Pub Date : 2022-05-31DOI: 10.1108/ijhg-02-2022-0023
Jigi Lucas, S. Leggat, N. Taylor
PurposeTo investigate the association between implementation of clinical governance and patient safety.Design/methodology/approachA pre-post study was conducted in an Australian health service following the implementation of clinical governance systems (CGS) in the inpatient wards in 2016. Health service audit data from 2017 on CGS implementation and the rate of adverse patient safety events (PSE) for 2015 (pre-implementation) and 2017 (post-implementation), across 45 wards in six hospitals were collected. CGS examined compliance with 108 variables, based on the Australian National Safety and Quality Health Service standards. Patient safety was measured as PSE per 100 bed days. Data were analysed using odds ratios to explore the association between patient safety and CGS percentage compliance score.FindingsThere was no change in PSE between 2015 and 2017 (MD 0.04 events/100 bed days, 95% CI -0.11 to 0.21). There were higher odds that wards with a CGS score >90% reported reduced PSE, compared to wards with lower compliance. The domains of leadership and culture, risk management and clinical practice had the strongest association with the reduction in PSE.Practical implicationsGiven that wards with a CGS score >90% showed increased odds of reduced PSE health service boards need to put in place strategies that engage frontline managers and staff to facilitate full implementation of clinical governance systems for patient safety.Originality/valueThe findings provide evidence that implementation of all facets of CGS in a large public health service is associated with improved patient safety.
{"title":"Association between use of clinical governance systems at the frontline and patient safety: a pre-post study","authors":"Jigi Lucas, S. Leggat, N. Taylor","doi":"10.1108/ijhg-02-2022-0023","DOIUrl":"https://doi.org/10.1108/ijhg-02-2022-0023","url":null,"abstract":"PurposeTo investigate the association between implementation of clinical governance and patient safety.Design/methodology/approachA pre-post study was conducted in an Australian health service following the implementation of clinical governance systems (CGS) in the inpatient wards in 2016. Health service audit data from 2017 on CGS implementation and the rate of adverse patient safety events (PSE) for 2015 (pre-implementation) and 2017 (post-implementation), across 45 wards in six hospitals were collected. CGS examined compliance with 108 variables, based on the Australian National Safety and Quality Health Service standards. Patient safety was measured as PSE per 100 bed days. Data were analysed using odds ratios to explore the association between patient safety and CGS percentage compliance score.FindingsThere was no change in PSE between 2015 and 2017 (MD 0.04 events/100 bed days, 95% CI -0.11 to 0.21). There were higher odds that wards with a CGS score >90% reported reduced PSE, compared to wards with lower compliance. The domains of leadership and culture, risk management and clinical practice had the strongest association with the reduction in PSE.Practical implicationsGiven that wards with a CGS score >90% showed increased odds of reduced PSE health service boards need to put in place strategies that engage frontline managers and staff to facilitate full implementation of clinical governance systems for patient safety.Originality/valueThe findings provide evidence that implementation of all facets of CGS in a large public health service is associated with improved patient safety.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44781447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-31DOI: 10.1108/ijhg-07-2021-0072
I. Benati, M. Coccia
PurposeThe goal of this study is to analyze the relationship between public governance and COVID-19 vaccinations during early 2021 to assess the preparedness of countries to timely policy responses to cope with pandemic crises.Design/methodology/approachThis global study elaborates descriptive statistics, correlations, regression analyses and Independent Samples T-Test on 112 countries, comparing those with high/low level of governance, to determine whether statistical evidence supports the hypothesis that good governance can improve the timely administration of vaccines.FindingsBivariate correlation reveals that doses of vaccines administered × 100 inhabitants have a high positive association with the General Index of Governance (r = 0.58, p-value <0.01). The result is confirmed by partial correlation (controlling density of population per km2): r = 0.584, p-value <0.001. The coefficient of regression in the models also indicates that an increase in the General Index of Governance improves the expected administration of doses of COVID-19 vaccines (p-value <0.001).Research limitations/implicationsAlthough this study has provided interesting results that are, of course, tentative, it has several limitations. First, a limitation is the lack of data in several countries. Second, not all the possible confounding factors that affect the vaccination against COVID-19 are investigated, such as country-specific health investments and expenditures, and these aspects should be examined in the future development of this research. A third limit is related to the measurement of governance through the World Governance Indicators, which are based only on perceptions and can be biased by different socio-economic factors.Practical implicationsThe identification of factors determining the timely vaccinations may help to design best practices of health policy for improving the resilience of countries to face pandemic crises.Social implicationsThe improvement of preparedness of countries through good governance can foster a rapid rollout of vaccinations to cope with pandemic threats and the negative effects of their socio-economic impact.Originality/valueThis study presents a global analysis of the role of public governance for timely vaccinations to face pandemic crises in society.
