Service Delivery

Inadequate pharmacy human resources have been a significant challenge faced in delivering public health interventions. In GHAIN project, the average pharmacist-patient ratio per clinic day was about 1:100. This had a negative effect on quality of care provided to patients. The project evolved a volunteer scheme aimed at mitigating the inadequacy of pharmacists amidst increasing workload. This article describes how the scheme was used to improve the human resource challenge in supported health facilities and the lessons learnt. [from abstract]

Rural residents seeking health care face barriers due to a shortage of healthcare professionals and the travel distance required to obtain medical services. A pilot study was conducted to examine rural residents’ ability to access specialized care. This quantitative pen and paper survey was implemented in two communities with similar health care infrastructure(Tweed, Ontario and Hensall, Ontario). [adapted from abstract]

Community health care services provide vital care out of hospital for millions of people. From children’s services to care for older people and end-of-life support, the community sector plays a key part in meeting the challenges facing our health and care system. This report presents findings from a small-scale study into how quality is managed in community services. It explores how community care providers define and measure quality and recommends important next steps to support better measurement and management of quality. [from introduction]

Whole-system interventions are those that entail system wide changes in goals, service delivery arrangements and relationships between actors, requiring approaches to implementation that go beyond projects or programmes. Drawing on concepts from complexity theory, this paper describes the catalysts to implementation of a whole-system intervention in the North West Province of South Africa.

We explore whether social exclusion determines enrolment of older people in Senegal’s Plan Sesame and Ghana’s NHIS. Social exclusion affects older people’s uptake of social health protection (SHP) programs in both Senegal and Ghana. Reducing financial barriers is not enough to achieve universal coverage.Efforts to cover older people at risk of social exclusion should be increased. Sociocultural, political and economic dimensions should be considered while designing SHP schemes. [from abstract]

The use of community health workers to administer prompt treatments is gaining popularity in most sub-Saharan African countries. Their performance is a key challenge because it varies considerably, depending on the context, while being closely associated with the effectiveness of case management strategies. What determines community health workers’ performance is still under debate. Based on a realist perspective, a systematic review recently hypothesized that several mechanisms are associated with good performance and successful community interventions.

This study investigated whether increased numbers of primary healthcare clinical consultations in Indigenous communities in some remote areas of Australia are associated with the reduced need for urgent medical evacuations and remote telephone consultations. [from abstract]

The objective of this research was to analyze the organizational culture of a Brazilian public hospital. It is a descriptive study with quantitative approach of data, developed in a public hospital of São Paulo State, Brazil. [from abstract]

The WHO Patient Safety Curriculum Guide for Medical Schools, published in 2009 aims to encourage and facilitate the teaching of patient safety topics to medical students.

The science of team performance and training can help the medical community improve patient safety. This report, commissioned by the Agency for Healthcare Research and Quality (AHRQ), assesses the status of relevant team training research from aviation and other domains and applies this research to the field of medicine. It additionally provides a comprehensive review and evaluation of current medical team training initiatives and their effectiveness. [from resource]

This paper aims to explore and explain the use of models of care delivery that optimally utilize the role of nurses in primary healthcare, community-based care and other non-acute care contexts such as chronic disease management, long-term care, continuing care, health promotion and disease prevention. Additionally, exemplar models of care, as case studies, are identified to highlight essential elements of effective service delivery models and strategies for successful application. [from introduction]

While it is recognised that effective health care teams are associated with quality patient care, the literature is comparatively sparse in defining the outcomes of effective teamwork. This literature review of the range of organisational, team and individual benefits of teamwork complements an earlier article which summarised the antecedent conditions for (input) and team processes (throughput) of effective teams. This article summarises the evidence for a range of outcome measures of effective teams. [from abstract]

In this study, an intervention to enhance teamwork and staff engagement was tested on a medical unit in an acute care hospital. The results showed that the intervention resulted in a significantly lower patient fall rate, staff ratings of improved teamwork on the unit, and lower staff turnover and vacancy rates. Patient satisfaction ratings approached, but did not reach, statistical significance. [from abstract]

To prepare this report, an interprofessional research team conducted in-depth interviews with key informants and
undertook a wide-ranging survey of peer-reviewed and grey literature on the components of teamwork; effectiveness of teams; types of interventions; healthcare team dynamics; and the impact of government infrastructure, legislation,
and policy on teamwork in the Canadian healthcare system. [from summary]

This review examines current research on teamwork in highly dynamic domains of healthcare such as operating rooms, intensive care, emergency medicine, or trauma and resuscitation teams with a focus on aspects relevant to the quality and safety of patient care. [from abstract]

