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Article
Publication date: 30 August 2019

Jeffrey Braithwaite, Kristiana Ludlow, Kate Churruca, Wendy James, Jessica Herkes, Elise McPherson, Louise A. Ellis and Janet C. Long

Much work about health reform and systems improvement in healthcare looks at shortcomings and universal problems facing health systems, but rarely are accomplishments…

Abstract

Purpose

Much work about health reform and systems improvement in healthcare looks at shortcomings and universal problems facing health systems, but rarely are accomplishments dissected and analyzed internationally. The purpose of this paper is to address this knowledge gap by examining the lessons learned from health system reform and improvement efforts in 60 countries.

Design/methodology/approach

In total, 60 low-, middle- and high-income countries provided a case study of successful health reform, which was gathered into a compendium as a recently published book. Here, the extensive source material was re-examined through inductive content analysis to derive broad themes of systems change internationally.

Findings

Nine themes were identified: improving policy, coverage and governance; enhancing the quality of care; keeping patients safe; regulating standards and accreditation; organizing care at the macro-level; organizing care at the meso- and micro-level; developing workforces and resources; harnessing technology and IT; and making collaboratives and partnerships work.

Practical implications

These themes provide a model of what constitutes successful systems change across a wide sample of health systems, offering a store of knowledge about how reformers and improvement initiators achieve their goals.

Originality/value

Few comparative international studies of health systems include a sufficiently wide selection of low-, middle- and high-income countries in their analysis. This paper provides a more balanced approach to consider where achievements are being made across healthcare, and what we can do to replicate and spread successful examples of systems change internationally.

Details

Journal of Health Organization and Management, vol. 34 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

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Article
Publication date: 16 May 2016

Ross Millar, Weiyan Jian, Russell Mannion and Robin Miller

The purpose of this paper is to explore recent healthcare reform in China. Reflecting on the current literature, the viewpoint argues that greater attention should be paid…

Abstract

Purpose

The purpose of this paper is to explore recent healthcare reform in China. Reflecting on the current literature, the viewpoint argues that greater attention should be paid to healthcare reform in China as a public policy process, particularly one that is built on policy experimentation.

Design/methodology/approach

The viewpoint argues that while recent efforts to understand the impact of reform have brought significant understanding of key issues and processes, such interest tends to focus on pragmatic concerns rather than pose wider theoretical and methodological questions about the nature and pace of reform.

Findings

The authors suggest that the lens of public policy is particular relevant and insightful given what has been documented elsewhere regarding China’s unique policy process characterised by “policy experimentation”. The authors discuss how a policy experiment perspective can provide a useful heuristic for understanding healthcare reform in China.

Originality/value

The viewpoint concludes by outlining possible applications of this approach and looks forward at the emerging research agenda in this area.

Details

Journal of Health Organization and Management, vol. 30 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

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Article
Publication date: 16 November 2015

David Greenfield, Deborah Debono, Anne Hogden, Reece Hinchcliff, Virginia Mumford, Marjorie Pawsey, Johanna Westbrook and Jeffrey Braithwaite

Health systems are changing at variable rates. Periods of significant change can create new challenges or amplify existing barriers to accreditation program credibility…

Abstract

Purpose

Health systems are changing at variable rates. Periods of significant change can create new challenges or amplify existing barriers to accreditation program credibility and reliability. The purpose of this paper is to examine, during the transition to a new Australian accreditation scheme and standards, challenges to health service accreditation survey reliability, the salience of the issues and strategies to manage threats to survey reliability.

Design/methodology/approach

Across 2013-2014, a two-phase, multi-method study was conducted, involving five research activities (two questionnaire surveys and three group discussions). This paper reports data from the transcribed group discussions involving 100 participants, which was subject to content and thematic analysis. Participants were accreditation survey coordinators employed by the Australian Council on Healthcare Standards.

Findings

Six significant issues influencing survey reliability were reported: accreditation program governance and philosophy; accrediting agency management of the accreditation process, including the program’s framework; survey coordinators; survey team dynamics; individual surveyors; and healthcare organizations’ approach to accreditation. A change in governance arrangements promoted reliability with an independent authority and a new set of standards, endorsed by Federal and State governments. However, potential reliability threats were introduced by having multiple accrediting agencies approved to survey against the new national standards. Challenges that existed prior to the reformed system remain.

Originality/value

Capturing lessons and challenges from healthcare reforms is necessary if improvements are to be realized. The study provides practical and theoretical strategies to promote reliability in accreditation programs.