{"title":"Global analysis of timely COVID-19 vaccinations: improving governance to reinforce response policies for pandemic crises","authors":"I. Benati, M. Coccia","doi":"10.1108/ijhg-07-2021-0072","DOIUrl":"https://doi.org/10.1108/ijhg-07-2021-0072","url":null,"abstract":"PurposeThe goal of this study is to analyze the relationship between public governance and COVID-19 vaccinations during early 2021 to assess the preparedness of countries to timely policy responses to cope with pandemic crises.Design/methodology/approachThis global study elaborates descriptive statistics, correlations, regression analyses and Independent Samples T-Test on 112 countries, comparing those with high/low level of governance, to determine whether statistical evidence supports the hypothesis that good governance can improve the timely administration of vaccines.FindingsBivariate correlation reveals that doses of vaccines administered × 100 inhabitants have a high positive association with the General Index of Governance (r = 0.58, p-value <0.01). The result is confirmed by partial correlation (controlling density of population per km2): r = 0.584, p-value <0.001. The coefficient of regression in the models also indicates that an increase in the General Index of Governance improves the expected administration of doses of COVID-19 vaccines (p-value <0.001).Research limitations/implicationsAlthough this study has provided interesting results that are, of course, tentative, it has several limitations. First, a limitation is the lack of data in several countries. Second, not all the possible confounding factors that affect the vaccination against COVID-19 are investigated, such as country-specific health investments and expenditures, and these aspects should be examined in the future development of this research. A third limit is related to the measurement of governance through the World Governance Indicators, which are based only on perceptions and can be biased by different socio-economic factors.Practical implicationsThe identification of factors determining the timely vaccinations may help to design best practices of health policy for improving the resilience of countries to face pandemic crises.Social implicationsThe improvement of preparedness of countries through good governance can foster a rapid rollout of vaccinations to cope with pandemic threats and the negative effects of their socio-economic impact.Originality/valueThis study presents a global analysis of the role of public governance for timely vaccinations to face pandemic crises in society.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43533948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-13DOI: 10.1108/ijhg-01-2022-0015
Karin Nilsson, B. Landstad, K. Ekberg, Anna Nyberg, M. Sjöström, Emma Hagqvist
PurposeThis aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in 2020 when hospitals transitioned to pandemic care.Design/methodology/approachThe study has a qualitative design. Twenty-five hospital-based physicians were interviewed about their experiences from working in a hospital while healthcare organisations initially responded to COVID-19 pandemic in 2020. A thematic analysis was used to analyse the empirical material.FindingsThe analysis resulted in four themes: involuntary self-management, a self-restrictive bureaucracy, passive occupational safety and health (OSH) management, and information overload. These themes reflect how the physicians perceived their work situation during the pandemic and how they tried to maintain quality care for their patients.Practical implicationsThe study gives valuable insights for formulating preparedness in regard to crisis management plans that can secure the provision of care for future emergencies in the healthcare services.Originality/valueThis paper shows that a crisis management plans in the healthcare services should include decision structures and management, measures of risk assessment and OSH management, and the maintenance of personnel wellbeing. A prepared healthcare management can preserve quality care delivery while under crisis.
