scholarly journals Re-imagining Research: A Bold Call, but Bold Enough? Comment on "Experience of Health Leadership in Partnering with University-Based Researchers in Canada: A Call to ‘Re-Imagine’ Research"

2019 ◽  
Author(s):  
Bev J. Holmes
Keyword(s):  
Health System ◽  
Health Systems ◽  
Research Area ◽  
Evidence Use ◽  
Health System Change ◽  
Health Leadership ◽  
System Leaders ◽  
Change Projects ◽  
High Level ◽  
Partnership Models

Many articles over the last two decades have enumerated barriers to and facilitators for evidence use in health systems. Bowen et al’s article "Response to Experience of Health Leadership in Partnering with University-Based Researchers: A Call to ‘Re-imagine Research’" furthers the debate by focusing on an under-explored research area (health system design and health service organization) with an under-studied stakeholder group (health system leaders), by undertaking a broad program of research on partnerships, and, based on participant responses, by calling for re-imagining of research itself. In response to the claim that the research community is not providing expertise to this pressing issue in the health system, I provide four high level reasons: partnerships mean different things to different people, our language does not reflect the reality we want, our health systems have yet to fully embrace evidence use, and complexity is easier to talk about than act within. Bowen et al’s study, and their broader program of research, is well-placed to explore these issues further, helping identify appropriate researcher-health system leader partnership models for various health system change projects. Given the positive shifts identified in this study, and the knowledge that participants demonstrate about what needs to change, the time is right for bold action, re-imagining not only research, but healthcare, such that the production and use of evidence for better health is embraced and supported.

scholarly journals Integration of an Academic Medical Center and a Large Health System: Implications for Pharmacy

2019 ◽  
Vol 54 (3) ◽  
pp. 170-174
Author(s):  
Brian L. Erstad ◽  
Tina Aramaki ◽  
Kurt Weibel
Keyword(s):  
Health System ◽  
Health Systems ◽  
Integration Method ◽  
Medical Center ◽  
Academic Medical Center ◽  
Lessons Learned ◽  
Faculty Members ◽  
Pharmacy Services ◽  
Academic Medical ◽  
High Level

Objective: To provide lessons learned for colleges of pharmacy and large health systems that are contemplating or in the process of undergoing integration. Method: This report describes the merger of an academic medical center and large health system with a focus on the implications of the merger for pharmacy from the perspectives of both a college of pharmacy and a health system’s pharmacy services. Results: Overarching pharmacy issues to consider include having an administrator from the college of pharmacy directly involved in the merger negotiation discussions, having at least one high-level administrator from the college of pharmacy and one high-level pharmacy administrator from the health system involved in ongoing discussions about implications of the merger and changes that are likely to affect teaching, research, and clinical service activities, having focused discussions between college and health system pharmacy administrators on the implications of the merger on experiential and research-related activities, and anticipating concerns by clinical faculty members affected by the merger. Conclusion: The integration of a college of pharmacy and a large health system during the acquisition of an academic medical center can be challenging for both organizations, but appropriate pre- and post-merger discussions between college and health system pharmacy administrators that include a strategic planning component can assuage concerns and problems that are likely to arise, increasing the likelihood of a mutually beneficial collaboration.

Health leadership and health system change

2011 ◽  
Vol 24 (4) ◽  
Author(s):  
Graham Dickson ◽  
Donald J. Philippon
Keyword(s):  
Health System ◽  
System Change ◽  
Health System Change ◽  
Health Leadership

PP22 How Do Health System Leaders Use Evidence To Inform Action?

