scholarly journals The Perioperative Surgical Home, Enhanced Recovery After Surgery and how integration of these models may improve care for medically complex patients

2021 ◽  
Vol 64 (4) ◽  
pp. E381-E390
Author(s):  
Tyrone G. Harrison ◽  
Paul E. Ronksley ◽  
Matthew T. James ◽  
Mary E. Brindle ◽  
Shannon M. Ruzycki ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Care Delivery ◽  
Health Care Systems ◽  
Models Of Care ◽  
Level Of Evidence ◽  
Perioperative Surgical Home ◽  
Care System

Perioperative medicine is changing rapidly, and with this change comes the opportunity to improve upon current models of care delivery and integration within the health care system. Perioperative models of care are structured or conceptual arrangements for surgical patients before, during and after their surgery. Models of care such as the Perioperative Surgical Home and Enhanced Recovery After Surgery pathways are increasingly used to guide the structure of perioperative care delivery with an aim to improve patient outcomes and experience in Canadian settings. In this narrative review, we summarize the origins of these perioperative models of care. They are fundamentally different in scope and level of evidence. Both models have potential benefits and limitations to their broad implementation in our health care system. As currently developed, both models are limited in their application to patients with chronic disease. We discuss how these models of care can be used to develop integrated horizontal and vertical perioperative pathways in a Canadian setting. Such integration is a potential solution that will improve their applicability to patients with medically complex conditions and in times when health care systems are under pressure. We describe this approach using the example of patients with kidney failure receiving dialysis.

scholarly journals Evaluation of the Implementation of Multiple Enhanced Recovery After Surgery Pathways Across a Provincial Health Care System in Alberta, Canada

2021 ◽  
Vol 4 (8) ◽  
pp. e2119769
Author(s):  
Gregg Nelson ◽  
Xiaoming Wang ◽  
Alison Nelson ◽  
Peter Faris ◽  
Laura Lagendyk ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Care System

Overview of health care systems

2013 ◽  
Author(s):  
Blánaid Daly ◽  
Paul Batchelor ◽  
Elizabeth Treasure ◽  
Richard Watt
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Care Delivery ◽  
Health Care Systems ◽  
Dental Service ◽  
World Health ◽  
Care Systems ◽  
Health Organization ◽  
The Uk ◽  
Care System

The World Health Organization defines a health care system as: . . . all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities. . . . . . . (WHO 2007) . . . Such a definition covers a myriad of potential elements and factors, of which the dental element is but one. A health care system is not static: it evolves as part of the more general social and welfare arrangements in a society. As a member of a health care profession, all dental care providers need to have an appreciation of the wider aspects of any arrangements of health, its determinants, and care delivery, if only to understand how the pressures on a system may impact on their current and future activities. This chapter provides an overview of health care systems and provides the framework for Chapters 18–23. Health care systems are complex organizations that are in a constant process of change and evolution. Dentistry is one very small component of the wider health care system, which is itself part of the overall social welfare system within society. Dentists, as health professionals, need to understand the basic elements of the health care system within which they are working. The development of health care systems is an ongoing process in which all societies try to meet the health needs of its citizens. There is no society that has yet designed a system that meets the needs of all its citizens. Indeed, historically in many countries it was only the wealthy that were able to access health care in a society. As societies evolved, the pressures to make the health care system accessible to all its members grew. Mays (1991) has highlighted the political importance of health care, showing that many health care systems reforms were designed to prevent political instability and improve the fitness of army recruits. Indeed, the development of the then School Dental Service in the UK was brought about following questions in Parliament about the poor state of soldiers’ teeth in the Boer War.

scholarly journals Unmasking a health care system: the Dutch policy response to the Covid-19 crisis

2021 ◽  
pp. 1-10 ◽  
Author(s):  
Iris Wallenburg ◽  
Jan-Kees Helderman ◽  
Patrick Jeurissen ◽  
Roland Bal
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care System ◽  
Health Care Systems ◽  
Economic Policies ◽  
Hard Time ◽  
Dutch Health ◽  
Care Systems ◽  
Policy Systems ◽  
Care System

Abstract The Covid-19 pandemic has put policy systems to the test. In this paper, we unmask the institutionalized resilience of the Dutch health care system to pandemic crisis. Building on logics of crisis decision-making and on the notion of ‘tact’, we reveal how the Dutch government initially succeeded in orchestrating collective action through aligning public health purposes and installing socio-economic policies to soften societal impact. However, when the crisis evolved into a more enduring one, a more contested policy arena emerged in which decision-makers had a hard time composing and defending a united decision-making strategy. Measures have become increasingly debated on all policy levels as well as among experts, and conflicts are widely covered in the Dutch media. With the 2021 elections ahead, this means an additional test of the resilience of the Dutch socio-political and health care systems.

