scholarly journals How Can Health Systems Better Prepare for the Next Pandemic? Lessons Learned From the Management of COVID-19 in Quebec (Canada)

2021 ◽  
Vol 9 ◽  
Author(s):  
Hassane Alami ◽  
Pascale Lehoux ◽  
Richard Fleet ◽  
Jean-Paul Fortin ◽  
Joanne Liu ◽  
...  
Keyword(s):  
Health Systems ◽  
Emerging Infectious Diseases ◽  
Lessons Learned ◽  
System Level ◽  
Policy And Practice ◽  
Health Crisis ◽  
System Perspective ◽  
Learning Health System ◽  
Federal Governance ◽  
Globalized World

The magnitude of the COVID-19 pandemic challenged societies around our globalized world. To contain the spread of the virus, unprecedented and drastic measures and policies were put in place by governments to manage an exceptional health care situation while maintaining other essential services. The responses of many governments showed a lack of preparedness to face this systemic and global health crisis. Drawing on field observations and available data on the first wave of the pandemic (mid-March to mid-May 2020) in Quebec (Canada), this article reviewed and discussed the successes and failures that characterized the management of COVID-19 in this province. Using the framework of Palagyi et al. on system preparedness toward emerging infectious diseases, we described and analyzed in a chronologically and narratively way: (1) how surveillance was structured; (2) how workforce issues were managed; (3) what infrastructures and medical supplies were made available; (4) what communication mechanisms were put in place; (5) what form of governance emerged; and (6) whether trust was established and maintained throughout the crisis. Our findings and observations stress that resilience and ability to adequately respond to a systemic and global crisis depend upon preexisting system-level characteristics and capacities at both the provincial and federal governance levels. By providing recommendations for policy and practice from a learning health system perspective, this paper contributes to the groundwork required for interdisciplinary research and genuine policy discussions to help health systems better prepare for future pandemics.

scholarly journals Accelerating implementation of research in Learning Health Systems: Lessons learned from VA Health Services Research and NCATS Clinical Science Translation Award programs

2020 ◽  
Vol 4 (3) ◽  
pp. 195-200
Author(s):  
Amy M. Kilbourne ◽  
Patricia L. Jones ◽  
David Atkins
Keyword(s):  
Health Services Research ◽  
Health Services ◽  
Health System ◽  
Health Systems ◽  
Real World ◽  
Veterans Affairs ◽  
Lessons Learned ◽  
Services Research ◽  
Community Based Research ◽  
Learning Health System

AbstractTranslation of research to practice is challenging. In addition to the scientific challenges, there are additional hurdles in navigating the rapidly changing US health care system. There is a need for innovative health interventions that can be adopted in “real-world” settings. Barriers to translation involve misaligned timing of research funding and health system decision-making, lack of research questions aligned with health system and community priorities, and limited incentives in academia for health system and community-based research. We describe new programs from the US Department of Veterans Affairs Health Services Research and Development (HSR&D) and the National Center for Advancing Translational Sciences (NCATS) Clinical and Translational Science Award (CTSA) Programs that are building capacity for Learning Health System research. These programs help to incentivize adopting and adapting Learning Health System principles to ensure that, primarily in implementation science within academic/veterans affairs health systems, there is alignment of the research with the health system and community needs. Both HSR&D and NCATS CTSA Program encourage researchers to develop problem-focused research innovations in partnership with health systems and communities to ultimately facilitate design treatments that are feasible in “real-world” practice.

Learning Health Systems Can Promote and Sustain High-Value Occupational Therapy

2021 ◽  
Vol 76 (1) ◽  
Author(s):  
Adam R. Kinney ◽  
Beth Fields ◽  
Lisa Juckett ◽  
Halley Read ◽  
M. Nicole Martino ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Health Systems ◽  
Health Care Systems ◽  
Quality Care ◽  
System Level ◽  
Learning Health System ◽  
Care Systems ◽  
Concrete Action ◽  
Therapy Services ◽  
Professional Contexts

In the current policy context, the occupational therapy profession must act to promote and sustain high-value care. Stakeholders have delineated efforts, such as defining and measuring high-quality care processes or promoting the adoption of evidence into practice, that can enhance the value of occupational therapy services. There is a growing recognition, however, that low-value care is the product of deficiencies within health care systems and is therefore most amenable to system-level solutions. To date, the specific nature of system-level changes capable of identifying and rectifying low-value occupational therapy has yet to be elucidated. In this “The Issue Is. . .” column, we introduce occupational therapy to the Learning Health System concept and its essential functions. Moreover, we discuss action steps for occupational therapy stakeholders to lay the foundation for Learning Health Systems in their own professional contexts. What This Article Adds: This article is the first to outline concrete action steps needed to transform occupational therapy practice contexts into Learning Health Systems. Such a transformation would represent a system-level change capable of fostering the delivery of high-value occupational therapy services to clients in a variety of practice settings.

scholarly journals 22.F. Workshop: What makes for resilient health systems? Evidence from the State of Health in the EU country profiles

