scholarly journals Qualitative Analysis of the Coordination of Major System Change Within the Colombian Health System in Response to COVID-19: Study Protocol

2020 ◽  
Author(s):  
Simon Turner ◽  
Natalia Niño
Keyword(s):  
Health Service ◽  
Health Services ◽  
Health System ◽  
Case Studies ◽  
Health Systems ◽  
National Level ◽  
System Change ◽  
Service Planning ◽  
Local Health ◽  
Health Service Planning

Abstract Background Coronavirus (COVID-19) is posing a major and unprecedented challenge to health service planning and delivery across health systems internationally. This nationally-funded study is analysing the response of the Colombian health system to the COVID-19 pandemic, drawing on qualitative case studies of three local health systems within the country. The approach will be informed by the concept of 'major system change' - or coordinated change among a variety of healthcare organisations and other relevant stakeholders - in order to identify processes that both enable and inhibit adaptation of health services to the challenges presented by COVID-19. The study will collect information on capacity “bottlenecks” as well as successful practices and forms of innovation that have emerged locally, which have the potential for being 'scaled up' across Colombia's health services. Methods/design This qualitative study will be undertaken in two phases. In the first, up to 30 stakeholder interviews will be conducted to ascertain and share immediate challenges and opportunities for improvement in response to COVID-19 that can be shared in a timely way with health service leaders to inform immediate health service planning. The stakeholders will be selected in order to sample a range of planning, provider and intermediary organizations within the health system at the national level. In the second, up to 60 further interviews will be conducted to develop in-depth case studies of three local health systems at the metropolitan area level within Colombia. The interview data will be supplemented with documentary analysis and, where feasible, non-participant observation of meetings directly related to the planning and implementation of actions responding to COVID-19. The study will also establish mechanisms for providing timely, formative feedback to inform health system planning relating to COVID-19 and future pandemics by ascertaining stakeholders' preferences during the interviews and wider scoping discussions. Discussion The study's findings will aid evaluation of the relevance of the concept of major system change in a context of 'crisis' decision-making and contribute to international lessons on improving health systems' capacity to respond to COVID-19 and future pandemics. Study findings will be shared among various stakeholders in the Colombian healthcare system in a formative and timely way in order to inform healthcare planning in response to COVID-19 and future pandemics. Conducting the study at a time of COVID-19 raises a number of practical issues (including physical distancing and pressure on health services) which have been anticipated in the study design and research team's ways of working.

scholarly journals Qualitative analysis of the coordination of major system change within the Colombian health system in response to COVID-19: study protocol

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Simon Turner ◽  
Natalia Niño
Keyword(s):  
Health Service ◽  
Health Services ◽  
Health System ◽  
Case Studies ◽  
Health Systems ◽  
National Level ◽  
System Change ◽  
Service Planning ◽  
Local Health ◽  
Health Service Planning

Abstract Background Coronavirus (COVID-19) is posing a major and unprecedented challenge to health service planning and delivery across health systems internationally. This nationally funded study is analysing the response of the Colombian health system to the COVID-19 pandemic, drawing on qualitative case studies of three local health systems within the country. The approach will be informed by the concept of ‘major system change’—or coordinated change among a variety of healthcare organizations and other relevant stakeholders— to identify processes that both enable and inhibit adaptation of health services to the challenges presented by COVID-19. The study will collect information on capacity ‘bottlenecks’ as well as successful practices and forms of innovation that have emerged locally, which have the potential for being ‘scaled up’ across Colombia’s health services. Methods/design This qualitative study will be undertaken in two phases. In the first, up to 30 stakeholder interviews will be conducted to ascertain immediate challenges and opportunities for improvement in response to COVID-19 that can be shared in a timely way with health service leaders to inform health service planning. The stakeholders will include planning, provider and intermediary organizations within the health system at the national level. In the second, up to 60 further interviews will be conducted to develop in-depth case studies of three local health systems at the metropolitan area level within Colombia. The interview data will be supplemented with documentary analysis and, where feasible, non-participant observation of planning meetings. Discussion The study’s findings will aid evaluation of the relevance of the concept of major system change in a context of ‘crisis’ decision-making and contribute to international lessons on improving health systems’ capacity to respond to COVID-19 and future pandemics. Study findings will be shared among various stakeholders in the Colombian healthcare system in a formative and timely way in order to inform healthcare planning in response to COVID-19 and future pandemics. Conducting the study at a time of COVID-19 raises a number of practical issues (including physical distancing and pressure on health services) which have been anticipated in the study design and research team’s ways of working.

