scholarly journals The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis

2020 ◽  
Author(s):  
Jenelle Marie Clarke ◽  
Justin Waring ◽  
Simon Bishop ◽  
Jean Hartley ◽  
Mark Exworthy ◽  
...  
Keyword(s):  
Leadership Development ◽  
Health Services ◽  
Mixed Methods Research ◽  
Health Care Services ◽  
Political Skill ◽  
Group Processes ◽  
Narrative Synthesis ◽  
Individual Level ◽  
Health System Change ◽  
Care Services

Abstract Background The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature.Methods The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in health care services.Results 62 papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is compromised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through six dimensions of leadership: personal performance, contextual awareness, inter-personal influence, stakeholder engagement, networking and policy influence.Conclusion There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes.

scholarly journals The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenelle M. Clarke ◽  
Justin Waring ◽  
Simon Bishop ◽  
Jean Hartley ◽  
Mark Exworthy ◽  
...  
Keyword(s):  
Leadership Development ◽  
Health Services ◽  
Mixed Methods Research ◽  
Political Skill ◽  
Group Processes ◽  
Healthcare Services ◽  
Narrative Synthesis ◽  
Five Dimensions ◽  
Individual Level ◽  
Health System Change

Abstract Background The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature. Methods The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in healthcare services. Results Sixty-two papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is comprised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through five dimensions of leadership: personal performance; contextual awareness; inter-personal influence; stakeholder engagement, networks and alliances; and influence on policy processes. Conclusion There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes.

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

The validity of mobile applications to facilitate patient care provided to cancer patients: opportunities and limitations

2021 ◽  
Vol 16 ◽  
Author(s):  
Haneen Amawi ◽  
Sayer Alazzam ◽  
Tasnim Alzanati ◽  
Neveen Altamimi ◽  
Alaa Hammad ◽  
...  
Keyword(s):  
Health Services ◽  
Patient Care ◽  
Health Care Services ◽  
Rating Scale ◽  
Assessment Tools ◽  
Free Access ◽  
User Engagement ◽  
Care Services ◽  
Health Related ◽  
Detailed Assessment

Background: The use of health-related applications (apps) on smartphones has become widespread. This is especially of value during the ongoing SAR-COV-2 pandemic, where the accessibility for health care services has been greatly limited. Patients with free access to apps can obtain information to improve their understanding and management of health issues. Currently, there are cancer-related apps available on iPhones and androids. However, there are no guidelines to control these apps and ensure their quality. Furthermore, these apps may significantly modify the patients’ perception and knowledge toward drug-related health services. Objective: The aim of this study was to assess the convenience, quality, safety and efficacy of apps for cancer patient care. Methods: The study was conducted by searching all apps related to cancer care on both Google Play Store and Apple iTunes Store. A detailed assessment was then performed using the mobile application rating scale (MARS) and risk assessment tools. Results: The results indicated that on a scale from 1-5, 47% of the apps were rated ≥ 4. The MARS assessment of the apps indicated an overall quality rating of 3.38 ± 0.9 (mean ± SD). The visual appeal of the app was found to have a significant effect on app functionality and user engagement. The potential benefits of these apps come with challenges and limitations. Patents related to smartphone applications targeting patients were also discussed. Conclusion: We recommend a greater emphasis toward producing evidence-based apps. These apps should be rigorously tested, evaluated and updated by experts, particularly clinical pharmacists. Also, these may alter patient attitudes toward services provided by physicians and pharmacists. Finally, these apps should not replace in-person interactive health services.

scholarly journals Helsepersonells erfaringer med pasientforløp i kommuner i Vest-Norge

2017 ◽  
Vol 13 (2) ◽  
Author(s):  
Torill Aarskog Skorpen ◽  
Marit Kvangarsnes ◽  
Torstein Hole
Keyword(s):  
Health Services ◽  
Health Personnel ◽  
Health Care Services ◽  
User Participation ◽  
Local Health ◽  
Care Services ◽  
Western Norway ◽  
Patient Pathways ◽  
Specialist Health Care ◽  
Group Interviews

