scholarly journals The role of managers in improving the health care system in Serbia

2014 ◽  
Vol 61 (3) ◽  
pp. 142-148
Author(s):  
Jovana Aleksic ◽  
Ivan Stevanovic ◽  
Milena Gajic-Stevanovic
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health System ◽  
System Development ◽  
Interdisciplinary Approach ◽  
Legal Framework ◽  
Strategic Decision ◽  
Central Type ◽  
Knowledge And Skills ◽  
Organization And Management

Health institutions have the most complex organization and management among all institutions. Unlike traditional management in organizational systems characterized by analytical and interdisciplinary approach, health institution management is characterized by trans-disciplinary approach to solving business problems. Introduction of quality improvement is a challenge for health care managers due to their responsibility to create an environment that will lead to quality improvement and safety of health services. New Health care Act (2005) has created a legal framework for defining quality indicators, and setting up various committees and bodies in order to improve the quality of health care. As the planning, management and quality control are the most important parameters of the health system development, health manager must be a leader with exceptional communication skills and able to apply his knowledge and skills in the management of resources. Top managers, central type and lower level managers must be the driving force of their institutions creating the basis for activities related to quality. They should have a proper education as well. New concept of management emphasizes people and their specialized knowledge. Past practice in Serbia did not show significant improvements in the management process through the knowledge and skills of managers, especially in terms of strategic decision-making in the operation and development of the health system.

scholarly journals Quality indicators of dental health care in Serbia

2019 ◽  
Vol 66 (1) ◽  
pp. 36-42
Author(s):  
Svetlana Jovanović ◽  
Maja Milošević ◽  
Irena Aleksić-Hajduković ◽  
Jelena Mandić
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health System ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Care Quality ◽  
System Quality ◽  
Quality Health Care ◽  
Quality Health

Summary Health care has witnessed considerable progresses toward quality improvement over the past two decades. More precisely, there have been global efforts aimed to improve this aspect of health care along with experts and decision-makers reaching the consensus that quality is one of the most significant dimensions and features of health system. Quality health care implies highly efficient resource use in order to meet patient’s needs in terms of prevention and treatment. Quality health care is provided in a safe way while meeting patients’ expectations and avoiding unnecessary losses. The mission of continuous improvement in quality of care is to achieve safe and reliable health care through mutual efforts of all the key supporters of health system to protect patients’ interests. A systematic approach to measuring the process of care through quality indicators (QIs) poses the greatest challenge to continuous quality improvement in health care. Quality indicators are quantitative indicators used for monitoring and evaluating quality of patient care and treatment, continuous professional development (CPD), maintaining waiting lists, patients and staff satisfaction, and patient safety.

scholarly journals Integrating Breast Cancer Early Detection Services Into the Rwandan Health Care System

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 147s-147s
Author(s):  
J.M.V. Dusengimana ◽  
T. Mpunga ◽  
C. Shyirambere ◽  
L.N. Shulman ◽  
E. Mpanumusingo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Early Detection ◽  
Health System ◽  
Health Care System ◽  
Breast Ultrasound ◽  
Knowledge And Skills ◽  
Breast Cancer Early Detection ◽  
Cancer Early Detection ◽  
The Impact

Background and context: Promoting earlier detection of breast cancer is critical in low-income countries like Rwanda where symptomatic women face long diagnostic delays and most patients present with advanced disease. In these settings, promoting earlier clinical diagnosis should be the initial priority before screening of asymptomatic women. However, there are few data to guide such early detection policies. Aim: Develop a pilot breast cancer early detection program in a rural Rwandan district to evaluate its clinical and health system impact, identify the most effective and feasible roles for staff from each health care system level, and inform national policy. Strategy/Tactics: From 2015-2017 we implemented a training program for 12 randomly selected health centers (HCs) in Burera District, where Butaro Cancer Center of Excellence is located. We trained 1076 community health workers in breast awareness and 127 HC nurses in clinical breast exam (CBE) and management of breast concerns. We trained 9 hospital-level nurses and doctors in diagnostic breast ultrasound to facilitate evaluation of palpable masses. We used pre- and posttests, focus groups, patient surveys, HC registries, and hospital medical records to determine the impact of the training on trainees' knowledge and skills, the volume of patients presenting to health facilities and services provided, cancer detection rate, and clinical stage at diagnosis. Program/Policy process: We met regularly with cancer policy leaders in the Ministry of Health (MOH) and Rwanda Biomedical Centre (RBC) to share findings, identify successes and challenges and build support. Clinicians trained through the project have been invited to serve as national trainers in CBE and contribute to national cancer strategy discussions. Outcomes: Trainings significantly improved knowledge and skills among trainees and increased the number of patients with breast concerns at HCs and the hospital. There was an increase in the proportion of patients with benign disease and the number of needed ultrasounds and biopsies. HCs and the hospital were able to accommodate the increased volume without compromising other services. We had limited power to assess the impact on cancer stage, but noted a nonsignificant increase in incidence of early stage disease among patients referred by intervention HCs. We are now working with MOH/RBC in planning scale-up of the program to other districts and identify a strategy of diagnostic breast ultrasound at the DH level to facilitate evaluation of patients referred from HCs. What was learned: A strategy to promote earlier detection of symptomatic breast cancer was feasible in a rural Rwandan district, effectively strengthened health system capacity to care for patients with breast concerns, and suggests promising impact on patient outcomes. Engagement of key stakeholders in implementation science can help foster evidence-based national cancer control policy.

