Organizational Leadership and Health Care Reform

2016 ◽  
pp. 1043-1063
Author(s):  
T. Ray Ruffin ◽  
Joyce Marie Hawkins ◽  
D. Israel Lee
Keyword(s):  
Health Care ◽  
Organizational Leadership ◽  
Health Care Systems ◽  
Future Research ◽  
Health Care Reforms ◽  
Use Of Technology ◽  
Hitech Act ◽  
Care Systems ◽  
Future Research Directions ◽  
And Function

Policies, health, and government regulations affect various Health Care organizations and their members. One such policy, the Health Information Technology for Economic and Clinical Health (HITECH) Act, attempts to improve the performance of health care systems through the use of technology, such as Electronic Health Records (Bluementhal, 2010). The most critical task of leadership is to establish a mindset at the top of the organization and function to infuse a culture of excellence throughout the organization (Bentkover, 2012). Health organizations can only progress if their members share a set of values and are single-mindedly committed to achieving openly defined objectives (Bentkover, 2012). This chapter investigates organizational leadership in relation to health care reforms to include trends in health care leadership, Stratified Systems Theory (SST), Systems Thinking, and regulators perspectives. The chapter will consist of the following sections: background; issues controversies, and problems; solutions and recommendation; future research directions; and conclusion.

Organizational Leadership and Health Care Reform

2016 ◽  
pp. 42-62
Author(s):  
T. Ray Ruffin ◽  
Joyce Marie Hawkins ◽  
D. Israel Lee
Keyword(s):  
Health Care ◽  
Organizational Leadership ◽  
Health Care Systems ◽  
Future Research ◽  
Health Care Reforms ◽  
Use Of Technology ◽  
Hitech Act ◽  
Care Systems ◽  
Future Research Directions ◽  
And Function

Policies, health, and government regulations affect various Health Care organizations and their members. One such policy, the Health Information Technology for Economic and Clinical Health (HITECH) Act, attempts to improve the performance of health care systems through the use of technology, such as Electronic Health Records (Bluementhal, 2010). The most critical task of leadership is to establish a mindset at the top of the organization and function to infuse a culture of excellence throughout the organization (Bentkover, 2012). Health organizations can only progress if their members share a set of values and are single-mindedly committed to achieving openly defined objectives (Bentkover, 2012). This chapter investigates organizational leadership in relation to health care reforms to include trends in health care leadership, Stratified Systems Theory (SST), Systems Thinking, and regulators perspectives. The chapter will consist of the following sections: background; issues controversies, and problems; solutions and recommendation; future research directions; and conclusion.

scholarly journals The impact of chronic disease and disability on the elderly

1999 ◽  
Vol 55 (3) ◽  
pp. 9-14
Author(s):  
C. J. Eales
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Health Care Systems ◽  
The Elderly ◽  
Therapeutic Interventions ◽  
Elderly Persons ◽  
Care Systems ◽  
And Function ◽  
The Impact

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.

scholarly journals Η επίδραση του θεσμικού, πολιτικού και διοικητικού περιβάλλοντος στη μεταρρύθμιση του τομέα της υγείας στην Ελλάδα, 1950-2005

2013 ◽  
Author(s):  
Ηλίας Γορανίτης
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Health Care Systems ◽  
Implementation Process ◽  
The United States ◽  
International Experience ◽  
Health Care Reforms ◽  
Care Systems ◽  
Veto Points ◽  
Theories Of Change

The Greek NHS, thirty years after its establishment, faces important performance deficiencies. With an ongoing economic crisis placing a further burden, a call for national health care reform is urgent. This doctoral thesis drawing upon (a) political theories of change, (b) institutional, political and administrative developments in Greece as well as (c) international experience, aims to provide a framework, in terms of planning and implementation process, for health care reform in Greece. The existing order of things, in every public policy system, impedes change and forces policies along specific paths, the deviation from which to a new policy paradigm is extremely difficult. The Greek NHS has never deviated from this path indicating the existence of strong interest groups, institutions with high set-up cost and limited political willingness or ability for strategic approach to overcome the ‘veto points’ of the reform in the system. In this thesis the way forward in reforming fragmented and path-dependent health care systems like the Greek NHS has been identified. By addressing big questions such as: How the Greek NHS reached this low performing level? What are the ingredients of a well performing health care system? What factors impede or promote successful reforms? How health care reforms in systems with multiple ‘veto points’ should be implemented? Political science and international experience from Spain, Portugal, Italy, the Netherlands and the United States provide important insights to our study.