Health services in Norway have been described as fragmented with weak coordination between different care levels with respect to patient pathways. The Coordination Reform’s aim was to improve patient pathways and strengthen user participation. The aim of this study was to investigate health personnel ́s experiences with patient pathways in municipalities in Western Norway. A qualitative design was chosen. Six focus group interviews with health personnel working in municipalities in Western Norway were conducted in 2013 and 2014. The interviews revealed that health personnel experienced that local health services gave cohesive patient pathways and strengthened user participation. Cohesive patient pathways and locally adapted pathways were considered important. Coordination and electronic communication between primary and specialist health care services were seen as inadequate. Trust, teamwork, competence and necessary resources were considered vital. Health personnel ́s experiences indicated that the intended aim of cohesive patient pathways near the patient was met. 

scholarly journals Effects of results based financing models on the performance of exposed health zones in Benin

2018 ◽  
Vol 5 (10) ◽  
pp. 4188
Author(s):  
Lamidhi Salami ◽  
Edgard-Marius Ouendo ◽  
Benjamin Fayomi
Keyword(s):  
Health Services ◽  
Health System ◽  
System Performance ◽  
Health Care Services ◽  
Child Health Services ◽  
Double Difference ◽  
Health System Performance ◽  
Care Services ◽  
Curative Care ◽  
Results Based Financing

Background: Since 2011, Benin adhered to results-based financing (RBF), with the implementation of RBF_PRPSS model by Health System Performance Strengthening Project (PRPSS) and RBF_PASS model by health system support project (PASS). Notwithstanding the lack of evidence on this experimental phase, the Ministry of Health initiated the extension of the RBF_PRPSS model to uncovered areas. This comparative study was led to evaluate the health system performance in RBF zones.Methods: The study examined data from sixty-seven health facilities in six health zones offering maternal and child health services, using the double difference, the Student's test and the variance comparison, with 5% significance level.Results: The study found that between 2011 and 2014, staff numbers remained stable in the RBF strata (p>0.05). The cumulative duration over a six-month period of stock-outs of five key drugs (paracetamol, amoxicillin, oxytocin, iron, sulfadoxine pyrimetamine) decreased from 51 days to 29 days (p<0.05). Direct revenues per health facility increased more in the RBF strata (p<0.05). Financial viability increased in RBF_PRPSS stratum. Health services utilization improved significantly for institutional delivery, tetanus toxoid immunization, DTP (Hib) HepB 3 and MCV immunization and curative care. Decreasing of maternal and neonatal mortalities in RBF strata were not significant.Conclusions: In sum, the RBF implementation has not yet generated a significant effect on the overall performance of the health system in exposed areas, although it is already accompanied by a significant improvement in the utilization of certain health care services. 

scholarly journals Research on the Path of China Cities Service Consumption Upgrading

2021 ◽  
Vol 236 ◽  
pp. 03021
Author(s):  
Chen Fan ◽  
Wang Shengjin
Keyword(s):  
Health Services ◽  
Health Care Services ◽  
Income Elasticity ◽  
Empirical Test ◽  
First Line ◽  
Communication Services ◽  
Education Services ◽  
Care Services ◽  
Marginal Propensity ◽  
Expenditure System

Based on the panel data of “first-line cities” and “new first-line” cities from 2006 to 2018, this paper constructs an extended linear expenditure system model (ELES) to empirically study the path law of service sub-consumption upgrade. Based on the full-sample OLS estimation, it is found that the overall marginal propensity for service consumption in the sample cities is 0.418, of which the sub-consumption propensity for cultural, entertainment and education services is the most obvious, followed by medical and health services, and transportation and communication services are the lowest. Based on service subconsumption, the research on price and income elasticity found that the expenditure and income elasticity of cultural entertainment and education, which has the most significant marginal propensity to consume, is the largest, while the price and income elasticity of health care services is the smallest. An empirical test based on sub-samples found that the marginal service consumption propensity of “first-line cities” and “new firstline cities” are 0.558 and 0.379, respectively; in terms of service breakdown, “first-line cities” have propensity to consume cultural entertainment and education services Significantly higher than the “new first-line cities”, the sub-item propensity to consume in medical and health services is slightly higher, and the sub-item propensity to consume in transportation and communication services is slightly lower.

