Information Governance and Risk Stratification: Advice and Options for CCGs and GPs – NHS England – 14 June 2013

Posted on June 18, 2013. Filed under: Health Informatics | Tags: , , |

Information Governance and Risk Stratification: Advice and Options for CCGs and GPs – NHS England – 14 June 2013

“Key points

 Risk stratification tools can help determine which people in a population are at high risk of experiencing outcomes, such as unplanned hospital admissions, that are simultaneously: undesirable for patients; costly to the health service; and potential markers of low-quality care.
 Also known as predictive risk models, these tools are used widely in the NHS, both for:
o analysing the health of a population (“risk stratification for commissioning”); and
o targeting additional preventive care interventions, such as the support of a community matron, to high-risk patients (“risk stratification for case finding”).
 The Health and Social Care Act 2012 has complicated the legal landscape relating to risk stratification (see page 10).
 In this paper, we:
o explain the information governance issues relating to risk stratification
o provide a checklist of steps that GP practices, CCGs, and other organisations involved in risk stratification should undertake to comply with the law (see page 13)
o describe a range of options (options A to F) that t CCGs can use in order to conduct risk stratification legally (see page 17)”

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Countering the biggest risk of all: attempting to govern uncertainty in healthcare management – Good Governance Institute – May 2013

Posted on May 14, 2013. Filed under: Clin Governance / Risk Mgmt / Quality, Health Mgmt Policy Planning | Tags: , , |

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.”

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Global Risks 2013 – Eighth Edition – World Economic Forum – January 2013

Posted on January 23, 2013. Filed under: Aged Care / Geriatrics, Infectious Diseases | Tags: , , , |

Global Risks 2013 – Eighth Edition – World Economic Forum – January 2013

Includes a section on – The Dangers of Hubris on Human Health

“Health is a critical system that is constantly being challenged, be it by emerging pandemics or chronic illnesses. Scientific discoveries and emerging technologies allow us to face such challenges, but the medical successes of the past century may also be creating a false sense of security. Arguably, one of the most effective and common means to protect human life – the use of antibacterial and antimicrobial compounds (antibiotics) – may no longer be readily available in the near future. Every dose of antibiotics creates selective evolutionary pressures, as some bacteria survive to pass on the genetic mutations that enabled them to do so. Until now, new antibiotics have been developed to replace older, increasingly ineffective ones. However, human innovation may no longer be outpacing bacterial mutation. None of the new drugs currently in the development pipeline may be effective against certain new mutations of killer bacteria that could turn into a pandemic. Are there ways to stimulate the development of new antibiotics as well as align incentives to prevent their overuse, or are we in danger of returning to a pre-antibiotic era in which a scratch could be potentially fatal?”

and on the  Costs of Living Longer

“We are getting better at keeping people alive for longer. Are we setting up a future society struggling to cope with a mass of arthritic, demented and, above all, expensive, elderly who are in need of long term care and palliative solutions?”

ISBN: 92-95044-50-9
978-92-95044-50-0

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Communicating Risks and Benefits: An Evidence-Based User’s Guide – FDA – August 2011

Posted on September 7, 2011. Filed under: Evidence Based Practice | Tags: , |

Communicating Risks and Benefits: An Evidence-Based User’s Guide – FDA – August 2011

Baruch Fischhoff, PhD, Noel T. Brewer, PhD, & Julie S. Downs, PhD, editors

US Department of Health and Human Services, Food and Drug Administration, Risk Communication Advisory Committee and consultants
 
Extract from the introduction:

“Organizations bear economic, legal, and ethical obligations to provide useful information about the risks and benefits of their products, policies, and services. Failure to fulfill those obligations can be costly, as seen with Three Mile Island, Hurricane Katrina, Vioxx, and other cases when people believe that they have been denied vital information. Less dramatic versions of these problems arise with poorly handled produce recalls, badly labeled appliances, and confusing medication instructions. Financial analysts estimate that 70% of a typical private firm’s assets are intangibles, like goodwill, that can be lost when communications fail. Public institutions’ reputations often depend on their ability to communicate.

