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Mubiri P, Ssengooba F, O'Byrne T, Aryaija-Keremani A, Namakula J, Chikaphupha K, Aikins M, Martineau T, Vallières F. A new scale to assess health-facility level management: the development and validation of the facility management scale in Ghana, Uganda, and Malawi. BMC Health Serv Res 2024; 24:371. [PMID: 38528595 PMCID: PMC10964570 DOI: 10.1186/s12913-024-10781-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 02/25/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The increased recognition of governance, leadership, and management as determinants of health system performance has prompted calls for research focusing on the nature, quality, and measurement of this key health system building block. In low- or middle-income contexts (LMIC), where facility-level management and performance remain a challenge, valid tools to measure management have the potential to boost performance and accelerate improvements. We, therefore, sought to develop a Facility-level Management Scale (FMS) and test its reliability in the psychometric properties in three African contexts. METHODS The FMS was administered to 881 health workers in; Ghana (n = 287; 32.6%), Malawi (n = 66; 7.5%) and Uganda (n = 528; 59.9%). Half of the sample data was randomly subjected to exploratory factor analysis (EFA) and Monte Carlo Parallel Component Analysis to explore the FMS' latent structure. The construct validity of this structure was then tested on the remaining half of the sample using confirmatory factor analysis (CFA). The FMS' convergent and divergent validity, as well as internal consistency, were also tested. RESULTS Findings from the EFA and Monte Carlo PCA suggested the retention of three factors (labelled 'Supportive Management', 'Resource Management' and 'Time management'). The 3-factor solution explained 51% of the variance in perceived facility management. These results were supported by the results of the CFA (N = 381; χ2 = 256.8, df = 61, p < 0.001; CFI = 0.94; TLI = 0.92; RMSEA [95% CI] = 0.065 [0.057-0.074]; SRMR = 0.047). CONCLUSION The FMS is an open-access, short, easy-to-administer scale that can be used to assess how health workers perceive facility-level management in LMICs. When used as a regular monitoring tool, the FMS can identify key strengths or challenges pertaining to time, resources, and supportive management functions at the health facility level.
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Affiliation(s)
- Paul Mubiri
- School of Public Health, Makerere University, Kampala, Uganda.
| | | | - Thomasena O'Byrne
- Trinity Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Dublin, Ireland
| | | | | | | | - Moses Aikins
- School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Tim Martineau
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Frédérique Vallières
- Trinity Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Dublin, Ireland
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Affiliation(s)
- Suchita Rastogi
- From the Stanford University School of Medicine, Stanford, CA
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Dewau R, Mekonnen TC, Tadesse SE, Muche A, Bogale GG, Tadesse Amsalu E. Knowledge and practice of clients on preventive measures of COVID-19 pandemic among governmental health facilities in South Wollo, Ethiopia: A facility-based cross-sectional study. PLoS One 2021; 16:e0247639. [PMID: 33647034 PMCID: PMC7920351 DOI: 10.1371/journal.pone.0247639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/10/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Coronavirus-19 is a global health challenge and need an immediate action. Thus, understanding client's knowledge about SARS-COV2 causes, roots of transmissions, and prevention strategies are urgently warranted. Although there were global studies reported knowledge and preventive practices of COVID-19, but the information is not representative and inclusive for Ethiopia. Thus, the current study is done to identify the knowledge and the prevention strategies for COVID-19 among clients in South Wollo, Ethiopia. METHODS An institutional based cross-sectional study was conducted from May 21 to 30, 2020 among clients seeking service in Dessie town health facilities. A total of 81 clients were included from the selected health facilities with simple random sampling technique. We developed measuring tools by adopting from World Health Organization and center for disease prevention recommendation manual for assessing service providers' knowledge and preventive practices. For data entry Epi-data 3.1 version was employed and further data management and analysis was performed using STATA Version 14. Student T-test and one way ANOVA were computed to see the mean difference in knowledge and practice between and among the group. Chi-square test was also done to portray the presence of association between different co-variants with client's knowledge and preventive practices. RESULTS Findings of the study showed that more than half (56.8%) of the participants had good knowledge about its symptoms, way of spread and prevention of the virus. Furthermore, 65.4% of clients demonstrated five or more preventive practice measures of COVID-19. The mean preventive practice score with standard deviation was (4.75±1.28 from 6 components). In the current study, knowledge had no significant difference among sex, education status, and monthly income. However, COVID-19 transmission knowledge was significantly higher among urban residents. Thus, clients who were knowledgeable about way of transmission and symptoms of COVID-19 had significantly higher COVID-19 preventive practice. CONCLUSION Our findings revealed that clients' knowledge and preventive practice of COVID-19 were not optimal. Clients with good knowledge and urban residents had practiced better prevention measures of the pandemic, signifying that packages and programs directed in enhancing knowledge about the virus is useful in combating the pandemic and continuing safe practices.
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Affiliation(s)
- Reta Dewau
- Department of Epidemiology and Biostatistics, school of public health, College of Medicine and Health sciences, Wollo University, Dessie, Ethiopia
| | - Tefera Chane Mekonnen
- Department of nutrition and dietetics, school of public health, College of Medicine and Health sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Eshete Tadesse
- Department of nutrition and dietetics, school of public health, College of Medicine and Health sciences, Wollo University, Dessie, Ethiopia
| | - Amare Muche
- Department of Epidemiology and Biostatistics, school of public health, College of Medicine and Health sciences, Wollo University, Dessie, Ethiopia
| | - Getahun Gebre Bogale
- Department of Health informatics, school of public health, College of Medicine and Health sciences, Wollo University, Dessie, Ethiopia
| | - Erkihun Tadesse Amsalu
- Department of Epidemiology and Biostatistics, school of public health, College of Medicine and Health sciences, Wollo University, Dessie, Ethiopia
- * E-mail:
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Affiliation(s)
- Thomas H Lee
- From Press Ganey and Harvard Medical School - both in Boston (T.H.L.); and Covered California and the University of California San Francisco - both in San Francisco (A.H.C.)
| | - Alice H Chen
- From Press Ganey and Harvard Medical School - both in Boston (T.H.L.); and Covered California and the University of California San Francisco - both in San Francisco (A.H.C.)
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Affiliation(s)
- Lawrence O Gostin
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, DC
| | - Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Heidi J Larson
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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Guillaumie L, Boiral O, Baghdadli A, Mercille G. Integrating sustainable nutrition into health-related institutions: a systematic review of the literature. Can J Public Health 2020; 111:845-861. [PMID: 32959328 PMCID: PMC7728986 DOI: 10.17269/s41997-020-00394-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 07/20/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Sustainable nutrition is increasingly important, as the food system contributes one third of greenhouse gas emissions. Sustainable nutrition, or sustainable diet, refers to diets with low environmental impacts that contribute to food security and health. This systematic review aimed to identify factors that influence whether professionals in health-related institutions integrate sustainable nutrition into their practice. METHODS A mixed-methods systematic review was conducted using the MEDLINE, Embase, PsycINFO, and CINAHL databases. To be included, the studies had to document perspectives on sustainable nutrition from health professionals, including dietitians, students and educators in health sciences, public health officers, and hospital food service managers. Data extraction focused on perceived barriers, facilitating factors, and top recommendations for promoting sustainable nutrition. SYNTHESIS Twenty studies were included, most of which focused on dietitians. Data analysis revealed that 25 factors influenced the integration of sustainable nutrition into professional practice. The factors most reported in the included studies were perceived knowledge of sustainable nutrition, self-efficacy, awareness of environmental issues, and perceiving the promotion of sustainable nutrition to be part of one's professional role. Increasing societal support through awareness campaigns and increasing institutional support through guidelines, information tools, and financial support were also frequently mentioned. CONCLUSION Sustainable nutrition is a multifaceted concept; integrating it into already complex professional practices is therefore challenging. At the present time, dietitians seem to be the health professionals predominantly researched regarding their views on sustainable nutrition. Many concrete avenues to promote sustainable nutrition were identified through this review.