Details

Journal of Health Organization and Management, vol. 29 no. 7
Type: Research Article
ISSN: 1477-7266

Keywords

Content available
Article
Publication date: 4 May 2010

Abstract

Details

Leadership in Health Services, vol. 23 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Content available
Article
Publication date: 1 March 2019

Russell Mannion, Huw Davies, Martin Powell, John Blenkinsopp, Ross Millar, Jean McHale and Nick Snowden

The purpose of this paper is to explore whether official inquiries are an effective method for holding the medical profession to account for failings in the quality and…

Abstract

Purpose

The purpose of this paper is to explore whether official inquiries are an effective method for holding the medical profession to account for failings in the quality and safety of care.

Design/methodology/approach

Through a review of the theoretical literature on professions and documentary analysis of key public inquiry documents and reports in the UK National Health Service (NHS) the authors examine how the misconduct of doctors can be understood using the metaphor of professional wrongdoing as a product of bad apples, bad barrels or bad cellars.

Findings

The wrongdoing literature tends to present an uncritical assumption of increasing sophistication in analysis, as the focus moves from bad apples (individuals) to bad barrels (organisations) and more latterly to bad cellars (the wider system). This evolution in thinking about wrongdoing is also visible in public inquiries, as analysis and recommendations increasingly tend to emphasise cultural and systematic issues. Yet, while organisational and systemic factors are undoubtedly important, there is a need to keep in sight the role of individuals, for two key reasons. First, there is growing evidence that a small number of doctors may be disproportionately responsible for large numbers of complaints and concerns. Second, there is a risk that the role of individual professionals in drawing attention to wrongdoing is being neglected.

Originality/value

To the best of the authors’ knowledge this is the first theoretical and empirical study specifically exploring the role of NHS inquiries in holding the medical profession to account for failings in professional practice.

Details

Journal of Health Organization and Management, vol. 33 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Content available
Article
Publication date: 22 March 2011

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 3
Type: Research Article
ISSN: 0952-6862

Keywords

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Book part
Publication date: 26 October 2020

Gregg M. Gascon and Gregory I. Sawchyn

Bundled payments for care are an efficient mechanism to align payer, provider, and patient incentives in the provision of health care services for an episode of care. In…

Abstract

Bundled payments for care are an efficient mechanism to align payer, provider, and patient incentives in the provision of health care services for an episode of care. In this chapter, we use agency theory to examine the evolution of bundled payment programs in private and public payer arrangements, and postulate future directions for bundled payment development as a key component in the provision and payment of health care services.

Content available
Article
Publication date: 4 May 2010

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 23 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Content available
Article
Publication date: 6 September 2011

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 7
Type: Research Article
ISSN: 0952-6862

Keywords

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Article
Publication date: 12 February 2018

Sally Elizabeth Hardy, Rebecca Malby, Nina Hallett, Anam Farooq, Carol Chamley, Gwendoline Young, Xavier Hilts White and Warren Turner

The introduction of a People’s Academy (PA) within the School of Health and Social Care (HSC) at London South Bank University has created ripples across the pond that is…

Abstract

Purpose

The introduction of a People’s Academy (PA) within the School of Health and Social Care (HSC) at London South Bank University has created ripples across the pond that is Higher Education. The paper aims to discuss this issue.

Design/methodology/approach

Working as a coproduction innovation hub, the PA celebrates inclusion of those with a lived experience of HSC services into the academic community as valued members of the teaching and learning team. In its second year the PA has gained attention and achieved a “highly commended” status from external regulating bodies.

Findings

In this paper the authors report on aspects arising from an entrepreneurial education approach. First, is the work-based learning experience students achieve within the Higher Education Institution (HEI) setting, preparing them for clinical placements and client encounters. Second are ripples of activity the PA work streams have sent throughout the academic staff via critically creative working practices as a process of entrepreneurial education. Conclusions focus on a sustainable approach to recovery and resilience (whether physical or psychological) and overall well-being that PA members recognise as a raised level of compassion for sustainable health and well-being for all.

Social implications

The work and enthusiasm of the PA as an authentic social engagement process rippling across the “University” experience; whether for students in the classroom or when working alongside academic staff, is identifiable in all aspects of academic activities. Most importantly is a positive gain in terms of knowledge, skills and confidence for the PA members themselves and their own well-being enhancement.

Originality/value

The PA approach to entrepreneurial education and work-based learning across the HEI setting is one of the first of its kind. This paper outlines core practices to achieve innovative coproduction approach that others may wish to replicate.

Details

Higher Education, Skills and Work-Based Learning, vol. 8 no. 1
Type: Research Article
ISSN: 2042-3896

Keywords

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