{"title":"Physicians' experiences of challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in Sweden","authors":"Karin Nilsson, B. Landstad, K. Ekberg, Anna Nyberg, M. Sjöström, Emma Hagqvist","doi":"10.1108/ijhg-01-2022-0015","DOIUrl":"https://doi.org/10.1108/ijhg-01-2022-0015","url":null,"abstract":"PurposeThis aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in 2020 when hospitals transitioned to pandemic care.Design/methodology/approachThe study has a qualitative design. Twenty-five hospital-based physicians were interviewed about their experiences from working in a hospital while healthcare organisations initially responded to COVID-19 pandemic in 2020. A thematic analysis was used to analyse the empirical material.FindingsThe analysis resulted in four themes: involuntary self-management, a self-restrictive bureaucracy, passive occupational safety and health (OSH) management, and information overload. These themes reflect how the physicians perceived their work situation during the pandemic and how they tried to maintain quality care for their patients.Practical implicationsThe study gives valuable insights for formulating preparedness in regard to crisis management plans that can secure the provision of care for future emergencies in the healthcare services.Originality/valueThis paper shows that a crisis management plans in the healthcare services should include decision structures and management, measures of risk assessment and OSH management, and the maintenance of personnel wellbeing. A prepared healthcare management can preserve quality care delivery while under crisis.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49660751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-06DOI: 10.1108/ijhg-06-2022-147
F. M. MacVane Phipps
{"title":"IJHG 27.2 Review","authors":"F. M. MacVane Phipps","doi":"10.1108/ijhg-06-2022-147","DOIUrl":"https://doi.org/10.1108/ijhg-06-2022-147","url":null,"abstract":"","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49402081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-06DOI: 10.1108/ijhg-06-2022-145
L. Münter, K. Sørensen, Tanja Schjoedt Jørgensen, B. Ray-Sannerud
It is said that understanding the past can be a key to unlocking the future. This might ring true for health systems also. Understanding the reasons why our modern cultures, thinkers and politicians built the current model can help us understand, why the model, the design works as it does, why financing works as it does, why governance etc. The challenge with this retrospective approach can often be that it tends to assume that design and transformation are Darwinian. That natural evolution and adaption will lead to efficient systems by constantly tweaking it to fit minor changes in the environment (physical or political). However, with a rising number of challenges before us, this assumption might lead us of a cliff edge – and it is certainly not a way of leading from the future (Johnson and Suskewicz, 2020). In recent years, it has become evident that the combined challenge of continued urbanization, shifting demographics, implementation of new, better, and more costly clinical practices, roaring digitalization, a dwindling health workforce and a pandemic too have a two-fold impact on our systems; it underlines and stresses current weaknesses in the system – and it reveals the impossibility of solving all these by simply increasing healthcare spending. The Nordic countries are among themost affluent countries in the world and have some of the most cost-efficient health systems too. And yet these welfare countries also struggle with cracks and flaws related to shortcomings of logistics, services, implementation and human resources. Thus, if it is difficult for even the best-in-class to strike a balance, it might be questioned, if the problem is that the design is simply no longer fit for purpose? This is a core recognition in the work of the Nordic Health 2030 Movement (NH2030 [1]). Voices calling for a more people-centered, equitable, inclusive and preventive public health system have around for a long time but gathered extra speed after the Sustainable Development Goals were decided in 2015. The basic question remains: How can we build a system that provides the health and security that we need, but also balances and respects the need to reduce our carbon footprint, minimizes health inequalities and ensures that it focuses in the “demos”; the people; in matters relating to epidemiology? These are not easy questions. And they are not easier to answer, if one assumes that the current system must fit inside a transformed, better system. This is the fallacy of sunk cost (Ronayne et al., 2021). And thus, we needed to use a different mindset to be able to decide on how a new system of health services should work, focus on and be governed. In 2019, the members of the NH2030 Movement set out to uncover the basic values of a different system for health. Not based on a transformed model but rather on the joint, basic Nordic values that also helped shape and build the current Nordic health systems – and use these to dare reimagine the roles of people, sy
