Health Mgmt Policy Planning
Admitted patient care 2013–14: Australian hospital statistics – Australian Institute of Health and Welfare – 19 March 2015Read Full Post | Make a Comment ( Comments Off on Admitted patient care 2013–14: Australian hospital statistics – Australian Institute of Health and Welfare – 19 March 2015 )
Delivering Universal Health Coverage: A Guide For Policymakers – WISH (World Innovation Summit for Health) – February 2015Read Full Post | Make a Comment ( Comments Off on Delivering Universal Health Coverage: A Guide For Policymakers – WISH (World Innovation Summit for Health) – February 2015 )
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The reconfiguration of clinical services. What is the evidence? – The King’s Fund – 25 November 2014
“The reconfiguration of clinical services continues to generate public and political controversy, locally and nationally. Given significant financial and workforce constraints, now and in the future, pressure to reconfigure services is only likely to increase. But what are the key drivers of reconfiguration and what is the evidence to underpin it?
This paper aims to help those planning and implementing major clinical service reconfigurations ensure that change is as evidence-based as possible. It investigates the five key drivers – quality, workforce, cost, access and technology – across 13 clinical service areas, summarising the research evidence and professional guidance available in each. It builds on a major forthcoming analysis of reviews of service reconfigurations commissioned by the National Institute of Health Research and conducted by the National Clinical Advisory Team (NCAT). “Read Full Post | Make a Comment ( Comments Off on The reconfiguration of clinical services. What is the evidence? – The King’s Fund – 25 November 2014 )
The NHS Five Year Forward View – NHS England – 23 October 2014
“The NHS Five Year Forward View was published on 23 October 2014 and sets out a vision for the future of the NHS. It has been developed by the partner organisations that deliver and oversee health and care services including NHS England, Public Health England, Monitor, Health Education England, the Care Quality Commission and the NHS Trust Development Authority. Patient groups, clinicians and independent experts have also provided their advice to create a collective view of how the health service needs to change over the next five years if it is to close the widening gaps in the health of the population, quality of care and the funding of services.
The purpose of the Five Year Forward View is to articulate why change is needed, what that change might look like and how we can achieve it. It describes various models of care which could be provided in the future, defining the actions required at local and national level to support delivery. Everyone will need to play their part – system leaders, NHS staff, patients and the public – to realise the potential benefits for us all. It covers areas such as disease prevention; new, flexible models of service delivery tailored to local populations and needs; integration between services; and consistent leadership across the health and care system.
The Five Year Forward View starts the move towards a different NHS, recognising the challenges and outlining potential solutions to the big questions facing health and care services in England. It defines the framework for further detailed planning about how the NHS needs to evolve over the next five years.”Read Full Post | Make a Comment ( Comments Off on The NHS Five Year Forward View – NHS England – 23 October 2014 )
System leadership: Lessons and learning from AQuA’s Integrated Care Discovery Communities – The King’s Fund – 14 October 2014
“A consensus is emerging in England around the concept of ‘integrated care’ as the best hope for a sustainable NHS. For leaders in the health care system, this represents an immense challenge. Leading across complex interdependent systems of care is a new and different role, undertaken alongside the already difficult task of leading successful institutions.
This paper seeks to identify the skills, knowledge and behaviours required of new system leaders and to learn from systems attempting to combine strong organisational leadership with collaborative system-level leadership approaches. The paper draws on three years’ development work with leaders in health care systems in north-west England, undertaken by the Advancing Quality Alliance (AQuA) and The King’s Fund which has adopted a ‘discovery’ approach to developing integrated care and the leadership capabilities supporting it.”
A formative evaluation of Collaboration for Leadership in Applied Health Research and Care (CLAHRC): institutional entrepreneurship for service innovation – Health Serv Deliv Res Sept 2014;2(31)
A formative evaluation of Collaboration for Leadership in Applied Health Research and Care (CLAHRC): institutional entrepreneurship for service innovation – Health Serv Deliv Res Sept 2014;2(31) “Background Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) are a time-limited funded initiative to form new service and research collaboratives in the English health system. Their aim is to bring together NHS organisations and universities to accelerate the translation of evidence-based innovation into clinical practice. In doing so, CLAHRCs are positioned to help close the second translation gap (T2), which is described as the problem of introducing and implementing new research and products into clinical practice. Objectives In this study, we draw on ideas from institutional theory and institutional entrepreneurship to examine how actors may engage in reshaping existing institutional practices in order to support, and help sustain efforts to close the T2. Our objective was to understand how the institutional context shapes actors’ attempts to close the T2 by focusing on the CLAHRC initiative. Methods The study employed a longitudinal mixed-methods approach. Qualitative case studies combined interview data (174 in total across all nine CLAHRCs and the four in-depth sites), archival data and field notes from observations, over a 4-year period (2009–13). Staff central to the initiatives were interviewed, including CLAHRC senior managers; theme leads; and other higher education institution and NHS staff involved in CLAHRCs. Quantitative social network analysis (SNA) employed a web-based sociometric approach to capture actors’ own individual (i.e. ego) networks of interaction across two points in time (2011 and 2013) in the four in-depth sites, and their personal characteristics and roles. Results We developed a process-based model of institutional entrepreneurship that encompassed the different types of work undertaken. First, ‘envisaging’ was the work undertaken by actors in developing an ‘embryonic’ vision of change, based on the interplay between themselves and the context in which they were situated. Second, ‘engaging’ was the work through which actors signed up key stakeholders to the CLAHRC. Third, ‘embedding’ was the work through which actors sought to reshape existing institutional practices so that they were more aligned with the ideals of CLAHRC. ‘Reflecting’ involved actors reconsidering their initial decisions, and learning from the process of establishing CLAHRCs. Furthermore, we employed the qualitative data to develop five different archetype models for organising knowledge translation, and considered under what founding conditions they are more or less likely to emerge. The quantitative SNA results suggested that actors’ networks changed over time, but that important institutional influences continued to constrain patterns of interactions of actors across different groups. Conclusion The development of CLAHRCs holds important lessons for policy-makers. Policy-makers need to consider whether or not they set out a defined template for such translational initiatives, since the existence of institutional antecedents and the social position of actors acted to ‘lock in’ many CLAHRCs. Although antecedent conditions and the presence of pre-existing organisational relationships are important for the mobilisation of CLAHRCs, these same conditions may constrain radical change, innovation and the translation of research into practice. Future research needs to take account of the effects of institutional context, which helps explain why many initiatives may not fully achieve their desired aims.”Read Full Post | Make a Comment ( Comments Off on A formative evaluation of Collaboration for Leadership in Applied Health Research and Care (CLAHRC): institutional entrepreneurship for service innovation – Health Serv Deliv Res Sept 2014;2(31) )
NHS hospitals under pressure: trends in acute activity up to 2022 – Nuffield Trust – 6 October 2014 “In this analysis we look at trends in admissions and bed use over the last few years, and use population projections to explore the likely pressures on hospitals in the future.”Read Full Post | Make a Comment ( Comments Off on NHS hospitals under pressure: trends in acute activity up to 2022 – Nuffield Trust – 6 October 2014 )
A new settlement for health and social care: final report – Commission on the Future of health and Social Care in England – 4 September 2014
“This is the final report from the independent Commission on the Future of Health and Social Care in England. In it, the commission discusses the need for a new settlement for health and social care to provide a simpler pathway through the current maze of entitlements. The commission, chaired by Kate Barker, proposes a new approach that redesigns care around individual needs regardless of diagnosis, with a graduated increase in support as needs rise, particularly towards the end of life. The commission has concluded that this vision for a health and care system fit for the 21st century is affordable and sustainable if a phased approach is taken and hard choices are taken about taxation.”Read Full Post | Make a Comment ( Comments Off on A new settlement for health and social care: final report – Commission on the Future of health and Social Care in England – 4 September 2014 )
Economic crisis, health systems and health in Europe: impact and implications for policy – European Observatory on Health Systems and Policies – 4 September 2014
“How have health systems in Europe responded to the crisis? How have these responses affected health system performance and population health? And what are the implications of this experience for health systems facing economic and other forms of shock in the future?