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Affiliation(s)
- Laurence Guillaumie
- Faculty of Nursing, Research Centre CHU de Québec-Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, QC, G1V 0A6, Canada.
| | - Olivier Boiral
- Canada Research Chair in Internalization of Sustainability Practices and Organizational Accountability, Department of Management, Université Laval, Québec, Canada
| | - Amel Baghdadli
- Department of Management, Université Laval, Pavillon Palasis-Prince, 2325 rue de la Terrasse, Québec, QC, G1V 0A6, Canada
| | - Geneviève Mercille
- Department of Nursing, Université de Montréal, Pavillon Liliane de Stewart, 2405, chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1A8, Canada
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Lee SM, Lee D. Lessons Learned from Battling COVID-19: The Korean Experience. Int J Environ Res Public Health 2020; 17:E7548. [PMID: 33081367 PMCID: PMC7590030 DOI: 10.3390/ijerph17207548] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/04/2020] [Accepted: 10/15/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The COVID-19 pandemic has swept the world like a gigantic tsunami, turning social and economic activities upside down. METHODS This paper presents some of the innovative response strategies implemented by the public health system, healthcare facilities, and government in South Korea, which has been hailed as the model country for its success in containing COVID-19. Korea reinvented its public health infrastructure with a sense of urgency. RESULTS Korea's success rests on its readiness, with the capacity for massive testing and obtaining prompt test results, effective contact tracing based on its world-leading mobile technologies, timely provision of personal protective equipment (PPE) to first responders, effective treatment of infected patients, and invoking citizens' community and civic conscience for the shared goal of defeating the pandemic. The lessons learned from Korea's response in countering the onslaught of COVID-19 provide unique implications for public healthcare administrators and operations management practitioners. CONCLUSION Since many epidemic experts warn of a second wave of COVID-19, the lessons learned from the first wave will be a valuable resource for responding to the resurgence of the virus.
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Affiliation(s)
- Sang M. Lee
- College of Business Administration, University of Nebraska-Lincoln, Lincoln, NE 68588, USA;
| | - DonHee Lee
- College of Business Administration, Inha University, Incheon 22212, Korea
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Irgens I, Bach B, Rekand T, Tornås S. Optimal management of health care for persons with disability related to spinal cord injury: learning from the Sunnaas model of telerehabilitation. Spinal Cord Ser Cases 2020; 6:88. [PMID: 32973161 PMCID: PMC7512204 DOI: 10.1038/s41394-020-00338-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/21/2020] [Accepted: 08/25/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ingebjørg Irgens
- Sunnaas Rehabilitation Hospital, Bjørnemyrveien 11, 1450, Nesoddtangen, Norway.
- Institute of Clinical Medicine, University of Oslo, PO Box 1171, Blindern, 0318, Oslo, Norway.
| | - Bodil Bach
- SMARTsam AS, Bølgenveien 8, 3514, Hønefoss, Norway
| | - Tiina Rekand
- Department of Neurology/Spinal Cord Unit, Haukeland University Hospital, Jonas Lies vei 65, 5053, Bergen, Norway
- Sahlgrenska Academy and Institute for Neuroscience and Physiology, University of Gothenburg, Box 100, S-405 30, Gothenburg, Sweden
| | - Sveinung Tornås
- Sunnaas Rehabilitation Hospital, Bjørnemyrveien 11, 1450, Nesoddtangen, Norway
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Defar A, Getachew T, Taye G, Tadele T, Getnet M, Shumet T, Molla G, Gonfa G, Teklie H, Tadesse A, Bekele A. Quality antenatal care services delivery at health facilities of Ethiopia, assessment of the structure/input of care setting. BMC Health Serv Res 2020; 20:485. [PMID: 32487097 PMCID: PMC7268345 DOI: 10.1186/s12913-020-05372-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/27/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND According to the Donabedian model, the assessment for the quality of care includes three dimensions. These are structure, process, and outcome. Therefore, the present study aimed at assessing the structural quality of Antenatal care (ANC) service provision in Ethiopian health facilities. METHODS Data were obtained from the 2018 Ethiopian Service Availability and Readiness Assessment (SARA) survey. The SARA was a cross-sectional facility-based assessment conducted to capture health facility service availability and readiness in Ethiopia. A total of 764 health facilities were sampled in the 9 regions and 2 city administrations of the country. The availability of equipment, supplies, medicine, health worker's training and availability of guidelines were assessed. Data were collected from October-December 2017. We run a multiple linear regression model to identify predictors of health facility readiness for Antenatal care service. The level of significance was determined at a p-value < 0.05. RESULT Among the selected health facilities, 80.5% of them offered Antenatal care service. However, the availability of specific services was very low. The availability of tetanus toxoid vaccination, folic acid, iron supplementation, and monitoring of hypertension disorder was, 67.7, 65.6, 68.6, and 75.1%, respectively. The overall mean availability among the ten tracer items that are necessary to provide quality Antenatal care services was 50%. In the multiple linear regression model, health centers, health posts and clinics scored lower Antenatal care service readiness compared to hospitals. The overall readiness index score was lower for private health facilities (β = - 0.047, 95% CI: (- 0.1, - 0.004). The readiness score had no association with the facility settings (Urban/Rural) (p-value > 0.05). Facilities in six regions except Dire Dawa had (β = 0.067, 95% CI: (0.004, 0.129) lower readiness score than facilities in Tigray region (p-value < 0.015). CONCLUSION This analysis provides evidence of the gaps in structural readiness of health facilities to provide quality Antenatal care services. Key and essential supplies for quality Antenatal care service provision were missed in many of the health facilities. Guaranteeing properly equipped and staffed facilities shall be a target to improve the quality of Antenatal care services provision.
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Affiliation(s)
- Atkure Defar
- Reproductive Health Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Department of Epidemiology and Biostatistics, University of Gondar, College of Medicine and Health Science, Institute of Public health, Gondar, Ethiopia
| | - Theodros Getachew
- Health System Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- College of Medicine and Health Science, Institute of Public health, University of Gondar, Gondar, Ethiopia
| | - Girum Taye
- Health System Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tefera Tadele
- Reproductive Health Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Misrak Getnet
- Reproductive Health Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tigist Shumet
- Health System Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Gebeyaw Molla
- Health System Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Geremew Gonfa
- Health System Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Habtamu Teklie
- Reproductive Health Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ambaye Tadesse
- Health System Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abebe Bekele
- Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Biganzoli L, Cardoso F, Beishon M, Cameron D, Cataliotti L, Coles CE, Delgado Bolton RC, Trill MD, Erdem S, Fjell M, Geiss R, Goossens M, Kuhl C, Marotti L, Naredi P, Oberst S, Palussière J, Ponti A, Rosselli Del Turco M, Rubio IT, Sapino A, Senkus-Konefka E, Skelin M, Sousa B, Saarto T, Costa A, Poortmans P. The requirements of a specialist breast centre. Breast 2020; 51:65-84. [PMID: 32217457 PMCID: PMC7375681 DOI: 10.1016/j.breast.2020.02.003] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 12/15/2022] Open
Abstract
This article is an update of the requirements of a specialist breast centre, produced by EUSOMA and endorsed by ECCO as part of Essential Requirements for Quality Cancer Care (ERQCC) programme, and ESMO. To meet aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this article, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.
