scholarly journals Improving Linkages and Referrals to the Broader Health System: For Quality Care Amidst Absolute Infrastructure and Resource Constraints

10.1596/31854 ◽  
2018 ◽  
Author(s):  
Keyword(s):  
Health System ◽  
Resource Constraints ◽  
Quality Care

Health system characteristics of quality care delivery: A comparative case study examination of palliative care for cancer patients in four regions in Ontario, Canada

2011 ◽  
Vol 26 (4) ◽  
pp. 322-335 ◽  
Author(s):  
Jonathan Sussman ◽  
Lisa Barbera ◽  
Daryl Bainbridge ◽  
Doris Howell ◽  
Jinghao Yang ◽  
...  
Keyword(s):  
Palliative Care ◽  
Health System ◽  
Acute Care ◽  
Pattern Analysis ◽  
Care Delivery ◽  
Quality Care ◽  
Structural Features ◽  
Comparative Case Study ◽  
Care Utilization

Background: A number of palliative care delivery models have been proposed to address the structural and process gaps in this care. However, the specific elements required to form competent systems are often vaguely described. Aim: The purpose of this study was to explore whether a set of modifiable health system factors could be identified that are associated with population palliative care outcomes, including less acute care use and more home deaths. Design: A comparative case study evaluation was conducted of ‘palliative care’ in four health regions in Ontario, Canada. Regions were selected as exemplars of high and low acute care utilization patterns, representing both urban and rural settings. A theory-based approach to data collection was taken using the System Competency Model, comprised of structural features known to be essential indicators of palliative care system performance. Key informants in each region completed study instruments. Data were summarized using qualitative techniques and an exploratory factor pattern analysis was completed. Results: 43 participants (10+ from each region) were recruited, representing clinical and administrative perspectives. Pattern analysis revealed six factors that discriminated between regions: overall palliative care planning and needs assessment; a common chart; standardized patient assessments; 24/7 palliative care team access; advanced practice nursing presence; and designated roles for the provision of palliative care services. Conclusions: The four palliative care regional ‘systems’ examined using our model were found to be in different stages of development. This research further informs health system planners on important features to incorporate into evolving palliative care systems.

Quality

2020 ◽  
pp. 166-183
Author(s):  
Julie Sin
Keyword(s):  
Health Services ◽  
Health System ◽  
Services Quality ◽  
Quality Care ◽  
System Level ◽  
Quality Of Services ◽  
Provider Perspective ◽  
Multidimensional Concept

This chapter looks at the topic of health services quality from a commissioning and whole population perspective. Quality is noted to be a multidimensional concept and dimensions of quality are considered. The role of the commissioner in maintaining and improving quality of services is explored, and this is seen within a wider backdrop of a health system with commissioner and provider functions (if there are such distinctions in the system). Commissioners need to know whether they are securing quality care for their population for the money spent. They also need an understanding of how this dovetails with the provider perspective on this topic. Commissioners also need to be able to articulate what they wish to assess in practice under the guise of quality. Finally, at a system level there are also bearings on how to compile and interpret a picture of a population’s health if needed.

scholarly journals Childbirth care: contributing to the debate on human development

2007 ◽  
Vol 15 (spe) ◽  
pp. 792-798 ◽  
Author(s):  
Cristina Maria Garcia de Lima Parada ◽  
Maria Antonieta de Barros Leite Carvalhaes
Keyword(s):  
Health Services ◽  
Health System ◽  
Human Development ◽  
Quality Care ◽  
Mortality Rates ◽  
World Health ◽  
Health Ministry ◽  
Public Resources ◽  
Health Organization ◽  
Childbirth Care

This study aimed to evaluate care during childbirth and neonatal development in the interior of São Paulo in order to support managers responsible for formulating public policies on human development and allocating public resources to the women's healthcare. This epidemiological study focused on the evaluation of health services based on the observation of the assistance delivered by the Single Health System in 12 maternities and 134 delivers. The Brazilian Health Ministry or World Health Organization standards were adopted for comparison. The results revealed problems related to the structure of some maternities, where some well-proven practices in normal childbirth are still little used, whereas other prejudicial or ineffective ones are routinely used. Reversing this picture is essential in order to offer humanized quality care to women with consequent reductions in maternal and neonatal mortality rates, in such a way that the region achieves the millennium goals established for improving human development.