This new document summarizes the findings of a joint study by WHO Europe and the Observatory analyzing the impact of health policy responses to the crisis in Europe from 2008 to 2013. It is a key part of a wider initiative to monitor the effects of the crisis on health systems and health, to identify the policies most likely to sustain the performance of health systems facing fiscal pressure and to gain insight into the political economy of implementing reforms in a crisis.
The study was supported by the Norwegian Directorate of Health and the UK Department for International Development. It will be published by the Open University Press in January 2015 and will be downloadable from this site soon afterwards.”Read Full Post | Make a Comment ( Comments Off on Economic crisis, health systems and health in Europe: impact and implications for policy – European Observatory on Health Systems and Policies – 4 September 2014 )
The Impact and Effectiveness of Equity Focused Health Impact Assessment in Health Service Planning – Harris-Roxas Health – 22 August 2014
“This free ebook looks at the use of equity focused health impact assessment (EFHIA) on health service plans. It examines:
What are the direct and indirect impacts of EFHIAs conducted on health sector plans?
Does EFHIA improve the consideration of equity in the development and implementation of health sector plans?
How does EFHIA improve the consideration of equity in health planning?”
“The nature of hospital activity is changing in many countries, with some experiencing a broad trend towards the creation of hospitals groups or chains and multi-hospital networks. This report seeks to contribute to the understanding of experiences in other countries about the extent to which different hospital ‘models’ may provide lessons for hospital provision in England by means of a review of four countries: France, Germany, Ireland and the United States, with England included for comparison. We find that here has been a trend towards privatisation and the formation of hospital groups in France, Germany and the United States although it is important to understand the underlying market structure in these countries explaining the drivers for hospital consolidation. Thus, and in contrast to the NHS, in France, Germany and the United States, private hospitals contribute to the delivery of publicly funded healthcare services. There is limited evidence suggesting that different forms of hospital cooperation, such as hospital groups, networks or systems, may have different impacts on hospital performance. Available evidence suggests that hospital consolidation may lead to quality improvements as increased size allows for more costly investments and the spreading of investment risk. There is also evidence that a higher volume of certain services such as surgical procedures is associated with better quality of care. However, the association between size and efficiency is not clear-cut and there is a need to balance ‘quality risk’ associated with low volumes and ‘access risk’ associated with the closure of services at the local level.”Read Full Post | Make a Comment ( Comments Off on The changing hospital landscape: An exploration of international experiences – RAND – August 2014 )
Improving NHS Care by Engaging Staff and Devolving Decision-Making: Report of the Review of Staff Engagement and Empowerment in the NHS – The King’s Fund – 15 July 2014
“An independent review for the government has concluded that more NHS organisations should be encouraged to become public service mutuals.
The review, led by Chris Ham, Chief Executive of The King’s Fund, found compelling evidence that NHS organisations with high levels of staff engagement – where staff are strongly committed to their work and involved in decision-making – deliver better quality care. Organisations with high levels of staff engagement report:
lower mortality rates
better patient experience
lower rates of sickness absence and staff turnover.
Organisations with low levels of staff engagement are more likely to provide poor-quality care – the failures in care at Mid Staffordshire NHS Foundation Trust are one high-profile example of this.
While staff engagement levels have increased across the NHS in recent years, the review found significant variations between organisations. It calls on all NHS organisations to make staff engagement a key priority in order to improve care at a time of unprecedented financial and service pressures.
The review found emerging evidence that, by giving employees a stronger stake in their organisation, public service mutuals deliver higher levels of staff engagement. This was reinforced by testimony from leaders and staff working for mutual organisations that they feel a strong sense of ownership and empowerment, leading to better organisational performance.”
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Defining Health and Health Care Sustainability – The Conference Board of Canada, 72 pages, July 2014
Defining Health and Health Care Sustainability – The Conference Board of Canada, 72 pages, July 2014
“Canadian health care costs are soaring and major reforms are needed to preserve and improve the quality of health care. This report develops a sustainability framework with guiding principles and key factors deemed essential to support sustainable health care.
Health care costs currently absorb about 11 per cent of Canada’s gross domestic product and almost half of provincial budgets. We will not be able to preserve, let alone improve, the quality of our health care without major reforms. To meet this challenge—the fiscally unsustainable public health care system in Canada—the Conference Board’s Canadian Alliance for Sustainable Health Care (CASHC) program researched and analyzed the issues and options for solution.
This report defines sustainability and presents a sustainability framework to guide CASHC’s policy work and future recommendations on health care. The definition and framework follow an extensive literature review and comprehensive interviews with representatives of health care stakeholders.
The sustainability framework has four guiding principles and six key factors deemed essential to support sustainable health and health care. While these may not be new to the reader, the innovation in the report comes from their systematic implementation across the continuum of care, across diseases, and across departments controlling determinants of health in order to create a well-functioning system.”Read Full Post | Make a Comment ( Comments Off on Defining Health and Health Care Sustainability – The Conference Board of Canada, 72 pages, July 2014 )
The Dalton Review: new options for providers of NHS care – 8 July 2014
“This independent review, led by Sir David Dalton (Chief Executive of Salford Royal), is investigating ways to secure the clinical and financial sustainability of providers of NHS care through offering new options for organisational forms. The review is running an informal engagement on the work and is seeking information and insight about organisational forms for providers of NHS care: what works best, and what changes are needed to improve the delivery of services.”
[organisational models]Read Full Post | Make a Comment ( Comments Off on The Dalton Review: new options for providers of NHS care – 8 July 2014 )
Future organisational models for the NHS: Perspectives for the Dalton review – The King’s Fund – 1 July 2014
“With a growing number of health care providers in deficit and others placed in special measures because of concerns about the quality of their care, the search is on to find ways in which they could be supported. Sir David Dalton’s forthcoming review provides a timely opportunity to explore the range of organisational models that providers could use to meet their current strategic and financial challenges.
This publication explores some of the organisational options available, including how high-performing NHS organisations might support providers in difficulty. It provides an evidence review and a range of individual perspectives on some of those new organisational arrangements, in health and other sectors, nationally and internationally – in a bid to inform the work of the Dalton review. The individual contributions highlight the benefits and challenges of different organisational models.”
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“The health care industry is ripe for disruptive innovation as systemic challenges continue to face the industry and stakeholders demand increased value.
A successful disruptor could emerge as value–based care gains traction and providers and health plans continue to look for new ways to deliver care and utilize technology to meet the needs of health care consumers.
The potential disruptor could enter the market with a low-cost solution that initially serves an unattractive segment. Powered by an enabling technology, this new solution could, in short order, meet mainstream customers’ needs so much better that the innovator unseats the market leader.
This is a likely scenario in the primary care physician market, where patient visits could shift to lower-cost settings, such as e-visits, or alternative clinicians, such as nurse practitioners.
Good for what ails us: The disruptive rise of value-based care explores how and where disruptive innovation might occur in health care, discusses what can be learned from other industries that have faced similar disruption and outlines innovation opportunities in a post-reform world.”
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NSW State Health Plan: Towards 2021 – 19 June 2014
“The NSW State Health Plan: Towards 2021 provides a strategic framework which brings together NSW Health’s existing plans, programs and policies and sets priorities across the system for the delivery of ‘the right care, in the right place, at the right time’.
The NSW State Health Plan highlights strategies to deliver on health priorities and improved health outcomes, and builds on previous reforms focusing on devolved decision-making, health system integration and increased transparency of funding and performance. It outlines in detail not only how we’re continuing to roll out and extend our reforms in clinical care, funding and governance, but the next steps we need to take to keep delivering world-class care in NSW.”Read Full Post | Make a Comment ( Comments Off on NSW State Health Plan: Towards 2021 – 19 June 2014 )
The prime provider model: An opportunity for better public service delivery? – Brotherhood of St Laurence – May 2014
Extract from the executive summary:
“Since governments began outsourcing services in the 1990s there has been considerable experimentation with different commissioning approaches. At a time of fiscal restraint and reductions in the size of the public sector, governments are exploring new service delivery models, particularly those that are seen to increase coordination in addressing complex policy problems, known as ‘wicked’ problems. One model that is receiving attention is the prime provider approach. This is an approach where government contracts with a lead or prime provider which in turn takes responsibility for organising and managing service delivery through a group of subcontractors or providers who are specialised and/or local suppliers.
