scholarly journals New Zealand’s Integration- Based Policy for Driving Local Health System Improvement – Which Conditions Underpin More Successful Implementation?

2021 ◽  
Vol 21 (2) ◽  
pp. 8
Author(s):  
Tim Tenbensel ◽  
Pushkar Raj Silwal ◽  
Lisa Walton ◽  
Reuben Olugbenga Ayeleke
Keyword(s):  
Health System ◽  
Successful Implementation ◽  
Local Health ◽  
Health System Improvement ◽  
System Improvement ◽  
Local Health System

Central COVID-19 Coordination Centers in Germany: Description, economic evaluation and systematic review (Preprint)

2021 ◽  
Author(s):  
Nikolas Schopow ◽  
Georg Osterhoff ◽  
Nikolaus von Dercks ◽  
Felix Girrbach ◽  
Christoph Josten ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health System ◽  
University Hospital ◽  
Local Health ◽  
The Public ◽  
Important Benefit ◽  
Economic Analyses ◽  
Management Institutions ◽  
Local Health System ◽  
Regional Hospitals

BACKGROUND During the COVID-19 pandemic, Central COVID-19 Coordination Centers (CCCC) have been established at several hospitals across Germany with the intention to assist local healthcare professionals in efficiently referring patients with suspected or confirmed SARS-CoV-2 infection to regional hospitals, and therefore to prevent the collapse of local health system structures. In addition, they coordinate interhospital transfers of COVID-19 patients and provide or arrange specialized telemedical consultations. OBJECTIVE This study describes the establishment and management of a CCCC at a German university hospital. METHODS We perform economic analyses (cost, cost-effectiveness, use and utility) according to the CHEERS criteria. Additionally, a systematic review was conducted to identify publications on similar institutions worldwide. RESULTS The two months with the highest local incidence (12/2020 and 01/2021) of COVID-19 cases were considered. During this time, 17.3 requests per day were made to CCCC regarding admission or transfer of COVID-19 patients. The majority of requests was made by emergency medical services (56.3%), patients with an average age of 71.8 years were involved and 69.0% of cases had already positive PCR detection. In 59.8% of the concerning patients, further treatment by the general practitioner or outpatient presentation in a hospital could be initiated after appropriate advice, 27.2% of patients were admitted to normal wards and 12.9% were directly transmitted to an intensive care unit. The operating costs of the CCCC amounted to more than €52,000 per month. 90.4% of all patients presented to the hospital were triaged and announced in advance by the CCCC. No other published economic analysis of COVID-19 coordination or management institutions at hospitals could be found. CONCLUSIONS Despite the high cost of the CCCC, we were able to show that it is a beneficial concept to both the providing hospital and the public health system. However, the most important benefit of the CCCC is that it prevents hospitals from being overrun by patients and that it avoids situations in which doctors have to weigh up one patient’s life against another´s.

scholarly journals Training for Health System Improvement: Emerging Lessons from Canadian and US Approaches to Embedded Fellowships

2019 ◽  
Vol 15 (SP) ◽  
pp. 34-48
Author(s):  
Meghan McMahon ◽  
Stephen Bornstein ◽  
Adalsteinn Brown ◽  
Lisa Simpson ◽  
Lucy Savitz ◽  
...  
Keyword(s):  
Health System ◽  
Health System Improvement ◽  
System Improvement

Fellowship Program in Health System Improvement: A novel approach integrating leadership development and patient-centred health system transformation

2018 ◽  
Vol 31 (2) ◽  
pp. 62-65 ◽  
Author(s):  
Donald J. Philippon ◽  
Stephanie Montesanti ◽  
Tania Stafinski
Keyword(s):  
Leadership Development ◽  
Health System ◽  
System Transformation ◽  
Fellowship Program ◽  
Early Assessment ◽  
University Of Alberta ◽  
Health System Improvement ◽  
Novel Approach ◽  
System Improvement ◽  
The University

