Embedding health literacy into health systems: a case study of a regional health service

2017 ◽  
Vol 41 (6) ◽  
pp. 621 ◽  
Author(s):  
Lucia Vellar ◽  
Fiorina Mastroianni ◽  
Kelly Lambert
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Health Information ◽  
Health Systems ◽  
Health District ◽  
Local Health ◽  
Consumer Health ◽  
Regional Health

Objective The aim of the present study was to describe how one regional health service the Illawarra Shoalhaven Local Health District embedded health literacy principles into health systems over a 3-year period. Methods Using a case study approach, this article describes the development of key programs and the manner in which clinical incidents were used to create a health environment that allows consumers the right to equitably access quality health services and to participate in their own health care. Results The key outcomes demonstrating successful embedding of health literacy into health systems in this regional health service include the creation of a governance structure and web-based platform for developing and testing plain English consumer health information, a clearly defined process to engage with consumers, development of the health literacy ambassador training program and integrating health literacy into clinical quality improvement processes via a formal program with consumers to guide processes such as improvements to access and navigation around hospital sites. Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems. What is known about the topic? Poor health literacy is a significant national concern in Australia. The leadership, governance and consumer partnership culture of a health organisation can have considerable effects on an individual’s ability to access, understand and apply the health-related information and services available to them. Currently, only 40% of consumers in Australia have the health literacy skills needed to understand everyday health information to effectively access and use health services. What does this paper add? Addressing health literacy in a coordinated way has the potential to increase safety and quality of care. This paper outlines the practical and sustainable actions the Illawarra Shoalhaven Local Health District took to partner with consumers to address health literacy and to improve the health experience and health outcomes of consumers. Embedding health literacy into public health services requires a coordinated whole-of-organisation approach; it requires the integration of leadership and governance, revision of consumer health information and revision of consumer and staff processes to effect change and support the delivery of health-literate healthcare services. What are the implications for practitioners? Embedding health literacy into health systems promotes equitable, safe and quality healthcare. Practitioners in a health-literate environment adopt consumer-centred communication and care strategies, provide information in a way that is easy to understand and follow and involve consumers and their families in decisions regarding and management of the consumer’s care.

scholarly journals Re-orientation of Health Services towards Health Promotion: An Australian Case Study of Aborted Health Service Reform

2006 ◽  
Vol 12 (2) ◽  
pp. 24 ◽  
Author(s):  
Fran Baum ◽  
Helen van Eyk ◽  
Catherine Hurley
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Health Service ◽  
Health Services ◽  
Health Care Reform ◽  
Health Systems ◽  
Local Health ◽  
Continuous Change ◽  
The Impact

This paper examines a case study of local health care reform in Australia that had as one of its aims the desire to increase the health promotion and partnership work of the region. The case study highlights the pressures contemporary health systems are facing and the challenge of re-orientating health services towards health promotion in this environment. Qualitative research, including interviews, focus groups, a staff survey and policy analysis were used to identify health system professionals? perceptions of the impact of health care reform. The case study portrays a complex system that is subject to frequent change but little reform. Our case study indicates that features of health systems that encourage collaborative partnerships are those where there is: an environment that encourages trust; a common purpose among the key players; a supportive external environment; practical projects to work on; organisational stability; commitment from staff throughout organisations; willingness to commit resources; evidence that change is likely to improve outcomes for users; and an organisational environment in which learning from past experience is encouraged. A number of constraints and tensions that work against introducing a greater emphasis on health promotion and collaboration within the system studied are discussed, including tensions between central funding bureaucracies and health care agencies and the reform fatigue and increasing cynicism among staff resulting from continuous change. The paper concludes that against the chaotic background of contemporary health service reform it is very difficult to bring about genuine reform to achieve a shift to more emphasis on health promotion and partnerships.

scholarly journals Qualitative analysis of the coordination of major system change within the Colombian health system in response to COVID-19: study protocol

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Simon Turner ◽  
Natalia Niño
Keyword(s):  
Health Service ◽  
Health Services ◽  
Health System ◽  
Case Studies ◽  
Health Systems ◽  
National Level ◽  
System Change ◽  
Service Planning ◽  
Local Health ◽  
Health Service Planning

