Search results

The purpose of this paper is to explore the antecedents and consequences of a value-dense environment in healthcare service delivery.

A structural model was developed based on a literature review. Circulation of a 31-indicator questionnaire among service receivers in the healthcare system across India generated 279 valid responses. The research model was assessed using a cross-sectional research design, and the data were analyzed by partial least squares-structural equation modeling.

Integrated supply chain performance (ISCP), internal service quality (ISQ) and coordinated care are antecedents of a value-dense environment, which drives patient-centricity. The leagile supply chain strategy strengthens the relationship between ISCP and coordinated care. Employee trust and commitment acts as a moderator between coordinated care and ISQ.

By adopting the perspective of service receivers, this paper highlights the influence of value-density on patient-centricity in healthcare organizations. Future research should include healthcare professionals’ perceptions of value-dense environment creation.

The study provides suggestions to practitioners for designing patient-centric healthcare services by leveraging ISCP, coordinated care and ISQ in the value-creation process. Recognizing the relationships among these constructs can aid the timely formulation of corrective actions and future policies.

This study underscores patient-centric care as a basis for effectively delivering healthcare as a social good.

This paper contributes to the body of knowledge by identifying and empirically validating the relationships between patient-centricity and value co-creation.

This is a report on a recent development of an innovative coordinated care solution named the Care Coordination Centre (CCC), which targets coordinated care arrangements for a populations expected to benefit the most. The purpose of this paper is to identify the patients who might comprise this group, and to assess the best ways to meet their health, community, and social care needs before and after introducing the coordinated care solution across care settings.

This is a summary of the author’s experience in the design and development of a care coordination business model for US providers and UK Clinical Commissioning Groups (CCGs) using coordinated care not only as a cost-cutting tool, but as a mechanism for creating a flexible and responsive patient-centered care. The author makes an assessment of the economic benefits of coordinated care resulting from: the shift to less costly interventions; reduction in readmissions; reduced unplanned admissions; increased time allocation efficiency of healthcare staff; and the overall reduction in per-patient costs.

The health and social care systems in the USA and the UK are facing the biggest challenges in their history. Payers, providers, governments, and communities need to work to build better coordination and integration mechanisms to manage the increasing demand on health and social care in a period of stagnant health and social care budgets. New innovative models of coordinated care have been developed in both countries, at the local economy level, as the health service systems are undergoing crucial transformation from a supply to a demand-based model. In the UK, the Trafford CCG has commissioned a new CCC, responsible for the delivery of high-quality coordinated care. The CCC is designed to function at clinical, service, and community levels across multiple providers to cover, among other tasks, chronic condition patient case management, risk stratification of preventative, elective, and unscheduled care for the whole region.

Insights from the work with Trafford CCG would be of considerable methodological and practical interest to researchers, policy makers, commissioners, healthcare professionals, and innovators.

The purpose of this paper is to identify the antecedents and outcomes of internal service quality (ISQ) in a health-care environment. The relationships among the heterogeneous health-care environment, coordinated care, perceived organisational support (POS), ISQ, internal customer satisfaction and patient-centred care were explored.

Based on a review of the literature, a structural model was developed. A 37-item questionnaire was circulated among service providers in the health-care system, including doctors, nurses and system staff, all over India. The random sampling method was adopted to collect data. A total of 238 valid responses were received. The data were analysed using structural equation modelling.

The results show that the heterogeneous environment, coordinated care and POS act as antecedents of ISQ, which drives internal customer satisfaction and patient centricity in health care.

The paper contributes to the health-care literature by identifying the antecedents and consequences of ISQ and developing a structural relationship among ISQ, the heterogeneous health-care environment, coordinated care, POS, internal customer satisfaction and patient-centred care.

Hospital administrators may use various constructs of POS, ISQ and coordinated care to measure process and employee performance, which may aid the design of appropriate processes and improve employee selection. The constructs of patient centricity and internal customer satisfaction may be used as benchmarking tools to facilitate the formulation of immediate corrective actions and policies for future courses of action.

This paper highlights how patient centricity may be achieved by focussing on ISQ, coordinated care processes and a facilitative internal environment. This understanding may aid the design of processes that in turn deliver health as a social good in an effective manner.