scholarly journals Informed Consent in Graduate Education in Croatia

2002 ◽  
Vol 26 (3) ◽  
pp. 215-223
Author(s):  
Nada Gosic
Keyword(s):  
Health Care ◽  
Informed Consent ◽  
Graduate Education ◽  
Health Care Professionals ◽  
Interdisciplinary Approach ◽  
Moral Dilemmas ◽  
Legal Framework ◽  
Professional Activities ◽  
Teaching Curriculum ◽  
Bioethical Education

Abstract: Along with research on informed consent (since 1972), the need emerged to introduce this problem into bioethical education. Graduate education offers the possibility for scientific analysis of professional moral dilemmas with which physicians and related health care professionals are confronted when performing their professional activities. The issue especially relates to the patronizing relationship with patients, their traditional position, the realization of patients´ rights, duties of physicians and related health care professionals towards patients, and ethical matters in biomedical research. The answers to these issues, which contain the specification of informed consent, cannot be found exclusively in medicine and are a topic of social and human sciences. This article stresses the interdisciplinary approach towards researching informed consent, explains the relationship between informed consent and bioethics and philosophy, and presents the legal framework for informed consent in Croatia. The author then proceeds to define the problem of informed consent in the teaching curriculum and the simplification of objectives and tasks in learning about informed consent. Methods and examples of pedagogical and andragogical principles used to help comprise this program are offered, and methods used to achieve it are provided.

Legal framework to put health actions for disabled people in practice in the unique health system

2011 ◽  
Vol 5 (4) ◽  
pp. 1007
Author(s):  
Evanira Rodrigues Maia ◽  
Eliana Gonçalves Nobre ◽  
Lorita Marlena Freitag Pagliuca
Keyword(s):  
Health Care ◽  
Health System ◽  
Legal Framework ◽  
Disabled Persons ◽  
Main Theme ◽  
Disabled People ◽  
System Method ◽  
El Sistema ◽  
Resource Transfers ◽  
Year 2000