Prime provider models operate in a range of health and welfare sectors. In Australia, a prominent lead provider model is the Communities for Children (CfC) initiative operating in 45 disadvantaged communities across Australia. Other examples of prime provider approaches in Australia include headspace and Partners in Recovery. The Brotherhood of St Laurence has been involved in developing innovative service models that operate within a prime provider framework.
The prime provider models in Australia tend to be locally based, partnership-type approaches delivering services to a specific client group. Many have been initiated by community or not-forprofit organisations rather than being driven by government. In contrast, internationally, prime provider models have been driven by government and developed as large-scale, commercial contracts that have attracted significant interest from large, for-profit companies. For example, the estimated cost of the UK Work Programme is £3 billion to £5 billion over five years(Finn, 2013).
The perceived benefits of prime provider models for government include greater coordination of local specialist providers, reduced administrative costs and enhanced opportunities for innovative service delivery resulting from economies of scale. The challenges for government in these approaches relate to the hollowing out of capabilities and provider or market failure. In addition, prime providers themselves are faced with challenges relating to managing potential risks and liabilities as well as contract and performance management.”
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Urgent and planned care: operational resilience and capacity planning for 2014/15 – Monitor, NHS England and NHS Trust Development Authority – 13 June 2014
“This framework covers both urgent and planned care. It has been jointly produced by Monitor, NHS England, the NHS Trust Development Authority and ADASS (Association of Directors of Adult Social Services).
It sets out best practice requirements across planned and urgent and emergency care that local healthcare systems should reflect in their local plans, as well as providing information on more general requirements such as operational planning, patient experience and planning for higher dependency patient groups.”Read Full Post | Make a Comment ( Comments Off on Urgent and planned care: operational resilience and capacity planning for 2014/15 – Monitor, NHS England and NHS Trust Development Authority – 13 June 2014 )
Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally – The Commonwealth Fund – 16 June 2014
The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance. Among the 11 nations studied in this report—Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2010, 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last or near last on dimensions of access, efficiency, and equity. In this edition of Mirror, Mirror, the United Kingdom ranks first, followed closely by Switzerland (Exhibit ES-1).
Expanding from the seven countries included in 2010, the 2014 edition includes data from 11 countries. It incorporates patients’ and physicians’ survey results on care experiences and ratings on various dimensions of care. It includes information from the most recent three Commonwealth Fund international surveys of patients and primary care physicians about medical practices and views of their countries’ health systems (2011–2013). It also includes information on health care outcomes featured in The Commonwealth Fund’s most recent (2011) national health system scorecard, and from the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD).”
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Reforming the NHS from within: beyond hierarchy, inspection and markets – King’s Fund – 11 June 2014
“Politicians’ role in the running of the National Health Service (NHS) needs to be better defined to counter interventionist and centralising tendencies that have hampered effective reform to date, says a new report published today by The King’s Fund.
The report, Reforming the NHS from within: beyond hierarchy, inspection and markets, argues that a new political settlement is needed that clarifies the strategic role of ministers in determining funding, establishing priorities and providing accountability to Parliament, and leaves local NHS leaders with the space to innovate and lead service change. This settlement should reflect lessons learnt from the experience of the present government’s health reforms, which have failed to distance ministers from the operational management of the NHS as originally intended.
The report challenges the dominant approaches to NHS reform over the past 20 years – targets and performance management; inspection and regulation; and competition and choice. It argues for a fundamental shift in how the NHS is reformed. The NHS needs to move on from prescriptive, top-down approaches to change by progressing from:”
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Healthcare in Australia 2012-13: Five years of performance – final report of the COAG Reform Council – 11 June 2014Read Full Post | Make a Comment ( Comments Off on Healthcare in Australia 2012-13: Five years of performance – final report of the COAG Reform Council – 11 June 2014 )
Nicola Pearce-Smith, Information Scientist
Sir Muir Gray, Joint Lead for Right Care
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Behavioral Health Integration Capacity Assessment Tool – Institute for Healthcare Improvement – 2014
“The purpose of the Behavioral Health Integration Capacity Assessment (BHICA) is to assist behavioral health organizations in evaluating their ability to implement integrated care. The BHICA enables behavioral health organizations to evaluate their processes related to three approaches to integrated care: coordinate care, co-locate care, or build primary care capacity in-house. It also allows organizations to assess their existing operational and cultural infrastructure to support greater integration. The BHICA was developed by IHI and the Lewin Group under a contract from the CMS Medicare-Medicaid Coordination Office.”Read Full Post | Make a Comment ( Comments Off on Behavioral Health Integration Capacity Assessment Tool – Institute for Healthcare Improvement – 2014 )
“With the NHS facing bigger challenges than ever before, leaders must ensure that cultures within health care organisations sustain high-quality, compassionate and ever-improving care. Key to shaping these cultures is leadership.
This paper argues that collective leadership – as opposed to command-and-control structures – provides the optimum basis for caring cultures. Collective leadership entails distributing and allocating leadership power to wherever expertise, capability and motivation sit within organisations. NHS boards bear ultimate responsibility for developing strategies for coherent, effective and forward-looking collective leadership.
This paper explains the interaction between collective leadership and cultures that value compassionate care, by drawing on wider literature and case studies of good organisational practice. It outlines the main characteristics of a collective leadership strategy and the process for developing this.”Read Full Post | Make a Comment ( Comments Off on Developing collective leadership for health care – The King’s Fund – 21 May 2014 )
Making fair choices on the path to universal health coverage: Final report of the WHO Consultative Group on Equity and Universal Health Coverage – launched 1 May 2014
ISBN 978 92 4 150715 8
Extract from the Executive Summary:
“Universal health coverage (UHC) is defined as all people receiving quality health services that meet their needs without being exposed to financial hardship in paying for the services. Given resource constraints, this does not entail all possible services, but a comprehensive range of key services that is well aligned with other social goals. UHC was firmly endorsed by the World Health Assembly in 2005 and further supported in the World Health Report 2010. Since then, more than seventy countries have requested policy support and technical advice for UHC reform from the World Health Organization (WHO). In response, WHO developed a plan of action that included providing guidance on how countries can manage the central issues of fairness and equity that arise on the path to UHC. The WHO Consultative Group on Equity and Universal Health Coverage was set up to develop this guidance.
This document is the Consultative Group’s final report. The report addresses the key issues of fairness and equity by clarifying these issues and offering recommendations for how countries can manage them. The report is relevant for a wide range of actors and particularly for governments in charge of overseeing and guiding the progress toward UHC.
To achieve UHC, countries must advance in at least three dimensions. Countries must expand priority services, include more people, and reduce out-of-pocket payments. However, in each of these dimensions, countries are faced with a critical choice: Which services to expand first, whom to include first, and how to shift from out-of-pocket payment toward prepayment? A commitment to fairness—and the overlapping concern for equity—and a commitment to respecting individuals’ rights to health care must guide countries in making these choices. For fair progressive realization of UHC, the three critical choices and the trade-offs between the dimensions must be carefully addressed. ”
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Building a Leadership Team for the Health Care Organization of the Future – American Hospital Association, Health Research & Educational Trust – April 2014
“Moving from a volume-based payment model to a value-based payment model requires a new set of management skills that encourage systems thinking and align clinical and operational resources to improve outcomes and efficiencies. Today’s leaders must implement strategies to:
Improve cost management and efficiency
Increase clinical integration and expand coordinated care
Improve quality and patient safety
Integrate information systems
Foster innovation and change management
Increase patient engagement”
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Horizon 2035: International responses to big picture challenges: a review of changing global models of care and the workforce of the future – Centre for Workforce Intelligence CFWI – May 2014
“The question we are addressing in this paper is: are there examples of models of care in other countries that are similar to the big picture challenges facing the health and care workforce in England, and therefore should be considered in plausible scenarios for Horizon 2035?
The report aims to provide short, digestible analysis of international examples which are clearly related to developments in health and care policy in England. It identifies various developments concerning six countries: Australia, Germany, Japan, Netherlands, Sweden and the USA – and relates these developments to the Big Picture Challenges identified by the CfWI Horizon Scanning team last year (http://www.cfwi.org.uk/our-work/horizon-scanning-big-picture-challenges) with suggestions on what the workforce implications of these are.”
