scholarly journals How Local Health Districts can prepare for the effects of climate change: an adaptation model applied to metropolitan Sydney

2019 ◽  
Vol 43 (6) ◽  
pp. 601
Author(s):  
Lucie Rychetnik ◽  
Peter Sainsbury ◽  
Greg Stewart
Keyword(s):  
Climate Change ◽  
Health Care ◽  
Risk Management ◽  
Health Service ◽  
Health Services ◽  
Local Population ◽  
Local Health ◽  
Climate Change Risks ◽  
Climate And Health ◽  
Health Districts

Climate change adaptation can be defined as a form of risk management (i.e. assessing climate change-related risks and responding appropriately so that the risks can be pre-emptively minimised and managed as they arise). Adapting to climate change by hospital and community health services will entail responding to changing health needs of the local population, and to the likely effects of climate change on health service resources, workforce and infrastructure. In this paper we apply a model that health services can use to predict and respond to climate change risks and illustrate this with reference to Sydney’s Local Health Districts (LHDs). We outline the climate change predictions for the Sydney metropolitan area, discuss the resulting vulnerabilities for LHDs and consider the potential of LHDs to respond. Three ‘core business’ categories are examined: (1) ambulance, emergency and acute health care; (2) routine health care; and (3) population and preventative health services. We consider the key climate change risks and vulnerabilities of the LHDs’ workforce, facilities and finances, and some important transboundary issues. Many Australian health services have existing robust disaster plans and management networks. These could be expanded to incorporate local climate and health adaptation plans. What is known about the topic? There is an inextricable relationship between climate change and human health, with important implications for the delivery of health services. Climate change will affect health service demand, and the resources, workforce and infrastructure of health services. What does this paper add? This paper outlines how local health services can use existing data sources and models for assessing their climate change-related risks and vulnerabilities to predict, prepare for and respond to those risks. This is illustrated with reference to Sydney’s LHDs. What are the implications for practitioners? Adaptation to climate change by health services is an important component of risk management. Local health services need to prepare for the effects of climate change by assessing the risks and developing and implementing climate and health adaptation plans.

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.

Health Service Impact from Mass Gatherings: A Systematic Literature Review

2016 ◽  
Vol 32 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Jamie Ranse ◽  
Alison Hutton ◽  
Toby Keene ◽  
Shane Lenson ◽  
Matt Luther ◽  
...  
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Services ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Ambulance Service ◽  
Local Health ◽  
Mass Gathering ◽  
Mass Gatherings ◽  
The Impact

AbstractBackgroundDuring a mass gathering, some participants may receive health care for injuries or illnesses that occur during the event. In-event first responders provide initial assessment and management at the event. However, when further definitive care is required, municipal ambulance services provide additional assessment, treatment, and transport of participants to acute care settings, such as hospitals. The impact on both ambulance services and hospitals from mass-gathering events is the focus of this literature review.AimThis literature review aimed to develop an understanding of the impact of mass gatherings on local health services, specifically pertaining to in-event and external health services.MethodThis research used a systematic literature review methodology. Electronic databases were searched to find articles related to the aim of the review. Articles focused on mass-gathering health, provision of in-event health services, ambulance service transportation, and hospital utilization.ResultsTwenty-four studies were identified for inclusion in this review. These studies were all case-study-based and retrospective in design. The majority of studies (n=23) provided details of in-event first responder services. There was variation noted in reporting of the number and type of in-event health professional services at mass gatherings. All articles reported that patients were transported to hospital by the ambulance service. Only nine articles reported on patients presenting to hospital. However, details pertaining to the impact on ambulance and hospital services were not reported.ConclusionsThere is minimal research focusing on the impact of mass gatherings on in-event and external health services, such as ambulance services and hospitals. A recommendation for future mass-gathering research and evaluation is to link patient-level data from in-event mass gatherings to external health services. This type of study design would provide information regarding the impact on health services from a mass gathering to more accurately inform future health planning for mass gatherings across the health care continuum.RanseJ, HuttonA, KeeneT, LensonS, LutherM, BostN, JohnstonANB, CrillyJ, CannonM, JonesN, HayesC, BurkeB. Health service impact from mass gatherings: a systematic literature review. Prehosp Disaster Med. 2017;32(1):71–77.