Planning health services

2020 ◽  
pp. 402-411
Author(s):  
David Lawrence
Keyword(s):  
Health Service ◽  
Health Services ◽  
Conceptual Framework ◽  
Service Planning ◽  
Health Service Planning ◽  
Soft Systems ◽  
Successes And Failures

This chapter shows you how to contribute to planning health services successfully at strategic and operational levels. It first explains what health service planning is and the nature of health services as mainly ‘soft’ systems. It provides a conceptual framework for planning and then goes through steps and tasks in planning. It then suggests some ways of overcoming pitfalls, notes some common fallacies about planning, and provides a real planning case study with its successes and failures. Finally, it notes ways to assess how well you are doing

Service planning in the Victorian community health sector

2015 ◽  
Vol 21 (3) ◽  
pp. 268 ◽  
Author(s):  
Véronique Roussy ◽  
Charles Livingstone
Keyword(s):  
Health Service ◽  
Health Services ◽  
Community Health ◽  
Local Population ◽  
Health Sector ◽  
Community Health Services ◽  
Community Health Service ◽  
Service Planning ◽  
Health Service Planning ◽  
Comprehensive Service

Until now, comprehensive service planning has been uncommon in the Victorian community health sector. Where it has occurred, it has primarily been undertaken by community health services embedded within larger, hospital-based health services. Reflections on the utility and efficacy of community health service planning are largely absent from the Australian peer-reviewed literature. Using a case study focussed on a specific centre in Melbourne’s outer suburbs, this paper explores how community health service planning is shaped by the current policy context, the legal status of registered community health services, and the data and methodologies available to inform planning. It argues that regular and systematic service planning could support registered community health centres to better understand their unique position within the primary health-care landscape, having regard to their inherent opportunities and vulnerabilities. Furthermore, consistent and effective service planning is proposed to benefit agencies in establishing themselves as critical players in promoting local population health initiatives and driving improved health outcomes.

The use of health services by non-resident patients in a border region with mixed health systems

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Pumi Alliana ◽  
F Nampo
Keyword(s):  
Health Services ◽  
Health System ◽  
Health Systems ◽  
Healthcare Services ◽  
Border Region ◽  
Local Health ◽  
High Complexity ◽  
Access To Health Services ◽  
Unified Health System ◽  
International Border

Abstract Background Access to health services in Brazil is universal, comprehensive, and equate, offering free healthcare to anyone, regardless of its country of residence. Cross-border patients may theoretically overload the healthcare services, mainly when the health systems or healthcare quality differ between countries. Sometimes, Brazilian politicians of border areas claim that non-residents overload local health services. Methods We collected data on the medium and high complexity Oncology and Cardiology care provided to in-patients by a reference Brazilian hospital located in the most populous international border of the country. This border is a conurbation that includes the cities of Foz do Iguassu (Brazil), Ciudad del Este (Paraguay), and Puerto Iguazu (Argentina), totaling around 900,000 inhabitants, of which 264,044 live in Foz do Iguassu. In addition to the poor migration control of citizens crossing these borders - especially the border with Paraguay - the Brazilian Unified Health System differs from that of the other two countries for being free of charge, and also for offering better healthcare. Results From January 2014 to December 2018, 107,434 procedures were performed, of which 240 (0.22%) on non-resident patients (Paraguay, [n = 236]; Argentina [n = 4]). Additionally, 238 (0.22%) other procedures were performed on foreign patients who did not declare their city/country of origin (Paraguay [n = 229]; Argentina [n = 8]; Portugal [n = 1]). Conclusions The use of medium and high complexity procedures by the non-residents on the Brazilian side of its most populous international border is low. Non-residents may benefit from medium and high complexity healthcare services of neighboring countries without overloading the health system. Key messages Advocating that non-residents overload medium and high complexity health services in Brazil is dishonest and may segregate people. Efforts should move toward integrating healthcare in border regions.

Embedding health literacy into health systems: a case study of a regional health service

2017 ◽  
Vol 41 (6) ◽  
pp. 621 ◽  
Author(s):  
Lucia Vellar ◽  
Fiorina Mastroianni ◽  
Kelly Lambert
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Health Information ◽  
Health Systems ◽  
Health District ◽  
Local Health ◽  
Consumer Health ◽  
Regional Health

Objective The aim of the present study was to describe how one regional health service the Illawarra Shoalhaven Local Health District embedded health literacy principles into health systems over a 3-year period. Methods Using a case study approach, this article describes the development of key programs and the manner in which clinical incidents were used to create a health environment that allows consumers the right to equitably access quality health services and to participate in their own health care. Results The key outcomes demonstrating successful embedding of health literacy into health systems in this regional health service include the creation of a governance structure and web-based platform for developing and testing plain English consumer health information, a clearly defined process to engage with consumers, development of the health literacy ambassador training program and integrating health literacy into clinical quality improvement processes via a formal program with consumers to guide processes such as improvements to access and navigation around hospital sites. Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems. What is known about the topic? Poor health literacy is a significant national concern in Australia. The leadership, governance and consumer partnership culture of a health organisation can have considerable effects on an individual’s ability to access, understand and apply the health-related information and services available to them. Currently, only 40% of consumers in Australia have the health literacy skills needed to understand everyday health information to effectively access and use health services. What does this paper add? Addressing health literacy in a coordinated way has the potential to increase safety and quality of care. This paper outlines the practical and sustainable actions the Illawarra Shoalhaven Local Health District took to partner with consumers to address health literacy and to improve the health experience and health outcomes of consumers. Embedding health literacy into public health services requires a coordinated whole-of-organisation approach; it requires the integration of leadership and governance, revision of consumer health information and revision of consumer and staff processes to effect change and support the delivery of health-literate healthcare services. What are the implications for practitioners? Embedding health literacy into health systems promotes equitable, safe and quality healthcare. Practitioners in a health-literate environment adopt consumer-centred communication and care strategies, provide information in a way that is easy to understand and follow and involve consumers and their families in decisions regarding and management of the consumer’s care.

