Redefining global health-care delivery

Initiatives to address the unmet needs of those facing both poverty and serious illness have expanded significantly over the past decade. But many of them are designed in an ad-hoc manner to address one health problem among many; they are too rarely assessed; best practices spread slowly. When assessments of delivery do occur, they are often narrow studies of the cost-effectiveness of a single intervention rather than the complex set of them required to deliver value to patients and their families. We propose a framework for global health-care delivery and evaluation by considering efforts to introduce HIV/AIDS care to resource-poor settings. The framework introduces the notion of care delivery value chains that apply a systems-level analysis to the complex processes and interventions that must occur, across a health-care system and over time, to deliver high-value care for patients with HIV/AIDS and cooccurring conditions, from tuberculosis to malnutrition. To ...

Learning about patients’ experiences of care in their own homes

Patient’s experiences are a main factor in order to design how health care services should work. Many different ways of measuring these experiences have been developed; in this post hosted by the King’s Fund Blog, Jo Maybin explains how they have used face-to-face interviews in patient’s home, what difficulties they have found and what they have been able to investigate thanks to this kind of methodology.

As it is said in the post, patient’s own homes interviews enabled the interviewers to get in contact with external carers, to analyze their point of view in relation to health care coordination and integration, and to identify what aspects should be improved in order to increase patient’s satisfaction with the care provided.

On the other hand, this post lists some of the difficulties found when doing face-to-face interviews, specially in what concerns to the amount of resources or ...

Using patient feedback to drive improvement

Increasing amount of information is being collected from patients after they are discharged in a hospital; this information can be used mainly in three ways: (I) to analyse how care is being performed, (II) to publish data in order to share information with general public and to enhance government’s accountability, and (III) to implement reforms in hospital activities and way of working.

In this post, the author defends the idea that not enough information is being used to make patient experience have actual influence at changing how health care organization work at a local level. Organizational leadership and patient-centered culture are said to be critical to use patient feedback to drive improvement.

The author, Joni Jabal, ends this post urging NHS to use its “NHS inpatient survey” to make NHS become an actual people-centered organization.

Improving Integrated Care: Can Implementation Science Unlock the ‘Black Box’ of Complexities?

In a previous IJIC editorial they reflected on the fact that we have yet to make any significant breakthrough to understand the implementation and sustainability of complex service innovations that so characterise the development of integrated care programmes [1]. Without such knowledge we might be able to explain the core building blocks of integrated care systems, but we cannot adequately explain the intricacies of effective implementation nor fully understand the causes of the outcomes we observe. This article show how this is not simply a methodological problem but reflects a more deep-rooted challenge in the lack of value that is placed both in the commissioning of such research and the findings that are produced.

The Development of a Logic Model to Guide the Planning and Evaluation of a Navigation Center for Children and Youth with Complex Care Needs

Most systems across health settings and sectors are not well integrated and do not provide the needed supports, resources, or access caregivers and families require to properly care for their child with complex care needs (CCNs). NaviCare/SoinsNavi is a research-based navigation center aimed to help facilitate more convenient and integrated care to support the needs of children, youth, and their families using a patient navigator to offer personalized family-centered care

Integrated care pilots in England revisited

The purpose of this paper is to explore the outcomes identified by the evaluation of the national programme of integrated care pilots (ICPs) in England in the context of wider policies designed to deliver integrated care and to consider the challenges presented to policy makers and evaluators in distilling usable insights to promote effective policy.

Also, this paper considers why evaluation findings appear limited in their impact on policy in the field of integrated care. Views as to how evaluation might be undertaken so that it generates actionable insights are advanced.

Integrated people-centred health services (IPCHS) in Ireland: lessons learnt

Following presentation of Dr. Áine Carroll, Consultant at The National Rehabilitation Hospital (NRH) and Professor of Healthcare Integration and Improvement at UCD describes current lessons learnt in the design and delivering of integrated people-centred health services in Ireland.

In the context of challenging emerging demands and system constraints, a clinical strategy and over 30 national programs have been developed to improve clinician and patient experience at the lower cost. Dr. Carroll, addresses the challenges of implementing integrated care programs and highlights the most recent achievements of national policy “Sláintecare Action Plan” that contributes to make integrated care a reality. Several elements as patient narratives, partnership and leadership make up the health system’s capacities for building integration at micro, meso and macro level.

Please check out the video: https://pro.panopto.com/Panopto/Pages/Viewer.aspx?tid=5e8a430a-519d-45ad-88ad-ac7100d48a92

Primary Health Care the heart of every health system. How do we get there?

A ten-part seminar series, run by the London School of Hygiene & Tropical Medicine, providing an overview of the key features and functions of Primary Health Care (PHC), the potential of PHC in all health systems and its role in achieving universal health coverage. The sessions draw on examples across different settings.

In this final session in the series on “Primary Health Care: The heart of every health system” a panel of cross-country experts will reflect on their key takeaways from the series and consider what more needs to happen to support countries to place PHC at the heart of their health system.

If you would like to submit a question to our panel please submit these here. 

Speakers

• Lakshmi Balaji is a Global Health and International Development leader, and until recently was Chief of PHC and Health Systems Strengthening at UNICEF Headquarters.  
• Dina Balabanova is a Professor of Health Systems ...