2018 ◽  
Vol 34 (S1) ◽  
pp. 74-75
Author(s):  
Matthew D Mitchell ◽  
C Michael White ◽  
Jeanne-Marie Guise ◽  
Lionel Bañez ◽  
Craig Umscheid ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Process Improvement ◽  
Systematic Reviews ◽  
Predictive Analytics ◽  
Structured Interview ◽  
Healthcare Research ◽  
System Quality ◽  
Study Results ◽  
System Leaders

Introduction:The US Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) program sponsors the development of systematic reviews to inform clinical policy and practice. The EPC program sought to better understand how health systems identify and use this evidence.Methods:Representatives from eleven EPCs, the EPC Scientific Resource Center, and AHRQ developed a semi-structured interview script to query a diverse group of nine Key Informants (KIs) involved in health system quality, safety and process improvement about how they identify and use evidence. Interviews were transcribed and qualitatively summarized into key themes.Results:All KIs reported that their organizations have either centralized quality, safety, and process improvement functions within their system, or they have partnerships with other organizations to conduct this work. There was variation in how evidence was identified, with larger health systems having medical librarians and central bureaus to gather and disseminate information and smaller systems having local chief medical officers or individual clinicians do this work. KIs generally prefer guidelines, especially those with treatment algorithms, because they are actionable. They like systematic reviews because they efficiently condense study results and reconcile conflicting data. They prefer information from systematic reviews to be presented as short digestible summaries with the full report available on demand. KIs preferred systematic reviews from reputable entities and those without commercial bias. Some of the challenges KIs reported include how to resolve conflicting evidence, the generalizability of evidence to local needs, determining whether the evidence is up-to-date, and the length of time required to generate reviews. The topics of greatest interest included predictive analytics, high-value care, advance care planning, and care coordination. To increase awareness of AHRQ EPC reviews, KIs suggest alerting people at multiple levels in a health-system when new evidence reports are available and making reports easier to find in common search engines.Conclusions:Systematic reviews are valued by health system leaders. To be most useful they should be easy to locate and available in different formats targeted to the needs of different audiences.

scholarly journals Two visions of clinical integration: perspectives from health system leaders

2014 ◽  
Vol 4 (1) ◽  
pp. 36 ◽  
Author(s):  
Wenke Hwang ◽  
Joseph Andrie ◽  
Michelle LaClair ◽  
Harold Paz
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Systems ◽  
Health Care Professionals ◽  
Success Factors ◽  
Leadership Roles ◽  
Health Care Environment ◽  
Clinical Integration ◽  
System Leaders ◽  
Patient Centric

Objective: Clinical Integration has been implicated as the key to achieving higher quality of care at a lower cost. However,ambiguity regarding the meaning of clinical integration poses challenges as health care professionals strive to adapt to the rapidlyevolving health care environment. This study aims to solicit insights from health system executives about what it means to beclinically integrated.Methods: The authors interviewed 13 health system executives from 11 different institutions in Pennsylvania ranging fromsmall community hospitals to large academic medical centers.Results: Two major viewpoints of clinical integration were identified from the interviews: patient-centric, which emphasized theimportance of the patient’s experience and strengthening patient involvement in their own healthcare, and provider-centric, whichfocused on leadership roles, organizational structure, and physician alignment. Participants with provider-centric viewpointswere associated with larger medical centers and were more likely to describe their health systems as highly clinically integrated.Conversely, patient-centric perspectives were affiliated with smaller health systems/hospitals and were more likely to describetheir health systems as less integrated. Participants also identified five key success factors of clinical integration: physicianalignment, shared data and analytics, culture, patient engagement, and an emphasis on primary care.Conclusions: Despite the central role of clinical integration in emerging health systems, there is not a shared understanding ofits definition. A better understanding of the varied perspectives regarding clinical integration can help current and future healthcare professionals to better communicate with one another about clinical integration and the practical steps necessary to achieveit.

scholarly journals Development and Implementation of a Combined Master of Science and PGY1/PGY2 Health-System Pharmacy Administration Residency Program at a Large Community Teaching Hospital

2018 ◽  
Vol 53 (2) ◽  
pp. 96-100 ◽  
Author(s):  
Nicholas P. Gazda ◽  
Emily Griffin ◽  
Kasey Hamrick ◽  
Jordan Baskett ◽  
Meghan M. Mellon ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Teaching Hospital ◽  
Medical Center ◽  
Degree Programs ◽  
Master Of Science ◽  
Pharmacy Administration ◽  
Large Community ◽  
High Level ◽  
Community Teaching

