A Proposed Architecture to Sustain Public-Private Partnership

2020 ◽  
pp. 185-199
Author(s):  
Mohan Tanniru ◽  
Mark Martz
Keyword(s):  
Service Delivery ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Transition Services ◽  
Care Providers ◽  
Post Discharge ◽  
Care Services ◽  
Discharge Care ◽  
Quality Of Patient Care

Information technology has enabled tertiary health care providers to improve patient access to preventive and post-discharge care transition services. When such services are supported by facilities that are under the control of the hospital, hospitals can still influence the delivery and overall quality of patient care services. However, for a variety of reasons, many hospitals rely on external care providers who operate relatively independently from the hospital to deliver these services. As such, service delivery intended to create efficiency and value to patients can become complex, challenging to deliver, and resource intensive—especially if the service delivery spans a prolonged time horizon. This chapter discusses one case of an intermediary who helps hospitals address the smoking cessation needs of patients. Using service dominant logic research, the service exchanges among three different ecosystems (healthcare providers, intermediary, and patients) are modeled and intelligence needed to align their goals using blockchain architecture is highlighted.

Payment Accuracy in Value-Based Care Contracts

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Mackenzie A ◽  
◽  
Wang J ◽  
Teppema S ◽  
Duncan I ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Model Risk ◽  
Care Services ◽  
Value Based Care ◽  
Stochastic Risk

Reimbursement for health care services is transferring more risk away from payers and toward health care providers in the form of Alternative Payment Models (APMs), also known as Value-Based Care (VBC) models. VBC models cover a wide variety of forms but all include guarantees by providers of services to improve quality of care and/or reduce cost. Types of risk include performance risk, contract design risk or stochastic risk (because of the random variation in health care services and costs). A form of contract risk that can be a significant driver of cost is model risk, defined as the probability that the savings calculated at contract reconciliation will deviate from the actual savings generated. To estimate the degree of risk we quantify the potential variance in outcomes in a naïve population prior to intervention and the components that could affect outcomes, using examples of maternity and type 2 diabetes. This analysis has implications for both participants in, and designers of value-based contracts.

scholarly journals Quality of antenatal care services in Rwanda: assessing practices of health care providers

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Akashi Andrew Rurangirwa ◽  
Ingrid Mogren ◽  
Joseph Ntaganira ◽  
Kaymarlin Govender ◽  
Gunilla Krantz
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Care Services

scholarly journals Is quality maternal healthcare all about successful childbirth? Views of mothers in the Wa Municipality, Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257401
Author(s):  
Linus Baatiema ◽  
Augustine Tanle ◽  
Eugene Kofuor Maafo Darteh ◽  
Edward Kwabena Ameyaw
Keyword(s):  
Service Delivery ◽  
Maternity Care ◽  
Healthcare Providers ◽  
Care Providers ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
West Region ◽  
Adverse Pregnancy ◽  
Wa Municipality

Introduction In spite of the countless initiatives of the Ghana government to improve the quality of maternal healthcare, Upper West Region still records poor childbirth outcomes. This study, therefore, explored women’s perception of the quality of maternal healthcare they receive in the Wa Municipality of the Upper West Region of Ghana. Materials and methods This is a qualitative cross-sectional study of 62 women who accessed maternal healthcare in the Wa Municipality of Ghana. We analysed the transcripts using the analytic inductive technique. An inter-coding technique (testing for inter-coding agreement) was employed. The iterative coding process resulted in a coding scheme with four main themes. We used peer-debriefing technique in ensuring credibility and trustworthiness. Results Logistics and equipment; referral service; empathic service delivery; inadequacy of care providers; affordability of service; satisfaction with services received; as well as experience and service delivery were the parameters used by the women in assessing quality maternity care. A number of gaps were reported in the healthcare system including limited healthcare providers, limited beds and inefficient referral system. Conversely, some of them reported that some healthcare providers offered empathetic healthcare. Contrary views were expressed with respect to satisfaction with maternity care. Conclusion Government and all stakeholders seeking to enhance quality of maternal health and accelerate the attainment of the third Sustainable Development Goal need to reconsider the financing of service delivery at health institutions. Indeed, our findings have illustrated that routine workshops on empathetic healthcare are required in efforts to increase the rate of facility-based childbirth, and thereby subside maternal mortality and all adverse pregnancy outcomes.

Making the Case for a Nurse-Led Vascular Access Team Utilizing a Quality Assurance Conceptual Framework

2009 ◽  
Vol 14 (2) ◽  
pp. 77-82 ◽  
Author(s):  
Amanda L. Beerman
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Financial Burden ◽  
Central Venous Access ◽  
Venous Access ◽  
Care Providers ◽  
Quality Of Patient Care ◽  
The Cost ◽  
Venous Access Devices

Abstract The cost of complications of central venous access devices (CVADs) in today's health care setting is creating a financial burden, increasing the expenditures of resources, and consuming the time of health care providers to resolve. As the roles of nurses continue to evolve, nurses may be in a position to recognize and prevent many of these complications. This paper proposes a conceptual model to address the issues related to caring for and monitoring CVADs, while reducing complications and increasing quality of patient care.