This article highlights a novel approach to professional development, integrating leadership, development and patient-centred health system transformation in the new Fellowship Program in Health System Improvement offered by the School of Public Health at the University of Alberta. Early assessment of the program is also provided.

scholarly journals Hypertension in Russia: Changes Observed After 4 Years of a Comprehensive Health System Improvement Program in the Yaroslavl Region

2016 ◽  
Vol 19 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Maria Mozheyko ◽  
Sergey Eregin ◽  
Natalia Danilenko ◽  
Alexey Vigdorchik ◽  
Sheldon W. Tobe ◽  
...  
Keyword(s):  
Health System ◽  
Improvement Program ◽  
Health System Improvement ◽  
Comprehensive Health ◽  
System Improvement

“Hybrid” medical leadership emergency medicine training for international medical graduates

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Prakash Subedi ◽  
Jill Aylott ◽  
Naushad Khan ◽  
Niki Shrestha ◽  
Dayaram Lamsal ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Health System ◽  
International Medical Graduates ◽  
Content Type ◽  
Medical Graduates ◽  
Health System Improvement ◽  
New Learning ◽  
System Improvement ◽  
The Uk ◽  
Medical Leadership

Purpose The purpose of this paper is to outline the “Hybrid” “International” Emergency Medicine (HIEM) programme, which is an ethical pathway for the recruitment, employment and training of Emergency Medicine doctors; with a rotation through the NHS on a two-year medical training initiative with a Tier 5 visa, “earn, learn and return” programme. The HIEM programme offers an advantage to the Tier 2 visa by combining training, education and employment resulting in new learning to help improve the health system in Nepal and provide continued cultural support, clinical and leadership development experience in the UK NHS. Finally, this programme also provides a Return on Investment to the NHS. Design/methodology/approach A shortage of doctors in the UK, combined with a need to develop Emergency Medicine doctors in Nepal, led to a UK Emergency Medicine Physician (PS) to facilitate collaboration between UK/Nepal partners. A mapping exercise of the Royal College of Emergency Medicine curriculum with the competencies for the health system and quality improvement leaders and partners with patients produced a “HIEM programme”. The HIEM programme aims to develop first-class doctors to study in Emergency Departments in the UK NHS while also building trainee capability to improve the health system in Nepal with a research thesis. Findings The HIEM programme has 12 doctors on its programme across years one and two, with the first six doctors working in the UK NHS and progressing well. There are reports of high levels of satisfaction with the trainees in their transition from Nepal to the UK and the hospital is due to save £720,000 (after costs) over two years. Each trainee will earn £79,200 over two years which is enough to pay back the £16,000 cost for the course fees. Nepal as a country will benefit from the HIEM programme as each trainee will submit a health system improvement Thesis. Research limitations/implications The HIEM programme is in its infancy as it is two years through a four-year programme. Further evaluation data are required to assess the full impact of this programme. In addition, the HIEM programme has only focussed on the development of one medical speciality which is Emergency Medicine. Further research is required to evaluate the impact of this model across other medical and surgical specialties. Practical implications The HIEM programme has exciting potential to support International Medical Graduates undertake a planned programme of development while they study in the UK with a Tier 5 visa. IMGs require continuous support while in the UK and are required to demonstrate continued learning through continuous professional development (CPD). The HIEM programme offers an opportunity for this CPD learning to be structured, meaningful and progressive to enable new learning. There is also specific support to develop academic and research skills to undertake a thesis in an area that requires health system improvement in Nepal. Originality/value This is the first time an integrated clinical, leadership, quality improvement and patient partnership model curriculum has been developed. The integrated nature of the curriculum saves precious time, money and resources. The integrated nature of this “hybrid” curriculum supports the development of an evidence-based approach to generating attitudes of collaboration, partnership and facilitation and team building in medical leadership with patient engagement. This “hybrid” model gives hope for the increased added value of the programme at a time of global austerity and challenges in healthcare.

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