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
The State ◽  
Lessons Learned ◽  
Three Dimensions ◽  
Health System Strengthening ◽  
New Work ◽  
State Of Health ◽  
The Eu

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.

scholarly journals Curricular Change and Resiliency in the Era of Coronavirus (COVID-19): The Uniformed Services University of the Health Sciences (USU) Experience

2020 ◽  
Author(s):  
Arnyce R Pock ◽  
Pamela M Williams ◽  
Ashley M Maranich ◽  
Ryan R Landoll ◽  
Catherine T Witkop ◽  
...  
Keyword(s):  
Health System ◽  
Health Sciences ◽  
Lessons Learned ◽  
Organizational Response ◽  
Educational Goals ◽  
Military Health System ◽  
Military Health ◽  
Health Crisis ◽  
Core Curricula ◽  
The Military

ABSTRACT Introduction The Coronavirus (COVID-19) pandemic has presented a myriad of organizational and institutional challenges. The Uniformed Services University of the Health Sciences, like many other front line hospitals and clinics, encountered a myriad of challenges in fostering and sustaining the education of students enrolled at the nation’s only military medical school. Critical to the function of any academic medical institution, but particularly one devoted to the training of future physicians for the Military Health System, was the ability to rapidly adapt, modify, and create new means of keeping medical students engaged in their core curricula and progressing toward full and timely attainment of established educational goals and objectives. Methods This article highlights some of the particular challenges faced by faculty and students during the first 6 months of the COVID-19 pandemic and describes how they were managed and/or mitigated. Results Six key “lessons learned” were identified and summarized in this manuscript. These lessons may be applicable to other academic institutions both within and outside of the Military Health System. Conclusions Recognizing and embracing these key tenets of academic change management can accelerate the generation of a cohesive, organizational response to the next pandemic or public health crisis.

scholarly journals Quality in crisis: a systematic review of the quality of health systems in humanitarian settings

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Keely Jordan ◽  
Todd P. Lewis ◽  
Bayard Roberts
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Health Systems ◽  
Point Of Care ◽  
System Level ◽  
System Quality ◽  
High Quality ◽  
Humanitarian Settings ◽  
Quality Health

Abstract Background There is a growing concern that the quality of health systems in humanitarian crises and the care they provide has received little attention. To help better understand current practice and research on health system quality, this paper aimed to examine the evidence on the quality of health systems in humanitarian settings. Methods This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The context of interest was populations affected by humanitarian crisis in low- and middle- income countries (LMICs). We included studies where the intervention of interest, health services for populations affected by crisis, was provided by the formal health system. Our outcome of interest was the quality of the health system. We included primary research studies, from a combination of information sources, published in English between January 2000 and January 2019 using quantitative and qualitative methods. We used the High Quality Health Systems Framework to analyze the included studies by quality domain and sub-domain. Results We identified 2285 articles through our search, of which 163 were eligible for full-text review, and 55 articles were eligible for inclusion in our systematic review. Poor diagnosis, inadequate patient referrals, and inappropriate treatment of illness were commonly cited barriers to quality care. There was a strong focus placed on the foundations of a health system with emphasis on the workforce and tools, but a limited focus on the health impacts of health systems. The review also suggests some barriers to high quality health systems that are specific to humanitarian settings such as language barriers for refugees in their host country, discontinued care for migrant populations with chronic conditions, and fears around provider safety. Conclusion The review highlights a large gap in the measurement of quality both at the point of care and at the health system level. There is a need for further work particularly on health system measurement strategies, accountability mechanisms, and patient-centered approaches in humanitarian settings.

A free, open-source, offline digital health system for refugee care (Preprint)

2021 ◽  
Author(s):  
Henry Ashworth ◽  
Senan Ebrahim ◽  
Hassaan Ebrahim ◽  
Zahra Bhaiwala ◽  
Michael Chilazi
Keyword(s):  
Health Systems ◽  
Digital Health ◽  
Healthcare Providers ◽  
Lessons Learned ◽  
Extreme Weather Events ◽  
Mobile Clinic ◽  
Low Resource ◽  
Displaced Populations ◽  
Weather Events ◽  
Displaced People

BACKGROUND Rise of conflict, extreme weather events, and pandemics have led to larger displaced populations worldwide. Displaced populations have unique acute and chronic health needs that need to be met by low resource health systems. Electronic Health Records (EHRs) have been shown to improve health outcomes in displaced populations but need to be adapted to meet the constraints of these health systems. OBJECTIVE To describe the development and deployment of a EHR designed to care for displaced populations in low resource settings. METHODS Using a human-centered design approach we conducted in-depth interviews and focus groups with patients, healthcare providers, and administrators in Lebanon and Jordan to identify the essential EHR features. These features including modular workflows, multilingual interfaces, and offline-first capabilities led to the development of the Hikma Health EHR which has been deployed in Lebanon and Nicaragua. RESULTS We report the successes and challenges from 12 months of Hikma Health EHR deployment in a mobile clinic providing care to Syrian Refugees in the Bekaa Valley, Lebanon. Successes include the EHR’s ability to (1) increase clinical efficacy by providing detailed patient records, (2) prove adaptable to the threats of COVID-19, and (3) improve organizational planning. Lessons learned include technical fixes to methods of identifying patients through name or their medical record ID. CONCLUSIONS As the number of displaced people continues to rise globally, it is imperative that solutions are created to help maximize the healthcare they receive. Free, open-sourced and adaptable EHRs can enable organizations to better provide for displaced populations.

