scholarly journals Defining Access Management in Healthcare Delivery Organizations

2019 ◽  
Author(s):  
Susanne Hempel ◽  
Lara G. Hilton ◽  
Susan Stockdale ◽  
Peter Kaboli ◽  
Isomi Miake-Lye ◽  
...  
Keyword(s):  
Management Practice ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Access Management ◽  
Healthcare Organizations ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Care Access ◽  
Evidence Review

Abstract Background: Managing patient access to care in healthcare delivery organizations is complex, yet instrumental in shaping patient healthcare experiences. Conceptual work to understand the dimensions of access and access management is critical for improvement initiatives. This work aims to advance primary care access management practice and research to support healthcare delivery organizations. Methods: We convened a stakeholder panel, informed by evidence review, to establish access and access management definitions. Stakeholders were selected based on a patient-centered framework and included patients, healthcare providers, policy makers, product makers, payers, and purchasers of healthcare. Methods included evidence review; written surveys; in-person stakeholder panel discussions; and concurrent sub-panels to establish recurring, cross-panel themes. Results: Literature review results showed variation in access concept definition but consistent use of the temporal measure “time to third next available appointment” as an indicator of access. Panel deliberations highlighted the importance of patient-centeredness and resulted in three comprehensive definitions: 1) “ Access management encompasses the set of goals, evaluations, actions and resources needed to achieve patient-centered healthcare services that maximize access for defined eligible populations of patients; ” 2) “ Optimal access management engages patients, providers, and teams in continuously improving care design and delivery to achieve optimal access;” and 3) “ Optimal access balances considerations of equity, patient preferences, patient needs, provider and staff needs, and value.” Conclusions: Access to healthcare is substantially determined by how healthcare delivery organizations manage it. The developed concepts of access management suggest that access management, improvement initiatives, and research studies require ongoing attention to organizational processes and multiple relevant outcomes. Healthcare organizations and researchers can use the definitions as starting points for initiatives to improve access management and evaluations of access initiative success.

P043 FOCUSING ON THE FUTURE: REDUCING BARRIERS AND IMPROVING ACCESS TO IBD SPECIALTY CARE ACROSS CANADA

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S63-S63
Author(s):  
Courtney Heisler ◽  
Raza Mirza ◽  
Olga Kits ◽  
Sandra Zelinsky ◽  
Sander Veldhuyzen van Zanten ◽  
...  
Keyword(s):  
Focus Groups ◽  
Diagnostic Delay ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Specialty Care ◽  
Nutrition Support ◽  
Prevalence Rates ◽  
Patient Centered ◽  
Care Access ◽  
Qualitative Approaches

Abstract Background Inflammatory Bowel Disease (IBD) is a chronic immune-mediated disease which affects nearly two million North Americans, with Canada demonstrating the highest age-adjusted incidence and prevalence rates globally. Resulting from compounding prevalence rates, the IBD clinical burden continues to grow. With high demand and limited resources, timely access to specialty healthcare services continues to be a difficulty faced by both patients and healthcare providers. Despite this pervasive issue, there has been no published research to date elucidating the patient perspective using qualitative approaches to compare and contrast the patient experience across Canada. Aims The aim of the study was to elicit a qualitative stream of data to better understand phenomena related to access to healthcare for individuals living with IBD from a patient-centered perspective. Methods Patients diagnosed with IBD (≥18 years of age) were recruited from gastroenterology clinics and communities through IBD specialists and Crohn’s & Colitis Canada. To ensure geographic diversity and representation, patients were recruited from both urban and rural regions. In order to acquire multiple access perspectives, patients were invited to bring a family member who was involved in their care to the focus groups. Co-facilitated by a researcher and a patient research partner, the focus groups were held in seven provinces across Canada. All focus groups were audio recorded, transcribed verbatim, and coded for themes. Themes were distilled through qualitative thematic analysis using Atlas.ti software to ascertain congruence or discordance of patient experiences in relation to IBD care access. Results A total of 63 participants were recruited in fourteen focus groups across seven provinces. The majority of participants were female (41/63, 65%) and from urban/suburban regions (34/63, 54%). The mean age of participants was 48 years (SD=16 years, range=16 to 77 years). Preliminary analyses illustrated three patient-identified access barrier themes: 1) Lack of multidisciplinary care (psycho-social and nutrition support), 2) Diagnostic delay, and 3) Inability to effectively receive and provide communication with healthcare providers. In response, four solutions were proposed: 1) Integration of holistic care into the clinical practice, 2) Readily accessible psycho-social and nutritional support, 3) Increased patient advocacy, and 4) Continuity and liaison through provision of a healthcare navigator resource. Conclusions The complexity of specialty care access for IBD patients cannot be underestimated. It is vital to possess a robust understanding of healthcare system structures, processes, and the significant impact these factors have on patients and the care received. Through the use of patient-centered exploration of barriers and facilitators, access to IBD specialty care in can be better understood and improved on both a provincial and national scale.