Health Service Planning in a British New Town

1975 ◽  
Vol 5 (3) ◽  
pp. 429-439
Author(s):  
John J. A. Reid ◽  
Dulcie G. Gooding
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Health Services ◽  
National Health ◽  
Planning Process ◽  
Target Population ◽  
Service Planning ◽  
Health Service Planning ◽  
New Town ◽  
New Towns

The initial postwar development of new towns in Britain took place at a time when the present British National Health Service was in its infancy, and few attempts were made to integrate health service planning into the overall planning process. The more recent new towns have been the object of better social planning and, at the same time, the National Health Service has been substantially unified, at first functionally and, in 1974, administratively. In consequence, attempts have been made to use the opportunities which such towns present for planning health services in a comprehensive and integrated manner. The evolution of a planning and implementation structure for health services in Milton Keynes, a new town with a target population of 250,000, is described, together with some of the implications for the administratively unified National Health Service which came into being in 1974.

What is the role of health systems in responding to domestic violence? An evidence review

2017 ◽  
Vol 41 (6) ◽  
pp. 639 ◽  
Author(s):  
Jo Spangaro
Keyword(s):  
Risk Assessment ◽  
Domestic Violence ◽  
Health Service ◽  
Health Services ◽  
Health System ◽  
Health Systems ◽  
Systematic Reviews ◽  
System Level ◽  
Safety Planning ◽  
First Line

Objective The aim of the present study was to review and analyse academic literature and program evaluations to identify promising evidence for health system responses to domestic violence in Australia and internationally. Methods English-language literature published between January 2005 and March 2016 was retrieved from search results using the terms ‘domestic violence’ or ‘intimate partner violence’ in different combinations with other relevant terms, resulting in 1671 documents, of which 59 were systematic reviews. Electronic databases (Medline (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psycinfo, Social work Abstracts, Informit, Violence and Abuse Abstracts, Family Studies Abstracts, Cochrane Library of Systematic Reviews and EMBASE) were searched and narrative analysis undertaken. Results This review details the evidence base for the following interventions by health services responding to domestic violence: first-line responses, routine screening, risk assessment and safety planning, counselling with women, mother–child interventions, responses to perpetrators, child protection notifications, training and system-level responses. Conclusions There is growing evidence for the effectiveness of health service interventions to reduce the extent of harm caused by domestic violence. What is known about the topic? Domestic violence is a significant problem globally with enormous human, social and economic costs. Although women who have experienced abuse make extensive use of healthcare services, health services have lagged behind the policing, criminal justice and other human service domains in responding to domestic violence. What does this paper add? The present comprehensive review identifies best-practice health system responses to domestic violence. What are the implications for practitioners? Health systems can play a key role in identifying and responding to domestic violence for women who often do not access other services. There is growing evidence for the effectiveness of health service interventions to reduce the extent of harm caused by domestic violence, in particular for specialist counselling, structured risk assessment and safety planning, training for first-line responses and interventions for mothers and children affected by domestic violence.

scholarly journals Re-orientation of Health Services towards Health Promotion: An Australian Case Study of Aborted Health Service Reform

2006 ◽  
Vol 12 (2) ◽  
pp. 24 ◽  
Author(s):  
Fran Baum ◽  
Helen van Eyk ◽  
Catherine Hurley
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Health Service ◽  
Health Services ◽  
Health Care Reform ◽  
Health Systems ◽  
Local Health ◽  
Continuous Change ◽  
The Impact

This paper examines a case study of local health care reform in Australia that had as one of its aims the desire to increase the health promotion and partnership work of the region. The case study highlights the pressures contemporary health systems are facing and the challenge of re-orientating health services towards health promotion in this environment. Qualitative research, including interviews, focus groups, a staff survey and policy analysis were used to identify health system professionals? perceptions of the impact of health care reform. The case study portrays a complex system that is subject to frequent change but little reform. Our case study indicates that features of health systems that encourage collaborative partnerships are those where there is: an environment that encourages trust; a common purpose among the key players; a supportive external environment; practical projects to work on; organisational stability; commitment from staff throughout organisations; willingness to commit resources; evidence that change is likely to improve outcomes for users; and an organisational environment in which learning from past experience is encouraged. A number of constraints and tensions that work against introducing a greater emphasis on health promotion and collaboration within the system studied are discussed, including tensions between central funding bureaucracies and health care agencies and the reform fatigue and increasing cynicism among staff resulting from continuous change. The paper concludes that against the chaotic background of contemporary health service reform it is very difficult to bring about genuine reform to achieve a shift to more emphasis on health promotion and partnerships.

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