有人说，了解过去可以成为开启未来的钥匙。这对卫生系统来说可能也是如此。了解我们的现代文化、思想家和政治家建立当前模式的原因，可以帮助我们理解为什么这个模式、设计如此有效，为什么融资如此有效，以及为什么治理等等。这种回顾性方法的挑战往往是，它倾向于认为设计和转型是达尔文主义的。这种自然进化和适应将通过不断调整来适应环境（物理或政治）的微小变化，从而产生高效的系统。然而，随着我们面临的挑战越来越多，这种假设可能会让我们陷入悬崖边缘——而且这肯定不是从未来开始的一种领导方式（Johnson和Suskewicz，2020）。近年来，很明显，持续的城市化、人口结构的变化、新的、更好的、成本更高的临床实践的实施、数字化的蓬勃发展、卫生劳动力的减少和疫情的共同挑战也对我们的系统产生了双重影响；它强调并强调了该系统目前的弱点&它揭示了仅仅通过增加医疗支出来解决所有这些问题的不可能。北欧国家是世界上最富裕的国家之一，也拥有一些最具成本效益的卫生系统。然而，这些福利国家也在与物流、服务、实施和人力资源方面的缺陷作斗争。因此，如果即使是同类中最优秀的人也很难取得平衡，那么可能会有人质疑，如果问题是设计不再符合目的？这是北欧健康2030运动（NH2030[1]）工作的核心认可。呼吁建立一个更加以人为本、公平、包容和预防性的公共卫生系统的声音已经存在很长一段时间了，但在2015年确定可持续发展目标后，这种声音加快了速度。基本问题仍然存在：我们如何建立一个系统，既能提供我们所需的健康和安全，又能平衡和尊重减少碳足迹的需要，最大限度地减少健康不平等，并确保其集中在“演示”中；人民；在与流行病学有关的问题上？这些问题并不容易。如果人们认为当前的系统必须适应一个经过改造的、更好的系统，那么答案就不容易了。这就是沉没成本的谬论（Ronayne et al.，2021）。因此，我们需要用不同的心态来决定新的卫生服务体系应该如何运作、关注和治理。2019年，NH2030运动的成员开始揭示不同卫生系统的基本价值观。不是基于一个转变的模式，而是基于共同的、基本的北欧价值观，这些价值观也有助于塑造和建立当前的北欧卫生系统——并利用这些价值观来大胆重新想象人、系统的角色，以及卫生数据和见解的互动。这创造了健康平衡模式的愿景（CIFS，2019[2]），NH2030认为该模式应成为社区、机构和卫生系统设计战略的管理原则和框架（见图1）。这个系统本质上是通过认识到个人和系统之间平衡的关键价值来管理的，以及健康数据的联合流，从而认识到将它们相互连接的价值。目前，这种方法正以不同的方式应用，作为反馈的一部分，例如欧洲健康数据空间联合行动[3]、编辑政策
{"title":"Editorial: How to build health?","authors":"L. Münter, K. Sørensen, Tanja Schjoedt Jørgensen, B. Ray-Sannerud","doi":"10.1108/ijhg-06-2022-145","DOIUrl":"https://doi.org/10.1108/ijhg-06-2022-145","url":null,"abstract":"It is said that understanding the past can be a key to unlocking the future. This might ring true for health systems also. Understanding the reasons why our modern cultures, thinkers and politicians built the current model can help us understand, why the model, the design works as it does, why financing works as it does, why governance etc. The challenge with this retrospective approach can often be that it tends to assume that design and transformation are Darwinian. That natural evolution and adaption will lead to efficient systems by constantly tweaking it to fit minor changes in the environment (physical or political). However, with a rising number of challenges before us, this assumption might lead us of a cliff edge – and it is certainly not a way of leading from the future (Johnson and Suskewicz, 2020). In recent years, it has become evident that the combined challenge of continued urbanization, shifting demographics, implementation of new, better, and more costly clinical practices, roaring digitalization, a dwindling health workforce and a pandemic too have a two-fold impact on our systems; it underlines and stresses current weaknesses in the system – and it reveals the impossibility of solving all these by simply increasing healthcare spending. The Nordic countries are among themost affluent countries in the world and have some of the most cost-efficient health systems too. And yet these welfare countries also struggle with cracks and flaws related to shortcomings of logistics, services, implementation and human resources. Thus, if it is difficult for even the best-in-class to strike a balance, it might be questioned, if the problem is that the design is simply no longer fit for purpose? This is a core recognition in the work of the Nordic Health 2030 Movement (NH2030 [1]). Voices calling for a more people-centered, equitable, inclusive and preventive public health system have around for a long time but gathered extra speed after the Sustainable Development Goals were decided in 2015. The basic question remains: How can we build a system that provides the health and security that we need, but also balances and respects the need to reduce our carbon footprint, minimizes health inequalities and ensures that it focuses in the “demos”; the people; in matters relating to epidemiology? These are not easy questions. And they are not easier to answer, if one assumes that the current system must fit inside a transformed, better system. This is the fallacy of sunk cost (Ronayne et al., 2021). And thus, we needed to use a different mindset to be able to decide on how a new system of health services should work, focus on and be governed. In 2019, the members of the NH2030 Movement set out to uncover the basic values of a different system for health. Not based on a transformed model but rather on the joint, basic Nordic values that also helped shape and build the current Nordic health systems – and use these to dare reimagine the roles of people, sy","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41530776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-18DOI: 10.1108/ijhg-08-2021-0078
Akeem Modeste-James, Camille L Huggins