Health system reconstitution syndrome: an often misunderstood phenomenon in global health practice

2019 ◽  
Vol 34 (8) ◽  
pp. 618-624
Author(s):  
Anatole Manzi ◽  
Alyssa Ierardo ◽  
Jean Claude Mugunga ◽  
Cate Oswald ◽  
Patrick Ulysse ◽  
...  
Keyword(s):  
Global Health ◽  
Health System ◽  
Low Income ◽  
Program Implementation ◽  
Quality Care ◽  
Building Blocks ◽  
Health Systems Strengthening ◽  
Low Income Countries ◽  
Global Movement ◽  
Active Implementation

Abstract The beginning of the 21st century was marked by the new definition and framework of health systems strengthening (HSS). The global movement to improve access to high-quality care garnered new resources to design and implement comprehensive HSS programs. In this effort, billions of dollars flowed from novel mechanisms such as The Global Fund to Fight AIDS, Tuberculosis and Malaria; Gavi, the Vaccine Alliance; and several bilateral funders. However, poor health outcomes, particularly in low-income countries, raise questions about the effectiveness of HSS program implementation. While several evaluation projects focus on the ultimate impact of HSS programs, little is known about the short- and mid-term reactions occurring throughout the active implementation of HSS interventions. Using the well-documented WHO framework of six HSS building blocks, we describe the evolution and phases of health system reconstitution syndrome (HSRS), including: (1) quiescent phase, (2) reactive phase, (3) restorative phase and (4) stability phase. We also discuss the implications of HSRS on global health funding, implementation, policy and research. Recognizing signs of HSRS could improve the rigour of HSS program design and minimize premature decisions regarding the progress of HSS interventions.

scholarly journals Quality care during labour and birth: a multi-country analysis of health system bottlenecks and potential solutions

2015 ◽  
Vol 15 (S2) ◽  
Author(s):  
Gaurav Sharma ◽  
Matthews Mathai ◽  
Kim E Dickson ◽  
Andrew Weeks ◽  
G Justus Hofmeyr ◽  
...  
Keyword(s):  
Health System ◽  
Quality Care ◽  
Country Analysis

Operational modelling to guide implementation and scale-up of diagnostic tests within the health system: exploring opportunities for parasitic disease diagnostics based on example application for tuberculosis

Parasitology ◽  
2014 ◽  
Vol 141 (14) ◽  
pp. 1795-1802 ◽  
Author(s):  
IVOR LANGLEY ◽  
EMILY ADAMS ◽  
BASRA DOULLA ◽  
S. BERTEL SQUIRE
Keyword(s):  
Health System ◽  
Diagnostic Tests ◽  
Resource Constraints ◽  
Scale Up ◽  
Diagnostic Tools ◽  
Parasitic Diseases ◽  
Extensive Literature ◽  
Middle Income ◽  
Diagnostic Strategies ◽  
Operational Modelling

SUMMARYResearch and innovation in the diagnosis of infectious and parasitic diseases has led to the development of several promising diagnostic tools, for example in malaria there is extensive literature concerning the use of rapid diagnostic tests. This means policymakers in many low and middle income countries need to make difficult decisions about which of the recommended tools and approaches to implement and scale-up. The test characteristics (e.g. sensitivity and specificity) of the tools alone are not a sufficient basis on which to make these decisions as policymakers need to also consider the best combination of tools, whether the new tools should complement or replace existing diagnostics and who should be tested. Diagnostic strategies need dovetailing to different epidemiology and structural resource constraints (e.g. existing diagnostic pathways, human resources and laboratory capacity). We propose operational modelling to assist with these complex decisions. Projections of patient, health system and cost impacts are essential and operational modelling of the relevant elements of the health system could provide these projections and support rational decisions. We demonstrate how the technique of operational modelling applied in the developing world to support decisions on diagnostics for tuberculosis, could in a parallel way, provide useful insights to support implementation of appropriate diagnostic innovations for parasitic diseases.

