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. 

How a Gender-sensitive Quality Improvement Approach Supports Integrated People-centered Health Services

Clients, family and friends, communities, and health providers are all influenced by the culture they live in and by that culture’s perspectives on gender. To ignore gender is to ignore a vital part of the people and their local context that the WHO framework aims to center. Gender must be considered in order to have truly people-centered health services. A gender-sensitive approach takes the different needs, constraints, and opportunities of women, men, girls, and boys into account and responds to them strategically in program design, implementation, and evaluation. By considering and responding to these differences, health services are more ...

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. 

Co-Leadership – A Management Solution for Integrated Health and Social Care

Because of teh Co-leadership has been identified as one approach to meet the managerial challenges of integrated services, but research on the topic is limited, the aim of the present study is to investigate co-leadership in integrated health and social care, identify essential preconditions in fulfilling the management assignment, its operationalization and impact on provision of sustainable integration of health and social care. 

Self-perception of leadership styles and behaviour in primary health care

The concept of leadership has been studied in various disciplines and from different theoretical approaches. 

In the primary health care (PHC) setting, managers´leadership style is defined as a set of acttitudes, behaviours, beliefs and values. The objetives of this study were to describe and learn about the self-perception of behaviours and leadership style among PHC managers; to determine the influence of the leadership style on job satisfaction, efficiency and willingness to work in a team; and to determine the relationship between transformational and transactional styles according age, gender, profession and the type of organization. 

Perceptions of health managers and professionals about mental health and primary care integration in Rio de Janeiro: a mixed methods study

Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health.

Impact of Patient-Centered Care Innovations on Access to Providers, Ambulatory Care Utilization, and Patient Clinical Indicators in the Veterans Health Administration

The Veterans Health Administration piloted patient-centered care (PCC) innovations beginning in 2010 to improve patient and provider experience and environment in ambulatory care. We use secondary data to look at longitudinal trends, evaluate system redesign, and identify areas for further quality improvement.

METHODS:

This was a retrospective, observational study using existing secondary data from multiple US Department of Veteran Affairs sources to evaluate changes in veteran and facility outcomes associated with PCC innovations at 2 innovation and matched comparison sites between FY 2008-2010 (pre-PCC innovations) and FY 2011-2012 (post-PCC innovations). Outcomes included access to primary care providers (PCPs); primary, specialty ...

Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability.

Purpose: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts. 

Methods: The Context and Capabilities for Integrating Care (CCIC) Framework was developed through a literature review, and revised and validated through interviews with leaders and care providers engaged in integrated care networks ...