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Australian hospital statistics 2012-13 – AIHW – 30 April 2014
“Australian hospital statistics 2012–13 presents a detailed overview of Australia’s public and private hospitals. In 2012–13, there were about 9.4 million separations from hospitals, including: 5.2 million same-day acute separations; 3.7 million overnight acute separations; about 450,000 sub-acute and non-acute separations. There were also 7.9 million non-admitted patient emergency services and more than 46 million outpatient services provided by public hospitals.”
ISSN 1036-613X; ISBN 978-1-74249-561-3; Cat. no. HSE 145; 356ppRead Full Post | Make a Comment ( Comments Off on Australian hospital statistics 2012-13 – AIHW – 30 April 2014 )
“Supporting health care workers to classify waste appropriately can bring benefits to health organisations as well as the environment, according to new waste management guidance issued by the RCN.
Reflecting legislative changes and current forms of best practice, the guidance calls for a greater focus on the waste hierarchy and for more distinction to be made between different waste types.
The RCN is highlighting the need to risk assess all waste rather than simply labelling it infectious. It also argues for strengthening staff training on waste management and suggests that all organisations should consider appointing a dedicated waste manager.”
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Measuring the Level and Determinants of Health System Efficiency in Canada – Canadian Institute for Health Information – 10 April 2014
“This study measures health system efficiency in Canada to gain insight into factors that help explain variations in efficiency at the health region level. The study builds on findings from the CIHI report Developing a Model for Measuring the Efficiency of the Health System in Canada and examines questions such as why some of Canada’s health regions are more efficient than others.”Read Full Post | Make a Comment ( Comments Off on Measuring the Level and Determinants of Health System Efficiency in Canada – Canadian Institute for Health Information – 10 April 2014 )
Exploring Accountable Care in Canada: Integrating Financial and Quality Incentives for Physicians and Hospitals – Canadian Foundation for Healthcare Improvement – 1 April 2014
“ACOs are promising vehicles for aligning physician and hospital interests in improving quality and reducing cost. However, successful implementation and realization of the ACO mission requires that attention be paid to supporting capacity building within the ACOs, development of a culture of learning and improvement, as well as rigorous monitoring and evaluation. While the jury is still out on success of ACO implementation efforts in the United States, the results presented here suggest that further exploration of their potential in Canada is warranted, and that distinct characteristics of the Canadian system might require a slightly different approach.”Read Full Post | Make a Comment ( Comments Off on Exploring Accountable Care in Canada: Integrating Financial and Quality Incentives for Physicians and Hospitals – Canadian Foundation for Healthcare Improvement – 1 April 2014 )
Extract from the introduction.
“This guide is designed to help departments and agencies formulate robust implementation plans that clearly articulate how new policies, programs, and services will be delivered on time, on budget and to expectations. It supports the Australian Government’s approach to strengthening Cabinet decision-making and improving program governance and implementation.
This guide aims to assist those involved in implementation planning to understand how they should formulate an implementation plan.”Read Full Post | Make a Comment ( Comments Off on Guide to Implementation Planning – Department of the Prime Minister and Cabinet – 2014 )
Making sense of evidence in management decisions: the role of research-based knowledge on innovation adoption and implementation in health care. Health Serv Deliv Res 2014;2(6)
Kyratsis Y, Ahmad R, Hatzaras K, Iwami M, Holmes A..
Extract from the Abstract
Although innovation can improve patient care, implementing new ideas is often challenging. Previous research found that professional attitudes, shaped in part by health policies and organisational cultures, contribute to differing perceptions of innovation ‘evidence’. However, we still know little about how evidence is empirically accessed and used by organisational decision-makers when innovations are introduced.
Aims and objectives
We aimed to investigate the use of different sources and types of evidence in innovation decisions to answer the following questions: how do managers make sense of evidence? What role does evidence play in management decision-making when adopting and implementing innovations in health care? How do wider contextual conditions and intraorganisational capacity influence research use and application by health-care managers?”
“This report, published by the Nuffield Trust and the Health Foundation, assesses the performance of the NHS on the quality of patient care in all four UK countries since devolution.
Since political devolution in 1999, there has been increasing policy divergence between the health systems of the four countries of the United Kingdom (UK). This report attempts to update earlier comparisons of the publicly financed health systems of England, Scotland, Wales and Northern Ireland in terms of funding, inputs and performance before and since devolution.
It also includes comparisons with the North East of England, which has been chosen as a better comparator with the three devolved nations than England as a whole.”
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On effective, accessible and resilient health systems – Communication from the European Commission – 4 April 2014
“Capitalising on experience and work carried out over recent years, and with a view to further developing approaches at EU level, this Communication focuses on actions to:
1. Strengthen the effectiveness of health systems
2. Increase the accessibility of healthcare
3. Improve the resilience of health systems”
A Diagnostic Tool for Assessing Organisational Readiness for Complex Change – Australian and New Zealand School of Government – 2013
Blackman, D., O’Flynn, J. and Ugyel, L. (2013) “A Diagnostic Tool for Assessing Organisational Readiness for Complex Change”, paper presented to the Australian and New Zealand Academy of Management conference, Hobart, 4-6 December
Much is made of the best way to manage change, including a large body of work that argues that there is no point in undertaking such programs unless the organisation is actually ready and able to adopt these new ways of working. In this paper we focus, in particular, on the issue of organisations working together in more ‘joined-up’ ways across government – an example of complex change. We contribute to this literature, arguing that in cases of complex change, not only does there need to be readiness in terms of the change itself, but that there also needs to be readiness in the capacity of the organisation to work together, both within and across organisations. The paper outlines the development of a new diagnostic tool that combines macro and micro levels of analysis in order to enable organisations to gauge their preparedness for complex change.”
One person, supported by people acting as One Team, from organisations behaving as One System: Report of the Independent Commission on Whole Person Care for the Labour Party launched 4 March 2014
One Person, One Team, One System – Chairman Sir John Oldham, Independent Commission on Whole Person Care
“Today sees the launch of “One Person, One Team, One System” a report by John Oldham’s Independent Commission for the Labour party into health and social care policy.”
Sir John Oldham (Chair)
Controlling the cost of care: a billion dollar hospital opportunity – Grattan Institute – 4 March 2014
by Stephen Duckett and Peter Breadon
“A better pricing system for public hospital treatment would show where costs are too high, and free up $1 billion for more and better health care.
The gulf between treatments in high and low-cost hospitals in Australia is vast, with no good reason for such variation. In New South Wales, for example, the difference in the cost of a common gall bladder treatment between the highest and lowest-cost hospitals is more than $4,000, and the difference in the cost of a hip replacement more than $16,000. In many states the gap between the most and least expensive hospitals is more than $1,500 for every admission — and in some states it is much greater — even when all legitimate funding differences among hospitals that we can measure are taken into account.
This money is not being used to provide better care – it is simply being spent inefficiently and could be used for much better ends.
To achieve the savings, the report urges state governments to make three reforms. They should pay hospitals for treatments on the basis of an average price once all avoidable costs we can measure have been removed.
Second, they should make data available to hospitals so they can compare themselves to their peers and see where they can cut costs. Third, governments need to be tougher and hold hospital boards to account when they fail to control costs. But even with these changes, it is up to hospital leaders, managers and doctors to find the best ways to improve.
Hospital spending is the fastest growing area of government spending, and is projected to increase with new technologies and an ageing population. We have to keep health care affordable and the health budget under control. Rooting out inefficiencies in public hospital systems is a good place to start.”Read Full Post | Make a Comment ( Comments Off on Controlling the cost of care: a billion dollar hospital opportunity – Grattan Institute – 4 March 2014 )
“Person-centred, individualised, personalised, patient-centred, family-centred, patient-centric and many other terms have been used to signal a change in how health services engage with people. This rapid review summarises research about measuring the extent to which care is person-centred.
Three key questions guided the review:
How is person-centred care being measured in healthcare?
What types of measures are used?
Why and by whom is measurement taking place?
The review signposts to research about commonly used approaches and tools to help measure person-centred care. It aims to showcase the many tools available.