This paper extends past research on ISQ by showing that ISQ affects internal customer satisfaction and, in turn, the quality of service delivery in the system. In the health-care context, heterogeneity in patient needs, coordinated care and organisational support play crucial roles in determining ISQ, which in turn influences the level of patient-centred care.

The purpose of this paper is to describe the development of a narrative to redefine integrated care from the user's perspective, which is being promoted across England.

The content of the narrative for person-centred coordinated care, recently launched in England, is described. The need for the narrative is explained in the context of the failure of previous integrated care programmes to identify and deliver clear benefits to service users. The sources and stages of development of the narrative are described. The author considers its place in national policy, further content development and its potential to help those planning programmes of integration.

A clear consensus on the need to define integrated care from the service user perspective now exists in England, and a narrative now exists to fulfil this purpose which has been developed by service users, patient groups, care professionals and system leaders. It has radical potential to change service delivery but this will be subject to the degree of local adoption.

The paper is the first journal publication describing the narrative for person-centred coordinated care and creates a record of its developmental stages which will be of interest to system leaders, professionals and researchers in England and internationally.

The purpose of this study is to assess the relationship between patient-centricity, care coordination and delivery of quality care for older people with multiple chronic conditions. Care coordination is defined as a process where physicians, nurses and allied professionals work together to clarify responsibilities, care objectives, treatment plans and discharge plans for delivery of unified care. Patient-centricity is defined as an approach of delivering quality care to patients that focuses on creating a positive experience for them.

A literature review was used to identify measures of care coordination and then partial least square structural equation modeling was used to assess interrelationship among patient-centricity, measures of care coordination and delivery of quality care.

Results reveal that care coordinated pathways consist of IT-enabled coordination, interprofessional teamwork, information sharing and facilitative infrastructure requirements and are influenced by patient-centricity. These are deliberate requisites for delivering of quality care. Results of this study present a validated model of care coordination for older people, which may be further explored to refine the concept of care coordination.

Based on these results, practitioners may develop an overarching strategy to deliver seamless care and to achieve better health outcomes. Measures of care coordination may be used as a performance benchmarking tool and will also help in the process mapping of hospitals.

This paper highlights how patient-centricity may be achieved by focusing on coordinated care processes. This understanding may help in designing processes, which in turn deliver health as a social good in an effective manner.

Results of this study present such a validated model for care coordination, which can be used by researchers.

Following the development of a service that consisted of a “single point of contact” to coordinate end-of-life care (EoLC), including EoLC facilitators and an urgent response team, we aimed to explore whether the provision of coordinated EoLC would support patients being cared or dying in their preferred place and avoid unwanted hospital admissions.

Using a realist evaluation approach, the authors examined “what worked for whom, how, in what circumstances and why”. Multiple data were collected, including activity/performance indicators, observations of management meetings, documents, satisfaction survey and 30 interviews with service providers and users.

Advance care planning (ACP) increased through the first three years of the service (from 45% to 83%) and on average 74% of patients achieved preferred place of death. More than 70% of patients avoided an emergency or unplanned hospital admission in their last month of life. The mechanisms and context identified as driving forces of the service included: 7/7 single point of contact; coordinating services across providers; recruiting and developing the workforce; understanding and clarifying new roles; and managing expectations.

This was a service evaluation and the outcomes are related to the specific context and mechanisms. However, findings can be transferable to similar settings.

“Single point of contact” services that offer coordinated EoLC can contribute in supporting people to be cared and die in their preferred place.

This paper provides an evaluation of a novel approach to EoLC and creates a set of hypotheses that could be further tested in similar services in the future.