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Affiliation(s)
- Laura Biganzoli
- European Society of Breast Cancer Specialists (EUSOMA); Breast Centre, AUSL Toscana Centro, Prato, Italy.
| | - Fatima Cardoso
- European Society of Medical Oncology (ESMO); Breast Unit, Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal
| | | | - David Cameron
- European Cancer Concord (ECC); University of Edinburgh Cancer Centre, IGMM, Western General Hospital, Edinburgh, UK
| | - Luigi Cataliotti
- European Society of Breast Cancer Specialists (EUSOMA), Senonetwork Italia and Breast Centres Certification, Florence, Italy
| | - Charlotte E Coles
- European Society for Radiotherapy and Oncology (ESTRO); University of Cambridge, Cambridge, UK
| | - Roberto C Delgado Bolton
- European Association of Nuclear Medicine (EANM); Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), University of La Rioja, Logroño, La Rioja, Spain
| | - Maria Die Trill
- International Psycho-Oncology Society (IPOS); ATRIUM: Psycho-Oncology & Clinical Psychology, Madrid, Spain
| | - Sema Erdem
- European Cancer Organisation Patient Advisory Committee (ECCO PAC); Europa Donna, Milan, Italy
| | - Maria Fjell
- European Oncology Nursing Society (EONS); Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Romain Geiss
- International Society of Geriatric Oncology (SIOG); Medical Oncology, Hôpital René Huguenin - Institut Curie, St. Cloud, France
| | - Mathijs Goossens
- European Cancer League (ECL); Centre for Cancer Detection (CvKO), Brussels, Belgium
| | - Christiane Kuhl
- European Society of Radiology (ESR); Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany
| | - Lorenza Marotti
- European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy
| | - Peter Naredi
- European Cancer Organisation (ECCO); Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Simon Oberst
- Organisation of European Cancer Institutes (OECI); Cancer Research UK Cambridge Centre, Cambridge, UK
| | - Jean Palussière
- Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Department of Imaging, Institut Bergonié, Bordeaux, France
| | - Antonio Ponti
- European Society of Breast Cancer Specialists (EUSOMA), Centre for Epidemiology and Prevention in Oncology (CPO) Piemonte, AOU Citta' Della Salute e Della Scienza, Turin, Italy
| | | | - Isabel T Rubio
- European Society of Surgical Oncology (ESSO); Breast Surgical Oncology, Clinica Universidad de Navarra Madrid, Spain
| | - Anna Sapino
- European Society of Pathology (ESP); Department of Medical Sciences, University of Turin, Turin, Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Elzbieta Senkus-Konefka
- European Organisation for Research and Treatment of Cancer (EORTC); Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Marko Skelin
- European Society of Oncology Pharmacy (ESOP); Pharmacy Department, General Hospital Sibenik, Sibenik, Croatia
| | - Berta Sousa
- European Society of Oncology Pharmacy (ESOP); Pharmacy Department, General Hospital Sibenik, Sibenik, Croatia
| | - Tiina Saarto
- Flims Alumni Club (FAC); Breast Unit, Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal
| | | | - Philip Poortmans
- Iridium Kankernetwerk, University of Antwerp, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Wilrijk-Antwerp, Belgium
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Garg S, Basu S, Rustagi R, Borle A. Primary Health Care Facility Preparedness for Outpatient Service Provision During the COVID-19 Pandemic in India: Cross-Sectional Study. JMIR Public Health Surveill 2020; 6:e19927. [PMID: 32452819 PMCID: PMC7265797 DOI: 10.2196/19927] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/24/2020] [Accepted: 05/26/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Primary health centers (PHCs) represent the first tier of the Indian health care system, providing a range of essential outpatient services to people living in the rural, suburban, and hard-to-reach areas. Diversion of health care resources for containing the coronavirus disease (COVID-19) pandemic has significantly undermined the accessibility and availability of essential health services. Under these circumstances, the preparedness of PHCs in providing safe patient-centered care and meeting the current health needs of the population while preventing further transmission of the severe acute respiratory syndrome coronavirus 2 infection is crucial. OBJECTIVE The aim of this study was to determine the primary health care facility preparedness toward the provision of safe outpatient services during the COVID-19 pandemic in India. METHODS We conducted a cross-sectional study among supervisors and managers of primary health care facilities attached to medical colleges and institutions in India. A list of 60 faculties involved in the management and supervision of PHCs affiliated with the community medicine departments of medical colleges and institutes across India was compiled from an accessible private organization member database. We collected the data through a rapid survey from April 24 to 30, 2020, using a Google Forms online digital questionnaire that evaluated preparedness parameters based on self-assessment by the participants. The preparedness domains assessed were infrastructure availability, health worker safety, and patient care. RESULTS A total of 51 faculties responded to the survey. Each medical college and institution had on average a total of 2.94 (SD 1.7) PHCs under its jurisdiction. Infrastructural and infection control deficits at the PHC were reported in terms of limited physical space and queuing capacity, lack of separate entry and exit gates (n=25, 49%), inadequate ventilation (n=29, 57%), and negligible airborne infection control measures (n=38, 75.5%). N95 masks were available at 26 (50.9%) sites. Infection prevention and control measures were also suboptimal with inadequate facilities for handwashing and hand hygiene reported in 23.5% (n=12) and 27.4% (n=14) of sites, respectively. The operation of outpatient services, particularly related to maternal and child health, was significantly disrupted (P<.001) during the COVID-19 pandemic. CONCLUSIONS Existing PHC facilities in India providing outpatient services are constrained in their functioning during the COVID-19 pandemic due to weak infrastructure contributing to suboptimal patient safety and infection control measures. Furthermore, there is a need for effective planning, communication, and coordination between the centralized health policy makers and health managers working at primary health care facilities to ensure overall preparedness during public health emergencies.