A spreadsheet listing 160 of the most commonly researched measurement tools accompanies the review. This allows users to search according to the type of tool, who it targets and the main contexts it has been tested in. Hyperlinks to the abstracts of examples of research using each tool are also provided.
The review shows that, while a large number of tools are available to measure person-centred care, there is no agreement about which tools are most worthwhile.”
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How do government agencies use evidence? – Socialstyrelsen: the National Board of Health and Welfare, Sweden – 1 June 2013
Extract from the executive summary:
“Significant research gaps remain in our understanding about what happens inside government agencies in relation to the production, commissioning, assessment and incorporation of research-based evidence into their policy advice and their program delivery and review activities. Practices and capabilities vary enormously across types of public agencies, levels of government, and policy areas. Understanding these patterns and potentialities better would help focus attention on effective methods for improving the quality of decision-making through evidence-informed processes.”
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Many to many: How the relational state will transform public services – IPPR – 12 February 2014
“This landmark report sets out a new ‘relational state’ agenda for public service reform that would address complex problems holistically, provide more intensive and personalised engagement at the frontline of service delivery, and empower and engage citizens.
We need a radical reconfiguration of our public services to make them better able to tackle the complex challenges – such as antisocial behaviour, chronic ill-health, and long-term unemployment – that are consuming a growing proportion of public expenditure. In the past, public service reform has relied too heavily on bureaucratic and market-based tools that are ill-equipped to deal with these problems.
In this publication, the authors set out how we can build a more relational state in practice, and consider how the lessons offered by some cutting-edge initiatives could help reshape mainstream services. By managing public services as interconnected and decentralised systems, promoting deep relationships and neighbourhood-based approaches in key services, and designing institutions that enable citizens to tackle shared problems together, we can make those services fit for the more complex times that we live in.”Read Full Post | Make a Comment ( Comments Off on Many to many: How the relational state will transform public services – IPPR – 12 February 2014 )
AMA Public Hospital Report Card 2014 – Public hospitals struggling to meet demand and targets as Federal funding declines – 14 February 2014Read Full Post | Make a Comment ( Comments Off on AMA Public Hospital Report Card 2014 – Public hospitals struggling to meet demand and targets as Federal funding declines – 14 February 2014 )
Your Hospital’s Path to the Second Curve: Integration and Transformation – American Hospital Association – January 2014
“Environmental pressures are driving hospitals and care systems toward greater clinical integration, more financial risk and increased accountability. To provide high-quality, efficient and integrated care, hospitals and care systems must explore and pursue transformational paths that align with the organization’s mission and vision and cater to patients and communities. Hospital leaders need to develop strategies that move their organizations from the first curve, or volume-based environment, to the second curve, in which they will be building value-based systems and business models.
To navigate the evolving health care environment, the 2013 AHA Committee on Research developed the report Your Hospital’s Path to the Second Curve: Integration and Transformation. This report outlines must-do strategies, organizational capabilities to master and 10 strategic questions that every organization should answer to begin a transformational journey. The report’s “guiding questions” will help hospitals and care systems reflect and gain new perspectives on the benefits and value of integration. A comprehensive assessment, also found in the report, may lead health care organizations toward a customized path or series of paths to successfully transform for the future. Five paths for hospitals and care systems to consider are:”
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Equality counts – Care Quality Commission [UK] – 30 January 2014
“Our progress on promoting equality
We’ve published our annual equality information report, called ‘Equality counts’, which sets out how we have promoted equality and tackled inequality both for people who use health and social care services and for our staff.”Read Full Post | Make a Comment ( Comments Off on Equality counts – Care Quality Commission [UK] – 30 January 2014 )
by Nick Goodwin, Anna Dixon, Geoff Anderson, Walter Wodchis
“Lessons from seven international case studies
Around the world, rapidly ageing populations are resulting in increased demand for health and social care services, which presents significant challenges for national health and care systems. Many have adopted an integrated care approach to meet the needs of older people with chronic or multiple conditions. This approach often involves a single point of entry – designating a care manager to help with assessing needs, sharing information, and co-ordinating care delivery by multiple caregivers (formal and informal).
This report synthesises evidence from seven case studies covering Australia, Canada, the Netherlands, New Zealand, Sweden, the United Kingdom and the United States. It considers similarities and differences of programmes that are successfully delivering integrated care, and identifies lessons for policy-makers and service providers to help them address the challenges ahead.”Read Full Post | Make a Comment ( Comments Off on Providing integrated care for older people with complex needs – King’s Fund – 30 January 2014 )
Sustainable, resilient, healthy people & places: a sustainable development strategy fo the NHS, Public Health and Social Care system – NHS England, Sustainable Development Unit – January 2014
“The approach described in this strategy is the result of intensive engagement across the health and care system. It describes the most important principles and opportunities that can be taken to enable a more sustainable health and care system over the next five years. These align with the current policy direction for integrated care closer to home and we know this is what the public expects of us.”Read Full Post | Make a Comment ( Comments Off on Sustainable, resilient, healthy people & places: a sustainable development strategy fo the NHS, Public Health and Social Care system – NHS England, Sustainable Development Unit – January 2014 )
Strengthening national health systems capacity to respond to future global pandemics – McMaster University Health Forum Issue Brief – 4 November 2013
Edge J, Gauvin FP, Hoffman SJ, Lavis JN. Issue Brief: Strengthening National Health Systems’ Capacity to Respond to Future Global Pandemics. Hamilton, Canada: McMaster Health Forum, 4 November 2013.
Extract from the Key Messages
“What’s the problem?
The challenges to strengthening national health systems’ capacity to respond to future global pandemics of infectious disease can be understood by considering six manifestations of, or contributors to, the problem:
1) pandemics challenge conventional systems of governance;
2) timely information sharing and evidence-informed decision-making is difficult;
3) domestic and international partners often encounter coordination problems;
4) public health and animal health perspectives can be difficult to reconcile when addressing emerging zoonoses;
5) antimicrobial resistance represents a growing threat; and
6) risk and protective factors for pandemics are changing.
Moreover, existing programs, health system arrangements and implementation strategies may not be optimal:
o programs and plans may limit capacity to respond to future pandemics;
o health system arrangements complicate matters; and
o some previously agreed upon courses of action have not been fully implemented.
What do we know about three elements of a comprehensive approach to address the problem?”
… continues on the site
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Report on Government Services 2014 – Productivity Commission – volume E Health due for publication Thursday 30 January 2014
Report on Government Services 2014 – Productivity Commission – volume E – Health due for publication Thursday 30 January 2014
Primary and community health
Mental health management
Volume A: Approach to performance reporting – 28 January 2014
Volume B: Child care, education and training – 28 January 2014
Volume C: Justice 29 January 2014
Volume D: Emergency Management – 29 January 2014
Volume F: Community services – 31 January 2014
Volume G: Housing and Homelessness – 31 January 2014
Indigenous compendium – due April 2014
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Saying what you do and doing what you say: The performative dynamics of lean management theory – Universita Ca’Foscari Venezia – December 2013
Why are certain theories able to impose themselves and influence organizational practices in a significant way? Rooted at the intersection of inquiries into management fashions and into performativity, we investigate the case of the Québec public health care system, where a managerial theory – that of “lean management” – has recently emerged, gained saliency and become dominant in organizational practice. Adopting a longitudinal and multi-level research approach, we focus more precisely on the conditions that allow performativity to occur and increase, considering how this process unfolds over time. We therefore study the processes and the conditions through which lean management theory imposed itself, both in the global health care system and in two distinct health care organizations and the processes and the conditions through which this theory, while imposing itself, constructs a reality for these organizations, eventually reinforcing the theory itself. By unveiling the action of three performative dynamics in this particular case, our study provides a reflection on the catalysts and inhibitors of performativity, that goes beyond the specific case and that could be relevant to researchers interested by performativity.”Read Full Post | Make a Comment ( Comments Off on Saying what you do and doing what you say: The performative dynamics of lean management theory – Universita Ca’Foscari Venezia – December 2013 )
Integrated care value case toolkit – Local Government Association [UK] – 17 January 2014
“The LGA has partnered with NHS England, The Association of Directors of Adult Social Services (ADASS), The Association of Directors of Children’s Services (ADCS), Monitor, NHS Confederation and the Department of Health (DH) to deliver a programme of work carried out by Integrating Care.