PurposeIncreased migration to small island developing states poses major challenges on receiving countries' healthcare systems. Due to public health policy on treating migrants in Trinidad and Tobago, Venezuelan migrants are experiencing less than optimal care. This paper examines the retrospective accounts of physicians treating Venezuelan migrants with limited access to healthcare.Design/methodology/approachTen in depth, semi-structured interviews were conducted with physicians working in primary healthcare and emergency departments about their clinical decision-making process in providing care for Venezuelan migrants. A narrative approach was used to highlight the personal experiences of participants. Participants were recruited by their response to an online advertisement on social media (i.e. Facebook and Instagram) and via email invitations. Interviews were transcribed verbatim and coded using NVIVO-12 software.FindingsFindings revealed language barriers between Venezuelan migrants and Trinidad and Tobago-based physicians hindered providing optimal care coordination. Physicians indicated the use of a translator app to bridge the service gap but questioned their ethics. Participants noted tensions between junior and senior physicians regarding referrals of Venezuelan migrants to outpatient care. The data suggests physicians' felt constrained providing additional services such as primary care due to the Provision of Public Healthcare Services Policy which forbids primary care services to migrants.Originality/valueSparse research on the barriers to accessing healthcare for Venezuelan migrants residing in the small island states.
{"title":"Barriers to healthcare for Venezuelan migrants: physicians' perspective","authors":"Akeem Modeste-James, Camille L Huggins","doi":"10.1108/ijhg-08-2021-0078","DOIUrl":"https://doi.org/10.1108/ijhg-08-2021-0078","url":null,"abstract":"PurposeIncreased migration to small island developing states poses major challenges on receiving countries' healthcare systems. Due to public health policy on treating migrants in Trinidad and Tobago, Venezuelan migrants are experiencing less than optimal care. This paper examines the retrospective accounts of physicians treating Venezuelan migrants with limited access to healthcare.Design/methodology/approachTen in depth, semi-structured interviews were conducted with physicians working in primary healthcare and emergency departments about their clinical decision-making process in providing care for Venezuelan migrants. A narrative approach was used to highlight the personal experiences of participants. Participants were recruited by their response to an online advertisement on social media (i.e. Facebook and Instagram) and via email invitations. Interviews were transcribed verbatim and coded using NVIVO-12 software.FindingsFindings revealed language barriers between Venezuelan migrants and Trinidad and Tobago-based physicians hindered providing optimal care coordination. Physicians indicated the use of a translator app to bridge the service gap but questioned their ethics. Participants noted tensions between junior and senior physicians regarding referrals of Venezuelan migrants to outpatient care. The data suggests physicians' felt constrained providing additional services such as primary care due to the Provision of Public Healthcare Services Policy which forbids primary care services to migrants.Originality/valueSparse research on the barriers to accessing healthcare for Venezuelan migrants residing in the small island states.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43989129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-11DOI: 10.1108/ijhg-08-2021-0083
Moutasem A. Zakkar, C. Janes, S. Meyer
PurposePatient experience (PE) evaluation can identify critical issues in healthcare quality. Various methods are used for PE evaluation in the healthcare system in Ontario; however, evidence suggests that PE evaluation is not systematically performed and has not received substantial buy-in from healthcare providers. This study explores the perspectives of healthcare providers, managers and policymakers in Ontario on PE evaluation methods, barriers, utility and reliability.Design/methodology/approachThe study used a qualitative descriptive design. Twenty-one semistructured interviews were conducted with healthcare providers, managers and policymakers in Ontario between April 2018 and May 2019. The authors used thematic analysis to analyze the data. The Consolidated Criteria for Reporting Qualitative Research quality criteria were used.FindingsBarriers to PE evaluation include evaluation cost and the time and effort required to collect and analyze the data. Several factors affect the reliability of the evaluation, resulting in an unrealistically high level of patient satisfaction. These include the inclusivity of evaluation, the subjective nature of patient feedback, patients' concerns about health service continuity and the anonymity of evaluation. Participants were skeptical about the meaningfulness of evaluation because it may only yield general information that cannot be acted upon by healthcare providers, managers and policymakers for quality improvement.Originality/valueThis paper reveals that many healthcare providers, managers and policymakers do not see a tangible value in PE evaluation, regardless of Ontario's patient-centeredness and “patient first” rhetoric. An improvement in evaluation methods and a cultural change in the healthcare system regarding the value of PE are required to foster a better appreciation of the benefits of PE evaluation.