A Context-Aware Authorization Model for Process-Oriented Personal Health Record Systems

2011 ◽  
pp. 46-65
Author(s):  
Eleni Mytilinaiou ◽  
Vassiliki Koufi ◽  
Flora Matamateniou ◽  
George Vassilacopoulos
Keyword(s):  
Care Delivery ◽  
Personal Health Record ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Information Support ◽  
Personal Health ◽  
Health Record ◽  
Healthcare Organizations ◽  
Process Oriented

Healthcare delivery is a highly complex process involving a broad range of healthcare services, typically performed by a number of geographically distributed and organizationally disparate healthcare providers requiring increased collaboration and coordination of their activities in order to provide shared and integrated care. Under an IT-enabled, patient-centric model, health systems can integrate care delivery across the continuum of services, from prevention to follow-up, and also coordinate care across all settings. In particular, much potential can be realized if cooperation among disparate healthcare organizations is expressed in terms of cross-organizational healthcare processes, where information support is provided by means of Personal Health Record (PHR) systems. This chapter assumes a process-oriented PHR system and presents a security framework that addresses the authorization and access control issues arisen in these systems. The proposed framework ensures provision of tight, just-in-time permissions so that authorized users get access to specific objects according to the current context. These permissions are subject to continuous adjustments triggered by the changing context. Thus, the risk of compromising information integrity during task executions is reduced.

Survey of Cloud Computing in Healthcare Sector

2017 ◽  
Vol 7 (7) ◽  
pp. 337
Author(s):  
S. Karthiga Devi ◽  
B. Arputhamary
Keyword(s):  
Cloud Computing ◽  
Healthcare Providers ◽  
High Volume ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Cloud Infrastructure ◽  
Healthcare Organizations ◽  
Privacy And Security ◽  
Healthcare Data ◽  
Number Of Patients

Today the volume of healthcare data generated increased rapidly because of the number of patients in each hospital increasing.  These data are most important for decision making and delivering the best care for patients. Healthcare providers are now faced with collecting, managing, storing and securing huge amounts of sensitive protected health information. As a result, an increasing number of healthcare organizations are turning to cloud based services. Cloud computing offers a viable, secure alternative to premise based healthcare solutions. The infrastructure of Cloud is characterized by a high volume storage and a high throughput. The privacy and security are the two most important concerns in cloud-based healthcare services. Healthcare organization should have electronic medical records in order to use the cloud infrastructure. This paper surveys the challenges of cloud in healthcare and benefits of cloud techniques in health care industries.

scholarly journals An Analysis of Methodologies That Can Be Used to Validate if a Perioperative Surgical Home Improves the Patient-centeredness, Evidence-based Practice, Quality, Safety, and Value of Patient Care

2013 ◽  
Vol 119 (6) ◽  
pp. 1261-1274 ◽  
Author(s):  
Thomas R. Vetter ◽  
Nataliya V. Ivankova ◽  
Lee A. Goeddel ◽  
Gerald McGwin ◽  
Jean-Francois Pittet
Keyword(s):  
Perioperative Care ◽  
Healthcare Delivery ◽  
Standard Of Care ◽  
The United States ◽  
Surgical Patients ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Perioperative Surgical Home ◽  
Future Demands ◽  
Evidenced Based

Abstract Approximately 80 million inpatient and outpatient surgeries are performed annually in the United States. Widely variable and fragmented perioperative care exposes these surgical patients to lapses in expected standard of care, increases the chance for operational mistakes and accidents, results in unnecessary and potentially detrimental care, needlessly drives up costs, and adversely affects the patient healthcare experience. The American Society of Anesthesiologists and other stakeholders have proposed a more comprehensive model of perioperative care, the Perioperative Surgical Home (PSH), to improve current care of surgical patients and to meet the future demands of increased volume, quality standards, and patient-centered care. To justify implementation of this new healthcare delivery model to surgical colleagues, administrators, and patients and maintain the integrity of evidenced-based practice, the nascent PSH model must be rigorously evaluated. This special article proposes comparative effectiveness research aims or objectives and an optimal study design for the novel PSH model.

scholarly journals Quality and safety by design

2006 ◽  
Vol 15 (suppl 1) ◽  
pp. i1-i3 ◽  
Author(s):  
J B Battles
Keyword(s):  
Healthcare Delivery ◽  
Clinical Work ◽  
Design Methods ◽  
Quality And Safety ◽  
Healthcare Organizations ◽  
Patient Centered ◽  
Framework Design ◽  
Design Attributes ◽  
Centered Care

