and the Google Scholar search engine, from 1999 to 2017.Results and conclusion: Highly targeted safety research without addressing quality at first can only be a long-term panacea for current health policies. For cause, a one-way look at patient safety could lead to significant impacts at the population level. In order to get out of this craze, health system decision-makers would benefit from supporting clinical governance advocating humanistic and holistic strategies for interventions, engaging in a process of continuous improvement of the Quality of care more profitable in the long term. In order to overcome this craze, health system decision-makers would benefit from supporting clinical governance that advocates humanistic and holistic strategies for interventions, by engaging in a process of continuous improvement in the quality of care that is most beneficial in the long term. This posture is similar to Caring's well-known nursing model.

Il ruolo della previsione nel processo decisionale*

1985 ◽  
Vol 3 (3) ◽  
pp. 189-200
Author(s):  
Ornello Vitali
Keyword(s):  
Present Situation ◽  
Good Information ◽  
Short Term ◽  
Middle Term ◽  
The Future ◽  
Future Events

Abstract Though undertakings prefer, usually, to concentrate on short-term previsions, it seems essential for them to develop middle-term and also long-term forecasting.Taking into consideration the interdependence among these three kinds of forecasts, it is unavoidable the suggestion to make an effort to look not only to the next future, but much further, in such a way to reinforce the quality of previsions.To forecast future events, it is important a good information about the present situation, whilst to understand the actual problems it is essential to be able to foresee the future.

Generics at the Crossroads: Will Europe Lead the Way Forward?

2009 ◽  
Vol 6 (3) ◽  
pp. 193-205
Author(s):  
Eric Gorka
Keyword(s):  
Economies Of Scale ◽  
New Technologies ◽  
National Level ◽  
Fixed Costs ◽  
The European Union ◽  
Global Trends ◽  
The Future ◽  
Operational Excellence

The generics industry is at a crossroads. Fundamental growth drivers remain unchanged, and should result in sustained long-term growth. However, growing cost and pricing pressures mean the industry of the future will look very different and the longer term impact of the financial crisis is still unclear. Future industry structure will also be determined by the extent to which genuine competition is allowed to emerge and to overcome the trend towards nationalist protectionist policies. The companies that succeed will be those that excel in four key areas: launches, differentiation, geographic presence and operational excellence. They will implement variations on three basic strategies: leveraging fixed costs/economies of scale, using new technologies and focusing on value products. Although many questions remain to be answered, including the future role of Europe, several global trends are clear, including ongoing industry consolidation and the growing importance of biosimilars. Otherwise, much will depend on developments in the European Union (EU), the world's largest single market. The EU offers an object lesson in the need for political leadership not only from the top but also at the national level, where varying approaches can have make-or-break importance for generic penetration rates and thus for the industry as a whole.

scholarly journals Resident and family perceptions of the nurse practitioner role in long term care settings: a qualitative descriptive study

2021 ◽  
Author(s):  
Jenny Ploeg ◽  
Sharon Kaasalainen ◽  
Carrie McAiney ◽  
Ruth Martin-Misener ◽  
Faith Donald ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Nurse Practitioners ◽  
Long Term Care ◽  
Family Members ◽  
Term Care ◽  
Qualitative Descriptive

Background Research evidence supports the positive impact on resident outcomes of nurse practitioners (NPs) working in long term care (LTC) homes. There are few studies that report the perceptions of residents and family members about the role of the NP in these settings. The purpose of this study was to explore the perceptions of residents and family members regarding the role of the NP in LTC homes. Methods The study applied a qualitative descriptive approach. In-depth individual and focus group interviews were conducted with 35 residents and family members from four LTC settings that employed a NP. Conventional content analysis was used to identify themes and sub-themes. Results Two major themes were identified: NPs were seen as providing resident and family-centred care and as providing enhanced quality of care. NPs established caring relationships with residents and families, providing both informational and emotional support, as well as facilitating their participation in decision making. Residents and families perceived the NP as improving availability and timeliness of care and helping to prevent unnecessary hospitalization. Conclusions The perceptions of residents and family members of the NP role in LTC are consistent with the concepts of person-centred and relationship-centred care. The relationships NPs develop with residents and families are a central means through which enhanced quality of care occurs. Given the limited use of NPs in LTC settings, there is an opportunity for health care policy and decision makers to address service inadequacies through strategic deployment of NPs in LTC settings. NPs can use their expert knowledge and skill to assist residents and families to make informed choices regarding their health care and maintain a positive care experience

Improving Quality of Care through Risk Management Knowledge Transfer and Quality Assurance in Nursing Care

