Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
27,906
result(s) for
"Delivery of Health Care organization "
Sort by:
Interprofessional teamwork for health and social care
PROMOTING PARTNERSHIP FOR HEALTH This book forms part of a series entitled Promoting Partnership for Health publishedin association with the UK Centre for the Advancement of Interprofessional Education (CAIPE).The series explores partnership for health from policy, practice and educational perspectives.
eBook
Systems thinking for health systems strengthening
Many developing countries are looking to scale-up what works through major systems strengthening investments. With leadership, conviction and commitment, systems thinking can facilitate and accelerate the strengthening of systems to more effectively deliver interventions to those in need and be better able to improve health in an equitable way. Systems thinking is not a panacea. Its application does not mean that resolving problems and weaknesses will come easily or naturally or without overcoming the inertia of the established way of doing things. But it will identify, with more precision, where some of the true blockages and challenges lie. It will help to: 1) explore these problems from a systems perspective; 2) show potentials of solutions that work across sub-systems; 3) promote dynamic networks of diverse stakeholders; 4) inspire learning; and 5) foster more system-wide planning, evaluation and research. And it will increase the likelihood that health system strengthening investments and interventions will be effective. The more often and more comprehensively the actors and components of the system can talk to each other from within a common framework --communicating, sharing, problem-solving - the better chance any initiative to strengthen health systems has. Real progress will undoubtedly require time, significant change, and momentum to build capacity across the system. However, the change is necessary - and needed now. This report therefore speaks to health system stewards, researchers and funders and maps out a set of strategies and activities to harness these approaches, to link them to these emerging opportunities and to assist systems thinking to become the norm in design and evaluation of interventions in health systems. But, the final message is to the funders of health system strengthening and health systems research who will
need to recognize the potential in these opportunities, be prepared to take risks in investing in such innovations, and play an active role in both driving and following this agenda towards more systemic and evidence-informed health development.
eBook
Enhancing implementation of measurement-based mental health care in primary care: a mixed-methods randomized effectiveness evaluation of implementation facilitation
Background
Mental health care lags behind other forms of medical care in its reliance on subjective clinician assessment. Although routine use of standardized patient-reported outcome measures, measurement-based care (MBC), can improve patient outcomes and engagement, clinician efficiency, and, collaboration across care team members, full implementation of this complex practice change can be challenging. This study seeks to understand whether and how an intensive facilitation strategy can be effective in supporting the implementation of MBC. Implementation researchers partnering with US Department of Veterans Affairs (VA) leaders are conducting the study within the context of a national initiative to support MBC implementation throughout VA mental health services. This study will focus specifically on VA Primary Care-Mental Health Integration (PCMHI) programs.
Methods
A mixed-methods, multiple case study design will include 12 PCMHI sites recruited from the 23 PCMHI programs that volunteered to participate in the VA national initiative. Guided by a study partnership panel, sites are clustered into similar groups using administrative metrics. Site pairs are recruited from within these groups. Within pairs, sites are randomized to the implementation facilitation strategy (external facilitation plus QI team) or standard VA national support. The implementation strategy provides an external facilitator and MBC experts who work with intervention sites to form a QI team, develop an implementation plan, and, identify and overcome barriers to implementation. The RE-AIM framework guides the evaluation of the implementation facilitation strategy which will utilize data from administrative, medical record, and primary qualitative and quantitative sources. Guided by the iPARIHS framework and using a mixed methods approach, we will also examine factors associated with implementation success. Finally, we will explore whether implementation of MBC increases primary care team communication and function related to the care of mental health conditions.
Discussion
MBC has significant potential to improve mental health care but it represents a major change in practice. Understanding factors that can support MBC implementation is essential to attaining its potential benefits and spreading these benefits across the health care system.
Journal Article
A factory of one : applying lean principles to banish waste and improve your personal performance
\"The same Lean principles that are helping hospitals eliminate waste and improve efficiencies are applicable to individuals working in healthcare. This book not only provides the tools to alleviate the obvious symptoms of inefficiency but also demonstrates how to find the root causes underlying that inefficiency. It presents a practical, step-by-step approach to applying Lean principles to individuals, including real-world examples that illustrate how these principles have been applied in the healthcare industry\"-- Provided by publisher.
Book
The European health report 2009 : health and health systems
Investing in health and health systems is especially important during times of crisis, such as the severe economic crisis and pandemic (H1N1) 2009 influenza. To address these issues, governments and policy-makers need information that is current, accurate, comparable and user-friendly. What were the trends in public health indicators over the last four years? What factors influence health, and what are the challenges for the future? What contribution can health systems make to improve population health in the WHO European Region? In addressing these questions, this report illustrates the wide-ranging reforms countries have undertaken to strengthen performance in four core functions of health systems: service delivery, resource generation, financing and stewardship. This report presents essential public health information to support countries in choosing sound investments in health. It should encourage the successful implementation of effective health system reforms and policies, and help countries improve their health systems’ performance to provide efficient, patient-centred, high-quality health care. The annex provides some of the data used in the analysis.
eBook
The work of local healthcare innovation: a qualitative study of GP-led integrated diabetes care in primary health care
Background
Service delivery innovation is at the heart of efforts to combat the growing burden of chronic disease and escalating healthcare expenditure. Small-scale, locally-led service delivery innovation is a valuable source of learning about the complexities of change and the actions of local change agents. This exploratory qualitative study captures the perspectives of clinicians and managers involved in a general practitioner-led integrated diabetes care innovation.
Methods
Data on these change agents’ perspectives on the local innovation and how it works in the local context were collected through focus groups and semi-structured interviews at two primary health care sites. Transcribed data were analysed thematically. Normalization Process Theory provided a framework to explore perspectives on the individual and collective work involved in putting the innovation into practice in local service delivery contexts.
Results
Twelve primary health care clinicians, hospital-based medical specialists and practice managers participated in the study, which represented the majority involved in the innovation at the two sites. The thematic analysis highlighted three main themes of local innovation work: 1) trusting and embedding new professional relationships; 2) synchronizing services and resources; and 3) reconciling realities of innovation work. As a whole, the findings show that while locally-led service delivery innovation is designed to respond to local problems, convincing others to trust change and managing the boundary tensions is core to local work, particularly when it challenges taken-for-granted practices and relationships. Despite this, the findings also show that local innovators can and do act in both discretionary and creative ways to progress the innovation.
Conclusions
The use of Normalization Process Theory uncovered some critical professional, organizational and structural factors early in the progression of the innovation. The key to local service delivery innovation lies in building coalitions of trust at the point of service delivery and persuading organizational and institutional mindsets to consider the opportunities of locally-led innovation.
Journal Article