The toolkit should enable Health and Wellbeing Boards and local partners to understand the evidence and impact of different integrated care models on service users, as well as the associated impact on activity and cost to different parts of the health and care system.”Read Full Post | Make a Comment ( Comments Off on Integrated care value case toolkit – Local Government Association [UK] – 17 January 2014 )
New Evidence on Management and Leadership – NHS National Institute for Health Research – December 2013
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Measuring people’s experiences of integrated care; an options appraisal and a recommended set of questions – Picker Institute Europe – 8 January 2014Read Full Post | Make a Comment ( Comments Off on Measuring people’s experiences of integrated care; an options appraisal and a recommended set of questions – Picker Institute Europe – 8 January 2014 )
Planning and delivering service changes for patients – NHS England – 20 December 2013
“This guidance outlines a good practice framework for clinical commissioning groups (CCGs) and NHS England to use when developing plans for major service change to improve the quality and sustainability of services for patients. The framework outlines how NHS commissioners should work together, and with communities, providers and local authorities, to ensure that proposals and plans have effective preparation, robust evidence and are based on extensive engagement with staff, patients and the public. ”
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Health and care integration: making the case from a public health perspective – Public Health England – 19 December 2013
“The aim of this document is to help local areas, in particular health and wellbeing boards, make the case for integration focused on individuals’ health and wellbeing as well as their quality of life if they become sick.”
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Everyone Counts: Planning for Patients 2014/15 to 2018/19 – NHS England – 20 December 2013
“Everyone Counts: Planning for Patients 2014/15 to 2018/19 describes NHS England’s ambition for the years ahead and its ongoing commitment to focus on better outcomes for patients. It describes the vision for transformed, integrated and more convenient services, set within the context of significant financial challenge. The planning guidance is accompanied by a suite of support tools intended to assist commissioners with their planning considerations to maximise the best possible outcomes for their local communities.”
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Final report of the Office of the Trust Special Administrator of Mid Staffordshire NHS Foundation Trust – 18 December 2013
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High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs – Institute for Healthcare Improvement – 6 December 2013
Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2013.Read Full Post | Make a Comment ( Comments Off on High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs – Institute for Healthcare Improvement – 6 December 2013 )
The influence of cost-effectiveness and other factors on NICE decisions – Centre for Health Economics, University of York – November 2013
Background: The National Institute for Health and Care Excellence (NICE) emphasises that costeffectiveness is not the only consideration in health technology appraisal and is increasingly explicit about other factors considered relevant. Observing NICE decisions and the evidence considered in each appraisal allows us to ‘reveal’ its implicit weights.
Objectives: This study aims to investigate the influence of cost-effectiveness and other factors on NICE decisions and to investigate whether NICE’s decision-making has changed through time.
Methods: We build on and extend the modelling approaches in Devlin and Parkin (2004) and Dakin et al (2006). We model NICE’s decisions as binary choices: i.e. recommendations for or against use of a healthcare technology in a specific patient group. Independent variables comprised: the clinical and economic evidence regarding that technology; the characteristics of the patients, disease or treatment; and contextual factors affecting the conduct of health technology appraisal. Data on all NICE decisions published by December 2011 were obtained from HTAinSite [www.htainsite.com].
Results: Cost-effectiveness alone correctly predicted 82% of decisions; few other variables were significant and alternative model specifications led to very small variations in model performance. The odds of a positive NICE recommendation differed significantly between musculoskeletal disease, respiratory disease, cancer and other conditions. The accuracy with which the model predicted NICE recommendations was slightly improved by allowing for end of life criteria, uncertainty, publication date, clinical evidence, only treatment, paediatric population, patient group evidence, appraisal process, orphan status, innovation and use of probabilistic sensitivity analysis, although these variables were not statistically significant. Although there was a non-significant trend towards more recent decisions having a higher chance of a positive recommendation, there is currently no evidence that the threshold has changed over time. The model with highest prediction accuracy suggested that a technology costing £40,000 per quality-adjusted life-year (QALY) would have a 50% chance of NICE rejection (75% at £52,000/QALY; 25% at £27,000/QALY).
Discussion: Past NICE decisions appear to have been based on a higher threshold than the £20,000 – £30,000/QALY range that is explicitly stated. However, this finding may reflect consideration of other factors that drive a small number of NICE decisions or cannot be easily quantified.”Read Full Post | Make a Comment ( Comments Off on The influence of cost-effectiveness and other factors on NICE decisions – Centre for Health Economics, University of York – November 2013 )
Reassessing existing funded health services and products to support appropriate care – Canadian Foundation for Healthcare Improvement – 29 November 2013
“In Ontario, new healthcare services and technologies coming into the system must undergo a rigorous evidence-based assessment. But what about existing services and technologies that are already in use? Which of those should be subjected to new evidence-based analyses to determine if they add value and are appropriate? Without a framework to identify priorities for reassessment from the thousands of existing funded services and products, the prospect of determining which services to scale back, focus or discontinue would be problematic at best.”
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Improving patient flow across organisations and pathways: evidence scan – The Health Foundation – November 2013
“Poor patient flow increases the likelihood of harm to patients and raises healthcare costs by failing to make the best use of skilled staff time. This evidence scan compiles examples, from published empirical research, of strategies used to help improve patient flow across organisations or pathways of care.
The scan addressed the question:
What empirical literature exists about methods to analyse or alter patient flow across organisations or pathways of care?
The empirical evidence reviewed by the scan suggests that healthcare teams wanting to analyse and alter patient flow should note the following key learning points:”
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International Profiles of Health Care Systems, 2013 – The Commonwealth Fund – 14 November 2013
S. Thomson, R. Osborn, D. Squires, and M. Jun, International Profiles of Health Care Systems, 2013, The Commonwealth Fund, November 2013.
“This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.”Read Full Post | Make a Comment ( Comments Off on International Profiles of Health Care Systems, 2013 – The Commonwealth Fund – 14 November 2013 )
Strategic transformation: How the Best Companies for Leadership excel at both innovation and operational excellence – Hay Group – October 2013
“The Best Companies for Leadership identified in Hay Group’s 2013 survey avoid intermittent revolutions that are normally forged by periodic strategic reviews. Instead, these companies are as adept at innovation as they are at operational excellence. These are the twin peaks they must ascend simultaneously – a feat that requires an unusual but crucial mix of leadership skills.”
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Organizational Factors that Contribute to Operational Failures in Hospitals – Harvard Business School – 1 October 2013
by Anita L. Tucker, W. Scott Heisler, and Laura D. Janisse
“Executive summary – Despite a pressing need to do so, hospitals are struggling to improve efficiency, quality of care, and patient experience. Operational failures—defined as instances where an employee does not have the supplies, equipment, information, or people needed to complete work tasks—contribute to hospitals’ poor performance. Such failures waste at least 10 percent of caregivers’ time, delay care, and contribute to safety lapses. This paper seeks to increase hospital productivity and quality of care by uncovering organizational factors associated with operational failures so that hospitals can reduce the frequency with which these failures occur. The authors, together with a team of 25 people, conducted direct observations of nurses on the medical/surgical wards of two hospitals, which surfaced 120 operational failures. The team also shadowed employees from the support departments that provided materials, medications, and equipment needed for patient care, tracing the flow of materials through the organizations’ internal supply chains. This approach made it possible to discover organizational factors associated with the occurrence and persistence of operational failures. Overall, the study develops propositions that low levels of internal integration among upstream supply departments contributed to operational failures experienced by downstream frontline staff, thus negatively impacting performance outcomes, such as quality, timeliness, and efficiency. Key concepts include:”
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Better health, better care, better value for all: Refocusing health care reform in Canada – Health Council of Canada – September 2013
“This report looks back on the last decade of health care reform, identifies what worked and what didn’t, and recommends a
better path to achieving a high-performing health system for Canada into the future.”