Risk communication is the term of art used for situations when people need good information to make sound choices. It is distinguished from public affairs (or public relations) communication by its commitment to accuracy and its avoidance of spin. Having been spun adds insult to injury for people who have been hurt because they were inadequately informed. Risk communications must deal with the benefits that risk decisions can produce (e.g., profits from investments, better health from medical procedures), as well as the risks — making the term something of a misnomer, although less clumsy than a more inclusive one.

The risk communication research literature is large and diverse, including results from many contributing disciplines (e.g., psychology, decision science, sociology, communications) and a wide range of applications. Unfortunately, the norms of academic research make it inaccessible to outsiders, filling it with jargon and technical details. Moreover, academic researchers’ theoretical interests often lead to studying communication processes in isolation, leaving gaps as to how research results apply to complex, real-world situations. Unable to access the research literature, practitioners rely on their intuition, unproven best practices, and popular accounts of psychological research.

This guide seeks to fill that gap, making evidence-based communication possible. The chapters that follow cover key topics in risk communication, focusing on three questions:

(1) What does the science say about that aspect of human behavior?
(2) What are the practical implications of those scientific results?
(3) How can one evaluate communications based on that science?

These questions assume that sound communications must be evidence-based in two related ways. One is that communications should be consistent with the science — and not do things known not to work nor ignore known problems. The second is communications should be evaluated — because even the best science cannot guarantee results. Rather, the best science produces the best-informed best guesses about how well communications will work. However, even these best guesses can miss the mark, meaning that they must be evaluated to determine how good they are and how they can be improved.”   … continues

 

 

 

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A Risk-Characterization Framework for Decision-Making at the Food and Drug Administration – National Academies Press – 2011

Posted on May 10, 2011. Filed under: Pharmacy | Tags: , |

A Risk-Characterization Framework for Decision-Making at the Food and Drug Administration – National Academies Press – 2011

Authors: Committee on Ranking FDA Product Categories Based on Health Consequences, Phase II; National Research Council

ISBN-10: 0-309-21280-4
ISBN-13: 978-0-309-21280-9

“This report, prepared by the Committee on Ranking FDA Product Categories Based on Health Consequences, Phase II, in response to the request from FDA and DHHS, describes a risk characterization framework that can be used to evaluate and compare the public-health consequences of different decisions concerning a wide variety of products.”

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Predictive risk and health care: an overview – Nuffield Trust – 2 March 2011

Posted on March 18, 2011. Filed under: Health Economics | Tags: , |

Predictive risk and health care: an overview – Nuffield Trust – 2 March 2011

Author: Dr Martin Bardsley and others

“Predictive risk adjustment tools are becoming increasingly important in the NHS, with primary care trusts (PCTs) and GP consortia expected to make greater use of such tools to stratify the health risk of the populations they serve.

These tools use relationships in historic, routinely collected electronic health data to determine the expected future health care resource use of each individual in a population. The tools can be used to estimate future events for people at different levels of risk, providing commissioners with more accurate estimates of likely future costs.

In the US and Europe, risk adjustment models are used widely to help determine health payments, either for fixing ‘capitated’ budgets or for deciding reimbursement rates for individual patients. In the NHS, the most widespread use of these techniques so far has been in the use of ‘case finding’ tools, such as the Patients At Risk of Re-hospitalisation (PARR) and the ’Combined Model’.

Predictive risk and health care: an overview explores how predictive risk adjustment techniques are currently being used in the NHS and identifies some of the challenges involved in applying the techniques in practice. The research summary also looks at emerging developments, including modelling with social care data, predicting the impact of preventive care and making shorter-term predictions of readmissions.”

…continues on the site

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Risk Communication in the Early Stages of the H1N1 (Swine Flu) Alert – How Effective Were State and Local Public Health Departments? – US – August 2009

Posted on August 14, 2009. Filed under: Influenza A(H1N1) / Swine Flu, Public Hlth & Hlth Promotion | Tags: , , |

Risk Communication in the Early Stages of the H1N1 (Swine Flu) Alert – How Effective Were State and Local Public Health  Departments?
By: Jeanne S. Ringel, Elizabeth Trentacost, Nicole Lurie

Presents an assessment of how effectively state and local health departments communicated information regarding the April 2009 H1N1 virus (swine flu) outbreak via the Web to their constituents.

RAND Corporation   3 p.    Document Number: RB-9466   Year: 2009

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