scholarly journals The role of boards in clinical governance: activities and attitudes among members of public health service boards in Victoria

2013 ◽  
Vol 37 (5) ◽  
pp. 682 ◽  
Author(s):  
Marie M. Bismark ◽  
Simon J. Walter ◽  
David M. Studdert

Objectives To determine the nature and extent of governance activities by health service boards in relation to quality and safety of care and to gauge the expertise and perspectives of board members in this area. Methods This study used an online and postal survey of the Board Chair, Quality Committee Chair and two randomly selected members from the boards of all 85 health services in Victoria. Seventy percent (233/332) of members surveyed responded and 96% (82/85) of boards had at least one member respond. Results Most boards had quality performance as a standing item on meeting agendas (79%) and reviewed data on medication errors and hospital-acquired infections at least quarterly (77%). Fewer boards benchmarked their service’s quality performance against external comparators (50%) or offered board members formal training on quality (53%). Eighty-two percent of board members identified quality as a top priority for board oversight, yet members generally considered their boards to be a relatively minor force in shaping the quality of care. There was a positive correlation between the size of health services (total budget, inpatient separations) and their board’s level of engagement in quality-related activities. Ninety percent of board members indicated that additional training in quality and safety would be ‘moderately useful’ or ‘very useful’. Almost every respondent believed the overall quality of care their service delivered was as good as, or better than, the typical Victorian health service. Conclusions Collectively, health service boards are engaged in an impressive range of clinical governance activities. However, the extent of engagement is uneven across boards, certain knowledge deficits are evident and there was wide agreement among board members that further training in quality-related issues would be useful. What is known about the topic? There is an emerging international consensus that effective board leadership is a vital element of high-quality healthcare. In Australia, new National Health Standards require all public health service boards to have a ‘system of governance that actively manages patient safety and quality risks’. What does this paper add? Our survey of all public health service Boards in Victoria found that, overall, boards are engaged in an impressive range of clinical governance activities. However, tensions are evident. First, whereas some boards are strongly engaged in clinical governance, others report relatively little activity. Second, despite 8 in 10 members rating quality as a top board priority, few members regarded boards as influential players in determining it. Third, although members regarded their boards as having strong expertise in quality, there were signs of knowledge limitations, including: near consensus that (additional) training would be useful; unfamiliarity with key national quality documents; and overly optimistic beliefs about quality performance. What are the implications for practitioners? There is scope to improve board expertise in clinical governance through tailored training programs. Better board reporting would help to address the concern of some board members that they are drowning in data yet thirsty for meaningful information. Finally, standardised frameworks for benchmarking internal quality data against external measures would help boards to assess the performance of their own health service and identify opportunities for improvement.