Purpose: The purpose of this article is to share experiences after the development of a health-system pharmacy administration residency with a MS degree and express the need for additional programs in nonacademic medical center health-system settings. Summary: Experiences with the development and implementation of a health-system pharmacy administration residency at a large community teaching hospital are described. Resident candidates benefit from collaborations with other health-systems through master’s degree programs and visibility to leaders at your health-system. Programs benefit from building a pipeline of future pharmacy administrators and by leveraging the skills of residents to contribute to projects and department-wide initiatives. Tools to assist in the implementation of a new pharmacy administration program are also described and include rotation and preceptor development, marketing and recruiting, financial evaluation, and steps to prepare for accreditation. Conclusion: Health-system pharmacy administration residents provide the opportunity to build a pipeline of high-quality leaders, provide high-level project involvement, and produce a positive return on investment (ROI) for health-systems. These programs should be explored in academic and nonacademic-based health-systems.

Innovation in the Canadian health system

2020 ◽  
Vol 34 (1) ◽  
pp. 5-8
Author(s):  
Tom Noseworthy
Keyword(s):  
Health System ◽  
Chronic Diseases ◽  
Health Systems ◽  
System Model ◽  
System Innovation ◽  
Learning Health System ◽  
Clinical Innovation ◽  
Canadian Health ◽  
High Level ◽  
Level Performance

The essence of human ingenuity is creation and novel ideas that result in collective and desired impact. Indeed, innovation is foundational to life in a changing world. In no situation today is this more relevant than in health systems, whether they be challenged to maintain population health, threatened by impending disasters, or expected to respond to the ever-expansive demand and inexorable course of those with chronic diseases. This article discusses health system innovation and its trajectory. It focuses on clinical innovation as a means of achieving high-level performance within a learning health system model. Examples of innovation in Canada are used to illustrate successful approaches worthy of broader consideration and pan-Canadian attention.

scholarly journals What Can Health Services Researchers Offer Health Systems? Developing Meaningful Partnerships Between Academics and Health System Workers Comment on "Experience of Health Leadership in Partnering with University-Based Researchers in Canada - A Call to ‘Re-imagine’ Research"

2020 ◽  
Author(s):  
Kate Churruca ◽  
Louise A. Ellis ◽  
Janet C. Long ◽  
Jeffrey Braithwaite
Keyword(s):  
Health System ◽  
Healthcare Systems ◽  
The Other ◽  
Complex Interplay ◽  
Research Partnerships ◽  
Research Collaborations ◽  
Interpersonal Factors ◽  
Health Leadership ◽  
Challenges And Opportunities ◽  
System Leaders

As healthcare researchers, we know very well our own experiences on the challenges of partnering with those in the health system to do collaborative, internationally-regarded studies aiming for impact. Bowen and colleagues’ study in Canada empirically examines these issues from the other side, interviewing health system leaders about their perspectives of us researchers, research collaborations and the challenges and opportunities these pose. Based on their findings, they propose a need to re-imagine the contours of research. Inspired by that, in this commentary we examine the context for research partnerships and consider some of the emerging models for fostering more meaningful collaborations between researchers and those working in healthcare systems and organisations. Based on principles of embedded research and researchers, these models—including translational research networks (TRNs) and researcher-in-residence models—rely on a complex interplay of personal and interpersonal factors to be successful.

scholarly journals Can We Re-Imagine Research So It Is Timely, Relevant and Responsive? Comment on "Experience of Health Leadership in Partnering with University-Based Researchers in Canada: A Call to ‘Re-Imagine’ Research"