ABSTRACT Objective: to analyze the documents from 1992 to 2008 of the Ministry of Health on the health assistance to disabled people in the Unique Health System. Method: reflexive study based on the ministerial decrees collected at the Virtual Healthcare Library and LEGIS SAÚDE. Results: most of the 84 decrees found were issued in the year 2000, when the National Health Policy for Disabled People was published. Resource transfers to cost health actions stood out as the main theme, followed by the creation of health care programs and policies for disabled people. The themes privileged the practice of care actions in cases of sensory, physical and mental disabilities. The content of the decrees aims to guarantee rights to health care in health promotion, prevention, rehabilitation and maintenance actions. Conclusion: the centralization of the federal government is evidenced with respect to the formulation of guidelines and the organization of services. These guidelines need to be disseminated among managers, health professionals and communities in order to promote access to the care possibilities they contain. Descriptors: disabled persons; health public Policy; legislation; Single Health System.RESUMO Objetivo: analisar os documentos do Ministério da Saúde de 1992 a 2008 sobre assistência à saúde da pessoa com deficiência no SUS. Método: estudo reflexivo a partir das portarias ministeriais coletadas na Biblioteca Virtual em Saúde e LEGIS SAÙDE. Resultados: localizadas 84 portarias, a maioria data de 2000, ano de publicação da Política Nacional de Saúde da Pessoa com Deficiência. Sobressai o repasse de recursos para custeio, seguido pela criação de programas e políticas de atenção à saúde. Foram privilegiadas as ações de assistência nas deficiências sensoriais, físicas e mentais. Os documentos visam garantir os direitos de assistência à saúde nas ações de promoção, prevenção, reabilitação e manutenção da saúde. Conclusão: evidencia-se a centralização do governo federal quanto à formulação de diretrizes e organização dos serviços. Ressalte-se  necessária a divulgação dos documentos junto a gestores, profissionais de saúde e comunidade para promover o acesso às possibilidades de assistência nelas contidas. Descritores: pessoas com deficiência; políticas públicas de saúde; legislação; Sistema Único de Saúde. RESUMENObjetivo: analizar los documentos del Ministerio de Salud, de 1992 a 2008, acerca de la salud de las personas con discapacidad en el Sistema Único de la Salud (SUS). Método: estudio reflexivo a partir de las órdenes ministeriales recogidas en la Biblioteca Virtual en Salud y LEGIS SALUD. Resultados: fueron localizadas 84 ordenanzas, la mayoría de 2000, año de publicación de la Política Nacional de Salud para las Personas con Discapacidad. Sobresalió la transferencia de recursos para la financiación seguida por la creación de programas y políticas para la atención en salud. Fueron predominantes las acciones de asistencia en las deficiencias sensoriales, físicas y mentales. El objetivo de los documentos era garantizar los derechos de atención de salud en las acciones de promoción, prevención, rehabilitación y mantenimiento de salud. Conclusión: se percibió la centralización del Gobierno Federal mientras a la formulación de políticas y organización de servicios. Se destaca la necesidad de la divulgación de los documentos con los administradores, profesionales de salud y comunidad para promover el acceso a las posibilidades de asistencia que figuran en ellos. Descriptores: personas con discapacidad; políticas públicas de salud; legislación; Sistema Único de Salud.

Patient-Centered, Integrated Health Care Quality Measures Could Improve Health Literacy, Language Access, and Cultural Competence

2019 ◽  
Author(s):  
Ignatius Bau ◽  
Robert A. Logan ◽  
Christopher Dezii ◽  
Bernard Rosof ◽  
Alicia Fernandez ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Literacy ◽  
Cultural Competence ◽  
Health Care Quality ◽  
Care Quality ◽  
National Committee ◽  
Patient Centered ◽  
Organizational System ◽  
Language Access

The authors of this paper recommend the integration of health care quality improvement measures for health literacy, language access, and cultural competence. The paper also notes the importance of patient-centered and equity-based institutional performance assessments or monitoring systems. The authors support the continued use of specific measures such as assessing organizational system responses to health literacy or the actual availability of needed language access services such as qualified interpreters as part of overall efforts to maintain quality and accountability. Moreover, this paper is informed by previous recommendations from a commissioned paper provided by the National Committee for Quality Assurance (NCQA) to the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. In the commissioned paper, NCQA explained that health literacy, language access, and cultural competence measures are siloed and need to generate results that enhance patient care improvements. The authors suggest that the integration of health literacy, language access, and cultural competence measures will provide for institutional assessment across multiple dimensions of patient vulnerabilities. With such integration, health care organizations and providers will be able to cultivate the tools needed to identify opportunities for quality improvement as well as adapt care to meet diverse patients’ complex needs. Similarly, this paper reinforces the importance of providing more “measures that matter” within clinical settings.

Issues of co-financing of drug provision for the population: international and Russian practice

2020 ◽  
pp. 49-56
Author(s):  
Vasiliy Ryazhenov ◽  
Victoriya Andreyeva ◽  
Elena Zakharochkina
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Health System ◽  
Health Care System ◽  
Russian Federation ◽  
High Quality ◽  
Russian President ◽  
The Russian Federation ◽  
Vladimir Putin ◽  
Drug Provision

Russian President Vladimir Putin defined increase in life expectancy from 72.7 to 78 years by 2024 as a national aim in the Decree № 204 of May 7, 2018. Achievement of this aim depends on drug provision system among other factors. Strategy of drug provision for the population of the Russian Federation for the period until 2025 sets the goal of increasing availability of high quality, effective and safe medicines to meet needs of the population and the health system based on the formation of a rational and balanced system of drug provision for the population of the country with available resources. The health care system should expand the possibilities of using modern and effective mechanisms to ensure the financing of drug provision for the population.

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