Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation

Many representations of the movement of healthcare knowledge through society exist, and multiple models for the translation of evidence into policy and practice have been articulated. Most are linear or cyclical and very few come dose to reflecting the dense and intricate relationships, systems and politicis of organizations and the processes required to enact sustainable improvements. This study illustrates how using complexity and network concepts can better inform knowledge translation (KT) and argue that changing the way we think and talk about KT could enhance the creation and movement of knowledge throughout those systems needing to develop and utilize it. 

Translating the Elements of Health Governance for Integrated Care from Theory to Practice: A Case Study Approach

Against a paucity of evidence, a model describing elements of health governance best suited to achieving integrated care internationally was developed. The aim of this study was to explore how health meso-level organizations used, or planned to use, the governance elements. 

Operationalizing mHealth to improve patient care: a qualitative implementation science evaluation of the WelTel texting intervention in Canada and Kenya

Mobile health (mHealth) applications have proliferated across the  globe with much enthusiasm, although few have reached scale and shown public health impact. In this study, they explored how different contextual factors influenced the implementation, effectiveness and potential for scale-up of welTel, an easy-to-use and evidence-based mHealth intervention. WelTel uses two-way SMS communication to improve patient adherence to medication and engagement in care, and has been developed and tested in Canada and Kenya. 

Approaches towards improving the quality of maternal and newborn health services in South Asia: challenges and opportunities for healthcare systems

South Asia is experiencing a dismal state of maternal and newborn health (MNH) as the region has been falling behind in reducing the levels of maternal and neonatal mortality. Most of the efforts are focused on enhancing coverage of MNH services; however, quality remains a serious concern if the region is to achieve expected outcomes in terms of standardised MNH services within healthcare delivery systems. This research consists of a review of south Asian quality improvement approaches/interventions, specifically implemented for MNH improvement. 

An Evaluation of the Role of an Intermediate Care Facility in the Continuum of Care in Western Cape, South Africa

A comprehensive primary healthcare (PHC) approach requires clear referral and continuity of care pathways. South Africa is a lower- middle income country (LMIC) that lacks data on the role of intermediate care (IC) services in the health system. This study described the model of service provision at one facility in Cape Town, including reason for admission, the mix of services and skills provided and needed, patient satisfaction, patient outcome and articulation with other services across the spectrum of care. 

How to assess and prepare health systems in low- and middle-income countries for integration of services—a systematic review

Despite growing support for integration of frontline services, a lack of information about the pre-conditions necessary to integrate such services hampers the ability of policy makers and implementers to assess how feasible or worthwhile integration may be, especially in low- and middle- income countries (LMICs). This article adopted a modified systematic review with aspects of realist review, including quantitative and qualitative studies that incorporated assessment of health system preparedness for capacity to implement integrated services. 

Good collaborative practice: reforming capacity building governance of international health research partnerships

In  line with the policy objetives of the United Nations sustainable Development Goals, this commentary seeks to examine the extent which provisions of international health research guidance promote capacity building and equitable partnerships in global health research. Theri evaluation finds that governance of collaborative research partnership, in resource- constrained settigns is limited but has improved with the implementation guidance of the International Ethical Guidelines for Health- related Research Involving Humans by The Council for International Organizations of Medical Sciences (CIOMS 2016)

Person-centred care in 2017: Evidence from service users

Policy makers have been aspiring to a ‘patient-centred NHS’ in England for at least 20 years. In 2008, patient experience became a key part of the national definition of quality in healthcare; and in 2012 that was codified in law.
Person-centred care has become an increasingly prominent stated ambition both of national policy and local practice. In 2013, the Department of Health and all the system leading bodies across health and social care in England declared a shared commitment to making ‘person-centred coordinated care’ the normiv.

What difference, if any, have these stated ambitions made to the experiences of people ...

Governing Collaborative Healthcare Improvement: Lessons From an Atlantic Canadian Case

The Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease (AHC) Quality Improvement Collaborative (QIC) in Eastern Canada provided an approach to spur system-level reform across multiple health systems for patients and families living with chronic disease. Developed and led by senior executives with a unique governance approach and involving clinical front-line teams, the AHC serves as a practical example of leadership creating and driving momentum for achieving success in collaborative health system improvements 

Integrated care: learning between high-income, and low- and middle-income country health systems

Integration is a challenging concept to define, in part because of its multiple dimensions and varied scope: from integrated clinical care for individual patients to broader systems integration- or linkage-involving wide range of interconnected services. This commentary compares integrated care in high-and lower- income countries. Although contexts may differ significantly between these settings, there are many common features of how integration has been understood and common challenges in its implementation