{"title":"Barriers and reliability of patient experience evaluation in Ontario: perspectives of healthcare providers, managers, and policymakers","authors":"Moutasem A. Zakkar, C. Janes, S. Meyer","doi":"10.1108/ijhg-08-2021-0083","DOIUrl":"https://doi.org/10.1108/ijhg-08-2021-0083","url":null,"abstract":"PurposePatient experience (PE) evaluation can identify critical issues in healthcare quality. Various methods are used for PE evaluation in the healthcare system in Ontario; however, evidence suggests that PE evaluation is not systematically performed and has not received substantial buy-in from healthcare providers. This study explores the perspectives of healthcare providers, managers and policymakers in Ontario on PE evaluation methods, barriers, utility and reliability.Design/methodology/approachThe study used a qualitative descriptive design. Twenty-one semistructured interviews were conducted with healthcare providers, managers and policymakers in Ontario between April 2018 and May 2019. The authors used thematic analysis to analyze the data. The Consolidated Criteria for Reporting Qualitative Research quality criteria were used.FindingsBarriers to PE evaluation include evaluation cost and the time and effort required to collect and analyze the data. Several factors affect the reliability of the evaluation, resulting in an unrealistically high level of patient satisfaction. These include the inclusivity of evaluation, the subjective nature of patient feedback, patients' concerns about health service continuity and the anonymity of evaluation. Participants were skeptical about the meaningfulness of evaluation because it may only yield general information that cannot be acted upon by healthcare providers, managers and policymakers for quality improvement.Originality/valueThis paper reveals that many healthcare providers, managers and policymakers do not see a tangible value in PE evaluation, regardless of Ontario's patient-centeredness and “patient first” rhetoric. An improvement in evaluation methods and a cultural change in the healthcare system regarding the value of PE are required to foster a better appreciation of the benefits of PE evaluation.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47055776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-25DOI: 10.1108/ijhg-03-2022-0025
K. Sørensen, Lars Steen Pedersen, Jakob Sander
PurposeNew models of thinking, organization and governance are needed when health systems are under pressure. Inspired by a recent Danish community project called Your Health, this paper sheds light on the nexus of health promotion, sport and well-being, and how an increased focus on synergies can improve public health capacity in the future.Design/methodology/approachThe three areas of interests are presented, and challenges and opportunities are discussed along with the lessons learned from the Danish community project serving as an example of an integrated approach. The project was hosted by a sports club with the aim to enhance the health and well-being of new members, engage volunteers as health motivators and develop new activities in partnership with community organizations.FindingsThe discussion on creating synergies between sport, health promotion and well-being inspired a new model encouraging moving away from silo-thinking towards the sweet-spot where all three perspectives are represented. In this way, public health can be developed to the next level, in particular with regards to actions taking place outside the health sector.Research limitations/implicationsMore research is warranted to develop the evidence that can push for a changed policy agenda and showcase the social and economic return on investments.Practical implicationsThere is a growing interest to support health and well-being. Capacity building is needed to engage non-health stakeholders actively in the health agenda.Originality/valueDespite the need for progress, research is still scarce. Thus, it is important to create a new momentum among relevant stakeholders to facilitate the integration of sport, health promotion and well-being to qualify and expand public health capacity, create better health for all and bridge inequity.