Building resilient and innovative health systems – European Observatory on Health Systems and Policies – 2013
“Eurohealth Observer – What makes health systems resilient and innovative?, Advancing public health in Europe and the US, Mental health in Europe, EU-US free-trade zone, Health at your fingertips, The future of health; Eurohealth International – Investing in Health, Improving care for multiple chronic conditions, Societal impact of health care research; Eurohealth Systems and Policies – Governed co-ordination (Austria), Transition towards universal coverage (USA), Pursuing efficiency (Lithuania); and Eurohealth Monitor. “Read Full Post | Make a Comment ( Comments Off on Building resilient and innovative health systems – European Observatory on Health Systems and Policies – 2013 )
A problem solving primer – DesignGov – September 2013
“Design is disciplined set of actions (and decisions) that takes you from a current state to a better future state. But it is not the only methodology for doing so. There are a growing range of approaches that aim to improve on the status quo and to create better futures and address the problems faced by the public sector.
Where should you start when problem solving? What role does design play? What role does innovation play?
DesignGov is seeking to leverage the expertise, the experience, and the wisdom of decision makers, practitioners and all-round talented people to collect together some insights about what makes for good problem solving.
DesignGov approached a number of people in our networks to contribute short pieces against the following four questions:
What one thing would you recommend when dealing with limited resources and competing priorities?
What is the key thing to remember when you are confronted by complex problems?
When you’re confronted with a difficult issue, where do you start?
What is your favourite tool or technique to use in problem solving?”Read Full Post | Make a Comment ( Comments Off on A problem solving primer – DesignGov – September 2013 )
Employee Outlook: Focus on culture change and patient care in the NHS – CIPD (Chartered Institute of Personnel and Development) – 9 September 2013
“The CIPD, in partnership with the Healthcare People Management Association (HPMA), commissioned YouGov to conduct a survey of employees working in the healthcare sector in the UK to find out their attitudes to working in the sector, the values in NHS organisations, trust within the health service, and culture change to improve patient care in the NHS. We received 1,021 responses to the online survey.
Attitudes to working in the sector
The survey explored the reasons why employees are attracted to working in the healthcare sector, the level of pride they feel in working for the NHS, levels of employee engagement, motivation and work-life balance, job satisfaction and relationships with colleagues, and opportunities for development.
Values within the NHS
The survey also looked at health sector workers’ awareness of their organisation’s values, and the strength of these values. Employees also gave their views on whether the decisions made by senior leaders, other staff and themselves are in line with their organisation’s values.
Trust in the health service
We examined the issue of trust in the health service, asking employees whether they are treated fairly by their employer and whether their employer has good intentions and high integrity. The survey also asked employees for their views on the behaviours of leaders, line managers and colleagues.
We asked respondents whether there has been a culture change initiative in their organisation to improve patient care, and their views on the effectiveness of any initiative. We examined employee views on whether the way they are recognised and rewarded supports efforts to deliver high-quality patient care. The survey looked at obstacles to improving patient care, changes that would improve it, and concern over potential future patient care crisis.”
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Future Hospital Commission: Care comes to the patient in the future hospital – Royal College of Physicians – 12 September 2013
“A new report from the Future Hospital Commission recommends that in future, care should come to the acutely ill patient, rather than the patient being moved around the hospital.
This is one of 50 recommendations aimed at improving care for acute medical patients in Future Hospital: Caring for medical patients, which puts the patient experience and the concept of ‘clinician citizenship’ back into the very heart of healthcare. This is matched with a radical restructuring of the wards where acutely ill patients are treated, and a new organisational and management structure whose responsibilities for acutely ill medical patients will stretch out from the hospital into the wider community, developing the idea of a local healthcare system.”
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“This report shows how consortia work in practice, what the barriers are and how these barriers can be overcome.
Case studies detail how networks can support the integration of care and services in different ways, including commissioning services together, providing services together and delivering services together.
The work of the People Powered Health teams has shown that three core actions are necessary for partnerships to be successful – establishing a common purpose, developing a shared culture and enabling information sharing and open dialogue.”
Read Full Post | Make a Comment ( Comments Off on Networks that work: partnerships for integrated care and services – Nesta – August 2013 )
Personal health budgets: challenges for commissioners and policy-makers – Nuffield Trust – August 2013
“A personal health budget is an allocation of NHS money to someone with an identified health need so that they can buy the services they think will improve certain aspects of their health and wellbeing. It is intended to give the recipient more control over the care that they receive.
In 2009 the Department of Health launched a pilot programme to look at the viability of personal health budgets and an independent evaluation was carried out. It was found that they have a positive impact on care-related quality of life and wellbeing and are cost-effective. It was recommended that they should have a wider roll-out. The Government has since committed that from April 2014 everyone who receives NHS continuing health care funding will have a right to request a personal health budget rather than receiving commissioned services. This will present issues and challenges for commissioners and policy-makers.
In this research summary we describe what personal health budgets are and how they are supposed to work in practice. We also look at the evidence from the national evaluation and explore some of the issues that will be raised for commissioners and policy-makers as personal health budgets are rolled out.”Read Full Post | Make a Comment ( Comments Off on Personal health budgets: challenges for commissioners and policy-makers – Nuffield Trust – August 2013 )
Better procurement, better value, better care: a procurement development programme for the NHS – NHS England – 5 August 2013
“This document sets out details of the NHS Procurement Development Programme, which aims to help the NHS save £1.5 billion by 2015 to 2016.
The programme sets out 4 major actions:
achieving immediate efficiencies and productivity gains
improving data, information and transparency
improving outcomes at a reduced cost through clinical procurement review partnerships
improving leadership and capability of procurement in the NHS
The report also gives examples of how money can be saved in the main NHS spending areas.”
Obsessive Hope Disorder – ConNetica – 6 August 2013
“Obsessive Hope Disorder examines mental health reform in Australia since the Richmond Report and Inquiry into Health Services for the Psychiatrically Ill and Developmentally Disabled in 1983 and the report by the then Federal Human Rights Commissioner, Brian Burdekin in 1993.”
Other links on the reportRead Full Post | Make a Comment ( Comments Off on Obsessive Hope Disorder – ConNetica – 6 August 2013 )
“NHS England sets out call to action to staff, public and politicians to help NHS meet future demand and tackle funding gap through ‘honest and realistic’ debate.
NHS England has today called on the public, NHS staff and politicians to have an open and honest debate about the future shape of the NHS in order to meet rising demand, introduce new technology and meet the expectations of its patients. This is set against a backdrop of flat funding which, if services continue to be delivered in the same way as now, will result in a funding gap which could grow to £30bn between 2013/14 to 2020/21.
A new publication, ‘The NHS belongs to the people: a call to action’ sets out these challenges facing the NHS, including more people living longer with more complex conditions, increasing costs whilst funding remains flat and rising expectation of the quality of care. The document says clearly that the NHS must change to meet these demands and make the most of new medicines and technology and that it will not contemplate reducing or charging for core services.”
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Integrated care in Northern Ireland, Scotland and Wales: Lessons for England – The King’s Fund – 16 July 2013
“At a time when policy-makers in England have made a commitment to bring about closer integration of care both within the NHS and between health and social care, what can the health and social care system in England learn from the experiences of the other countries of the United Kingdom?
Integrated care in Northern Ireland, Scotland and Wales examines the context in which health and social care is provided; identifies policy initiatives that promote integrated care and the impact of these initiatives; and considers the barriers and challenges to achieving integrated care. The King’s Fund commissioned authors in each of the three countries to write a paper considering these issues. The authors reflect on what England can learn, drawing on their own experience of what has and has not been achieved.
The report concludes that structural integration of health and social care will not bring benefits in itself but must be accompanied by other changes.”Read Full Post | Make a Comment ( Comments Off on Integrated care in Northern Ireland, Scotland and Wales: Lessons for England – The King’s Fund – 16 July 2013 )
“On 5 July 2013, the NHS reached its 65th anniversary. To mark this milestone, the Nuffield Trust has been carrying out a number of activities to promote debate and discussion on the current state of the NHS and social care system, and its future prospects.
This publication is the centrepiece of our activities. Enclosed are interviews and essays with a cast list of 65 health and political leaders, consisting of current and former health secretaries and ministers, senior civil servants, clinicians, managers, academics, patient representatives, journalists and other key individuals. It is edited by Nuffield Trust Senior Associate Nick Timmins, who has reprised a role he performed for the Nuffield Trust back in 2008 when we took a similar temperature check of the views of leaders at the time of the NHS’s 60th anniversary.”