Abstract Background Coronavirus (COVID-19) is posing a major and unprecedented challenge to health service planning and delivery across health systems internationally. This nationally funded study is analysing the response of the Colombian health system to the COVID-19 pandemic, drawing on qualitative case studies of three local health systems within the country. The approach will be informed by the concept of ‘major system change’—or coordinated change among a variety of healthcare organizations and other relevant stakeholders— to identify processes that both enable and inhibit adaptation of health services to the challenges presented by COVID-19. The study will collect information on capacity ‘bottlenecks’ as well as successful practices and forms of innovation that have emerged locally, which have the potential for being ‘scaled up’ across Colombia’s health services. Methods/design This qualitative study will be undertaken in two phases. In the first, up to 30 stakeholder interviews will be conducted to ascertain immediate challenges and opportunities for improvement in response to COVID-19 that can be shared in a timely way with health service leaders to inform health service planning. The stakeholders will include planning, provider and intermediary organizations within the health system at the national level. In the second, up to 60 further interviews will be conducted to develop in-depth case studies of three local health systems at the metropolitan area level within Colombia. The interview data will be supplemented with documentary analysis and, where feasible, non-participant observation of planning meetings. Discussion The study’s findings will aid evaluation of the relevance of the concept of major system change in a context of ‘crisis’ decision-making and contribute to international lessons on improving health systems’ capacity to respond to COVID-19 and future pandemics. Study findings will be shared among various stakeholders in the Colombian healthcare system in a formative and timely way in order to inform healthcare planning in response to COVID-19 and future pandemics. Conducting the study at a time of COVID-19 raises a number of practical issues (including physical distancing and pressure on health services) which have been anticipated in the study design and research team’s ways of working.

scholarly journals Is health systems integration being advanced through Local Health District planning?

2017 ◽  
Vol 41 (2) ◽  
pp. 154
Author(s):  
Carla Saunders ◽  
David J. Carter
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Systems ◽  
Systems Integration ◽  
Health District ◽  
Local Health ◽  
Service Plan ◽  
Integration Strategies ◽  
Health Systems Integration ◽  
Health Districts

Objective Delivering genuine integrated health care is one of three strategic directions in the New South Wales (NSW) Government State Health Plan: Towards 2021. This study investigated the current key health service plan of each NSW Local Health District (LHD) to evaluate the extent and nature of health systems integration strategies that are currently planned. Methods A scoping review was conducted to identify common key principles and practices for successful health systems integration to enable the development of an appraisal tool to content assess LHD strategic health service plans. Results The strategies that are planned for health systems integration across LHDs focus most often on improvements in coordination, health care access and care delivery for complex at-risk patients across the care continuum by both state- and commonwealth-funded systems, providers and agencies. The most common reasons given for integrated activities were to reduce avoidable hospitalisation, avoid inappropriate emergency department attendance and improve patient care. Conclusions Despite the importance of health systems integration and finding that all NSW LHDs have made some commitment towards integration in their current strategic health plans, this analysis suggests that health systems integration is in relatively early development across NSW. What is known about the topic? Effective approaches to managing complex chronic diseases have been found to involve health systems integration, which necessitates sound communication and connection between healthcare providers across community and hospital settings. Planning based on current health systems integration knowledge to ensure the efficient use of scarce resources is a responsibility of all health systems. What does this paper add? Appropriate planning and implementation of health systems integration is becoming an increasingly important expectation and requirement of effective health systems. The present study is the first of its kind to assess the planned activity in health systems integration in the NSW public health system. NSW health districts play a central role in health systems integration; each health service plan outlines the strategic directions for the development and delivery of all state-funded services across each district for the coming years, equating to hundreds of millions of dollars in health sector funding. The inclusion of effective health systems integration strategies allows Local Health Districts to lay the foundation for quality patient outcomes and long-term financial sustainability despite projected increases in demand for health services. What are the implications for practice? Establishing robust ongoing mechanisms for effective health systems integration is now a necessary part of health planning. The present study identifies several key areas and strategies that are wide in scope and indicative of efforts towards health systems integration, which may support Local Health Districts and other organisations in systematic planning and implementation.

First impressions: towards becoming a health-literate health service

2014 ◽  
Vol 38 (2) ◽  
pp. 190 ◽  
Author(s):  
Anne Johnson
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Rural Health ◽  
Health Information ◽  
First Impressions ◽  
Phone Call ◽  
Literacy Environment ◽  
Rural Health Service ◽  
Lack Of Information