The belief that children have mental health needs different than those of adults is a relatively recent phenomenon. Systematic field studies of mental illness began in the early 19th century (Anthony, Eaton, & Henderson, 1995), although awareness of these illnesses and the recognition of the need for treatment were well established by the 1600s (Grob, 1994). Field studies and census data from mental hospitals in the 1800s reveal few cases of mental illness identified among children under the age of 16. In the late 19th and early 20th centuries, the recognition that children have specific mental health needs arose as the result of the confluence of several factors. The Progressive Movement promoted child labor and mandatory public education laws that created legal separations between the role of children and adults (Abbott, 1908; Sutton, 1983). Hall (1905) helped popularize the idea that childhood and adolescence constituted distinct periods of development. Perhaps most pressing, however, was a perceived rise in juvenile delinquency and sexual promiscuity. To address these problems, separate courts were established for juvenile offenders to keep children out of institutions and to provide treatment and rehabilitation (Alper, 1941). Based on the work of Healy and Bronner (1916), researchers and policy makers began to think of juvenile crime as arising from “mental conflicts” in children. Institutions such as the Chicago Juvenile Psychopathic Institute and the Boston Psychopathic Hospital were established to care for these children (Horn, 1989).

The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by physicians and nurses involved.

A qualitative case study primarily consisting of interviews.

The paper's findings indicate that certain factors (i.e. distinct mission, clear treatment protocols and support from external stakeholders) relevant for the provision of coordinated paediatric oncology care have not received sufficient attention in previous research. In addition, emphasis is placed on the necessity of facilitating constructive working relationships and a bottom-up perspective when pursuing improved care coordination.

The factors described and analyzed may act as insights for how paediatric oncology might be improved in terms of care coordination and thus facilitate care integration. In addition, the paper's findings identify factors relevant for further empirical studies in order to delineate their generalizability.

As all countries in the world, Polish health care system has to challenge four fundamental transformations: demographic, technological, epidemiological and cultural. Each of them generates serious threats for the sustainability of the system. The Polish society is ageing even faster than other in the European Union. For the sustainability of the system, the ageing of the population is a double challenge: on the expenditure side and on the financing side.

The Polish health care system is characterised by three negative features: under-financing of health care, misguided organisation of the health sector and health care entities and a dramatic shortage of health care professionals. The share of GDP devoted to health has remained constant over the last years at the level of 6.3%–6.7%. Poland has one of the lowest rates of practicing doctors and nurses in the EU countries. Lack of attractiveness of the medical professions caused by consistently low wages has created a huge generation gap.

Looking from the perspective of cost-effectiveness, we must to state, that the system, with its small financial outlays, provides a relatively high level of health for the population. However, it does not mean that better results could not be achieved. The majority of the public hospitals run in the form of independent public health care units that are highly inefficient and indebted. All attempts to restructure the sector and to solve the problem of arrears of the public hospitals failed so far.

To face the challenges, Poland must change its health policy. An increase in the sector's financing is needed, bearing in mind that increasing outlays alone is certainly not enough to solve all problems and secure sustainability. Deep structural and organisational changes are necessary. Unfortunately, politicians avoid making difficult but necessary decisions, e.g., drastic restructuring of the hospital sector, preferring above all to increase public spending on health.

This study illuminates the experiences of adults diagnosed with autism spectrum disorders (ASDs) and intellectual disabilities (IDs) and their challenges and successes in receiving quality healthcare services. Individuals with developmental disabilities often experience health issues associated with aging at earlier ages and at higher rates than the general population. This population has a higher incidence of chronic health conditions that require regular medical attention.

The intent of this project was to learn directly from adults and their caregivers how well healthcare providers understand autism, explore their experience with how well their care is coordinated between primary healthcare and other specialty services, and identify factors which could impact access to care and to discover what other barriers which may potentially influence health outcomes for ASD adult.

A qualitative study conducted with semi-structured interviews with 12 adults diagnosed with ASD and/or their guardians/caregivers.

Some of the adults interviewed experienced negative health outcomes and suboptimal relationships with healthcare providers; others seemed to have positive relationships. Clinical and communications accommodations were necessary to make healthcare provision more comfortable. Barriers to accessing healthcare services existed in many forms.

The healthcare needs of the growing population adults diagnosed with ASD/ID are anticipated to be significant. This challenge is further exacerbated given there are few trained healthcare providers who are prepared or dedicated to serve this population. Continuing to build awareness of the health needs of the ASD/ID adult population is critical.

This project is highly innovative as it is the first attempt to understand how the adult autism population accesses care and perceives their healthcare interactions. This study serves as a starting point to suggest new opportunities for further research for this growing population.