Supporting nurse practitioners’ practice in primary healthcare settings: a three-level qualitative model

While greater reliance on nurse practitioners in primary healthcare settings can improve service efficiency and accessibility, their integration is not straihtfoward, challenging existing role definitions of both registered nurses and physicians. This study´s main objetive is to examine different structures and mechanims put in place to support the development of primary healthcare nurse practitiones´s practice in different healthcare settings, and develop a practical model for identifying and planning adequate support practices. 

A new paradigm on health care accountability to improve the quality of the system: four parameters to achieve individual and collective accountability

Healthcare systems the world over are facing significant financial pressures and growing demands for services. Many nations have therefore set common goal of improving the population´s health, the quality of the outcomes, and the containment of costs. So, these changes in the health care systems´priorities have set the ground for an interdisciplinary approach necessary to assess the activities of health care professionals and, in general, of health care systems. 

Centers of excellence in healthcare institutions: what they are and how to assemble them

Centers of excellence-specialized programs within healthcare institutions which supply exceptionally high concentrations of expertise and related resources centered on particular medical areas and delivered in a comprehensive, interdisciplinary fashion-afford many advantages for healthcare providers and the populations they serve. To achieve full value from centers of excellence, proper assembly is an absolute necessity, but guidance is somewhat limited. This effectively forces healthcare providers to pursue establishment largely via trial-and-error, diminishing opportunities for success. 

Health assessments for health governance—concepts and methodologies

For better supporting science-governance interface, the potential of health assessments appear underrated. The aims of this article is to identify what various types of health assessment have in common; how they differ, which assessments to apply for which purpose; and what needs and options there are for future joint development. 

Interventions and approaches to integrating HIV and mental health services: a systematic review

• Available literature on interventions integrating HIV and mental health services reveal that there is much diversity in the approaches adopted in combining treatment modalities; ranging from integration within a single facility, to multi-facility integration, and integrated care coordinated by non-physician case managers.

• Existing evidence, although limited, suggest that integrating HIV and mental health services may be linked to improved patient and service delivery outcomes in diverse settings.

• There is a need for higher quality and robustly designed studies to evaluate and compare integration models at different levels of service delivery in terms ...

The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization

The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization reviews PCMH results from 45 peer-reviewed reports and additional government and state evaluations. Implementation of the PCMH and high performing primary care differs depending upon the needs and preferences of those delivering, receiving, and paying for related care. 

The sixth annual PCPCC report, authored by the Robert Graham Center of the American Academy of Family Physicians and published with support from the Milbank Memorial Fund, employed broader search terms and more rigorous search criteria that evaluated studies, reports, and evaluations published between November 1, 2015 to February 28 ...

The SELFIE framework for integrated care for multi-morbidity: Development and description

The rise of multi-morbidity constitutes a serious challenge in health and social care organisation that requires a shift from disease-towards person-centred integrated care. The aim of the current study was to develop a conceptual framework that can aid the development, implementation, description, and evaluation of integrated care programmes for multi-morbidity. The framework structures relevant concepts in integrated care for multimorbidity and can be applied by different stakeholders to guide development, implementation, description, and evaluation. 

Integrated Person-Centered Health Care for All Women During Pregnancy: Implementing World Health Organization Recommendations on Antenatal Care for a Positive Pregnancy Experience

In 2015, Unnited Nations member states adopted the Sustainable Development Goals (SDGs) in order to continue the momentum of the Milennium Development Goals and address a broarder range of development issues. The World Health Organization (WHO) identified target 3.8, universal health coverage, as the key to achieving all other health-related SDGs. To that end, Every Woman Every Child movement developed the Global Strategy for Women´s, Children´s, and Adolescentss´Health (2016-2030) with the aim of ending all preventable deaths of women, children, and adolescents and ensuring their health and well-being. The strategy provides a framework for countries to ...

Integrating Social Services and Home-Based Primary Care for High-Risk Patients

There is a consensus that our current hospital-intensive approach to care is deeply flawed. This review article describes the research evidence for developing a better system of care for high-cost, high-risk patients. It reviews the evidence that home-centred care and integration of health care with social services are the cornerstones of a more humane and efficient system. In the hope of stimulating further discussion and debate, the authors summarize existing viewpoints on how a home-centered system, which integrates social and medical services, might emerge in the next few years. 

Understanding and Evaluating the Implementation on Integrated Care: A "Three Pipe Problem"

Altought we have come a long way in being able to articulate the key building blocks of integrated care, the interplay between them is so complex and interwined that it seems an impossible challenge to create any simple implementation model. Yet, if integrated care is to advance, we must become better at smoothing over the many obstacles and challenges to implementation that have bedevilled the uptake and roll-out of even the most proven of integrated care interventions.

This is quite the "three-pipe problem" for integrated care since science has yet to make the real breakthrough to address how we might ...