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Affiliation(s)
- Suneela Garg
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Saurav Basu
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Ruchir Rustagi
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Amod Borle
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
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Dyrbye LN, Major-Elechi B, Hays JT, Fraser CH, Buskirk SJ, West CP. Relationship Between Organizational Leadership and Health Care Employee Burnout and Satisfaction. Mayo Clin Proc 2020; 95:698-708. [PMID: 32247343 DOI: 10.1016/j.mayocp.2019.10.041] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/09/2019] [Accepted: 10/15/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To explore the relationship between immediate supervisor leadership behaviors and burnout and professional satisfaction of health care employees. PARTICIPANTS AND METHODS From October 2 to 20, 2017, we surveyed nonphysician health care employees. The survey included 2 items from the Maslach Burnout Inventory and items on their immediate supervisor leadership behaviors. Logistic regression was performed to evaluate the relationship between the leadership score and the prevalence of burnout and satisfaction after adjusting for age, sex, duration of employment, and job category. Sensitivity analysis was performed using mixed models with a random intercept for work unit to assess the impact of the correlation within work units on burnout and satisfaction with the organization. RESULTS Of the 57,414 employees surveyed, 39,896 (69.5%) responded and answered the leadership questions. Supervisor scores in each dimension and composite leadership scores correlated with burnout and satisfaction of employees (P<.001 for all). In logistic regression, each 1-point increase in leadership score was associated with a 7% decrease in odds of burnout and an 11% increase in odds of satisfaction (P<.001 for both) of employees. The mean composite leadership score rating of each immediate supervisor correlated with rate of burnout (r=-0.247; P<.001) and the satisfaction with the organization (r=0.416; P<.001) at the work unit level. CONCLUSION Leadership qualities of immediate supervisors relate to burnout and satisfaction of nonphysician health care employees working in a large organization. Further studies are needed to determine whether strategies to monitor and improve supervisor leadership scores result in reduction in burnout and improved satisfaction among health care employees.
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Affiliation(s)
- Liselotte N Dyrbye
- Department of Medicine Program on Physician Well-Being, Mayo Clinic, Rochester, MN.
| | | | - J Taylor Hays
- Mayo Clinic Leadership and Workforce Development, Mayo Clinic, Rochester, MN
| | | | | | - Colin P West
- Department of Medicine Program on Physician Well-Being, Mayo Clinic, Rochester, MN
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Mpango J, Nabukenya J. A Qualitative Study to Examine Approaches used to Manage Data about Health Facilities and their Challenges: A Case of Uganda. AMIA Annu Symp Proc 2020; 2019:1157-1166. [PMID: 32308913 PMCID: PMC7153096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Availability of an accurate and complete health facility list is fundamental in producing quality and timely data that is sufficient to aid evidence-based decision, resource allocation and planning within the healthcare ecosystem. This study aimed at examining the approaches used in Uganda to manage data about health facilities and the challenges they are facing. We conducted a qualitative study involving 32 interviews with participants from Ministry of Health, government regulatory organizations, district local government, general public, academia, implementing partners and healthcare providers. Our analysis identified four divergent approaches that had five common challenges, namely; lack of a health facility unique identifier, non-standardized, incomplete, inaccurate data, difficulty accessing and using data. Establishing a national central health facility registry to manage the national health facility list would improve patient referrals, facility look-ups, health information exchange, data curation and access and health information system integration.
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Affiliation(s)
- Jonathan Mpango
- School of Public Health, Makerere University, Kampala, Uganda
| | - Josephine Nabukenya
- School of Computing and Informatics Technology, Makerere University, Kampala, Uganda
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Affiliation(s)
- Michael Nurok
- From the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (M.N.); and Press Ganey and Harvard Medical School - both in Boston (T.H.L.)
| | - Thomas H Lee
- From the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (M.N.); and Press Ganey and Harvard Medical School - both in Boston (T.H.L.)
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Chen CH, Lan YL, Yang WP, Hsu FM, Lin CL, Chen HC. Exploring the Impact of a Telehealth Care System on Organizational Capabilities and Organizational Performance from a Resource-Based Perspective. Int J Environ Res Public Health 2019; 16:ijerph16203988. [PMID: 31635373 PMCID: PMC6844123 DOI: 10.3390/ijerph16203988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/16/2022]
Abstract
This study explored the effects of information technology (IT) resources-in conjunction with IT infrastructure and organizational resources-on organizational capabilities and performance. The study further analyzed the mediating effect of organizational capabilities on the relationship between IT resources and organizational performance. A cross-sectional research design was adopted, and questionnaire copies were administered to senior care supervisors of Taiwanese day care centers, care institutions, and hospitals. In total, 328 valid questionnaire responses were obtained. The study results are summarized as follows: (1) A direct effect analysis revealed that IT infrastructure significantly affected service performance and financial performance; organizational resources significantly affected service performance but did not significantly affect financial performance. (2) A mediation model analysis indicated that organizational capabilities exerted a mediating effect on the relationship between IT resources and organizational performance. These results can serve as a reference for medical care organizations in developing strategies for reviewing internal IT resources, integrating internal and external capabilities, creating a competitive advantage, and boosting their performance.
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Affiliation(s)
- Chun-Hsun Chen
- Department of Business Administration, National Dong Hwa University, Executive Officer Office, Buddhist Tzu Chi Medical Foundation, Hualien 97401, Taiwan.
| | - Yu-Li Lan
- Department of Health Administration, Tzu Chi University of Science and Technology, Hualien 970, Taiwan.
| | - Wei-Pang Yang
- Department of Information Management, National Dong Hwa University, Hualien 97401, Taiwan.
| | - Fang-Ming Hsu
- Department of Information Management, National Dong Hwa University, Executive Officer Office, Buddhist Tzu Chi Medical Foundation, Hualien 97401, Taiwan.
| | - Chin-Lon Lin
- Department of Information Management, National Dong Hwa University, Executive Officer Office, Buddhist Tzu Chi Medical Foundation, Hualien 97401, Taiwan.
| | - Hsing-Chu Chen
- Department of Information Management, National Dong Hwa University, Office of Superintendent, Hualien Tzu Chi Hospital, Hualien 97401, Taiwan.
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Biedron C, Lyman M, Stuckey MJ, Homsy J, Lamorde M, Luvsansharav UO, Wilson K, Gomes D, Omuut W, Okware S, Semanda JN, Kiggundu R, Bulwadda D, Brown V, Nelson LJ, Driwale A, Fagan R, Park BJ, Smith RM. Evaluation of Infection Prevention and Control Readiness at Frontline Health Care Facilities in High-Risk Districts Bordering Ebola Virus Disease-Affected Areas in the Democratic Republic of the Congo - Uganda, 2018. MMWR Morb Mortal Wkly Rep 2019; 68:851-854. [PMID: 31581162 PMCID: PMC6776373 DOI: 10.15585/mmwr.mm6839a4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Infection prevention and control (IPC) in health care facilities is essential to protecting patients, visitors, and health care personnel from the spread of infectious diseases, including Ebola virus disease (Ebola). Patients with suspected Ebola are typically referred to specialized Ebola treatment units (ETUs), which have strict isolation and IPC protocols, for testing and treatment (1,2). However, in settings where contact tracing is inadequate, Ebola patients might first seek care at general health care facilities, which often have insufficient IPC capacity (3-6). Before 2014-2016, most Ebola outbreaks occurred in rural or nonurban communities, and the role of health care facilities as amplification points, while recognized, was limited (7,8). In contrast to these earlier outbreaks, the 2014-2016 West Africa Ebola outbreak occurred in densely populated urban areas where access to health care facilities was better, but contact tracing was generally inadequate (8). Patients with unrecognized Ebola who sought care at health care facilities with inadequate IPC initiated multiple chains of transmission, which amplified the epidemic to an extent not seen in previous Ebola outbreaks (3-5,7). Implementation of robust IPC practices in general health care facilities was critical to ending health care-associated transmission (8). In August 2018, when an Ebola outbreak was recognized in the Democratic Republic of the Congo (DRC), neighboring countries began preparing for possible introduction of Ebola, with a focus on IPC. Baseline IPC assessments conducted in frontline health care facilities in high-risk districts in Uganda found IPC gaps in screening, isolation, and notification. Based on findings, additional funds were provided for IPC, a training curriculum was developed, and other corrective actions were taken. Ebola preparedness efforts should include activities to ensure that frontline health care facilities have the IPC capacity to rapidly identify suspected Ebola cases and refer such patients for treatment to protect patients, staff members, and visitors.