2020 ◽  
Author(s):  
Cecilia Vindrola-Padros
Keyword(s):  
Health System ◽  
Academic Research ◽  
Health Sector ◽  
Policy And Practice ◽  
Collaborative Relationships ◽  
Design Studies ◽  
Health Leadership ◽  
System Leaders ◽  
Research Findings ◽  
Health Policy And Practice

Partnerships between academic institutions and healthcare organisations have been proposed as an effective way to integrate academic research findings into changes in health policy and practice. Bowen and colleagues explore these partnerships from a different angle, analysing them in relation to the experiences of health system leaders. The authors made a call to re-imagine research, rethinking how we train applied health researchers, fund health research and evaluation and design studies and collaborations with the health sector. In this paper, I respond to this call by discussing three strategies we can use to make sure our research is timely, relevant and responsive to the needs and context of healthcare organisations: the widespread use of rapid research approaches, the integration of scoping stages in all studies, and the training of applied health researchers to work in the health system and develop collaborative relationships with staff.

scholarly journals 1.F. Workshop: The barriers to effective hypertension care: a focus on the patient's journey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Lived Experiences ◽  
Chronic Conditions ◽  
The Philippines ◽  
Economic Consequences ◽  
Middle Income ◽  
Health System Change ◽  
Disadvantaged Populations ◽  
Technical Innovations

Abstract Millions of people across the world depend on health systems that simply do not work. They struggle to find someone who can help and, when they do, can face catastrophic bills for often substandard care. But we fail to listen to those whose needs, desires, and expectations are most unmet. We assume their understanding of health and illness is the same as ours and we ignore the coping strategies developed over years that they use to overcome the barriers that those who design health systems place in their way. They live their lives unseen and unheard by those who make the decisions that will determine whether they live or die. This workshop explores issues that arise when researchers actively engage with disadvantaged populations. It reports our experiences from the RESPOND project (Responsive and Equitable Health Systems - Partnership for Non-Communicable Diseases), working with disadvantaged communities in Malaysia and the Philippines to view the health system from the perspective of people whose health depends on a long-term relationship with it. We use a mixed methods approach, involving household surveys, in-depth interviews and digital diaries, where participants use mobile phones to record their experiences of living with chronic conditions and seeking care for it. The aim of this workshop is to demonstrate why it is important to listen to those in disadvantaged populations, in order to understand the barriers they face and the ways that they seek to overcome them as they seek care for a chronic disorder. We will illustrate this by achieving five objectives: To show why we need to look beyond the biomedical approach to illness;To recognise the many different journeys that patients follow;To understand the economic consequences of the choices that they make;To describe the theoretical and technical innovations developed as part of the RESPOND project to do this; andTo illustrate how bringing such insights together can be used to implement equitable health system change. The workshop will be chaired and moderated by Dina Balabanova and Martin McKee, two globally recognised leaders researching chronic conditions and health system reforms in low- and middle-income countries. The first three presentations will introduce people living with chronic conditions from the study communities, and will examine the challenges they face, their options and the choices they make to treat it. All five presentations, but particularly the remaining two, will describe the theoretical and technical innovations developed as part of the RESPOND project used to capture the voices and lived experiences of disadvantaged populations so that they may be better represented in the planning of health systems and services. The remaining 30 minutes will be devoted to guided interactive discussion with the audience on how we are using this people-centred evidence to implement change in each country, and how these approaches may be applied in other settings. Key messages Designing effective and responsive health systems that leave no one behind must account for the lived experiences of all beneficiaries, including those groups whose voices often go unheard. We present evidence from Malaysia and the Philippines from studies that used innovative methods to capture the lived experiences of disadvantaged populations seeking care for chronic conditions.

University-based continuing education and mental health system change.

1982 ◽  
Vol 37 (8) ◽  
pp. 966-970 ◽  
Author(s):  
George H. Wolkon ◽  
Carolyn L. Peterson ◽  
Patricia Gongla
Keyword(s):  
Mental Health ◽  
Health System ◽  
Continuing Education ◽  
Mental Health System ◽  
System Change ◽  
Health System Change
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