Health System in Poland

2017 ◽  
Vol 53 (2) ◽  
pp. 107-112
Author(s):  
Daniel Ślęzak ◽  
Przemysław Żuratyński ◽  
Klaudiusz Nadolny ◽  
Marlena Robakowska ◽  
Alicja Kalis
Keyword(s):  
Health Care ◽  
Health Care System ◽  
National Health ◽  
Health Care Services ◽  
Health Care Systems ◽  
State Budget ◽  
Right To Health Care ◽  
Health Fund ◽  
National Health Fund ◽  
Care System

Health care systems face challenges related to the technological advances in medicine, demographic changes and limited opportunities for growth funding for health, necessitating greater involvement in the search for more efficient systems. The authors present the functioning of the Polish health care system based on social, historical outline of the healthcare system in Poland and the functioning of the National Health Fund (NFZ). Poland has undergone many reforms of the health care system, the Bismarck model, the model Siemaszko, and finally to a model of universal health insurance. So everyone has the same right to health care services financed by the NFZ or directly from the state budget (eg. The system of state emergency medical services). The National Health Fund allows anyone insured to free healthcare and reimbursement of medicines. Introduced information about information programs.

scholarly journals The nursing shortage: a worldwide problem

2002 ◽  
Vol 10 (3) ◽  
pp. 392-400 ◽  
Author(s):  
Rachel Z. Booth
Keyword(s):  
Health Care ◽  
Work Environment ◽  
Health Care System ◽  
Health Care Systems ◽  
Developed Countries ◽  
World Health ◽  
Insurance Companies ◽  
Advisory Group ◽  
Positive Effects ◽  
Care System

A worldwide shortage of nurses has been acknowledged by the multidisciplinary Global Advisory Group of the World Health Organization. The shortage is caused by an increased demand for nurses, while fewer people are choosing nursing as a profession and the current nurses worldwide are aging. The shortage applies to nurses in practice as well as the nurse faculty who teach students. The inter-country recruitment and migration of nurses from developing countries to developed countries exacerbates the problem. Although public opinion polls identifies the nurse as the person who makes the health care system work for them, the conditions of the work environment in which the nurse functions is unsatisfactory and must change. Numerous studies have shown the positive effects on the nurse of a healthy work environment and the positive relationships between nursing care and patient outcomes. It is important that government officials, insurance companies, and administrators and leaders of health care systems acknowledge and operationalize the value of nurses to the health care system in order to establish and maintain the integrity and viability of that system.

scholarly journals Implementation of low-dose CT screening in two different health care systems: Mount Sinai Healthcare System and Phoenix VA Health Care System

2021 ◽  
Vol 10 (2) ◽  
pp. 1064-1082
Author(s):  
Claudia I. Henschke ◽  
David F. Yankelevitz ◽  
Artit Jirapatnakul ◽  
Rowena Yip ◽  
Vivian Reccoppa ◽  
...  
Keyword(s):  
Health Care ◽  
Healthcare System ◽  
Health Care System ◽  
Low Dose ◽  
Health Care Systems ◽  
Ct Screening ◽  
Low Dose Ct ◽  
Care Systems ◽  
Va Health Care System ◽  
Care System

Modern Western Science as a Standard for Traditional Chinese Medicine: A Critical Appraisal

2003 ◽  
Vol 31 (2) ◽  
pp. 213-221 ◽  
Author(s):  
Ruiping Fan
Keyword(s):  
Health Care ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Health Care System ◽  
Care Delivery ◽  
World Health ◽  
Scientific Medicine ◽  
Integrative Health ◽  
Integrative Health Care ◽  
Care System

It is generally recognized that China, while attempting to develop modern scientific medicine in carrying out its national policy for modernization, has also made significant efforts to integrate traditional Chinese medicine into its health care system. For instance, the World Health Organization's first global strategy on traditional and alternative medicine (released in May 2002) lists China as one of only four of its member states to have attained an integrative health care system. However, medical integration can take many different forms and involve quite different health care standards. A health care standard is a set of mechanisms by which distinct diagnostic and therapeutic practices and products are validated or accredited for use in health care delivery. Traditional Chinese medicine and modern scientific medicine adopt different sets of such mechanisms and thereby engage different health care standards. Accordingly, in appraising the Chinese integrative health care system, it is important to investigate which health care standard has been appealed to.