Institutionalization and Professionalization

2016 ◽  
Author(s):  
Trish Reay ◽  
Elizabeth Goodrick ◽  
Bob Hinings
Keyword(s):  
Health Care ◽  
Organizational Change ◽  
Health Care Systems ◽  
Future Research ◽  
Power Dynamics ◽  
Care Systems

Health care systems are both highly institutionalized and highly professionalized. We suggest that both characteristics should be considered to understand the underlying power dynamics and how organizational change can occur. Although these characteristics have mostly been considered separately, we identify three ways they are being brought together and show how each reveals different underlying power dynamics that in turn suggest different explanations of organizational change. To conclude, we set out three avenues for future research that will continue to advance our knowledge of change in health care.

scholarly journals Involving citizens in disinvestment decisions: what do health professionals think? Findings from a multi-method study in the English NHS

2017 ◽  
Vol 13 (2) ◽  
pp. 162-188 ◽  
Author(s):  
Tom Daniels ◽  
Iestyn Williams ◽  
Stirling Bryan ◽  
Craig Mitton ◽  
Suzanne Robinson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Public Involvement ◽  
Health Care Systems ◽  
Future Research ◽  
Local Health ◽  
The Public ◽  
Health Care Leaders ◽  
Local Health Care ◽  
Care Systems

AbstractPublic involvement in disinvestment decision making in health care is widely advocated, and in some cases legally mandated. However, attempts to involve the public in other areas of health policy have been accused of tokenism and manipulation. This paper presents research into the views of local health care leaders in the English National Health Service (NHS) with regards to the involvement of citizens and local communities in disinvestment decision making. The research includes a Q study and follow-up interviews with a sample of health care clinicians and managers in senior roles in the English NHS. It finds that whilst initial responses suggest high levels of support for public involvement, further probing of attitudes and experiences shows higher levels of ambivalence and risk aversion and a far more cautious overall stance. This study has implications for the future of disinvestment activities and public involvement in health care systems faced with increased resource constraint. Recommendations are made for future research and practice.

scholarly journals Barriers and Facilitators to the Implementation of a Mobile Insulin Titration Intervention for Uncontrolled Diabetes Patients: A Qualitative Analysis (Preprint)

2019 ◽  
Author(s):  
Erin Rogers ◽  
Sneha R Aidasani ◽  
Rebecca Friedes ◽  
Lu Hu ◽  
Aisha T. Langford ◽  
...  
Keyword(s):  
Health Care ◽  
Text Messaging ◽  
Diabetes Management ◽  
Health Care Systems ◽  
Unmet Need ◽  
Future Research ◽  
Management Support ◽  
Implementation Climate ◽  
Time Saving ◽  
Care Systems

BACKGROUND In 2016, a text-messaging intervention to titrate insulin in patients with uncontrolled type 2 diabetes was implemented at two health care systems in New York City. OBJECTIVE This study conducted a qualitative evaluation assessing barriers to, and facilitators of, implementation of the mobile insulin titration intervention (called “MITI”) into usual care. METHODS We conducted in-depth interviews with patients enrolled in the MITI program (N=36) and staff involved in MITI (N=19) at the two health care systems. Interviews were transcribed and iteratively coded by two study investigators both inductively and deductively using a codebook guided by the Consolidated Framework for Implementation Research. RESULTS Multiple facilitator themes emerged: 1) MITI had strong relative advantages to in-person titration including its convenience and time-saving design; 2) the free cost of MITI was important to patients; 3) MITI was easy to use and patients were confident in their ability to use MITI; 4) MITI was compatible with patients’ home routines and clinic workflow; 5) patients and staff perceived MITI to have value beyond insulin titration by reminding and motivating patients to engage in healthy behaviors and providing a source of patient support; and 6) implementation in clinics was made easy by having a strong implementation climate, communication networks to spread information about MITI, and a strong program champion. Barriers identified included: 1) language limitations; 2) initial nurse concerns about scope of practice changes required to deliver MITI; 2) initial provider knowledge gaps about the program; and 3) provider perceptions that MITI may not be appropriate for some patients (e.g., older, not tech-savvy). There was also a theme that emerged during patient and staff interviewees of an unmet need for longer-term, additional diabetes management support among this population, specifically diet, nutrition and exercise support. CONCLUSIONS Patients and staff were overwhelmingly supportive of MITI, believed it had many benefits and believed it was compatible with the clinic workflow and patient’s lives. Initial implementation efforts should address staff training and nurse concerns. Future research should explore options for integrating additional diabetes support for patients.

scholarly journals Effect of Public Deliberation on Patient Attitudes Regarding Consent and Data Use in a Learning Health Care System for Oncology