2020 ◽  
Vol 9 (1) ◽  
pp. 1048-1059
Author(s):  
Diding Sarifudin

Cakupan kegiatan keperawatan komunitas di Kabupaten Cirebon masih rendah, sedangkan perawat sebagai pelaksananya merupakan tenaga kesehatan terbanyak dibandingkan dengan tenaga kesehatan lainnya. Perawat melakukan asuhan keperawatan komunitas seharusnya dengan pendokummentasian atau pencatatan yang merupakan panduan sehingga kegiatannya terarah dan terpadu sesuai dengan masalah yang ditemukan. Tujuan penelitian ini adalah ingin mengetahui kualitas pencatatan asuhan keperawatan komunitas di Kabupaten Cirebon tahun 2006 dan faktor-faktor yang mempengaruhinya. Penelitian ini adalah penelitian kuantitatif dengan menggunakan rancangan cross-sectional. Data dikumpulkan dari 71 perawat puskesmas dengan menggunakan perhitungan besar sampel Lot quality assurance sampling (LQAS-Lot) secara sistematic random sampling, selain dilakukan wawancara juga dilakukan pemeriksaan catatan asuhan keperawatan masing-masing responden 5 dokumen. Penelitian dilakukan pada bulan September 2006 dengan menggunakan analisis univariat dan analisis jalur (path analysis). Dari data yang dikumpulkan diperoleh kualitas pencatatan dengan baik sebesar 59,2%. Hasil pemodelan dengan analisis jalur ternyata kepemimpinan merupakan variabel utama yang mempunyai pengaruh sebesar 46,8% terhadap kualitas pencatatan asuhan keperawatan, variabel lain yang mempunyai pengaruh terhadap kualitas pencatatan asuhan keperawatan adalah pengetahuan sebesar 31%, sikap sebesar 17,6 %, imbalan sebesar 11,6%, dan variabel masa kerja melalui sikap sebesar 4%. Kepemimpinan kepala puskesmas mampu meningkatkan kualitas pencatatan asuhan keperawatan yang dilakukan karyawannya, selain itu kepemimpinan dapat meningkatkan pengetahuan, mengatur imbalan yang diberikan, dan dapat merubah sikap karyawannya. Bagi Dinas Kesehatan yang mempunyai kewajiban membina kepala puskesmas maka harus selalu membina dan mengevaluasi kinerja kepala puskesmas.Kata Kunci : Kualitas pencataan Asuhan Keperawatan ABSTRACTScope of community nursing activity in district of Cirebon has undervalued. In fact, number of nurse resources there larger than another medical profession. They to be organized in community nursing activity and nursing activity record-keeping as principal guide, they will working in sistematic way and well integrated according to the problem raised from public health service. This research aim to determine the quality of community nursing activity record-keeping in district of Cirebon for year of 2006 and the influencing factors within. Research belong to quantitative research with cross-sectional design. Data collecting using Lot quality assurance sampling (LQAS-Lot) with sistematic random sampling method by surveying and interviewing 71 nurse from local public health services, including checking of  5 document from each respondent’s nursing record. Research taken during september 2006 and using univariat analysis and path analysis. The result shows the quality of record-keeping which noticed as good are 52,2 % in value. Modelling result from path analysis put leadership as main variable which influence the quality of nursing record-keeping at 46,8%. Another variable which having influence on quality of nursing record-keeping are nurse’s knowledge at 31%, nurse’s attitude at 17,6%, rewards at 11,6% and working period at 4%. Leadership skills of local public service’s head can improve the quality of record-keeping of community nursing activity by its employees (nurses). Besides, leaderships skills direct to improvement of knowledge, remuneration management, and change in attitude. District public health service which has responsibility in training and developing officer to become head of local public health service should  control and monitor their working performance continuously.Key word : quality of community nursing


2021 ◽  
Author(s):  
Guixia Fang ◽  
Li Wang ◽  
Yuanyuan Liang ◽  
Zhihao Wang ◽  
Jinxia Yang

UNSTRUCTURED Public health service is an important component and pathway to achieve universal health coverage (UHC), a major direction where many countries are striving for. China's National Basic Public Health Service Program are highly consistent with the direction. It provides life cycle services to the whole population with an equitable and affordable financing system. Its implementation builds up capacity and quality of health workforce and contributes to the integration of public health service delivery system. All of these is useful experience for China on its journey to UHC. Meanwhile, there are also some challenges, including lack of selection and exit mechanism of service items, inadequate system integration, shortage of qualified professionals, limited role of actors outside of health sector, and subsidy standard lower than the cost. In the future, China needs to address those challenges, especially to optimize service items, enhance quality of the services, and evaluate the health outcomes.


Author(s):  
Wuqi Qiu ◽  
Cordia Chu ◽  
Kun Wang ◽  
Yueli Meng ◽  
Yujie Yang ◽  
...  

ABSTRACT Objectives: Collaboration and cooperation are critical for public health management. Nevertheless, collaboration and cooperation between government departments, as well as other entities, are still in a weak condition in China. This article analyzes the status of collaboration and cooperation in the management of public health services in China and explores the problems and gives strategic suggestions for strengthening collaboration and cooperation in the development of public health service systems in China, in order to provide a reference for improvement of public health management in the future. Methods: This study uses a qualitative case study approach, including documents review, in-depth interview, and focus group. Results: The main problems of collaboration and cooperation in public health service management in China include problems of effective collaboration and cooperation between institutions and relevant departments, public information platform, and implementation of public health and health promotion. On this basis, several relevant policy recommendations are put forward. Conclusions: Collaboration and cooperation are critical for the overall coordination and sustainable development of public health in China, and there is still work to be done in order to achieve appropriate cooperation and collaboration between different entities in the provision of public health services.