Rather than continuing to try to measure the width and depths of the quality chasm, a legitimate question is how does one actually begin to close the quality chasm? One way to think about the problem is as a design challenge rather than as a quality improvement challenge. It is time to move from reactive measurement to a more proactive use of proven design methods, and to involve a number of professions outside health care so that we can design out system failure and design in quality of care. Is it possible to actually design in quality and design out failure? A three level conceptual framework design would use the six quality aims laid out in Crossing the quality chasm. The first or core level of the framework would be designing for patient centered care, with safety as the second level. The third design attributes would be efficiency, effectiveness, timeliness, and equity. Design methods and approaches are available that can be used for the design of healthcare organizations and facilities, learning systems to train and maintain competency of health professionals, clinical systems, clinical work, and information technology systems. In order to bring about major improvements in quality and safety, these design methods can and should be used to redesign healthcare delivery systems.

Adopting and Implementing Telehealth in Canada

2011 ◽  
pp. 1222-1231
Author(s):  
Penny A. Jennett ◽  
Eldon R. Smith ◽  
Mamoru Watanabe ◽  
Sharlene Stayberg
Keyword(s):  
Health Information ◽  
Best Practice ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Skills Training ◽  
Healthcare Services ◽  
Lessons Learned ◽  
Cultural Barriers ◽  
Statistics Canada ◽  
Government Of Canada

Canada spans 9,976,140 square kilometers and has an approximate population of 32 million people (Statistics Canada, 2001). More than 90% of Canada’s geography is considered rural or remote (Government of Canada, 2001). Despite the highly dispersed population, and, indeed, because of it, Canada is committed to the idea that a networked telehealth system could provide better access and equity of care to Canadians. Growing evidence of the feasibility and affordability of telehealth applications substantiates Canada’s responsibility to promote and to develop telehealth. Telehealth is the use of advanced telecommunication technologies to exchange health information and provide healthcare services across geographic, time, social, and cultural barriers (Reid, 1996). According to a systematic review of telehealth projects in different countries (Jennett et al., 2003a, 2003b), specific telehealth applications have shown significant socioeconomic benefits to patients and families, healthcare providers, and the healthcare system. Implementing telehealth can impact the delivery of health services by increasing access, improving quality of care, and enhancing social support (Bashshur, Reardon, & Shannon, 2001; Jennett et al., 2003a). It also has the potential to impact skills training of the health workforce by increasing educational opportunities (Jennett et al., 2003a; Watanabe, Jennett, & Watson, 1999). Therefore, telehealth has a strong potential to influence improved health outcomes in the population (Jennett et al., 2003a, 2003b). Fourteen health jurisdictions—one federal, 10 provincial, and three territorial—are responsible for the policies and infrastructure associated with healthcare delivery in Canada. This article presents a telehealth case study in one of Canada’s health jurisdictions—the province of Alberta. The rollout of telehealth in Alberta serves as an example of best practice. Significant milestones and lessons learned are presented. Progress toward the integration of the telehealth network into a wider province-wide health information network also is highlighted.

Supply Chain Thinking in Healthcare: Lessons and Outlooks

2020 ◽  
Author(s):  
Lidia Betcheva ◽  
Feryal Erhun ◽  
Houyuan Jiang
Keyword(s):  
Supply Chain ◽  
Supply Chain Management ◽  
Supply Chains ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Lessons Learned ◽  
Problem Definition ◽  
Healthcare Organizations ◽  
Chain Management ◽  
Managerial Implications

Problem definition: The lessons learned over decades of supply chain management provide an opportunity for stakeholders in complex systems, such as healthcare, to understand, evaluate, and improve their complicated and often inefficient ecosystems. Academic/practical relevance: The complexity in managing healthcare supply chains offers opportunities for important and impactful research avenues in key supply chain management areas such as coordination and integration (e.g., new care models), mass customization (e.g., the rise in precision medicine), and incentives (e.g., emerging reimbursement schemes), which might, in turn, provide insights relevant to traditional supply chains. We also put forward new perspectives for practice and possible research directions for the supply chain management community. Methodology: We provide a primer on supply chain thinking in healthcare, with a focus on healthcare delivery, by following a framework that is customer focused, systems based, and strategically orientated and that simultaneously considers clinical, operational, and financial dimensions. Our goal is to offer an understanding of how concepts and strategies in supply chain management can be applied and tailored to healthcare by considering the sector’s unique challenges and opportunities. Results: After identifying key healthcare stakeholders and their interactions, we discuss the main challenges facing healthcare services from a supply chain perspective and provide examples of how various supply chain strategies are being and can be used in healthcare. Managerial implications: By using supply chain thinking, healthcare organizations can decrease costs and improve the quality of care by uncovering, quantifying, and addressing inefficiencies.

