Bridging Inequity Gaps in Healthcare Systems While Educating Future Healthcare Professionals-The Social Health Bridge-Building Programme.

Social inequity in healthcare persists even in countries with universal healthcare. The Social Health Bridge-Building Programme aims to reduce healthcare inequities. This paper provides a detailed description of the programme. The Template for Intervention Description and Replication (TIDieR) was used to structure the description. The programme theory was outlined using elements from the British Medical Research Council's framework, including identifying barriers to healthcare, synthesising evidence, describing the theoretical framework, creating a logic model, and engaging stakeholders. In the Social Health Bridge-Building Programme, student volunteers accompany individuals to healthcare appointments and provide social support before, during, and after the visit. The programme is rooted in a recovery-oriented approach, emphasising personal resources and hope. The programme finds support in constructs within the health literacy framework. Student volunteers serve as health literacy mediators, supporting individuals in navigating the healthcare system while gaining knowledge and skills. This equips students for their forthcoming roles as healthcare professionals, and potentially empowers them to develop and implement egalitarian initiatives within the healthcare system, including initiatives that promote organisational health literacy responsiveness. The Social Health Bridge-Building Programme is a promising initiative that aims to improve equity in healthcare by addressing individual, social, and systemic barriers to healthcare. The programme's description will guide forthcoming evaluations of its impact.

Crossing and creating boundaries in healthcare innovation.

Purpose - This paper reports from a qualitative case study of a change initiative undertaken in a Danish public hospital setting during national healthcare reforms. The purpose of this paper is to challenge understandings of innovations as defined by being value-adding per se. Whether the effects of attempting to innovate are positive or negative is in this paper regarded as a matter of empirical investigation. Design/methodology/approach - Narrative accounts of activities during the change initiative are analysed in order to elucidate the effects of framing the change initiative as innovation on which boundaries are created and crossed. Findings - Framing change initiatives as innovation leads to intended as well as unanticipated boundary crossings where healthcare practitioners from different organizations recognize a shared problem and task. It also leads to unintended boundary reinforcements between "us and them" that may exclude the perspectives of patients or stakeholders when confronting complex problems in healthcare. This boundary reinforcement can lead to further fragmentation of healthcare despite the stated intention to create more integrated services. Practical implications - The paper suggests that researchers as well as practitioners should not presume that intentions to innovate will by themselves enhance creativity and innovation. When analysing the intended, unintended as well as unanticipated consequences of framing change initiatives as innovation, researchers and practitioner gain nuanced knowledge about the effects of intending to innovate in complex settings such as healthcare. Originality/value - This paper suggests the need for an analytical move from studying the effects of innovation to studying the effects of framing complex problems as a call for innovation.