Nov. 14, 2016 Global

How a Gender-sensitive Quality Improvement Approach Supports Integrated People-centered Health Services

Clients, family and friends, communities, and health providers are all influenced by the culture they live in and by that culture’s perspectives on gender. To ignore gender is to ignore a vital part of the people and their local context that the WHO framework aims to center. Gender must be considered in order to have truly people-centered health services. A gender-sensitive approach takes the different needs, constraints, and opportunities of women, men, girls, and boys into account and responds to them strategically in program design, implementation, and evaluation. By considering and responding to these differences, health services are more ...

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Oct. 27, 2016 Global

Developing a Patient-Centered Benefit-Risk Survey: A Community-Engaged Process

The Objectives

The objective of this article is to provide a community-engaged process to inform the design of a stated-preferences experiment. The process involved integrating patients and caregivers of people with Duchenne/Becker muscular dystrophy, advocates, clinicians, and the sponsor in conceptualizing and developing a benefit-risk survey on the basis of phase III trial results.

Methods

Our community-engagement process for the development of a stated-preference survey included a set of five guiding principles with a foundation in the principles of community-engaged research. Engagement efforts were carried out through an informal network of three committees. Members of the leadership, stakeholder, and ...

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Oct. 7, 2016 Americas Global

Integrating palliative care into primary care for patients with chronic, life-limiting conditions.

As longevity increases, individuals with chronic, life-limiting conditions will live longer with disease burden and functional decline. Nurse practitioners can integrate symptom management, early decision-making, and supportive care into the primary care setting to improve quality of life and decrease economic and emotional impact at the end of life.

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Sept. 28, 2016 Americas Global

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 ...

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Sept. 15, 2016 Europe Global

Power and Integrated Health Care: Shifting from Governance to Governmentality

Integrated care occurs within micro, meso and macro levels of governance structures, which are shaped by complex power dynamics. Yet theoretically-led notions of power, and scrutiny of its meanings and its functioning, are neglected in the literature on integrated care. We explore an alternative approach. Following a discussion on governance, two streams of theorising power are presented: mainstream and second-stream. Mainstream concepts are based on the notion of power-as-capacity, of one agent ­having the capacity to influence another—so the overall idea is ‘power over ’. Studies on integrated care ­typically employ mainstream ideas, which yield rather limited analyses. Second-stream concepts ...

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Sept. 14, 2016 Europe Global

Supporting self-management: A guide to enabling behaviour change for health and wellbeing using person- and community-centred approaches

This guide outlines how the science of behaviour can help people to self-manage their health and wellbeing.

Key findings

• The guide uses the EAST framework to organise ideas and examples. The core message of EAST is that if you want to encourage a behaviour, you should make it Easy, Attractive, Social and Timely.
• The guide features a number of low-tech, pragmatic and manageable activities which can increase the spread of person- and community-centred health and wellbeing programmes.

 

This action-focused guide is part of the NHS England-funded Realising the Value programme, which seeks to develop person- and community-centred approaches for health ...

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Sept. 14, 2016 Europe Global

Spreading change: A guide to enabling the spread of person- and community-centred approaches for health and wellbeing

This guide outlines how behavioural science can help spread the take-up of person- and community-centred approaches to health and wellbeing.

Key findings

•     The guide uses the EAST framework to organise ideas and examples. The core message of EAST is that if you want to encourage a behaviour, you should make it Easy, Attractive, Social and Timely.
•     The guide features a number of low-tech, pragmatic and manageable activities which can increase the spread of person- and community-centred health and wellbeing programmes.

This action-focused guide is part of the NHS England-funded Realising the Value programme, which seeks to develop person- and community-centred ...

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Aug. 24, 2016 Global

Association of Integrated Team-Based Care With Health Care Quality, Utilization, and Cost

The value of integrated team delivery models is not firmly established. So we evaluate the association of receiving primary care in integrated team-based care (TBC) practices vs traditional practice management (TPM) practices (usual care) with patient outcomes, health care utilization, and costs.

Conclusions: Among adults enrolled in an integrated health care system, receipt of primary care at TBC practices compared with TPM practices was associated with higher rates of some measures of quality of care, lower rates for some measures of acute care utilization, and lower actual payments received by the delivery system.

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Aug. 11, 2016 Americas Global

The Value of Continuity between Primary Care and Surgical Care in Colon Cancer

Improving continuity between primary care and cancer care is critical for improving cancer outcomes and curbing cancer costs. A dimension of continuity, we investigated how regularly patients receive their primary care and surgical care for colon cancer from the same hospital and whether this affects mortality and costs.Receiving primary care and surgical care at the same hospital, compared to different hospitals, was associated with lower costs but still similar survival among stage I-III colon cancer patients. Nonetheless, health care policy which encourages further integration between primary care and cancer care in order to improve outcomes and decrease costs will ...

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Aug. 11, 2016 Americas Global

Strategies To Empower Communities To Reduce Health Disparities

Community-based participatory research is a promising approach to reducing health disparities. It empowers individuals and communities to become the major players in solving their own health problems. We discuss the use of community-based participatory research and other strategies to enhance empowerment. We also discuss projects from the Centers for Population Health and Health Disparities that have empowered communities to achieve positive health outcomes aimed at reducing disparities. We offer recommendations to policy makers for involving residents in efforts to achieve health equity.

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