{"title":"Exploring the nexus of health promotion, sport and well-being to improve future synergies and public health capacity through integrated approaches","authors":"K. Sørensen, Lars Steen Pedersen, Jakob Sander","doi":"10.1108/ijhg-03-2022-0025","DOIUrl":"https://doi.org/10.1108/ijhg-03-2022-0025","url":null,"abstract":"PurposeNew models of thinking, organization and governance are needed when health systems are under pressure. Inspired by a recent Danish community project called Your Health, this paper sheds light on the nexus of health promotion, sport and well-being, and how an increased focus on synergies can improve public health capacity in the future.Design/methodology/approachThe three areas of interests are presented, and challenges and opportunities are discussed along with the lessons learned from the Danish community project serving as an example of an integrated approach. The project was hosted by a sports club with the aim to enhance the health and well-being of new members, engage volunteers as health motivators and develop new activities in partnership with community organizations.FindingsThe discussion on creating synergies between sport, health promotion and well-being inspired a new model encouraging moving away from silo-thinking towards the sweet-spot where all three perspectives are represented. In this way, public health can be developed to the next level, in particular with regards to actions taking place outside the health sector.Research limitations/implicationsMore research is warranted to develop the evidence that can push for a changed policy agenda and showcase the social and economic return on investments.Practical implicationsThere is a growing interest to support health and well-being. Capacity building is needed to engage non-health stakeholders actively in the health agenda.Originality/valueDespite the need for progress, research is still scarce. Thus, it is important to create a new momentum among relevant stakeholders to facilitate the integration of sport, health promotion and well-being to qualify and expand public health capacity, create better health for all and bridge inequity.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43658263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-24DOI: 10.1108/ijhg-01-2022-0011
Micaela Pinho, N. Durão, B. Zahariev
PurposeThe problematic surrounding patients' prioritization decisions are currently at the centre of political leaders' concerns. How to define whom to treat when there are not enough resources to treat everybody is the key question. This exploratory study aims to investigate the views of Bulgarian citizens regarding the relevance of the information concerning eight individual health-related behaviours in priority setting decisions: smoking, excess of alcohol, illegal drug use, overweight/obesity, speed driving, extreme sports practice, unsafe sex and overuse of internet and/or mobile devices.Design/methodology/approachData were collected through a questionnaire where 322 respondents faced hypothetical rationing dilemmas comprising option pairs of the eight risky behaviours. Descriptive statistics and non-parametric tests were performed to define the penalization of each of the risky behaviours and to test for the association between this penalization and the respondent's health habits and sociodemographic characteristics.FindingsMost respondents would refuse to grant access to healthcare based on patients' personal responsibility for the disease. Nevertheless, respondents were more willing to consider illegal drug use, excessive alcohol consumption, engagement in unsafe sex behaviours and smoking. Respondent's own interest or advantage seems to be somehow relevant in explaining the penalization of risk behaviours in priority setting.Practical implicationsThis study shows that most respondents support the lottery criterion and thus do not want to see lifestyle prioritization in action.Originality/valueThis study is the first attempt to awaken attention to the impact that personal responsibility for health may have on intergenerational access to healthcare in Bulgaria.
