Optimising the community-based aproach to health care improvement comparative case studies of the clinical community model in practice

Community-based approaches to healthcare improvement are receiving increasing attention. Such approaches could offer an infrastructure for efficient knowledge-sharing and a potent means of influencing behaviours, but their potential is yet to be optimised. After briefly reviewing challenges to community based approaches this study describes in detail the clinical community model. Through exploring clinical communities in practice, they seek to identify practical lessons for optimising this community-based approach to healthcare improvement. 

Intruments measuring integrated care: A systematic review of measurement properties

Integrated care is an important strategy for increasing health system preformance. Despite its growing significance, detailed evidence on the measurement properties of integrated care instruments remains vague an limited. This systematic review found 209 index instruments measuring different constructs related to integrated care which suggest that the quality of measurement properties of instruments measuring integrate care is in need of improvement with the less-studied constructs and domains to become part of newly developed instruments. 

Primary care managers´perceptions of their capability in providing care planning with complex needs

The aim of this study is to investigate primary care managers´perceptions of their capability in providing care planning to patients with complex needs. Care planning is defined as a process where the patient, family and health professionals engage in dialogue about the patient´s care needs and plan care interventions together. 

Integrated Care: theory to practice

"Integrated care" is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team management is frequently the primary focus of integrated care when implemented internationally. This study examine the practical application of integrated care in the NHS in England to exemplify the prevalence of the case management focus. It looks at the evidence for effectiveness of multi-disciplinary team case management, for the focus on high-risk groups and for integrated care more generally. They suggest realistic expectations of what integration of care alone can achieve and additional research ...

Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators

With an ageing population there is a move towards the use of assisted living technologies (ALTs) to provide social care and health care services, and to improve service processes. These technologies are at the forefront of the integration of health and social care. However, economic evaluatios of ALTs, and indeed economic evaluations of any interventions providing both health benefits and benefits beyond health are complex. This paper considers the challenges faced by evaluators and presents a method of economic evaluation for use with interventions where traditional methods may not be suitable for informing funders and decision makers. They propose a ...

4 Steps to Sustaining Improvement in Health Care

Leading health care organizations recognize that improving care isn´t enough; having a systematic approach to sustaining improvement is equally important.

To learn how to build systems that sustain improvement, the Institute for Healthcare Improvement studied health care organizations that were able to achieve standout results and ten build on them- organizations such as Intermountain Healthcare in Salt Lake City; Saskatoon Health Region in Saskatchewan, Canada; and Virginia Mason Health System in Seattle. These high-performing health systems affered a key insight: To sustain change, you need a strong strategy for engaging and standardizing the work of frontline managers. From their ...

Community health center provider ability to identify, treat and account for the social determinants of health: a card study

The social determinants of health (SDH) are conditions that shape the overall health of an individual on a continuous basis. As momentum for addressing social factors in primary care settings grows, provider ability to identify, treat and assess these factors remains unknown. Community health centers care for over 20- million of America´s highest risk populations. This study at three centers evaluates provider ability to identify, treat and code for the SDH.

The results suggest simple methods of identification may be sufficient. The addition of searchable codes and reimbursements may improve the way social factors are addressed for individuals and ...

How do we know? An assessment of integrated community case management data quality in four districts of Malawi

The World Health Organization contracted annual data quality assessments of Rapid Access Expansion (RAcE) proyects to review integrated community case management (iCCM) data quality and the monitoring and evaluation (M&E) system for iCCM, adn to suggest ways to improve data quality. 

This data quality assessment illuminates where an otherwise strong M&E system for iCCM fails to ensure some aspects of data quality. Prioritizing data management with documented protocols, additional training and approaches to create efficient supervision practices may improve iCCM data quality. 

Early Performance of Accountable Care Organizations in Medicare

In the Medicare Shared Savings Program (MSSP), accountable care organizations (ACOs) have financial incentives to lower spending and improve quality. In this article they used quasi-experimental methods to assess the early performance of MSSP and ACOs. In the conclusions they found that the first full year of contracts MSSP was associated with reductions in Medicare Early pass between the 2012 participants but not among the 2013 participants. Economies higher in primary care groups independent groups in integrated hospitals. 

New care models. Emerging innovations in governance and organisational form

Because the vanguards have shown just how important is to build collaborative relationships between the organisations and leaders involved in developing new care models as well as the technical elements; This report looks at the different approaches being taken by MCP (multispecialty community provider) and PACS (primary and acute care system) vanguards to contracting, governance and other organisational infrastructure. It focuses on development at five sites: Dudley, Sandwell and West Birmingham, Salford; Northumberland; and South Somerset.