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Chelagat T, Onyango J, Kokwaro G, Rice J. From strategy to action: a qualitative study on salient factors influencing knowledge transfer in project-based experiential learning in healthcare organisations in Kenya. BMJ Open 2019; 9:e031100. [PMID: 31575577 PMCID: PMC6773291 DOI: 10.1136/bmjopen-2019-031100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Knowledge transfer is recognised as a key determinant of organisational competitiveness. Existing literature on the transfer of knowledge and skills imply diminutive return on investment in training and development due to the low application of learnt knowledge. Following devolution of health services provision to new counties in Kenya in 2013, Strathmore Business School designed an experiential facility improvement project-based leadership training programme for healthcare managers in the new counties. Selected healthcare management teams participated in the leadership training to improve health systems performance in the devolved counties in Kenya. Despite similar training, the projects implementation contexts were different, leading to different implementation completion rates. The aim of this study was to investigate the reasons for this disparity and then recommend solutions. DESIGN A qualitative study using semi-structured interviews. A thematic framework approach was used in data analysis. SETTING AND PARTICIPANTS Thirty-nine projects teams constituting; 33 successful and 6 unsuccessful project teams, were purposively selected based on their project implementation success rates at the end of the leadership training. The managers had undertaken a team-based institutional improvement project. The prioritised projects were housed within; 23 public, 10 faith-based and 6 private health facilities in 19 counties in Kenya. RESULTS Our findings indicate projects completion rates were influenced by (training design, work environment climate, trainee characteristics, team-based coaching and leveraging on occurring opportunities). Transfer barriers were (inadequate management support, inadequate team and staff support, high staff turnover, misalignment of board's verses manager's priorities, missing technical expertise, endemic strikes, negative politics and poor communication). Recommendations were (need-driven curriculum, effective allocation and efficient utilisation of resources, proper prioritisation, effective communication, longitudinal coaching and work-teams recruitment). CONCLUSION The findings reveal that unless training interventions are informed by a need-driven curriculum customised to real-world work teams, the potential knowledge and skill transfer can be thwarted.
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Affiliation(s)
- Tecla Chelagat
- Institute of Healthcare Management, Strathmore University Business School, Strathmore University, Nairobi, Kenya
| | - Joseph Onyango
- Institute of Healthcare Management, Strathmore University Business School, Strathmore University, Nairobi, Kenya
| | - Gilbert Kokwaro
- Institute of Healthcare Management, Strathmore University Business School, Strathmore University, Nairobi, Kenya
| | - Jim Rice
- Institute of Healthcare Management, Strathmore University Business School, Strathmore University, Nairobi, Kenya
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Ousman K, Kabego L, Talisuna A, Diaz J, Mbuyi J, Houndjo B, Ngandu JP, Omba G, Aruna A, Mossoko M, Djingarey MH, Balde T, Abok P, Diallo B, Dovlo D, Yao M, Fortin A, Formenty P, Fall IS. The impact of Infection Prevention and control (IPC) bundle implementationon IPC compliance during the Ebola virus outbreak in Mbandaka/Democratic Republic of the Congo: a before and after design. BMJ Open 2019; 9:e029717. [PMID: 31492782 PMCID: PMC6731777 DOI: 10.1136/bmjopen-2019-029717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To assess the impact of refresher training of healthcare workers (HCWs) in infection prevention and control (IPC), ensuring consistent adequate supplies and availability of IPC kits and carrying out weekly monitoring of IPC performance in healthcare facilities (HCFs) DESIGN: This was a before and after comparison study SETTINGS: This study was conducted from June to July 2018 during an Ebola virus disease (EVD) outbreak in Equateur Province in the Democratic Republic of the Congo (DRC). PARTICIPANTS 48 HCFs INTERVENTIONS: HCWs capacity building in basic IPC, IPC kit donation and IPC mentoring. PRIMARY OUTCOME MEASURES IPC score RESULTS: 48 HCFs were evaluated and 878 HCWs were trained, of whom 437 were women and 441 were men. The mean IPC score at baseline was modestly higher in hospitals (8%) compared with medical centres (4%) and health centres (4%), respectively. The mean IPC score at follow-up significantly increased to 50% in hospitals, 39% in medical centres and 36% in health centres (p value<0.001). The aggregate mean IPC score at baseline for all HCFs, combined was 4.41% and at follow-up it was 39.51% with a mean difference of 35.08% (p-value<0.001). CONCLUSIONS Implementation of HCW capacity building in IPC, IPC kit donation to HCF and mentoring in IPC improved IPC compliance during the ninth EVD outbreak in the DRC.
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Affiliation(s)
- Kevin Ousman
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Landry Kabego
- Infection Control Africa Network, Bukavu, Democratic Republic of the Congo
- Microbiology, Universite Catholique de Bukavu Faculte de Medecine, Bukavu, Democratic Republic of the Congo
| | - Ambrose Talisuna
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Janet Diaz
- World Health Organization, Geneva, Switzerland
| | - John Mbuyi
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Bienvenu Houndjo
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | - Gaston Omba
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Aaron Aruna
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Mathias Mossoko
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | | | - Thierno Balde
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Patrick Abok
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Boubacar Diallo
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Delanyo Dovlo
- International Health System Services Expert, Accra, Ghana
| | - Michel Yao
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Anne Fortin
- World Health Organization, Geneva, Switzerland
| | | | - Ibrahima Soce Fall
- World Health Organization Regional Office for Africa, Brazzaville, Congo
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Affiliation(s)
| | | | - Prabhjot Singh
- Department of Health System Design and Global Health, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, New York
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Olaniyi FC, Ogola JS, Tshitangano TG. Efficiency of Health Care Risk Waste Management in Rural Healthcare Facilities of South Africa: An Assessment of Selected Facilities in Vhembe District, Limpopo Province. Int J Environ Res Public Health 2019; 16:ijerph16122199. [PMID: 31234379 PMCID: PMC6616489 DOI: 10.3390/ijerph16122199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 11/16/2022]
Abstract
Waste generated form healthcare facilities is a potential source of health risks to the public, if it is not properly handled from the point of generation to disposal. This study was conducted to assess the efficiency of healthcare risk waste (HCRW) management in Vhembe District of Limpopo Province, South Africa. Fifteen healthcare facilities were selected in Vhembe District for this study. Data were obtained through in-depth interviews, semi-structured questionnaires, observation and pictures. Qualitative data were thematically analyzed, while the quantitative data were analyzed using the Statistical Package for the Social Sciences, version 25. In all the healthcare facilities; mismanagement of HCRW was noted at different points along the management chain. Poor segregation, overfilling of waste bins, inappropriate transportation and storage of waste in substandard storage rooms were observed in the facilities. All the waste from the district are transported to a private-owned treatment facility outside the district, where they are mainly incinerated. Enforcement of healthcare risk waste guidelines, provision of standardized equipment for temporary storage, empowerment of each healthcare facility to treat at least some of the waste, and employment of non-burn techniques for treatment of waste are recommended for more efficient management of healthcare risk waste in Vhembe District.