{"title":"Are individual risky behaviours relevant to healthcare allocation decisions? An exploratory study","authors":"Micaela Pinho, N. Durão, B. Zahariev","doi":"10.1108/ijhg-01-2022-0011","DOIUrl":"https://doi.org/10.1108/ijhg-01-2022-0011","url":null,"abstract":"PurposeThe problematic surrounding patients' prioritization decisions are currently at the centre of political leaders' concerns. How to define whom to treat when there are not enough resources to treat everybody is the key question. This exploratory study aims to investigate the views of Bulgarian citizens regarding the relevance of the information concerning eight individual health-related behaviours in priority setting decisions: smoking, excess of alcohol, illegal drug use, overweight/obesity, speed driving, extreme sports practice, unsafe sex and overuse of internet and/or mobile devices.Design/methodology/approachData were collected through a questionnaire where 322 respondents faced hypothetical rationing dilemmas comprising option pairs of the eight risky behaviours. Descriptive statistics and non-parametric tests were performed to define the penalization of each of the risky behaviours and to test for the association between this penalization and the respondent's health habits and sociodemographic characteristics.FindingsMost respondents would refuse to grant access to healthcare based on patients' personal responsibility for the disease. Nevertheless, respondents were more willing to consider illegal drug use, excessive alcohol consumption, engagement in unsafe sex behaviours and smoking. Respondent's own interest or advantage seems to be somehow relevant in explaining the penalization of risk behaviours in priority setting.Practical implicationsThis study shows that most respondents support the lottery criterion and thus do not want to see lifestyle prioritization in action.Originality/valueThis study is the first attempt to awaken attention to the impact that personal responsibility for health may have on intergenerational access to healthcare in Bulgaria.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44051704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-16DOI: 10.1108/ijhg-10-2021-0107
D. Mathur
PurposeThe article aims to critically examine India's COVID-19 vaccination policy by analyzing the problem, politics and policy developed during the pandemic. The article would help the policy-makers and healthcare administrators to understand the situation in a holistic manner.Design/methodology/approachThe article employs Kingdon's multiple streams framework, which separately analyzes the problem at hand, the politics that are at work and the policy which is being developed when the problem and politics streams are activated. Directed approach to content analysis is adopted in this article.FindingsThe article provides a holistic overview of vaccine development and the vaccination policy during the COVID-19 pandemic in India.Practical implicationsThe analysis would help policy-makers and healthcare administrators to have a bird's-eye view of the COVID-19 vaccine development and the vaccination drive.Originality/valueThe article is a macro-level analysis of an extremely important situation of COVID-19 vaccine development and the subsequent vaccination drive for the world's largest democracy, which is also one of the largest drugs and vaccine manufacturing countries. The article captures the bird's-eye-view of the problem of vaccine development, the policy of funding as well as procurement, and the politics of vaccine distribution in the country.
{"title":"India’s COVID-19 vaccination policy-an analysis of problem, politics and policy","authors":"D. Mathur","doi":"10.1108/ijhg-10-2021-0107","DOIUrl":"https://doi.org/10.1108/ijhg-10-2021-0107","url":null,"abstract":"PurposeThe article aims to critically examine India's COVID-19 vaccination policy by analyzing the problem, politics and policy developed during the pandemic. The article would help the policy-makers and healthcare administrators to understand the situation in a holistic manner.Design/methodology/approachThe article employs Kingdon's multiple streams framework, which separately analyzes the problem at hand, the politics that are at work and the policy which is being developed when the problem and politics streams are activated. Directed approach to content analysis is adopted in this article.FindingsThe article provides a holistic overview of vaccine development and the vaccination policy during the COVID-19 pandemic in India.Practical implicationsThe analysis would help policy-makers and healthcare administrators to have a bird's-eye view of the COVID-19 vaccine development and the vaccination drive.Originality/valueThe article is a macro-level analysis of an extremely important situation of COVID-19 vaccine development and the subsequent vaccination drive for the world's largest democracy, which is also one of the largest drugs and vaccine manufacturing countries. The article captures the bird's-eye-view of the problem of vaccine development, the policy of funding as well as procurement, and the politics of vaccine distribution in the country.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46896647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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