How do we know? An assessment of integrated community case management data quality in four districts of Malawi

The World Health Organization contracted annual data quality assessments of Rapid Access Expansion (RAcE) proyects to review integrated community case management (iCCM) data quality and the monitoring and evaluation (M&E) system for iCCM, adn to suggest ways to improve data quality. 

This data quality assessment illuminates where an otherwise strong M&E system for iCCM fails to ensure some aspects of data quality. Prioritizing data management with documented protocols, additional training and approaches to create efficient supervision practices may improve iCCM data quality. 

Early Performance of Accountable Care Organizations in Medicare

In the Medicare Shared Savings Program (MSSP), accountable care organizations (ACOs) have financial incentives to lower spending and improve quality. In this article they used quasi-experimental methods to assess the early performance of MSSP and ACOs. In the conclusions they found that the first full year of contracts MSSP was associated with reductions in Medicare Early pass between the 2012 participants but not among the 2013 participants. Economies higher in primary care groups independent groups in integrated hospitals. 

Perceptions of health managers and professionals about mental health and primary care integration in Rio de Janeiro: a mixed methods study

Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health.

Impact of Patient-Centered Care Innovations on Access to Providers, Ambulatory Care Utilization, and Patient Clinical Indicators in the Veterans Health Administration

The Veterans Health Administration piloted patient-centered care (PCC) innovations beginning in 2010 to improve patient and provider experience and environment in ambulatory care. We use secondary data to look at longitudinal trends, evaluate system redesign, and identify areas for further quality improvement.

METHODS:

This was a retrospective, observational study using existing secondary data from multiple US Department of Veteran Affairs sources to evaluate changes in veteran and facility outcomes associated with PCC innovations at 2 innovation and matched comparison sites between FY 2008-2010 (pre-PCC innovations) and FY 2011-2012 (post-PCC innovations). Outcomes included access to primary care providers (PCPs); primary, specialty ...

Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability.

Purpose: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts. 

Methods: The Context and Capabilities for Integrating Care (CCIC) Framework was developed through a literature review, and revised and validated through interviews with leaders and care providers engaged in integrated care networks ...

Evolving Concepts of Patient-Centered Care and the Assessment of Patient Care Experiences: Optimism and Opposition

This article summarise, a personal view of the author (Paul D. Cleary dean of the Yale School of Public Health), on the available research, concerning measurement of “patient satisfaction” and “patient care experience”. Author argues that patient experiences measurement efforts are being devoted to providing high-quality patient-centered care. Some indicators and surveys are discussed in terms of their reliability, validity and correlation across individuals and settings with other quality indicators.

Special attention is paid to the Consumer Assessment of Healthcare Providers and Systems (CAHPS), launched in 1995 by the Agency for Healthcare Research and Quality (AHRQ). The CAHPS surveys are ...

Promoting Policy, Systems, and Environment Change to Prevent Chronic Disease: Lessons Learned From the King County Communities Putting Prevention to Work Initiative.

Initiatives that convene community stakeholders to implement policy, systems, environment, and infrastructure (PSEI) change have become a standard approach for promoting community health. To assess the PSEI changes brought about by the King County, Washington, Communities Putting Prevention to Work initiative and describe how initiative structures and processes contributed to making changes.

Measurement of the Patient Experience: Clarifying Facts, Myths, and Approaches

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a 32-item tool administered after discharge to a random sample of adult inpatients, creating standardized, publicly reported metrics that allow fair comparisons of patient experience in hospitals across the nation.

The 11 HCAHPS measures derived from the survey reported on the Hospital Compare website assess how well nurses and physicians communicate with patients, how responsive hospital staff are to patients’ needs, how well hospital staff help patients manage pain, how well the staff communicates with patients about new medicines, whether key information is provided at discharge, how smoothly ...

Integrating funds for health and social care: an evidence review

Objectives

Integrated funds for health and social care are one possible way of improving care for people with complex care requirements. If integrated funds facilitate coordinated care, this could support improvements in patient experience, and health and social care outcomes, reduce avoidable hospital admissions and delayed discharges, and so reduce costs. In this article, we examine whether this potential has been realized in practice.

Methods

We propose a framework based on agency theory for understanding the role that integrated funding can play in promoting coordinated care, and review the evidence to see whether the expected effects are realized in practice ...