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Affiliation(s)
- Foluke C Olaniyi
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou 0950, South Africa.
| | - Jason S Ogola
- Department of Mining and Environmental Geology, School of Environmental Sciences, University of Venda, Thohoyandou 0950, South Africa.
| | - Takalani G Tshitangano
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou 0950, South Africa.
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Díaz Herrera C, Galán Torres G. Modernización de centros de salud familiar. Tensión entre gestión, calidad y condiciones estructurales. Aten Primaria 2019; 51:390-391. [PMID: 30914146 PMCID: PMC6836918 DOI: 10.1016/j.aprim.2018.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022] Open
Affiliation(s)
- Claudio Díaz Herrera
- Instituto de Estudios Humanísticos "Juan Ignacio Molina", Facultad de Psicología, Universidad de Talca, Talca, Región del Maule, Chile.
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25
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Affiliation(s)
- Bryan N Becker
- Office of the Chief Medical Officer, DaVita, Inc., Denver, Colorado
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26
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Affiliation(s)
| | | | - Dana Gelb Safran
- The Health Institute, Institute for Clinical Research and Health Policy Studies, Boston, Massachusetts
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Chabannon C, Larghero J. Réglementations applicables aux CAR-T cells : comment les établissements de santé français peuvent-ils s’organiser pour participer à la production et permettre la délivrance de ces immunothérapies innovantes ? Bull Cancer 2019; 105 Suppl 2:S198-S204. [PMID: 30686358 DOI: 10.1016/s0007-4551(19)30050-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
REGULATORY FRAMEWORK FOR CAR-T CELLS HOW CAN FRENCH HEALTHCARE PROVIDERS ADAPT THEIR ORGANIZATION TO REQUIREMENTS FOR MANUFACTURING AND DELIVERY OF THESE INNOVATIVE CELL-BASED MEDICINAL PRODUCTS?: More than five years after the first US publications reporting a significant rate of clinical responses in patients with high-risk or advanced CD19+ lymphoid malignancies, access to treatment with CAR-T Cells at European hospitals in general and at French hospitals in particular remains limited. One - and not the least - hurdle lay in the need to set up a complex and unprecedented organization that complies with European regulations on Advanced Therapy Medicinal Products as well as with national (French) regulations. We here review the organizational framework for two situations: delivery and administration of industry-manufactured CAR-T Cells as well as engineering and distribution of CAR-T Cells produced as investigational drugs to be evaluated in the context of clinical research protocols. Cet article fait partie du numéro supplément Les cellules CAR-T : une révolution thérapeutique ? réalisé avec le soutien institutionnel des partenaires Gilead : Kite et Celgene.
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Affiliation(s)
- Christian Chabannon
- Institut Paoli-Calmettes, Centre de Thérapie Cellulaire & Inserm CBT-1409, Centre d'Investigations Cliniques en Biothérapies de Marseille, 13009 Marseille, France.
| | - Jérôme Larghero
- AP-HP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire & Inserm CBT-501, Centre d'Investigations Cliniques en Biothérapies, 75010 Paris, France
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Abstract
OBJECTIVE The objective of this study was to assess the readiness of health facilities for diabetes and cardiovascular services in Bangladesh. DESIGN This study was a cross-sectional survey. SETTING This study used data from a nationwide Bangladesh Health Facility Survey conducted by the Ministry of Health and Social Welfare in 2014. PARTICIPANTS A total of 319 health facilities delivering services focused on diabetes and cardiovascular diseases (CVD) were included in the survey. Some of these facilities were run by the public sector while others were managed by the private sector and non-governmental organisations. It was a mix of primary and secondary care facilities. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was readiness of health facilities for diabetes and cardiovascular services. We analysed relevant data following the Service Availability and Readiness Assessment manual of the WHO to assess the readiness of selected health facilities towards services for diabetes and CVD. RESULTS 58% and 24.1% of the facilities had diagnosis and treatment services for diabetes and CVD, respectively. Shortage of trained staff (18.8% and 14.7%) and lack of adequate medicine supply (23.5% and 43.9%) were identified to be factors responsible for inadequate services for diabetes and CVD. Among the facilities that offer services for diabetes and CVD, only 0.4% and 0.9% had all the four service readiness factors (guideline, trained staff, equipment and medicine). CONCLUSIONS The study suggests that health facilities suffered from numerous drawbacks, such as shortage of trained staff and required medicine. Most importantly, they lack effective guidelines on the diagnosis and treatment for diabetes and CVD. It is, therefore, essential now to ensure that there are trained staff, adequate medicine supply, and appropriate guidelines on the diagnosis and treatment for diabetes and CVD in Bangladesh.
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Affiliation(s)
- Tuhin Biswas
- Universal Health Coverage, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - M Moinuddin Haider
- Initiative for Climate Change and Health, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rajat Das Gupta
- Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Centre for Science of Implementation and Scale-Up, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Jasim Uddin
- Universal Health Coverage, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Higgins N, Meehan T, Dart N, Kilshaw M, Fawcett L. Implementation of the Safewards model in public mental health facilities: A qualitative evaluation of staff perceptions. Int J Nurs Stud 2018; 88:114-120. [PMID: 30236863 DOI: 10.1016/j.ijnurstu.2018.08.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 08/16/2018] [Accepted: 08/21/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND The Safewards model is gaining increasing acceptance in the mental health field in Australia and overseas. One of the most important goals of inpatient psychiatric services is to provide a safe and therapeutic environment for both patients and staff. However, this goal can be difficult to achieve if staff-patient interaction is not conducive to preventing violence and aggression. OBJECTIVE The purpose of this study was to explore nursing staff perceptions of the factors impacting on their capacity to establish Safewards in acute adult inpatient wards. DESIGN This study was guided by a phenomenological approach to develop a rich understanding of staff perceptions using semi-structured interviews. SETTING AND SAMPLE The setting was three acute mental health wards attached to general hospitals; one in a large provincial hospital and two in metropolitan hospitals in south-east Queensland. Interview participants were a purposive sample of fifteen registered nurses across each of the three wards. METHOD Semi-structured interviews were conducted at 12 months post-implementation of Safewards. The study was underpinned by Michie's integrative framework of behaviour change that helped identify target areas in order to enhance successful implementation of this model. RESULTS Content analysis of interview transcripts highlighted a range of factors including failure to address the difficulties encountered by some staff in engaging with Safewards interventions, lack of support from management, poor use of nurse educator time, the 'language' of Safewards, high acuity on the study wards, and staff and patient turnover. CONCLUSION This study highlights some difficulties with implementing Safewards and maintaining fidelity of the Safewards interventions in busy acute inpatient wards. Although these findings are from a qualitative study consisting of only 15 staff, our results indicate that efforts to implement Safewards need to address challenges faced by staff in engaging with the interventions, ensure buy-in from management, ensure adequate training and support during implementation and review training materials to ensure they fit with the local (i.e. Australian) context. Safewards provides an opportunity for a change in attitudes and development of a more therapeutic ward environment.