A ‘health-literate organisation’ recognises that miscommunication is very common and can negatively affect consumer care and outcomes, and makes it easier for people to navigate, understand, and use health information and services. This paper reports on the First Impressions Activities conducted by consumers to assess aspects of the literacy environment of a rural health service. The First Impressions Activities consists of three tools to assist health services to begin to consider some of the characteristics of their organisation that help and hinder a consumer’s ability to physically navigate their way to and about the health service. The results show that navigation to and within the rural health service was made more complex due to lack of information, difficulty finding information, inconsistent terminology used in signage, missing signage, signage obscured by foliage, and incorrect signage. What is known about the topic? The environment of a health service represents the health literacy expectations, preferences and skills of those providing health information and services. What does this paper add? This case study offers insight into the literacy demands placed on consumers, as well as an effective tool to assess aspects of those health literacy demands. What are the implications for practitioners? Health services can use the First Impressions Activities to actively engage consumers in the assessment of their first impressions of the health service shaped by a phone call, a visit to the website and a walk to the entrance and to different destinations. These activities can assist a health service to begin to examine the navigation of the service through ‘fresh eyes’, using a structured process to identify ways to decrease the health literacy demands on consumers.

scholarly journals Qualitative Analysis of the Coordination of Major System Change Within the Colombian Health System in Response to COVID-19: Study Protocol

2020 ◽  
Author(s):  
Simon Turner ◽  
Natalia Niño
Keyword(s):  
Health Service ◽  
Health Services ◽  
Health System ◽  
Case Studies ◽  
Health Systems ◽  
National Level ◽  
System Change ◽  
Service Planning ◽  
Local Health ◽  
Health Service Planning

Abstract Background Coronavirus (COVID-19) is posing a major and unprecedented challenge to health service planning and delivery across health systems internationally. This nationally-funded study is analysing the response of the Colombian health system to the COVID-19 pandemic, drawing on qualitative case studies of three local health systems within the country. The approach will be informed by the concept of 'major system change' - or coordinated change among a variety of healthcare organisations and other relevant stakeholders - in order to identify processes that both enable and inhibit adaptation of health services to the challenges presented by COVID-19. The study will collect information on capacity “bottlenecks” as well as successful practices and forms of innovation that have emerged locally, which have the potential for being 'scaled up' across Colombia's health services. Methods/design This qualitative study will be undertaken in two phases. In the first, up to 30 stakeholder interviews will be conducted to ascertain and share immediate challenges and opportunities for improvement in response to COVID-19 that can be shared in a timely way with health service leaders to inform immediate health service planning. The stakeholders will be selected in order to sample a range of planning, provider and intermediary organizations within the health system at the national level. In the second, up to 60 further interviews will be conducted to develop in-depth case studies of three local health systems at the metropolitan area level within Colombia. The interview data will be supplemented with documentary analysis and, where feasible, non-participant observation of meetings directly related to the planning and implementation of actions responding to COVID-19. The study will also establish mechanisms for providing timely, formative feedback to inform health system planning relating to COVID-19 and future pandemics by ascertaining stakeholders' preferences during the interviews and wider scoping discussions. Discussion The study's findings will aid evaluation of the relevance of the concept of major system change in a context of 'crisis' decision-making and contribute to international lessons on improving health systems' capacity to respond to COVID-19 and future pandemics. Study findings will be shared among various stakeholders in the Colombian healthcare system in a formative and timely way in order to inform healthcare planning in response to COVID-19 and future pandemics. Conducting the study at a time of COVID-19 raises a number of practical issues (including physical distancing and pressure on health services) which have been anticipated in the study design and research team's ways of working.

scholarly journals How to increase the value of self-reported health service data by using data linkage: a case study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
W Peng ◽  
J Maguire ◽  
A Hayen ◽  
J Adams ◽  
D Sibbritt
Keyword(s):  
Data Collection ◽  
Health Service ◽  
Health Services ◽  
Stroke Prevention ◽  
Data Linkage ◽  
Recurrent Stroke ◽  
Service Planning ◽  
Stroke Survivors ◽  
Reported Data

Abstract Background This is a case study for recurrent stroke prevention. Lifestyle factors account for about 80% of the risk of recurrent stroke. Most health services studies examining stroke prevention rely on stroke survivors' self-reported lifestyle behaviour data. How can researchers increase the value of collected self-reported data to provide additional information for more comprehensive assessments? Methods 45 and Up Study is the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. This case study linked self-reported longitudinal lifestyle data in the 45 and Up Study, with corresponding mortality data (i.e. NSW Registry of Births, Deaths and Marriages & NSW Cause of Death Unit Record File) and hospital data (i.e. NSW Admitted Patient Data Collection) via the Centre for Health Record Linkage (CHeReL). The main outcome measures are health services, clinical outcomes, and mortality rates for stroke care. The analyses will include descriptive analysis, multivariate regression analysis, and survival analysis. Results A total of 8410 stroke survivors who participated in the 45 and Up Study were included in this data linkage study. From January 2006 to December 2015, 99249 hospital claims (mean: 13 times admission to hospital per person) and 2656 death registration records have been linked to these participants. The mean age of the stroke survivors was 72 (SD = 11) years, with 56% being males. These results are preliminary and more analyses will be conducted by using quality of life status, clinical diagnosis, comorbidities, and procedures. Conclusions Data linkage enables researchers to generate comprehensive findings on health services studies and gain a more holistic understanding of the determinants and outcomes of stroke prevention with lower data collection costs and less burden on participants. Key messages Data linkage brings about a new opportunity for self-reported data on health services utilisation. It is a cost-effective way to enhance existing self-reported data via the data linkage approach to increase its usefulness for informing health service planning.