We examined associations between transdisciplinary collaboration, evidence-based practice, and primary care and public health services integration in Brazil’s Family Health Strategy. We aimed to identify practices that facilitate service integration and evidence-based practice. [from abstract]

The Outcome Report of the Global Consultation on Population Dynamics and the Post-2015 Development Agenda not only explains the linkages between today’s most pressing development challenges, population dynamics and sexual and reproductive health and rights, but also provides concrete recommendations on how to address these linkages in the post-2015 development agenda. To date, this report makes the clearest and strongest case for why population matters for the post-2015 development agenda and for why the ICPD Programme of Action must be firmly integrated into this new agenda. [from abstract]

The Partnership for Reviving Routine Immunization in Northern Nigeria - Maternal, Newborn and Child Health initiative supports efforts by the government of Nigeria to bridge primary health care (PHC) policies and services at three levels of government: federal, state and local. The paper suggests that understandings informed by complexity theory and complex adaptive systems have been helpful in shaping policy and programme design across these levels. [from abstract]

India faces enormous challenge in human resources for health care delivery system. Geographical misdistribution and urban-rural health worker deficit impedes the progress towards achieving Millennium Development Goals. Many rural Indians receive health care from unqualified providers. Rational distribution and retention of qualified providers in rural and remote areas is a daunting task for the government. Little attention is paid in public medical institutions for the real health needs of the community. [from abstract]

This report is not just a summary of a USAID-funded project: It is an extensively-documented milestone for global efforts to improve health in lower- and middle-income countries (LMICs). Increasingly, the central strategy for global health efforts to save lives focuses on selected, high impact interventions. Organizations have
supported these interventions chiefly by providing the required resources, such as training, drugs, and technical
assistance. But in order to implement any kind of service, the health system uses standardized processes for both
clinical and non-clinical activities.

The World Health Organization (WHO) has developed a new strategy on people-centered health care that places a strong focus on the re-orienting the health system as a whole, including the importance of engaging community and patient groups. ASSIST principles of people-centeredness are complementary to the WHO strategy, particularly with respect to coordination and continuity of care, information, and the micro-level interactions between a client and the health care service delivery team that promote or hinder people-centeredness.

The objective of the prevention of Mother-to-Child Transmission (pMTCT) cascade analysis tool is to
provide frontline health managers at the facility level with the means to rapidly, independently and quantitatively
track patient flows through the pMTCT cascade, and readily identify priority areas for clinic-level improvement
interventions. [from abstract]

This study measures service quality management in a private hospital in Gauteng, South Africa. This was done by
determining the current standard of service quality management, identifying the gap between the value and the satisfaction of the service quality dimensions, as well as the influence of gender on the perception of service quality. [from abstract]

Definitions of fragile states focus on state willingness and capacity to ensure security and provide essential
services, including health. Conventional analyses and subsequent policies that focus on state-delivered essential services miss many developments in severely disrupted healthcare arenas. The research seeks to gain insights about the large sections of the health field left to evolve spontaneously by the absent or diminished state. ]from abstract]

Quality of care can be significantly improved by engaging teams of frontline workers to identify problems and find local solutions for those problems. Based on the results achieved in Kunduz, Balkh, and Kabul, the collaborative improvement work was expanded from 2010–2012 to seven more provinces. The results achieved on the ground also led the MoPH to establish a unit for quality and a national health care quality improvement strategy for Afghanistan. [from abstract]

A new approach to the measurement of service delivery is introduced. The Service Delivery Underperformance Index (SDUI)
adapts the Alkire and Foster (2011) methodology used for poverty measurement to measure the underperformance, or multiple inadequacies, in service delivery. [from abstract]

Health care workers are exposed to different kinds of occupational hazards due to their day to day activities. The most common occupational exposure like body fluids are a potential risk of transmission of blood born infection like human immunodeficiency virus. [from abstract]

The world is witnessing the unprecedented unfolding of the West African Ebola epidemic. The epidemic could have major ramifications for global public health in ways that no other modern infectious disease has, perhaps including AIDS, and can be viewed as a “Black Swan” event. What we call here a Black Swan (and capitalize it) is an event with the following three attributes. First, it is an outlier, as it lies outside the realm of regular expecta- tions, because nothing in the past can convincingly point to its possibility.

The study observed the impact of an experimental supportive intervention to India’s malaria control program by location on the individual level. There are various possible reasons that account for the observed divergence across districts. [from abstract]

The goals of Universal Health Coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. [from resource]