scholarly journals A central role for the health call centre

2005 ◽  
Vol 29 (4) ◽  
pp. 435 ◽  
Author(s):  
Peter J Bentley ◽  
Valender F Turner ◽  
Sharon A Hodgson ◽  
Rosalia Drimatis ◽  
Jade Hart
Keyword(s):  
Health System ◽  
Quality Care ◽  
Clinical Information ◽  
Cost Effective ◽  
Adverse Outcomes ◽  
Asia Pacific ◽  
Call Centre ◽  
Australian Health ◽  
Western Australian Department ◽  
Western Australian

THERE ARE SIGNIFICANT CHALLENGES facing the health system that stem from the tendency for decisions to be made by disparate groups focusing more on the needs of institutions rather than the needs of patients.1 As a result, patient care is becoming episodic, with poor communication leading to inefficiencies, errors and adverse outcomes. An ideal health system provides ?quality care that is centred on the patient, communitybased, coordinated, continuous and cost-effective, and utilises clinical information systems?.2 (page 229) We believe health call centres (HCCs) could be instrumental in achieving such aims. In May 1999, the Western Australian Department of Health in conjunction with McKesson Asia Pacific established the Western Australian Health Call Centre (WAHCC).3 Clinical governance is overseen by three medical directors and a specialist nurse, and staff participate in comprehensive, continuous education and quality improvement. Since its inception, the WAHCC has witnessed an increase in demand and serves about 225 000 callers annually. This amounts to 600 callers per day at a cost (in 2004) of about $28 per call ? 0.0018% of the health budget. Seventy per cent of calls are received after hours, particularly on weekends and public holidays. The initial program offered by the WAHCC was HealthDirect. Services have expanded to include programs and pilot projects listed in the Box .

Great expectations: virus-mediated gene therapy in neurological disorders

2020 ◽  
Vol 91 (8) ◽  
pp. 849-860 ◽  
Author(s):  
Didu Kariyawasam ◽  
Ian E Alexander ◽  
Manju Kurian ◽  
Michelle Anne Farrar
Keyword(s):  
Gene Therapy ◽  
Health System ◽  
Neurological Disorders ◽  
Muscular Atrophy ◽  
Neurological Diseases ◽  
Quality Care ◽  
Great Expectations ◽  
Ongoing Research ◽  
Regulatory Policies ◽  
Effective Delivery

Gene therapy (GT) has tremendous potential for the treatment of neurological disorders to transform patient care. The successful application of virus-mediated GT to treat spinal muscular atrophy is a significant milestone, serving to accelerate similar progress in a spectrum of neurological conditions, with more than 50 clinical trials currently underway, across neurodevelopmental, neurodegenerative, muscular dystrophy, epilepsy, chronic pain and neoplastic diseases. This review provides an overview of the key features of virus-mediated GT, paradigms of delivery and dosing, potential risks and highlights ongoing research to optimise safe and effective delivery of vectors into the nervous system. Examples of the application of GT in various neurological diseases alongside clinical development challenges will be presented. As the development and translation of GTs gain pace, success can only ultimately be realised for patients following implementation in the health system. The challenges and controversies of daunting costs, ethics, early diagnosis and health system readiness will require innovative pricing schemes, regulatory policies, education and organisation of a skilled workforce to deliver of high-quality care in clinical practice as we prepare for advanced therapeutics in neurology.

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