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.

Health Care for South Lebanon's Civilian Population Following the June 1982 War

1985 ◽  
Vol 1 (1) ◽  
pp. 50-54
Author(s):  
T.H. Tulchinsky ◽  
Yakov Adler
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Child Nutrition ◽  
Renal Dialysis ◽  
Nutrition Status ◽  
Local Health ◽  
Dialysis Unit ◽  
Medical Needs ◽  
South Lebanon

AbstractFollowing the June 1982 war in South Lebanon, the Israel Ministry of Health sent a medical team to assess health conditions in the area, to assist in the restoration of local health services, and to provide additional medical assistance as needed in public health and specialized medical services. For the approximately 600,000 population of the area, public health sanitary conditions were restored by local authorities, with some external assistance. Sanitation and housing for the refugee camp populations were difficult to solve because of extensive damage in the camps; but United Nations activities, supported by international and Israeli sources, were effective. Epidemic conditions did not occur. Monitoring for specific infectious diseases showed increases not exceeding usual summer conditions. Child nutrition status was satisfactory. Medical needs for specialty services, not available in South Lebanon, were arranged through screening and referral to Israeli hospitals. Renal dialysis needs were met by establishing a dialysis unit using local personnel in a damaged and non-functioning government hospital. Private medical and hospital services, the bulk of health care in the area, functioned except for minor dislocations throughout the war and post-war period. Israeli medical aid, managed by a small multidisciplinary team, was designed to assist and, where necessary, augment rather than replace local health services.

scholarly journals Converging perspectives of providers and student users on extending a patient portal into a university-based mental health service: A qualitative study

2020 ◽  
Author(s):  
N Gasteiger ◽  
Theresa Fleming ◽  
K Day
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Qualitative Study ◽  
Health Services ◽  
Mental Health Care ◽  
Patient Portal ◽  
Patient Portals

© 2020 The Authors Background: Patient portals have the potential to increase access to mental health services. However, a lack of research is available to guide practices on extending patient portals into mental health services. This study explored stakeholder (student service users' and health providers') expectations and perceptions of extending patient portals into a New Zealand university-based mental health service. Materials and methods: This qualitative study explored the perspectives of 17 students and staff members at a university-based health and counselling service on an Internet-based patient portal through a software demonstration, two focus groups and 13 interviews. Data were analyzed thematically. Results: Staff and students perceived the patient portal as useful, easy to use and expected it to help make mental health care more accessible. Staff were most concerned with the portal's ability to support their triage processes and that it might enable students to ‘counselor hop’ (see multiple counselors). Staff recommended extension into services that do not require triage. Most students expected the portal to enhance patient-counselor contact and rapport, through continuity of care. Students were concerned with appointment waiting times, the stigmatization of poor mental health and their capacity to seek help. They considered the portal might assist with this. Students recommended extension into all services, including urgent appointments. After viewing findings from initial student and staff groups, staff concluded that extending a patient portal into their counseling services should be prioritized. Conclusion: This research suggests that there is value in extending patient portals into mental health care, especially into low-risk services. Future research should explore opportunities to support triage and appointment-making processes for mental health services, via patient portals.

Indian Health Services, Continued

PEDIATRICS ◽  
1973 ◽  
Vol 52 (5) ◽  
pp. 756-756
Author(s):  
Daniel P. Kohen ◽  
Gerald Yost ◽  
Jerry Lyle
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health Service ◽  
Health Services ◽  
American Indian ◽  
Indian Population ◽  
Health Needs ◽  
Indian Health Service ◽  
American Indian Population ◽  
Indian Health

We applaud Dr. Edward Mortimer's Commentary on the health status of the American Indian population (Pediatrics, 51:1065, 1973). Public statements that "Indian health care is inadequate because it is inadequately funded" and ". . . less than the minimum (money) is provided" are long overdue, and we concur completely with the necessity for us all to help Indians express and fulfill their health needs. We wish, however, to take issue with several remarks regarding the quality and scope of care provided in and through the Indian Health Service.

