Are wait lists inevitable in subacute ambulatory and community health services? A qualitative analysis

2018 ◽  
Vol 42 (1) ◽  
pp. 93 ◽  
Author(s):  
Katherine E. Harding ◽  
Nicole Robertson ◽  
David A. Snowdon ◽  
Jennifer J. Watts ◽  
Leila Karimi ◽  
...  
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Community Health ◽  
Human Resource ◽  
Service Providers ◽  
Health Service Delivery ◽  
Community Health Services ◽  
Wait Times ◽  
High Demand ◽  
Modifiable Factors

Objectives Wait lists are common in ambulatory and community-based services. The aim of the present study was to explore managers’ perceptions of factors that contribute to wait times. Methods A qualitative study was conducted using semi-structured interviews with managers and team leaders of ambulatory and community health services within a large health network. Interviews were transcribed and coded, and the codes were then grouped into themes and subthemes. Results Representatives from 26 services participated in the project. Four major themes were identified. Three themes related to reasons and factors contributing to increased wait time for services (inefficient intake and scheduling processes; service disruptions due to human resource issues; and high service demand). A fourth theme related to staff attitudes towards wait times and acceptance and acknowledgement of wait lists. Conclusions Service providers perceive high demand to be a key driver of wait times, but a range of other factors also contributes and may represent opportunities for improving access to care. These other factors include improving process efficiencies, greater consistency of service delivery through more efficient management of human resources and shifting to more consumer-centred approaches in measuring wait times in order to drive improvements in patient flow. What is known about the topic? Wait times are common in out-patient and ambulatory services. These services experience high demand, which is likely to continue to grow as health service delivery shifts from hospital to community settings. What does this paper add? Although demand is an important driver of wait times, there are other modifiable factors that also contribute, including process inefficiencies and service disruption related to human resource issues. An underlying staff attitude of acceptance of wait times appears to be an additional barrier to improving access. What are the implications for practitioners? The findings of the present study suggest that there are opportunities for improving access to ambulatory and community health services through more efficient use of existing resources. However, a more consumer-focused approach regarding acceptability of wait times is needed to help drive change.

scholarly journals Increasing autonomy in publically owned services

2015 ◽  
Vol 29 (6) ◽  
pp. 778-794
Author(s):  
Ailsa Cameron ◽  
Pauline Allen ◽  
Lorraine Williams ◽  
Mary Alison Durand ◽  
Will Bartlett ◽  
...  
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Community Health ◽  
Design Methodology ◽  
Community Health Services ◽  
Policy Makers ◽  
Content Type ◽  
Organisational Form ◽  
Foundation Trusts ◽  
Improve Service Delivery

Purpose – The purpose of this paper is to explore government efforts to enhance the autonomy of community health services (CHS) in England through the creation of Foundation Trusts status. It considers why some CHS elected to become nascent Community Foundation Trusts (CFTs) while others had not and what advantages they thought increased levels of autonomy offered. Design/methodology/approach – Data are drawn from the evaluation of the Department of Health’s CFT pilot programme. Participants were purposively selected from pilot sites, as well as from comparator non-pilot organisations. A total of 44 staff from 14 organisations were interviewed. Findings – The data reveals that regardless of the different pathways that organisations were on, they all shared the same goal, a desire for greater autonomy, but specifically within the NHS. Additionally, irrespective of their organisational form most organisations were considering an almost identical set of initiatives as a means to improve service delivery and productivity. Research limitations/implications – Despite the expectations of policy makers no CFTs were established during the course of the study, so it is not possible to find out what the effect of such changes were. Nevertheless, the authors were able to investigate the attitudes of all the providers of CHS to the plans to increase their managerial autonomy, whether simply by separating from PCTs or by becoming CFTs. Originality/value – As no CFTs have yet been formed, this study provides the only evidence to date about increasing autonomy for CHS in England.

Obtaining and Using Client Feedback in Community Health Services

1998 ◽  
Vol 4 (4) ◽  
pp. 105
Author(s):  
Gwyneth Jolley ◽  
Libby Kalucy ◽  
Joanne McNamara
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Service Providers ◽  
South Australia ◽  
Organisational Change ◽  
Community Health Services ◽  
Service Planning ◽  
Power Sharing ◽  
Client Feedback