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Affiliation(s)
- Niall Higgins
- Queensland University of Technology, Kelvin Grove, Australia; Royal Brisbane and Women's Hospital, Metro North Mental Health, Herston, Australia.
| | - Thomas Meehan
- West Moreton Hospital and Health Service, Ipswich, Australia; The University of Queensland, Herston, Australia
| | - Nathan Dart
- Royal Brisbane and Women's Hospital, Metro North Mental Health, Herston, Australia
| | - Michael Kilshaw
- The Prince Charles Hospital, Metro North Mental Health, Chermside, Australia
| | - Lisa Fawcett
- Royal Brisbane and Women's Hospital, Metro North Mental Health, Herston, Australia
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Abstract
Purpose Emphasis on quality and reducing costs has led many health-care organizations to reconfigure their management, process, and quality control infrastructures. Many are lean, a management philosophy with roots in manufacturing industries that emphasizes elimination of waste. Successful lean implementation requires systemic change and strong leadership. Despite the importance of leadership to successful lean implementation, few researchers have probed the question of ideal leadership attributes to achieve lean thinking in health care. The purpose of this paper is to provide insight into applicable attributes for lean leaders in health care. Design/methodology/approach The authors systematically reviewed the literature on principles of leadership and, using Dombrowski and Mielke’s (2013) conceptual model of lean leadership, developed a parallel theoretical model for lean leadership in health care. Findings This work contributes to the development of a new framework for describing leadership attributes within lean management of health care. Originality/value The summary of attributes can provide a model for health-care leaders to apply lean in their organizations.
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Affiliation(s)
- Kjeld Harald Aij
- Department of Anesthesiology and Operative Care, VU University Medical Center, Amsterdam, The Netherlands
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Abstract
OBJECTIVES The Affordable Care Act (ACA) shifted the focus in medical care from quantity to quality. This qualitative systematic review aimed to determine the key skills necessary for effective physician leaders after the implementation of the ACA, and to compare them with key skills identified prior to its implementation. METHODS A qualitative systematic review was conducted. A systematic literature search on leadership skills for physicians returned 26 articles published between 2009 and 2016. Thematic analysis was used to categorize the data presented in each article. The results from the thematic analysis were then compared with a similar article published before the implementation of the ACA. RESULTS Teamwork and team-building, communication, and self-awareness skills were mentioned most often. The percentage of articles mentioning teamwork and team-building skills (61.5%) was significantly greater than the percentage (25%) reported before the implementation of the ACA (P ≤ .04). CONCLUSION With the shift toward quality of patient care, health care workers at all levels should strive to work as a team to provide the best quality of care at all stages of patient care.
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Affiliation(s)
- Jennifer M. Sterbenz
- Research Associate, Section of Plastic Surgery, Department of Surgery, The University of Michigan Medical School, Ann Arbor, MI
| | - Kevin C. Chung
- Professor of Surgery, Section of Plastic Surgery, Assistant Dean for Faculty Affairs, The University of Michigan Medical School, Ann Arbor, MI
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Affiliation(s)
- Susan Haas
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Atul Gawande
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Hedda M, Malin BA, Yan C, Fabbri D. Evaluating the Effectiveness of Auditing Rules for Electronic Health Record Systems. AMIA Annu Symp Proc 2018; 2017:866-875. [PMID: 29854153 PMCID: PMC5977720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Healthcare organizations (HCOs) often deploy rule-based auditing systems to detect insider threats to sensitive patient health information in electronic health record (EHR) systems. These rule-based systems define behavior deemed to be high-risk a priori (e.g., family member, co-worker access). While such rules seem logical, there has been little scientific investigation into the effectiveness of these auditing rules in identifying inappropriate behavior. Thus, in this paper, we introduce an approach to evaluate the effectiveness of individual high-risk rules and rank them according to their potential risk. We investigate the rate of high-risk access patterns and minimum rate of high-risk accesses that can be explained with appropriate clinical reasons in a large EHR system. An analysis of 8M accesses from one-week of data shows that specific high-risk flags occur more frequently than theoretically expected and the rate at which accesses can be explained away with five simple reasons is 16 - 43%.
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Affiliation(s)
| | | | - Chao Yan
- Vanderbilt University, Nashville, TN
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Rostami P, Ashcroft DM, Tully MP. A formative evaluation of the implementation of a medication safety data collection tool in English healthcare settings: A qualitative interview study using normalisation process theory. PLoS One 2018; 13:e0192224. [PMID: 29489842 PMCID: PMC5830037 DOI: 10.1371/journal.pone.0192224] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 01/12/2018] [Indexed: 12/17/2022] Open
Abstract
Background Reducing medication-related harm is a global priority; however, impetus for improvement is impeded as routine medication safety data are seldom available. Therefore, the Medication Safety Thermometer was developed within England’s National Health Service. This study aimed to explore the implementation of the tool into routine practice from users’ perspectives. Method Fifteen semi-structured interviews were conducted with purposely sampled National Health Service staff from primary and secondary care settings. Interview data were analysed using an initial thematic analysis, and subsequent analysis using Normalisation Process Theory. Results Secondary care staff understood that the Medication Safety Thermometer’s purpose was to measure medication safety and improvement. However, other uses were reported, such as pinpointing poor practice. Confusion about its purpose existed in primary care, despite further training, suggesting unsuitability of the tool. Decreased engagement was displayed by staff less involved with medication use, who displayed less ownership. Nonetheless, these advocates often lacked support from management and frontline levels, leading to an overall lack of engagement. Many participants reported efforts to drive scale-up of the use of the tool, for example, by securing funding, despite uncertainty around how to use data. Successful improvement was often at ward-level and went unrecognised within the wider organisation. There was mixed feedback regarding the value of the tool, often due to a perceived lack of “capacity”. However, participants demonstrated interest in learning how to use their data and unexpected applications of data were reported. Conclusion Routine medication safety data collection is complex, but achievable and facilitates improvements. However, collected data must be analysed, understood and used for further work to achieve improvement, which often does not happen. The national roll-out of the tool has accelerated shared learning; however, a number of difficulties still exist, particularly in primary care settings, where a different approach is likely to be required.
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Affiliation(s)
- Paryaneh Rostami
- Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, United Kingdom
- * E-mail:
| | - Darren M. Ashcroft
- Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, United Kingdom
- National Institute for Health Research (NIHR), Greater Manchester Patient Safety Translational Research Centre, Greater Manchester, United Kingdom
| | - Mary P. Tully
- Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, United Kingdom
- Manchester Health e-Research Centre, Division of Informatics, Imaging and Data sciences, School of Health Sciences, University of Manchester, Manchester, United Kingdom
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Raduege TJ. Healthcare facilities. Issue Brief Health Policy Track Serv 2017; 2017:1-61. [PMID: 29359902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Ladika S. Disasters: In the Wake of the 2017 Annus Horribilis, Preparedness Rules To Get Tougher. Manag Care 2017; 26:18-19. [PMID: 29272233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Federal and state officials have moved this year to impose some preparedness requirements on providers that will have an effect in 2018 and years beyond. For instance, CMS' finalized emergency preparedness rules for health care providers that serve Medicare and Medicaid patients went into effect last month.