… continuesRead Full Post | Make a Comment ( Comments Off on The wisdom of the crowd: 65 views of the NHS at 65 – Nuffield Trust – July 2013 )
” This paper aims to probe what it sees as a woefully under-explored area: the differences between the United Kingdom’s four separate health systems. These systems, it argues, are diverging in terms of structures, management approaches, and the way social care relates to health.
In theory, this divergence should offer a unique opportunity to establish ‘what works’ in these different approaches. In practice, the exercise is hampered by hard-to-compare data and a political reluctance to back comparative studies.
Much more could be done to facilitate such studies. To this end, the paper explores devolution, finance and politics, documenting areas that diverge and those where cross-border transfer of policy has occurred. It concludes by listing opportunities for cross-border learning that are being ignored.”
… continuesRead Full Post | Make a Comment ( Comments Off on The four UK health systems: Learning from each other – The King’s Fund – 13 June 2013 )
Under-nutrition: Removing barriers to efficient patient nutrition within both the hospital and home-care setting – European Health Management Association – report from a workshop held November 2012
Under-nutrition: Removing barriers to efficient patient nutrition within both the hospital and home-care setting. Managerial and financial incentives and strategies to ensure good nutritional care – European Health Management Association – report from a workshop held November 2012Read Full Post | Make a Comment ( Comments Off on Under-nutrition: Removing barriers to efficient patient nutrition within both the hospital and home-care setting – European Health Management Association – report from a workshop held November 2012 )
“In Progress Report 2013: Health care renewal in Canada, the Health Council reports on the progress made by jurisdictions in five priority areas of the health accords:
access and wait times;
primary health care reform and electronic health records;
disease prevention, health promotion and public health; and
Policy paper by Prof Allyson M Pollock and David PriceRead Full Post | Make a Comment ( Comments Off on Duty to care: In defence of universal health care – Centre for Labour and Social Studies – May 2013 )
Integrated Care: Our Shared Committment – Gov.UK – 13 May 2013
“A framework that outlines ways to improve health and social care integration.
This framework document on integration, signed by 12 national partners, sets out how local areas can use existing structures such as Health and Wellbeing Boards to bring together local authorities, the NHS, care and support providers, education, housing services, public health and others to make further steps towards integration.”Read Full Post | Make a Comment ( Comments Off on Integrated Care: Our Shared Committment – Gov.UK – 13 May 2013 )
“There is a growing consensus that NHS trusts in general, and the acute sector in particular, are about to enter a new phase of organisational consolidation.
A combination of system pressures may mean a wave of mergers, as trusts look to increased scale as a means of weathering staffing pressures, declining tariff payments, long-term shifts in demand and, for some, the foundation trust pipeline.
Seeking an alternative, a number of acute providers have in recent years pursued more targeted alliances – often termed ‘groups’ – to get the benefits of collaboration without the upheaval or loss of autonomy required by a merger.
With some of these arrangements now showing real promise, and leaders looking with interest to see what might be replicated, this Briefing summarises key learning from those who have already had involvement in developing healthcare groups and considers what might be done to take the concept further.”Read Full Post | Make a Comment ( Comments Off on Healthcare groups: an alternative to merger-mania? – NHS Confederation – 1 May 2013 )
Best Care at Lower Cost: The Path to Continuously Learning Health Care in America – Committee on the Learning Health Care System in America, Institute of Medicine – 2013
ISBN-10: 0-309-26073-6 ISBN-13: 978-0-309-26073-2
“America’s health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation’s economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost.
The costs of the system’s current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009–roughly $750 billion–was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances.
About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care.
This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.”Read Full Post | Make a Comment ( Comments Off on Best Care at Lower Cost: The Path to Continuously Learning Health Care in America – Committee on the Learning Health Care System in America, Institute of Medicine – 2013 )
ISBN: 0 85801 286 3Read Full Post | Make a Comment ( Comments Off on Healthcare: Reform or ration – ceda – committee for economic development of australia – April 2013 )
Findings from 16 integrated care pilot initiatives in EnglandRead Full Post | Make a Comment ( Comments Off on Does integrated care deliver the benefits expected? – RAND – May 2013 )
Countering the biggest risk of all: attempting to govern uncertainty in healthcare management – Good Governance Institute – May 2013
by Paul Moore ISBN 978-1-907610-19-6
Extract from the introduction:
“I advance in this report a simple model for the governance of risk in healthcare settings, wherein it is proposed that effective assurance and resilience are dependent upon, or proportional to:
(i) clarity of organisational purpose and objectives;
(ii) effective treatment and monitoring of risk; and
(iii) robust accountability. Organisational culture and the behaviour of leaders also play a vital role in the development of good governance, as highlighted by Francis (2013a, 2013b, 2013c) and many others.
The Good Governance Institute (GGI) supports organisations to enhance their capacity to govern and control, but is increasingly asked what tools or techniques could be deployed to help boards protect their organisations against a broad set of high-consequence risks. This report enables the advancement of a new governance paradigm – a simplification, rationalisation and realignment of the basic elements of the clinical governance concept. Thus a new model is presented for countering the biggest risk of all – failing to make risk visible and failing to adapt to protect everything of value.”Read Full Post | Make a Comment ( Comments Off on Countering the biggest risk of all: attempting to govern uncertainty in healthcare management – Good Governance Institute – May 2013 )
“Metrics for the Second Curve of Health Care” expands on four strategies originally identified in the report, “Hospitals and Care Systems of the Future.” These strategies were identified as major priorities for hospitals and health care organizations moving from the volume-based first curve to the value-based second curve.
Aligning hospitals, physicians and other clinical providers across the continuum of care
Utilizing evidence-based practices to improve quality and patient safety
Improving efficiency through productivity and financial management
Developing integrated information systems
The NHS hospital complaints system. A case for urgent treatment? – Parliamentary and Health Service Ombudsman – 29 April 2013
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Are We There Yet? Models of Medical Leadership and their effectiveness: An Exploratory Study – NHS National Institute for Health Research – April 2013
Dickinson H, Ham C, Snelling I, Spurgeon P. Are We There Yet? Models of Medical Leadership and their effectiveness: An Exploratory Study. Final report. NIHR Service Delivery and Organisation programme; 2013Read Full Post | Make a Comment ( Comments Off on Are We There Yet? Models of Medical Leadership and their effectiveness: An Exploratory Study – NHS National Institute for Health Research – April 2013 )
Rights, risks and responsibilities in service redesign for vulnerable groups – Royal College of Nursing Guidance – April 2013
Extract from the background:
“In 2012 RCN Congress debated the issue of service redesign. The debate addressed the implications of redesign: the potential loss and fragmentation of specialist knowledge, expertise and staff, and the consequent effect on delivery of high quality services for vulnerable groups such as children, older people and those with learning disabilities or mental health conditions.
This document is designed to support RCN members engaged in service redesign to identify issues and mitigate against risks. While aimed primarily at nurses working with vulnerable groups, the core principles identified in this guidance may be helpful for any member going through any process of service redesign.
Although service redesign may be required to improve patient pathways, move care closer to home, maximise efficiency or centralise specialist services, it needs to be undertaken in the context of planned and managed networks of care which preserve the specialist knowledge, skills and expertise required. The RCN believes that the NHS needs systems in place to spread good practice and encourage real, well-planned service redesign and better collaboration between all organisations involved in delivering health and social care, rather than short-term, financially driven redesign.”
… continuesRead Full Post | Make a Comment ( Comments Off on Rights, risks and responsibilities in service redesign for vulnerable groups – Royal College of Nursing Guidance – April 2013 )
“Encouraging improvement through changing the relationships between healthcare service users and providers is a key area of work for the Health Foundation.
This report aims to contribute to the understanding of how changing relationships impacts on the quality of care. It does this by reviewing the conceptual and theoretical literature on relationships between service users and providers and then exploring the extent to which a chosen set of interventions correlate with the conceptual evidence, and their likely impacts on the quality of care.”
… continuesRead Full Post | Make a Comment ( Comments Off on The puzzle of changing relationships – The Health Foundation – March 2013 )
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