A Comparison of Organized and Traditional Health Care

2005 ◽  
Vol 44 (02) ◽  
pp. 273-277
Author(s):  
D. M. Lawrence
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Health Care Systems ◽  
Delivery Systems ◽  
Traditional Health ◽  
Traditional Health Care ◽  
Care Systems ◽  
Health Care Delivery Systems

Summary Purpose: To compare organized and traditional health care delivery systems and their ability to meet several major challenges facing health care in the next 25 years. Approach: Analysis of traditional and organized health care systems based on a career spent in organized health care systems. Conclusions: The traditional health care system based on independent autonomous physicians is not able to meet the challenges of current healthcare. Stronger integration and coordination, i.e., organized health care delivery systems are required.

Patient Experiences, Trust, and Preferences for Health Data Sharing

2021 ◽  
Author(s):  
Rochelle D. Jones ◽  
Chris Krenz ◽  
Kent A. Griffith ◽  
Rebecca Spence ◽  
Angela R. Bradbury ◽  
...  
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Health Care System ◽  
Lived Experiences ◽  
Care Delivery ◽  
Group Discussion ◽  
Final Analysis ◽  
Secondary Use ◽  
The Impact ◽  
Care System

PURPOSE: Scholars have examined patients' attitudes toward secondary use of routinely collected clinical data for research and quality improvement. Evidence suggests that trust in health care organizations and physicians is critical. Less is known about experiences that shape trust and how they influence data sharing preferences. MATERIALS AND METHODS: To explore learning health care system (LHS) ethics, democratic deliberations were hosted from June 2017 to May 2018. A total of 217 patients with cancer participated in facilitated group discussion. Transcripts were coded independently. Finalized codes were organized into themes using interpretive description and thematic analysis. Two previous analyses reported on patient preferences for consent and data use; this final analysis focuses on the influence of personal lived experiences of the health care system, including interactions with providers and insurers, on trust and preferences for data sharing. RESULTS: Qualitative analysis identified four domains of patients' lived experiences raised in the context of the policy discussions: (1) the quality of care received, (2) the impact of health care costs, (3) the transparency and communication displayed by a provider or an insurer to the patient, and (4) the extent to which care coordination was hindered or facilitated by the interchange between a provider and an insurer. Patients discussed their trust in health care decision makers and their opinions about LHS data sharing. CONCLUSION: Additional resources, infrastructure, regulations, and practice innovations are needed to improve patients' experiences with and trust in the health care system. Those who seek to build LHSs may also need to consider improvement in other aspects of care delivery.

A Principled Approach to Essential Health-Care Delivery System Reforms

2017 ◽  
pp. 159-201
Author(s):  
Gunnar Almgren
Keyword(s):  
Health Care ◽  
Population Health ◽  
Health Care System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Right To Health Care ◽  
Competing Interests ◽  
Political Feasibility ◽  
Future Health Care ◽  
Care System

The basic premise of this chapter is that we have at our disposal a wealth of evidence-based knowledge of critical health care delivery strategies that would, if implemented on a large scale, yield both a social right to health care for all citizens and favorable population health care outcomes at lower cost. This chapter provides a synthesis of this knowledge, and then identifies a limited set of very specific health care system delivery reforms that meet three evaluative criteria: equity, sustainability, and political feasibility. Equity refers to the extent to which any particular health care system delivery reform achieves a fair balance between the competing interests of different segments of the patient population and society at large. Sustainability refers to the extent to which a health care system delivery reform initiative yields favorable impacts on population health while realizing large reductions in immediate and future health care costs. Finally, political feasibility refers to the likelihood of a given health care system delivery reform in view of the competing interests of different stakeholder groups affected. This chapter offers a principled and empirically justified blueprint for the most promising health care system delivery reforms towards the fulfillment of these three ends.

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