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Guenther T, Moxon S, Valsangkar B, Wetzel G, Ruiz J, Kerber K, Blencowe H, Dube Q, Vani SN, Vivio D, Magge H, De Leon–Mendoza S, Patterson J, Mazia G. Consensus-based approach to develop a measurement framework and identify a core set of indicators to track implementation and progress towards effective coverage of facility-based Kangaroo Mother Care. J Glob Health 2017; 7:020801. [PMID: 29057074 PMCID: PMC5644361 DOI: 10.7189/jogh.07.020801] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND As efforts to scale up the delivery of Kangaroo Mother Care (KMC) in facilities are increasing, a standardized approach to measure implementation and progress towards effective coverage is needed. Here, we describe a consensus-based approach to develop a measurement framework and identify a core set of indicators for monitoring facility-based KMC that would be feasible to measure within existing systems. METHODS The KMC measurement framework and core list of indicators were developed through: 1) scoping exercise to identify potential indicators through literature review and requests from researchers and program implementers; and 2) face-to-face consultations with KMC and measurement experts working at country and global levels to review candidate indicators and finalize selection and definitions. RESULTS The KMC measurement framework includes two main components: 1) service readiness, based on the WHO building blocks framework; and 2) service delivery action sequence covering identification, service initiation, continuation to discharge, and follow-up to graduation. Consensus was reached on 10 core indicators for KMC, which were organized according to the measurement framework. We identified 4 service readiness indicators, capturing national level policy for KMC, availability of KMC indicators in HMIS, costed operational plans for KMC and availability of KMC services at health facilities with inpatient maternity services. Six indicators were defined for service delivery, including weighing of babies at birth, identification of those ≤2000 g, initiation of facility-based KMC, monitoring the quality of KMC, status of babies at discharge from the facility and levels of follow-up (according to country-specific protocol). CONCLUSIONS These core KMC indicators, identified with input from a wide range of global and country-level KMC and measurement experts, can aid efforts to strengthen monitoring systems and facilitate global tracking of KMC implementation. As data collection systems advance, we encourage program managers and evaluators to document their experiences using this framework to measure progress and allow indicator refinement, with the overall aim of working towards sustainable, country-led data systems.
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Affiliation(s)
| | - Sarah Moxon
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Juan Ruiz
- Kangaroo Mother Care Foundation, Bogota, Colombia
- Herbert Wertheim College of Medicine, FIU, Miami, Florida, USA
| | | | | | - Queen Dube
- Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | | | - Hema Magge
- Partners in Health, Kigali, Rwanda
- Brigham and Women’s Hospital, Division of Global Health Equity, Boston, Massachusetts, USA
| | | | | | - Goldy Mazia
- PATH, Washington DC, USA
- Maternal and Child Survival Programme, Washington DC, USA
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Affiliation(s)
- Paul J Hauptman
- Department of Medicine, Saint Louis University School of Medicine, St Louis, Missouri
| | - Richard J Bookman
- Department of Molecular and Cellular Pharmacology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Stephen Heinig
- Association of American Medical Colleges, Washington, DC
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Abstract
Les professionnels de la santé sont directement interpellés par le défi du système de santé québécois et canadien. La diversité et la force du leadership infirmier agissent comme un véritable levier dans la transformation du système. Cet article fait valoir l’engagement des infirmières autour du projet proposé par l’Ordre des infirmières et infirmiers du Québec (OIIQ), à la fois mobilisateur et facilitateur du changement. Fortement inspirées par l’approche LEADS du Collège canadien des leaders en santé (CCLS)1, les auteures ajoutent d’autres marqueurs cruciaux propres au leadership clinique infirmier, réunis sous l’acronyme de LEADERS. La présentation de résultats auprès des personnes soignées, de leur famille, des équipes de soins et des établissements, renforce la marque distinctive de ce leadership exercé sur le terrain. Des témoignages glanés auprès de leaders soutiennent la place déterminante de l’infirmière dans le réseau de la santé. Pour façonner l’avenir, les auteures misent sur les forces du leadership clinique.
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Affiliation(s)
- O Roy
- 1 Université de Montréal, département Sciences infirmières (Québec) Canada
| | - L Tremblay
- 2 Ordre des infirmières et infirmiers du Québec, Montréal (Québec) Canada
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Affiliation(s)
| | - Saranya Loehrer
- Institute for Healthcare Improvement, Cambridge, Massachusetts
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Barkholz D. Healthuare boards need more diversity, but pace of change is 'glacial'. Mod Healthc 2017; 47:20-22. [PMID: 30481416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Hospital and healthcare boards are adding newcomers at a slow pace, though consumerism and reimbursement changes are demanding new skill sets for trustees.
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Fabrizio NA. The struggles of an all-shareholder board in dealing with today's healthcare challenges. MGMA Connex 2017; 17:37-39. [PMID: 30358250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Sauers RJ. How the Body of Knowledge for Medical Practice Management benefits the administration of a PACE program. MGMA Connex 2017; 17:40-42. [PMID: 30358251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Affiliation(s)
- Mariam Claeson
- Global Financing Facility, World Bank, Washington, DC 20433, USA.
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Appelshaeuser M, Sengel D. [Simulation in health care, a partnership between a training institute and a health care facility]. Soins 2017; 62:29-31. [PMID: 28342465 DOI: 10.1016/j.soin.2017.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A system of collaboration around simulation, between a health care facility and a training institute, has been put in place. It has enabled the challenges for both institutions to be identified, thereby confirming the need to continue this project. In this context, interprofessionalality and intergenerationality are key elements.
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Affiliation(s)
- Michèle Appelshaeuser
- Établissement public de santé Alsace Nord, 141, avenue de Brumath, 67170 Brumath, France.
| | - Danièle Sengel
- Établissement public de santé Alsace Nord, 141, avenue de Brumath, 67170 Brumath, France
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Kang'a SG, Muthee VM, Liku N, Too D, Puttkammer N. People, Process and Technology: Strategies for Assuring Sustainable Implementation of EMRs at Public-Sector Health Facilities in Kenya. AMIA Annu Symp Proc 2017; 2016:677-685. [PMID: 28269864 PMCID: PMC5333339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The Ministry of Health (MoH) rollout of electronic medical record systems (EMRs) has continuously been embraced across health facilities in Kenya since 2012. This has been driven by a government led process supported by PEPFAR that recommended standardized systems for facilities. Various strategies were deployed to assure meaningful and sustainable EMRs implementation: sensitization of leadership; user training, formation of health facility-level multi-disciplinary teams; formation of county-level Technical Working Groups; data migration; routine data quality assessments; point of care adoption; successive release of software upgrades; and power provision. Successes recorded include goodwill and leadership from the county management (22 counties), growth in the number of EMR trained users (2561 health care workers), collaboration in among other things, data migration(90 health facilities completed) and establishment of county TWGs (13 TWGs). Sustenance of EMRs demand across facilities is possible through; county TWGs oversight, timely resolution of users' issues and provision of reliable power.
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Affiliation(s)
- Samuel G Kang'a
- International Training and Education Center for Health, University of Washington, Nairobi, Kenya
| | - Veronica M Muthee
- International Training and Education Center for Health, University of Washington, Nairobi, Kenya
| | - Nzisa Liku
- International Training and Education Center for Health, University of Washington, Nairobi, Kenya
| | - Diana Too
- International Training and Education Center for Health, University of Washington, Nairobi, Kenya
| | - Nancy Puttkammer
- International Training and Education Center for Health, University of Washington, Seattle, WA
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