Structuring the Design and Implementation of Leadership and Teamwork for Program Management

1997 ◽  
Vol 10 (2) ◽  
pp. 50-52 ◽  
Author(s):  
Brian Brittain ◽  
George Langill
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Program Management ◽  
Care Group ◽  
Working Relationships ◽  
Care Providers ◽  
Support Functions ◽  
Quality Of Patient Care ◽  
Current Program

Health care providers throughout Canada are aspiring to improve how they manage their resources, while maintaining or improving the quality of patient care through more patient-focused, team-based approaches. Many of the current program management models being implemented in the field are designed to realize these aspirations. Yet they are actually opposing them because of a lack of clarity about accountability and authority. Working relationships (teamwork) within clinical teams, and between clinical teams, physicians, support functions and the senior management committee, have been vague. This lack of clarity in role relationships has created many problems. This article demonstrates how we attempted to solve some of these problems at the Royal Ottawa Health Care Group.

scholarly journals The Needs and Practices of Fertility Preservation for Patients With Hematological Malignancies: A Medical Center Experience in Taiwan

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 61s-61s
Author(s):  
H.J. Lin ◽  
Y. Cheng ◽  
J.L. Tang
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Fertility Preservation ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Hematologic Malignancies ◽  
Care Providers ◽  
Treatment Procedures ◽  
Risk Of Cancer

Background: The incidence of hematologic malignancies has increased steadily in Taiwan. Along with the improvement of medical treatment, the survival of patients with hematologic malignancies has greatly improved. Cancer treatment may cause temporary or permanently infertility, which may lead to psychological distress and reduced quality of life. As patients live longer, the consequences of cancer treatments and fertility preservation are of increasing importance. Aim: The aims of this study was to understand the knowledge, needs and experiences of fertility preservation (FP) of patients with hematologic malignancies, and the perceptions and practices of healthcare providers concerning FP for patients with hematologic malignancies. This study also aimed to identify the challenges of FP in health care settings. Methods: In-depth interviews with 13 patients and 13 health care providers along with on-site observation were conducted. Results: Research findings were presented in three parts, respectively addressing patients' needs and attitudes, health care providers' perspective, and problems of current treatment procedures. In the first part, findings showed that among all the 13 interviewed patients, 10 had received counseling, and among them 4 had successfully completed FP. Most patients were unaware of infertility risk of cancer treatment and uninformed with FP information. At the time of cancer diagnosis, most patients were preoccupied with cancer treatment and own survival, but once informed, most of them expressed an aspiration to preserve fertility. In the second part, healthcare providers were found to encounter multiple barriers in initiating discussions about FP with patients, which included the health conditions of patients, the urgent need for treatment, and their perceived insufficiency in knowledge concerning FP procedures and in awareness of experiences of other cases. In the third part, the findings indicated that patients faced several challenges, including the passive attitudes of their physicians, the lack of the counselors or coordinators about FP, and the lack of collaborative guidelines or practices among different subspecialties. Conclusion: The fertility issues of patients with hematologic malignancies deserve attention, as their survival rate has been improved. To ensure the provisions of more friendly medical care resources and to improve life quality of patients with hematologic malignancies, the researcher proposed the following suggestions to the health care team: to provide patients the information concerning the infertility risks caused by cancer treatment and consultation services, establish and implement treatment procedures that incorporate FP, strengthen collaboration across subspecialties, communicate with patients about FP before the initiation of cancer treatment, and provide medical assistance to patients in needs.

scholarly journals Improving healthcare performance by focusing on individual productivity of healthcare provider and system thinking: a strategy proposal

2019 ◽  
Vol 5 (2) ◽  
pp. 45-51
Author(s):  
Choni Wangmo
Keyword(s):  
Service Delivery ◽  
Health System ◽  
Healthcare Provider ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
System Thinking ◽  
Care Providers ◽  
Mentorship Program ◽  
Individual Productivity ◽  
System Improvement

Bhutan’s health system, despite its commendable achievements in past few decades, continues to face shortage of skilled healthcare professionals and quality issues in service delivery. While recruiting more professionals, advocating for population health, better patient experience and safety, healthcare provider wellness has been overlooked. As the recent pay revision receives warm welcome from the health fraternity, a sense of greater professionalism and responsibility will be expected. Yet, aforementioned challenges still remain. Life and aspirations of professionals, brought up and trained in society that provides free healthcare and education, will become more convoluted. Mentorship program for healthcare providers at the beginning of their career and institutionalizing enabling environment for their personal and professional development need to be looked into. Decisions to pursue specialization should be a result of genuine interest and not a presumed exit hallway from professional frustrations, nor a shortcut to hefty pay. A promising and congruous career pathway can improve job satisfaction among health care providers. Endeavors to improve healthcare service delivery are present at every level but lack of coordination hampers favorable outcome. Variation in healthcare is major cause of adverse healthcare outcome and it is also known that every system is perfectly designed to achieve the results it gets. After conceptualizing few desired outcomes, a strategy framework that leads to health system improvement through improved individual productivity and systemic reforms enhancing intra- and inter sectoral coordination, while using evidence-based practice and existing resources, is proposed.