Countering Violent Extremism in Canada and Abroad

2018 ◽  
Author(s):  
Nora Abdelrahman Ibrahim
Keyword(s):  
Best Practice ◽  
Unintended Consequences ◽  
Lessons Learned ◽  
Policy And Practice ◽  
Far Right ◽  
Significant Development ◽  
The Us ◽  
Violent Extremism ◽  
Recent Trends ◽  
The Uk

Terrorism and violent extremism have undoubtedly become among the top security concerns of the 21st century. Despite a robust agenda of counterterrorism since the September 11, 2001 attacks, the evolution of global terrorism has continued to outpace the policy responses that have tried to address it. Recent trends such as the foreign fighter phenomenon, the rampant spread of extremist ideologies online and within communities, and a dramatic increase in terrorist incidents worldwide, have led to a recognition that “traditional” counterterrorism efforts are insufficient and ineffective in combatting these phenomena. Consequently, the focus of policy and practice has shifted towards countering violent extremism by addressing the drivers of radicalization to curb recruitment to extremist groups. Within this context, the field of countering violent extremism (CVE) has garnered attention from both the academic and policy-making worlds. While the CVE field holds promise as a significant development in counterterrorism, its policy and practice are complicated by several challenges that undermine the success of its initiatives. Building resilience to violent extremism is continuously challenged by an overly securitized narrative and unintended consequences of previous policies and practices, including divisive social undercurrents like Islamophobia, xenophobia, and far-right sentiments. These by-products make it increasingly difficult to mobilize a whole of society response that is so critical to the success and sustainability of CVE initiatives. This research project addresses these policy challenges by drawing on the CVE strategies of Canada, the US, the UK, and Denmark to collect best practice and lessons learned in order to outline a way forward. 

scholarly journals Four pandemics: lessons learned, lessons lost

2020 ◽  
Keyword(s):  
Public Health ◽  
Lessons Learned ◽  
World Health ◽  
Swine Flu ◽  
Global Public Health ◽  
Health Crisis ◽  
The World ◽  
Spanish Flu ◽  
Future Events ◽  
Health Organization

In the past 100 years, the world has faced four distinctly different pandemics: the Spanish flu of 1918-1919, the SARS pandemic of 2003, the H1N1 or “swine flu” pandemic of 2012, and the ongoing COVID-19 pandemic. Each public health crisis exposed specific systemic shortfalls and provided public health lessons for future events. The Spanish flu revealed a nursing shortage and led to a great appreciation of nursing as a profession. SARS showed the importance of having frontline clinicians be able to work with regulators and those producing guidelines. H1N1 raised questions about the nature of a global organization such as the World Health Organization in terms of the benefits and potential disadvantages of leading the fight against a long-term global public health threat. In the era of COVID-19, it seems apparent that we are learning about both the blessing and curse of social media.

scholarly journals The impact of the COVID-19 pandemic on digital globalization

2021 ◽  
Vol 129 ◽  
pp. 06008
Author(s):  
Maria Loredana Popescu ◽  
Svetlana Platagea Gombos ◽  
Sorin Burlacu ◽  
Amza Mair
Keyword(s):  
Global Economy ◽  
World Economy ◽  
Value Added ◽  
Digital Transformation ◽  
Lessons Learned ◽  
Health Crisis ◽  
Main Research ◽  
Documentary Analysis ◽  
The Impact

Research background: After more than a year of the Covid-19 pandemic, we can investigate whether it caused a shock to the global economy, pushing for deglobalization, or on the contrary, it was a challenge for digital globalization and digital transformation of economies. Through this research we join the research contributions that examine the process towards digital globalization that characterizes the world economy, its impact on businesses, consumers, and governments. We also discuss the challenges posed by the crisis caused by the coronavirus pandemic to globalization and perhaps the acceleration of the digital transformation of economies. Purpose of the article: The aim of this research is to highlight the impact of the COVID-19 pandemic in the age of digital globalization. Methods: Documentary analysis, as the main research method, is doubled by a case study that allows us to highlight the specific characteristics of digital globalization. Findings & Value added: The findings of the research allowed us to highlight the essential aspects of digital globalization that were perhaps exacerbated by the Covid-19 pandemic, but which contribute greatly to understanding the phenomenon of globalization. Our research also reveals four lessons learned in the COVID-19 pandemic. We also present some considerations regarding the globalization after the health crisis.

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