Client feedback is an important component of two primary health care strategies: participation and evaluation. Workers need feedback from clients to ensure that their practice meets the criterion of providing affordable, accessible and appropriate services to enhance the health of their communities. Telephone interviews were conducted with thirty staff and thirty clients from women's and community health services in South Australia, to identify current practice in obtaining and using feedback from users of one-to-one services and group health promotion and community development activities. Factors which encourage feedback to be given and used include: trust and effective communications between all stakeholders; and supportive organisational philosophies, culture and practices. Client feedback is more likely to be used when given in written form. Collection and use of feedback are discouraged by inappropriate methods and timing, rapid organisational change, and clients' lack of awareness of, or confidence in, giving feedback about the services they receive. Verbal feedback, although preferred by many clients, is less likely to be recorded and used in service planning and evaluation. Client feedback is a valuable tool to reinforce the notion of partnership and power sharing between clients and health care workers. Staff at all levels should be engaged in obtaining feedback and the information gained should be disseminated throughout the agency in order to improve the quality and effectiveness of services. The challenge is now for service providers and users to adopt new, and support currently successful, ways of obtaining and using feedback so that service providers and users are engaged in working in partnership to ensure the needs of the community are best met.

Factors Affecting the Adoption of ICT for Health Service Delivery in Namibia

2011 ◽  
pp. 75-99
Author(s):  
Blessing M. Maumbe ◽  
Meke I. Shivute ◽  
Vesper T. Owei
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Service Providers ◽  
Health Service Delivery ◽  
Public And Private ◽  
Factors Affecting ◽  
Functional Literacy ◽  
Ict Use ◽  
Health Service Providers

The article examines ICT use in health service provision in Namibia. The patterns of ICT use for health services by patients, public and private health service providers are not yet fully understood. This study describes ICT applications in health service delivery to patients in the Khomas and Oshana regions of Namibia. The study interviewed 134 patients and 21 health service providers. Factor analysis on ICT use identified three main factor groupings namely, ‘high technology’, ’mobile technology’ and ‘traditional technology’. Multinomial regression results showed the major factors affecting multiple ICT awareness in the two regions as functional literacy, diverse sources of health information services, age and educational level of the patients. Logistic regression results on individual ICT use identified functional literacy, personal privacy, cost of ICT, age, education, and positive perceptions about ICT applications in improving health services as statistically significant factors influencing adoption by both rural and urban patients in Namibia.

Factors Affecting the Adoption of ICT for Health Service Delivery in Namibia

2011 ◽  
pp. 1090-1114
Author(s):  
Blessing M. Maumbe ◽  
Meke I. Shivute ◽  
Vesper T. Owei
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Service Providers ◽  
Health Service Delivery ◽  
Public And Private ◽  
Factors Affecting ◽  
Functional Literacy ◽  
Ict Use ◽  
Health Service Providers

The article examines ICT use in health service provision in Namibia. The patterns of ICT use for health services by patients, public and private health service providers are not yet fully understood. This study describes ICT applications in health service delivery to patients in the Khomas and Oshana regions of Namibia. The study interviewed 134 patients and 21 health service providers. Factor analysis on ICT use identified three main factor groupings namely, ‘high technology’, ’mobile technology’ and ‘traditional technology’. Multinomial regression results showed the major factors affecting multiple ICT awareness in the two regions as functional literacy, diverse sources of health information services, age and educational level of the patients. Logistic regression results on individual ICT use identified functional literacy, personal privacy, cost of ICT, age, education, and positive perceptions about ICT applications in improving health services as statistically significant factors influencing adoption by both rural and urban patients in Namibia.

scholarly journals Human Resource Staffing and Service Functions of Community Health Services Organizations in China

2008 ◽  
Vol 6 (5) ◽  
pp. 421-427 ◽  
Author(s):  
J. Yang ◽  
A. Guo ◽  
Y. Wang ◽  
Y. Zhao ◽  
X. Yang ◽  
...  
Keyword(s):  
Health Services ◽  
Community Health ◽  
Human Resource ◽  
Community Health Services

The Impact of Social Mobilization on Health Service Delivery and Health Outcomes

2018 ◽  
Author(s):  
Xavier Giné ◽  
Salma Khalid ◽  
Mansuri Ghazala
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Health Outcomes ◽  
Health Workers ◽  
Health Service Delivery ◽  
Health Providers ◽  
Child Health Outcomes ◽  
Rural Pakistan ◽  
Post Natal Care ◽  
The Impact

This chapter uses a randomized community development programme in rural Pakistan to assess the impact of citizen engagement on public service delivery and maternal and child health outcomes. The programme had a strong emphasis on organizing women, who also identified health services as a development priority at baseline. At midline, we find that the mobilization effort alone had a significant impact on the performance of village-based health providers. We detect economically large improvements in pregnancy and well-baby visits by female health workers, as well as increased utilization of pre- and post-natal care by pregnant women. In contrast, the quality of supra-village health services did not improve, underscoring the importance of community enforcement and monitoring capacity for improving service delivery.