scholarly journals Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

2012 ◽  
Vol 68 (2) ◽  
Author(s):  
N. Mlenzana ◽  
R. Mwansa
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Care Services ◽  
Waiting Times ◽  
Care Providers ◽  
Persons With Disabilities ◽  
Care Services ◽  
Primary Health

To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54%) were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction. Other clients were satisfied with thoroughness ofhealth care providers regarding symptoms, feelings, reception and treatment received at the primary health care centre.Understanding the views of the clients is essential in improving health delivery services and could impact on thecompliance of people attending primary health care services.

The Finnish healthcare services lean management

2018 ◽  
Vol 31 (1) ◽  
pp. 17-32 ◽  
Author(s):  
Susanna Hihnala ◽  
Lilja Kettunen ◽  
Marjo Suhonen ◽  
Hanna Tiirinki
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Point Of View ◽  
Lean Management ◽  
Management Skills ◽  
Content Type ◽  
Care Services ◽  
Development Processes ◽  
Specialized Health Care

Purpose The purpose of this paper is to discuss health services managers’ experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers’ work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers (n = 7) and medical managers (n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers’ experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used in the training of health services managers in the health-care industry worldwide and to help them survive the pressure to change repeatedly.

Case Study E-Tailing Health Services in India

2016 ◽  
pp. 292-308
Author(s):  
Bobby Kurian
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Care Services ◽  
Information Dissemination ◽  
Health Providers ◽  
The Public ◽  
Care Services ◽  
The World

This case study has been developed to promote understanding the e-tailing of health services. E-health web portal provides a new medium for information dissemination, interaction and collaboration among institutions, health professionals, health providers and the public. This case study provides a founders perspective in setting up and running a medical website that offers online health care services to customers across the world. The case study discusses the challenges and issues faced by the founders and also the promoter's perspective on the lucrativeness of offering e-tailing services. Using this case study an attempt is made to stress the importance of a flexible e-tailing business model specific to the services offered and need of periodic assessments to ensure that the business runs profitable.

scholarly journals Perceived risks and barriers to care for international migrants in transit through Mexico

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Larrea ◽  
R Leyva-Flores ◽  
N Guarneros-Soto ◽  
C Infante-Xibille
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health Personnel ◽  
Health Care Services ◽  
Barriers To Care ◽  
Human Security ◽  
Public Health Services ◽  
Care Services ◽  
In Transit

Abstract Background Mexico has implemented policies seeking to reduce barriers to care for migrants in transit; however, it is estimated that only 3% of migrants use public health services when needed. The main purpose of this study was to identify the barriers to access public health services faced by migrants in transit through Mexico. Methods Under the human security perspective, in 2018, a qualitative study was carried out in Mexican communities with high migrant mobility. 34 semi-structured interviews were conducted with migrants in transit, and personnel from public health services and migrant shelters (NGOs). Values and meanings related to risks, health problems, barriers to care, experiences of health services utilization, and opinions on facilitating elements to diminish these barriers were identified. Results Migrants in transit through Mexico face risks that affect all dimensions of human security. Perceived anti-migratory and discriminative attitudes during the journey were constantly mentioned in the interviews. Barriers to care were found in the four stages of health care access, classified according to the Tanahashi framework, with the majority related to accessibility and acceptability. The following facilitating elements were also identified: political willingness of local government, knowledge and talent management of health personnel, and strategies implemented for adapting local health care services to migrants. Conclusions Social and political conditions in Mexico disrupt any effort to reduce social risks and barriers to care for migrants in transit. Non-governmental actors are key players for facilitating interactions between migrants and local governmental health care institutions. However, the general anti-migratory context negatively affects access to health care and influence the perspectives of migrants, NGOs, and health personnel. Key messages The predominant perceived barriers to care are in counterpoint to local governmental pro-migrant rights perspectives. NGOs are key actors to promote access to public health care services.

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