scholarly journals Examining Stakeholder’s Views On Refugee Healthcare Needs, Current Barriers in Accessing Healthcare Services and Future Healthcare Direction in New Zealand: A Qualitative Phenomenological Approach

2021 ◽  
Author(s):  
Bafreen Sherif ◽  
Ahmed Awaisu ◽  
Nadir Kheir
Keyword(s):  
New Zealand ◽  
Health Services ◽  
Qualitative Methodology ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Healthcare Personnel ◽  
Structured Interviews ◽  
Health Seeking ◽  
Healthcare Needs

Abstract Background The annual New Zealand refugee quota was increased to 1500 places from 2020 onwards as a response to the global refugee crisis. The specific healthcare needs of refugees are not clearly understood globally and communication between healthcare providers and refugees remains poor. Methods A phenomenological qualitative methodology was employed to conduct semi-structured interviews among purposively selected stakeholders who work in refugee organisations and relevant bodies in New Zealand. Results The participants indicated the need for a national framework of inclusion, mandating cultural competency training for frontline healthcare and non-healthcare personnel, creation of a national interpretation phone line, and establishing health navigators. Barriers to accessing health services identified included some social determinants of health such as housing and community environment; health-seeking behaviour and health literacy; and social support networks. Future healthcare delivery should focus on capacity building of existing services, including co-design processes, increased funding for refugee-specific health services, and whole government approach. Conclusion Policymakers and refugee organisations and their frontline personnel should seek to address the deficiencies identified in order to provide equitable, timely and cost-effective healthcare services for refugees in New Zealand.

scholarly journals Patient-centered approaches applied in inpatient and outpatient TB services in Armenia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
Z Grigoryan ◽  
N Truzyan ◽  
V Petrosyan
Keyword(s):  
Healthcare Providers ◽  
International Standards ◽  
Family Education ◽  
Outpatient Services ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Group Discussions ◽  
Legal Documents ◽  
Source Data

Abstract Background Healthcare system performance indicators are common instruments measuring and facilitating quality improvement. The End-TB strategy urges provision of integrated patient-centered (PC) care for all forms of tuberculosis (TB). This study aimed to assess and compare quality of inpatient and outpatient TB services using international standards on specific PC indicators to identify potential targets for improvement. Methods Joint Commission International (JCI) accreditation standards, adapted to local needs and context, were used as a basic instrument for qualitative and quantitative data collection. We utilized Patient and Family Right (PFR) and Patient and Family Education (PFE) 15 standards with 49 measurable elements as PC indicators for the nationwide assessment of TB services. A scoring system and a scaling approach were used to convert all-source-data and present the overall performance of services. Results We reviewed and analyzed data from 10 legal documents, 34 medical records and 155 interviews and focus group discussions with TB healthcare providers, patients and family members from inpatient and outpatient TB services to define the degree of compliance of their practices and treatment experiences to JCI standards. Outpatient TB services met the PFR and PFE standards at the 51%-level receiving a grading of partially performed and requiring improvements. The inpatient services met the PFR and PFE standards at 39%- and 26%-level respectively, receiving a grading of minimally performed for the JCI standards, showing statistically significantly less patient centeredness compared to the outpatient services (p = 0.007, CI 0.234; 0.4234), and requiring major improvements. Conclusions Strengthening interventions towards patient-centeredness are essential in both inpatient and outpatient services, but Armenia needs to put more emphasis on inpatient care to bridge the gap between the existing and recommended practices.

scholarly journals Implementation of Primary Healthcare Services in Community Health Stations in Highly Urbanized City

2021 ◽  
Vol 4 (3) ◽  
pp. 123-132
Author(s):  
Hanna B. Gella ◽  
Merlita V. Caelian
Keyword(s):  
Community Health ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Well Being ◽  
Healthcare Services ◽  
Health Improvement ◽  
Patient Centeredness ◽  
Sustainable Development Goal ◽  
The Sustainable Development ◽  
Child Healthcare

Primary healthcare is integral to the Sustainable Development Goal (SDG) of ensuring healthy lives and promoting well-being.  A descriptive study assessed the implementation of primary healthcare services in community health stations through a researcher-made questionnaire among healthcare providers and beneficiaries of 30 community health stations.  The results revealed that, as a whole, the implementation of primary healthcare services in community health stations is great, with maternal and child healthcare implemented to a very great extent while the treatment of non-communicable diseases to a great extent only.  The major challenges encountered are the lack of medical drugs, supplies and equipment, and medical professionals.  Primary healthcare has made contributions to the community's health improvement; however, challenges imply that the quality and efficiency of the services need improvement. The study contributed to new knowledge on implementing healthcare at the lowest level of government, emphasizing patient-centeredness.

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