An extensive review of patient health-care service satisfaction in Bangladesh

2020 ◽  
Vol 2 ◽  
pp. 5-16
Author(s):  
Abdul Kader Mohiuddin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Service Providers ◽  
Care Service ◽  
Waiting Times ◽  
Health Care Service ◽  
Care Providers ◽  
Care Services

Patient satisfaction is a useful measure for providing quality indicators in health-care services. Concern over the quality of health-care services in Bangladesh has resulted in a loss of faith in health-care providers, low use of public health facilities, and increased outflows of patients from Bangladesh to hospitals abroad. The main barriers to accessing health services are inadequate services and poor quality of existing facilities, shortage of medicine supplies, busyness of doctors due to high patient load, long travel distance to facilities, and long waiting times once facilities were reached, very short consultation time, lack of empathy of the health professionals, their generally callous and casual attitude, aggressive pursuit of monetary gains, poor levels of competence and occasionally, disregard for the suffering that patients endure without being able to voice their concerns. All of these service failures are frequently reported in the print media. Such failures can play a powerful role in shaping patients’ negative attitudes and dissatisfaction with health-care service providers and health-care itself.

scholarly journals Barriers to accessing TB clinics among Myanmar TB patients attending a Thailand‐Myanmar border hospital: a qualitative approach

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Theint Theint Lwin ◽  
Tawatchai Apidechkul ◽  
Jongkon Saising ◽  
Panupong Upala ◽  
Ratipark Tamornpark
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Qualitative Approach ◽  
Care Providers ◽  
Content Type ◽  
Care Services ◽  
Tb Treatment ◽  
Economic Barriers

PurposeThis qualitative approach study aimed to understand the barriers to accessing a tuberculosis (TB) clinic in a Thai hospital as experienced by TB patients from Myanmar living on the Thailand-Myanmar border.Design/methodology/approachTwenty-two participants were asked to provide information. In-depth interviews were used to gather the information. Each interview lasted 40 min.FindingsTB patients from Myanmar experience several barriers to accessing TB treatment and care at Mae Sai Hospital, such as language and economic problems, although they are very satisfied with the quality of service and positive attitude of the health care providers. A long waiting time and lack of explanation of the pathogenesis of TB were noted as negative aspects by the patients and their relatives. The medical staff at the TB clinic were negatively affected by the excessive workload and unsuitability of some methods or technologies. Using budgetary subsidies from agencies to fund TB care and treatment was not sustainable. Foreign TB patients are not subsidized by the national universal insurance scheme of Thailand, and sending TB patients back to their home country is sometimes unavoidable.Originality/valueThailand and Myanmar should strengthen their collaboration and develop a system to improve the quality of TB patient care and management for those who are living in poverty and lack education, by focusing on reducing language and economic barriers to accessing health care services including support for medicines and laboratory materials related to TB case management among these populations.

Coaching intervention as a strategy for enhancing accrual to phase I/II clinical trials

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6580-6580
Author(s):  
P. M. Fracasso ◽  
M. S. Walker ◽  
K. J. Mathews ◽  
H. P. Morgan ◽  
S. A. Goodner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Medical Mistrust ◽  
Care Providers ◽  
Coaching Intervention ◽  
Perceptions Of Racism ◽  
Prostate Cancers

6580 Background: Lack of both trust and rapport with health care providers has been identified as possible causes for under- representation of minorities within clinical trials. Our study used a “Peer Coach” (PC) to promote trust among minority patients with advanced cancer. Methods: Minority patients with advanced breast, colorectal, lung, or prostate carcinoma were randomly assigned to receive a PC or “Usual Care” (UC). Patients completed baseline and 6-month telephone interviews to assess demographics, trust in healthcare providers, attitudes toward clinical trials, and quality of life. Patients randomized to the coaching intervention were assigned a coach, trained in health communications, who made biweekly contacts for 6 months to address general issues, progress or development in cancer care, and available resources. Patients randomized to UC received no further intervention. Results: Over 21 months, we screened 268 patients and enrolled 73 African Americans and 2 Asians (56 women and 19 men) including 38, 18, 13, and 6 patients with breast, colorectal, lung and prostate cancers, respectively. Patients were randomly assigned to PC (38) and UC (37), with no baseline differences. Longitudinal data analysis was conducted on 69 patients who completed the 6-month follow-up assessment. Trial enrollment was slightly higher in the PC group but was found to be non-significant (p=0.226). Trust in doctor (p=0.053), absence of depressed mood (p=0.032) and higher quality of life (p=0.052) predicted enrollment. Adherence to care was unrelated to the assigned group and, in the PC group, to the number of coach contacts. Baseline depression was associated with missed physician appointments (p=0.039). There was no difference between the PC and UC groups on attitudes towards clinical trials, perceptions of racism, trust in doctor, medical mistrust, depression, or quality of life. Conclusions: Psychosocial elements of trust in doctor, depression and quality of life were found to predict trial enrollment, regardless of assignment to PC or UC. Future studies should include a more structured approach to clinical trial promotion, follow patients over a longer period, and consider treatment of depression given its association with trial enrollment and adherence. No significant financial relationships to disclose.

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