The personal experience of cancer

2007 ◽  
pp. 79-98
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health Services ◽  
Health Care Professionals ◽  
Service User ◽  
Fear Of Recurrence ◽  
Local Health ◽  
Government Health ◽  
The Uk ◽  
Living With Cancer

Introduction 80 The cancer journey 82 Calendars 84 Diagnosis 86 Reactions to diagnosis and treatment 88 Living with cancer 90 Fear of recurrence 92 Recurrence and facing death 94 Survivorship 96 Government health policy in the UK aims to put the patient, or service user, at the heart of local health services. For this to happen, health care professionals must gain an appreciation of what it is like to be a person with cancer, or a carer of someone with cancer. It is hard to know or understand the experience of another person, but there are various ways that we can gain insights into their experience. This section reviews ways of understanding the experience of cancer, and then goes on to look at different aspects of that experience for individuals, using the words of people with cancer....

Barriers to and facilitators of health services utilisation by refugees in resettlement countries: an overview of systematic reviews

2020 ◽  
Vol 44 (1) ◽  
pp. 132 ◽  
Author(s):  
Jamuna Parajuli ◽  
Dell Horey
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Services ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Health Service Utilisation ◽  
Barriers And Facilitators ◽  
Service Utilisation ◽  
Knowledge And Skills ◽  
Overview Of Systematic Reviews

Objective The aim of this study was to provide an overview of the previously reviewed research literature to identify barriers and facilitators to health service utilisation by refugees in resettlement countries. Methods An overview of systematic reviews was conducted. Seven electronic databases (Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, ProQuest Central, Scopus, EBSCO and Google Scholar) were searched for systematic reviews of barriers and facilitators to health-seeking behaviour and utilisation of health services by refugees following resettlement. The two authors independently undertook data selection, data extraction and quality assessment using a validated tool. Results Nine systematic reviews covered a range of study areas and refugee populations. Barriers to health service utilisation fell into three broad areas: (1) issues related to refugees, including refugee characteristics, sociocultural factors and the effects of previous experiences; (2) issues related to health services, including practice issues and the knowledge and skills of health professionals; and (3) issues related to the resettlement context, including policies and practical issues. Few facilitators were identified or evaluated, but these included approaches to care, health service responses and behaviours of health professionals. Conclusions Barriers to accessing health care include refugee characteristics, practice issues in health services, including the knowledge and skills of health professionals, and the resettlement context. Health services need to identify barriers to culturally sensitive care. Improvements in service delivery are needed that meet the needs of refugees. More research is needed to evaluate facilitators to improving health care accessibility for these vulnerable groups. What is known about the topic? Refugee health after resettlement is poor, yet health service use is low. What does this paper add? Barriers to accessing health services in resettlement countries are related not only to refugees, but also to issues regarding health service practices and health professionals’ knowledge and skill, as well as the context of resettlement. Few facilitators to improving refugee access to health services have been identified. What are the implications for practitioners? The barriers associated with health professionals and health services have been linked to trust building, and these need to be addressed to improve accessibility of care for refugees.

scholarly journals An Approach to Developing Local Climate Change Environmental Public Health Indicators in a Rural District

2017 ◽  
Vol 2017 ◽  
pp. 1-16 ◽  
Author(s):  
Adele Houghton ◽  
Jessica Austin ◽  
Abby Beerman ◽  
Clayton Horton
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Health Indicators ◽  
Health Department ◽  
Local Health ◽  
Public Health Department ◽  
Environmental Public Health ◽  
Vulnerability Indicators ◽  
Public Health Indicators ◽  
Climate And Health

Climate change represents a significant and growing threat to population health. Rural areas face unique challenges, such as high rates of vulnerable populations; economic uncertainty due to their reliance on industries that are vulnerable to climate change; less resilient infrastructure; and lower levels of access to community and emergency services than urban areas. This article fills a gap in public health practice by developing climate and health environmental public health indicators for a local public health department in a rural area. We adapted the National Environmental Public Health Tracking Network’s framework for climate and health indicators to a seven-county health department in Western Kentucky. Using a three-step review process, we identified primary climate-related environmental public health hazards for the region (extreme heat, drought, and flooding) and a suite of related exposure, health outcome, population vulnerability, and environmental vulnerability indicators. Indicators that performed more poorly at the county level than at the state and national level were defined as “high vulnerability.” Six to eight high vulnerability indicators were identified for each county. The local health department plans to use the results to enhance three key areas of existing services: epidemiology, public health preparedness, and community health assessment.

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