scholarly journals Health literacy and health outcomes in China’s floating population: mediating effects of health service

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hai-YanYu ◽  
Wei-Ling Wu ◽  
Lin-Wei Yu ◽  
Lei Wu
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Health Outcomes ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Mediating Effect ◽  
Floating Population ◽  
Equation Modeling ◽  
Mediating Effects

Abstract Background The floating population in China consists primarily of internal immigrants and represents a typical health vulnerable group. Poor health literacy has recently become an obstacle in the accessibility and utilization of health services for the vulnerable population, leading to adverse health outcomes. This study aimed to examine whether health literacy affected health outcomes in China’s floating population and whether health service utilization had a mediating effect between health literacy and health outcomes. Method The current study utilized a cross-sectional stratified, multistage, proportional to scale (PPS) study in Zhejiang Province, China, in November and December 2019. In total, 657 valid self-reported questionnaires were recovered and used for data collection. Questionnaires included questions regarding sociodemographic characteristics, health literacy, health outcomes, and health service utilization. Confirmatory factor analysis was used to test questionnaire validity; descriptive statistics were used to understand the demographic characteristics of the floating population; and structural equation modeling was used to determine whether health service utilization mediated health literacy and health outcomes. Results We report positive correlations between health literacy, health service utilization, and health outcomes. Mediation analysis demonstrated that health service utilization had partial mediating effects between health literacy and health outcomes. In the relationship between health literacy and health outcomes, the indirect effects of health service utilization accounted for 6.6–8.7% of the total effects. Conclusion Complete health literacy, through health care literacy and health promotion literacy, affects the mobile population’s initiative to use health services, which, in turn, affects health outcomes. Thus, improving the health literacy of the floating population will help to improve health outcomes. Furthermore, health service providers should enhance the diversity of health service supply to ensure that the floating population has the external resources to improve personal health literacy.

Context, culture and control: a case study on accounting change in an Italian regional health service

2019 ◽  
Vol 24 (1) ◽  
pp. 229-272 ◽  
Author(s):  
Rosanna Spanò ◽  
Adele Caldarelli ◽  
Luca Ferri ◽  
Marco Maffei
Keyword(s):  
Health Service ◽  
Regional Health ◽  
And Control

scholarly journals Factors supporting retention of health and wellbeing staff in Aboriginal health services: a strength-based case study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara Deroy ◽  
Heike Schütze
Keyword(s):  
Health Service ◽  
Health Services ◽  
Aboriginal Health ◽  
Social Accountability ◽  
Cultural Safety ◽  
Staff Retention ◽  
Professional Advancement ◽  
Aboriginal Community ◽  
Health And Wellbeing

Abstract Background Aboriginal Community Controlled Health Services are fundamental to improving the health and welfare of Aboriginal peoples. A key element that contributes to the effectiveness of these services are Aboriginal health and wellbeing staff. However, Aboriginal health and wellbeing staff often suffer high rates of stress and burnout. Current literature focuses on proposed strategies to increase staff retention in Aboriginal Health Services, yet, there is limited information available showcasing what has actually worked. Method This was an intrinsic strengths-based case study of one regional Aboriginal Community Controlled Health Service. Semi-structured research yarning interviews were conducted with past and present staff employed in health and wellbeing roles to highlight the factors that staff felt contributed to their retention. Results Ten interviews were conducted between February and April 2018. Six key themes emerged: social accountability, teamwork and collaboration, cultural safety, supervision, professional advancement, and recognition. We add to the literature by identifying the importance of bi-directional communication, and showing that social accountability, teamwork and collaboration, cultural safety, supervision, professional advancement, and recognition continue to be important factors that contribute to health and wellbeing staff retention in Aboriginal Health Services. Conclusion This exemplar Aboriginal Health Service may provide insights into future strategies to improve staff retention in other health services.

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