2019 ◽  
Vol 21 (6) ◽  
pp. 1-7
Author(s):  
Alline Mikaele Nunes Wildemberg Brauer ◽  
Débora Barreto Teresa Gradella ◽  
Anelise Andrade de Souza ◽  
Marco Antônio Andrade de Souza

Objective To carry out a socioeconomic, demographic and parasitological evaluation of quilombola communities in two of the oldest municipalities in Brazil.Material and Methods Between December 2015 and June 2016, of the total of 231 residents of the communities, socioeconomic questionnaires were applied and fecal samples collected from 150 individuals were analyzed by spontaneous sedimentation method and the Kato-Katz method.Results It was observed that 95.3% (n=143) of the interviewees had piped water at their residence, and 76% (n=114) came from wells or springs; 85.3% (n=128) reported that the toilet drain was made in a rudimentary septic tank and 59.3% (n=89) reported having litter buried or burned, showing precarious conditions in basic sanitation. Still on socioeconomic aspects, 80.7% (n=121) of the individuals reported having access to the public health service. Parasitological tests were positive for 48% (n=72) of the analyzed samples, and 25% (n=18) had two or more parasites. The most frequent organism in the study population was the commensal Entamoeba coli (55.6%, n=40), followed by Ascaris lumbricoides (19.4%, n=14) and the commensal Endolimax nana (16.7%, n=12). The Poisson regression showed an increase of 1.59 in the prevalence of parasites for individuals who do not have access to the public health service, when compared to those who have access to these services.Conclusions The results indicate the need to implement public health measures in order to reduce, prevent and treat the parasitological condition of the population to obtain better conditions and quality of life.


The BACIS program was developed then implemented and evaluated. There was an overall improvement in compliance from 85.1% to 89.3% after its introduction. This result was not statistically significant. However, when results were stratified into specific categories, the BACIS program showed statistically significant improvement in compliance over the checklist system in three out of nine important categories. These are compliance at booking, patients younger than 18 years, and patients booking after week 20. Furthermore, a qualitative study was undertaken to understand reasons for non-compliance with the maternal health guidelines. These results, insights, and experiences are valuable to the communities of health, public health, and health informatics persons who are practitioners or researchers in the area of addressing issues of quality in maternal health services.


Author(s):  
Ioannis Konstantinidis ◽  
Dimitra Trikka ◽  
Spyridon Gasparatos ◽  
Miltiadis Mitsias

Aim/Purpose: The primary aim of this study was to examine the clinical performance of posterior monolithic single crowns in terms of failure or complications and the secondary aim was to assess the quality of these restorations according to the United States Public Health Service (USPHS) criteria. Methods: Ιn a private dental clinic, 65 patients with need of posterior crowns were restored with monolithic zirconia crowns. All the restorations were evaluated 6 and 12 months after their cementation. The modified United States Public Health Service (USPHS) criteria and periodontal parameters were applied for the clinical evaluation of the crowns. Restorations with Alpha or Bravo rating were considered a success. Results: Descriptive statistics and nonparametric tests were used for statistical analysis. Sixty-five patients (mean age: 49.52) were restored with 65 monolithic zirconia crowns. No fracture of the restorations was recorded. The overall success rate was 98.5%. The clinical quality of all crowns was acceptable except for the marginal discoloration of one crown at the 6- and 12-month follow-up examination. Conclusions: In this study, no fracture of single-tooth monolithic crowns occurred and the success rate was high. Monolithic zirconia restorations fabricated is a viable option for the restoration of single posterior teeth.


2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Fatkhul Rosyadi

Quality of Social Service Health Service In Puskesmas In Puskesmas Wonoayu District Sidoarjo. One form of public service organized by the government is the fulfillment of public health needs through the National Health Insurance Program, the Social Security Administering Agency (BPJS) of Health. But in the service delivery, there are still problems that often occur such as, there are always long queues, inpatient rooms are often full, drugs are limited and there are usually additional costs. Puskesmas Wonoayu is one of the faskes that serves BPJS Health participants. Therefore the quality of health services is very important in serving patients BPJS Health. In general, this study aims to measure the quality of service BPJS Health Center at Wonoayu Sidoarjo. This research uses descriptive qualitative approach. The data collection method used is observation, interview, and documentation study conducted in approximately three months. The results showed that BPJS Health Service Quality at Wonoayu Public Health Center of Sidoarjo Regency measured using Lupioadi indicator which consist of direct evidence, reliability, responsiveness, assurance, and empathy is good. But in direct evidence indicator there are facilities that are still in the process of revamping and there are also equipment officers are still lacking.Keyword: Indicators of Quality of Public Service, Health Services


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