scholarly journals Health Status and Quality of Health Care Services of Congolese Refugees in Nakivale, Uganda

2016 ◽  
Vol 5 (3) ◽  
pp. 39
Author(s):  
Amegovu K. Andrew
Keyword(s):  
Health Status ◽  
Health Services ◽  
Resource Constraints ◽  
Service Providers ◽  
Geographic Origin ◽  
Health Service Delivery ◽  
Health Facilities ◽  
Cross Sectional ◽  
Adequate Food

Physical and emotional wellness, as well as access to healthcare, are foundations for successful resettlement. Without feeling healthy, it is difficult to work, to go school, or take care of a family. Many factors can affect refugee health, including geographic origin and refugee camp conditions. Refugees may face a wide variety of acute or chronic health issues (Office of Refugee Resettlement, ORR Annual Report to Congress 2014; http://www.acf.hhs.gov). Resettlement of refugees in Uganda is usually supported by concerted efforts of UNHCR, Governments through the Office of the Prime Minister, OPM with support from host communities, local and international Non-Governmental Organizations. Due to resource constraints and local factors, immigrants are often subjected to poor living conditions which coupled with inadequacy inessential medical supplies might significantly affects quality of care and health service delivery and hence, rendering refugees to poor health status. This study was conducted from 2013-2014 to assess the determinants of health status of Congolese refugees living in Nakivale refugee settlement, in Isingiro district- South Western Uganda. A cross-sectional study design was used involving mixed techniques of both qualitative and quantitative KAP survey. The study focussed on Congolese refugee population in Nakivale Refugee settlement. 2401 key informants’ interviews and 8 focus group discussions respectively were conducted targeting service providers and beneficiaries/Congolese refugees in this case. The data was analysed using SPSS ver.20, 2011. Although majority (97%) of respondents sought medical services from established health facilities, findings confirm a high level of ill health prevalence among Congolese refugees in Nakivale camp, however, the difference in health services and perceived health status in camp versus the one in DRcongo is insignificant ( p=0.000) with respondents perceiving their health status as worse than when they were their own Country before the resettlement. Identified key challenges affecting access & uptake of available health services includes: language barrier; inadequate drugs; and the long distances to access health facilities. The health status of refugees could be improved by addressing the challenges related to language, drug supplies in addition to humanising conditions of shelter, providing appropriate waste disposal facilities while proving adequate food rations and clean & safe drinking water.

scholarly journals Current status of antenatal care of pregnant women—8 provinces in China, 2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenling Hu ◽  
Huanqing Hu ◽  
Wei Zhao ◽  
Aiqun Huang ◽  
Qi Yang ◽  
...  
Keyword(s):  
Health Services ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Community Health ◽  
First Trimester ◽  
Community Health Services ◽  
Current Status ◽  
Categorical Variables ◽  
Chi Square ◽  
Prenatal Care Visit

Abstract Background Antenatal care (ANC) played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. The objective of this study was to evaluate the current status of ANC emphasizing the number, timing, and content of examinations on a national scale. Methods The data was collected from maternal and newborn’s health monitoring system at 8 provinces in China. After ethical approval, all pregnant women registered in the system at their first prenatal care visit, we included 49,084 pregnant women who had delivered between January 1, 2018 and December 31, 2018. Descriptive statistics of all study variables were calculated proportions and chi-square for categorical variables. Results Of the 49,084 women included in this study, the mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% women received ANC examinations at least five times, 39.93% of the women received ANC examinations at least eight times and 16.66% of the women received ANC examinations at least 11 times. The proportion of first ANC examination in first trimester was 61.87%. The percentage of normative ANC examinations and the percentage of qualified ANC examinations were 30.98 and 8.03% respectively. Only 49.40% of the total women received all six kinds of examination items in first ANC examination: 91.47% received a blood test, 91.62% received a urine test, 81.56% received a liver function examination, 80.52% received a renal function examination, 79.07% received a blood glucose test, and 86.66% received a HIV/HBV/syphilis tests. 50.85% women received the first ANC examination in maternal and child health care (MCH) institutions, 14.07% in a general hospital, 18.83% in a township hospital, 13.15% in a community health services center, and 3.08% in an unspecified place. The proportion of women who received each of the ANC examination items in community health services center was the highest, but that in the MCH institutions was the lowest. Conclusions There is a big difference between the results of this study and the data in official reports, this study found the current status of antenatal care is not optimal in China, findings from this study suggest that the systematization, continuity and quality of ANC examinations need to be improved.

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