2012 ◽  
pp. 233-241
Author(s):  
Kleopatra Alamantariotou
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Quality Assurance ◽  
Quality Of Care ◽  
Knowledge Transfer ◽  
Nursing Care ◽  
Health Professionals ◽  
Careful Consideration

The purpose of this chapter is to provide innovative knowledge and creative ideas of improving quality of care and to explore how risk management and Knowledge transfer and quality assurance can improve health care. Under careful consideration, our purpose is to summarize which factors improve and promote the quality of care and which factors diminish quality. There are forms of ongoing efforts to make performance better. Quality improvement must be a long-term, continuous effort, reducing errors and providing a safe trust environment for health professionals and patients. After reading this chapter, you should know the answer to these questions: What role can risk management and knowledge transfer play in quality of care? How can risk management and knowledge transfer work together? What are the factors that improve risk management and quality assurance in health care? How does knowledge transfer support, inform, and improve care?

Learning Places from Views: Variation in Scene Processing as a Function of Experience and Navigational Ability

2005 ◽  
Vol 17 (1) ◽  
pp. 73-83 ◽  
Author(s):  
Russell A. Epstein ◽  
J. Stephen Higgins ◽  
Sharon L. Thompson-Schill
Keyword(s):  
Functional Magnetic Resonance ◽  
Neural Basis ◽  
Short Term ◽  
Repetition Effects ◽  
Parahippocampal Cortex ◽  
Scene Processing ◽  
Fmri Adaptation ◽  
Over Time

Humans and animals use information obtained from different viewpoints to form representations of the spatial structure of the world. We used functional magnetic resonance imaging (fMRI) adaptation to investigate the neural basis of this learning process and to show how the concomitant representations vary across individuals as a function of navigational ability. In particular, we examined the effect of repeating viewpoint and/ or place information over both short (within-trial) and long (across-scan) intervals on the neural response in scene processing regions. Short-term fMRI adaptation effects in the parahippocampal cortex were initially highly viewpoint-specific but became less so over time. Long-term fMRI repetition effects included a significant viewpoint-invariant component. When individual differences in navigational ability were considered, a significant correlation between the strength of these effects and self-reported navigational competence was observed. In particular, good navigators encoded representations that differed between new and old views and new and old places, whereas bad navigators did not. These results suggest that cortical scene representations evolve over time to become more viewpoint-invariant and that the quality of these representations directly impacts navigational ability.

scholarly journals Humans adapt to social diversity over time

2019 ◽  
Vol 116 (25) ◽  
pp. 12244-12249 ◽  
Author(s):  
Miguel R. Ramos ◽  
Matthew R. Bennett ◽  
Douglas S. Massey ◽  
Miles Hewstone
Keyword(s):  
Cognitive Processes ◽  
Religious Diversity ◽  
Intergroup Contact ◽  
Short Term ◽  
New Era ◽  
Political Concern ◽  
Diverse World ◽  
Over Time

Humans have evolved cognitive processes favoring homogeneity, stability, and structure. These processes are, however, incompatible with a socially diverse world, raising wide academic and political concern about the future of modern societies. With data comprising 22 y of religious diversity worldwide, we show across multiple surveys that humans are inclined to react negatively to threats to homogeneity (i.e., changes in diversity are associated with lower self-reported quality of life, explained by a decrease in trust in others) in the short term. However, these negative outcomes are compensated in the long term by the beneficial influence of intergroup contact, which alleviates initial negative influences. This research advances knowledge that can foster peaceful coexistence in a new era defined by globalization and a socially diverse future.

Quality development in mental health care in Europe. Recent contributions by WHO

1997 ◽  
Vol 6 (S1) ◽  
pp. 211-215
Author(s):  
José G. Sampaio Faria
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Quality Of Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
European Region ◽  
Quality Development

In 1984 all Member States of the European Region agreed on a Pan European Health Policy, popularly known as Targets for Health for All (Health for all targets, 1991).Among the 38 targets agreed, Target 31 states (table I).More recently the first meeting of national directors/officials of mental health services in the European Member States stated that “there should be greater concern about the quality of mental health care in each Member State, and mechanisms must be established to guarantee a quality service. These include: a.encouraging mental health care professionals to develop systems to monitor the quality of care;b.independent inspection of services;c.the participation of consumers and relatives;d.improving the basic and continuing training of mental health professionals as well as their working conditions;Special attention should be paid to the quality of care provided to those with severe long-term mental disorder, the elderly, children and adolescents. Barriers to care should be avoided, particularly for people with long-term mental disabilities.”The need for quality development and evaluation differ quite significantly across the European Region as a result of the existing differences in the pattern of mental health services and priority policies to be implemented.

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