2019 ◽  
Vol 37 (34) ◽  
pp. 3203-3211 ◽  
Author(s):  
Reshma Jagsi ◽  
Kent A. Griffith ◽  
Rochelle D. Jones ◽  
Chris Krenz ◽  
Michele Gornick ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Record ◽  
Medical Records ◽  
Health Care Systems ◽  
Insurance Companies ◽  
Future Research ◽  
Democratic Deliberation ◽  
Recommended Care ◽  
Care Systems

PURPOSE We sought to generate informed and considered opinions regarding acceptable secondary uses of deidentified health information and consent models for oncology learning health care systems. METHODS Day-long democratic deliberation sessions included 217 patients with cancer at four geographically and sociodemographically diverse sites. Patients completed three surveys (at baseline, immediately after deliberation, and 1-month follow-up). RESULTS Participants were 67.3% female, 21.7% black, and 6.0% Hispanic. The most notable changes in perceptions after deliberation related to use of deidentified medical-record data by insurance companies. After discussion, 72.3% of participants felt comfortable if the purpose was to make sure patients receive recommended care ( v 79.5% at baseline; P = .03); 24.9% felt comfortable if the purpose was to determine eligibility for coverage or reimbursement ( v 50.9% at baseline; P < .001). The most notable change about secondary research use related to believing it was important that doctors ask patients at least once whether researchers can use deidentified medical-records data for future research. The proportion endorsing high importance decreased from baseline (82.2%) to 68.7% immediately after discussion ( P < .001), and remained decreased at 73.1% ( P = .01) at follow-up. At follow-up, non-Hispanic whites were more likely to consider it highly important to be able to conduct medical research with deidentified electronic health records (96.8% v 87.7%; P = .01) and less likely to consider it highly important for doctors to get a patient’s permission each time deidentified medical record information is used for research (23.2% v 51.6%; P < .001). CONCLUSION This research confirms that most patients wish to be asked before deidentified medical records are used for research. Policies designed to realize the potential benefits of learning health care systems can, and should be, grounded in informed and considered public opinion.

scholarly journals National Health Reforms in Georgia during 1994-2021 and their Success

2021 ◽  
Vol 12 (2) ◽  
pp. 102-108
Author(s):  
Iza Gigauri ◽  
Kakhaber Djakeli
Keyword(s):  
Health Care ◽  
Health Reform ◽  
Health Care Systems ◽  
Universal Coverage ◽  
Health Care Reforms ◽  
Health Reforms ◽  
Health Related ◽  
Care Systems ◽  
Cost Efficient ◽  
Health Model

Abstract The Health Reform of the country is a very difficult burden for two reasons: firstly, we need an appropriate economy level in the country, that can bear the new health model, established through reform, and secondly, the country needs a health system that is appropriate either for its economic system or for its tradition and history. Health reformers need to match all the points of the health reform concept, its implementation, and the systems of the country. Due to its Soviet past, Georgia struggled in the last twenty years to find an effective and cost efficient health model for its citizens. Starting from the 90s, Georgia instituted three health reforms and finally found some sustainable measures. The present article explores the three waves of the Georgian Health Care reforms, and analyses the factors of their success and the reasons for their failures. The importance of studying the Health Care systems is derived from Sustainable Development Goals targeting Health issues including health-related topics to improve the population’s health and wellbeing as well as achieve universal coverage of health services. The research contributes to the knowledge regarding the Health Care Reforms, and their practical implications on a country.

The Development of a Homecare Platform to Support Informal Caregivers

2014 ◽  
Author(s):  
Yu Song
Keyword(s):  
Pervasive Computing ◽  
Design Method ◽  
Health Care Systems ◽  
Informal Caregivers ◽  
Future Research ◽  
Web Database ◽  
Web Based ◽  
Care Systems ◽  
Future Research Directions ◽  
Critical Situations

In many European countries, the aging population and the consequent increase in the incidence of chronic disease is causing challenges to health care systems. One solution to avoid a collapse of the systems is to conduct patient care in home environments by informal caregivers. However, constantly caring and monitoring patients may lead to heavy physical and emotional burdens on those informal caregivers. To cope with this problem, this research presents a homecare platform to partially relieve those burdens. Using community-based co-design method, the requirements of the platform are generated first where the compatibility, portability, modularity, accessibility, usability, security, affordability and scalability are addressed. Based on those requirements, an architecture of the platform is constructed where a pervasive computing homecare environment and a web-based service form the core of the platform. In the proposed pervasive computing homecare environment, activities and locations of the patient are recorded as events via a wireless sensor network. Those events are then sent and stored in a web database. Possible critical situations are identified based on the analysis of those recorded events. If any critical situations are detected, the platform will push an alarm to mobile devices of responsible caregivers for possible interventions. To verify the effectiveness and efficiency of the proposed platform, an experiment were conducted to test different technical functionalities and the usability of the platform. Limitations of the proposed platform and future research directions are discussed as well.

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