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2.
Tex Med ; 116(8): 12-13, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32866274

RESUMO

Stephanie Stephens received a not-so-welcome gift entering her new job running Medicaid operations for the nation's second-largest state: A global pandemic. In that sense, the universe wasn't easy on Ms. Stephens, the new director of Medicaid and CHIP for the Texas Health and Human Services Commission (HHSC).


Assuntos
Acesso aos Serviços de Saúde , Administração de Serviços de Saúde , Liderança , Medicaid/organização & administração , Infecções por Coronavirus/epidemiologia , Feminino , Saúde Global , História do Século XXI , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Melhoria de Qualidade , Qualidade da Assistência à Saúde , Texas , Estados Unidos
5.
Enferm. foco (Brasília) ; 11(2): 76-82, jul. 2020. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1104173

RESUMO

Objetivo: analisar os atendimentos realizados na Central de Regulação de Urgência/SAMU do Estado do Rio Grande do Sul no período de 2016 e 2017. Metodologia: estudo observacional, descritivo e retrospectivo com abordagem quantitativa. Foram coletados os dados sobre perfil do usuário, dia da semana, classificação de risco, tipo do agravo, tempo médio de atendimento às solicitações, quantitativo de desistência da solicitação e número de chamados não regulados por falta de equipes ou veículos. Resultados: o número de solicitações por motivos clínicos foi 53.8%, destes 51,6% foram média gravidade. A prevalência foi do sexo masculino e idade entre 18 e 29 anos. Em 84,7% dos chamados solicitou-se suporte básico. O tempo resposta total foi entre 30 minutos e 1 hora, maior que o recomendado de acordo com a média nacional, seja nas as zonas urbanas ou rurais. Conclusão: este serviço necessita reduzir o tempo resposta de atendimento das solicitações. (AU)


Objective: to analyze the attendances performed at the Emergency Regulation Center / SAMU of the State of Rio Grande do Sul in 2016 and 2017, focusing in response time. Methodology: observational, descriptive and retrospective study with quantitative approach. Data were collected on user profile, day of the week, risk classification, type of grievance, average time to respond to requests, amount of withdrawal and number of calls not regulated due to lack of teams or vehicles. Results: The number of requests for clinical reasons was 53.8%, of these 51.6% were medium severity. The prevalence was male and aged between 18 and 29 years. In 84.7% of the calls, basic support was requested. The total response time was between 30 minutes and 1 hour, longer than recommended according to the national average, whether in urban or rural areas. Conclusion: After analyzing the calls, it is clear that the worst problem with the calls is the response time, and it is necessary to decrease the same of the requests. (AU)


Objetivo: analizar las asistencias realizadas en el Centro de Regulación de Emergencias / SAMU del Estado de Rio Grande do Sul en 2016 y 2017, centrándose en el tiempo de respuesta. Metodología: estudio observacional, descriptivo y retrospectivo con enfoque cuantitativo. Se recopilaron datos sobre el perfil del usuario, el día de la semana, la clasificación de riesgos, el tipo de queja, el tiempo promedio para responder a las solicitudes, la cantidad de retiros y la cantidad de llamadas no reguladas debido a la falta de equipos o vehículos. Resultados: El número de solicitudes por razones clínicas fue del 53.8%, de estas 51.6% fueron de gravedad media. La prevalencia fue masculina y de edades comprendidas entre 18 y 29 años. En el 84.7% de las llamadas, se solicitó soporte básico. El tiempo de respuesta total fue de entre 30 minutos y 1 hora, más de lo recomendado según el promedio nacional, ya sea en áreas urbanas o rurales. Conclusión: Después de analizar las llamadas, está claro que el peor problema con las llamadas es el tiempo de respuesta, y es necesario disminuir las mismas solicitudes. (AU)


Assuntos
Serviços Médicos de Emergência , Administração de Serviços de Saúde , Gestão em Saúde , Indicadores (Estatística)
6.
Enferm. foco (Brasília) ; 11(2): 160-167, jul. 2020. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1116001

RESUMO

Objetivo: O objetivo do estudo foi analisar a percepção de gerentes acerca do processo de gerenciamento dos Centros de Saúde da Família da zona urbana do município de Sobral, Ceará. Método: Trata-se de uma pesquisa exploratório descritiva, de abordagem qualitativa. Para coleta de dados utilizou-se entrevista semiestruturada com os gerentes dos Centros de Saúde da Família de Sobral-Ce da zona urbana no período de maio a agosto de 2019. Para tratamento dos dados empregou-se a análise de conteúdo proposto por Bardin e, como suporte neste processo, foi utilizado o software NVivo 11. Resultados: Os achados evidenciaram que o processo de gerenciamento é caracterizado pela falta de experiência, busca contínua de conhecimento para atuação no cargo e os maiores desafios enfrentados foram a burocratização do trabalho, a gestão de pessoas e falta de autonomia. Conclusão: O estudo reflete a necessidade de mudança das práticas na Estratégia Saúde da Família, no sentido de fortalecer a gestão compartilhada, efetivando práticas democráticas, coletivas e participativas. (AU)


Objective: The objective of this study was to analyze the perception of managers about the process of managing Family Health Centers in the urban area of Sobral, Ceará. Method: It is a descriptive exploratory research, with a qualitative approach. For data collection, semi-structured interviews were used with the managers of Family Health Centers in Sobral-Ce, in the urban area, from May to August 2019. For data analysis, the content analysis proposed by Bardin and NVivo 11 software were used to support this process. Results: Findings showed that the process of management is characterized by lack of experience, continuous search for knowledge to act in the position and the biggest challenges faced were bureaucratization of work, management people and lack of autonomy. Final considerations: The study reflects to the need of changing practices in the Family Health Strategy, in order to strengthen shared management, implementing democratic, collective and participatory practices. (AU)


Objetivo: El objetivo del estudio fue analizar la percepción de los gerentes sobre el proceso de gestión de los Centros de Salud Familiar en el área urbana de Sobral, Ceará. Método: Esta es una investigación exploratoria descriptiva, con un enfoque cualitativo. Para la recopilación de datos, se utilizaron entrevistas semiestructuradas con los gerentes de los Centros de Salud Familiar Sobral-Ce en el área urbana de mayo a agosto de 2019. Para el tratamiento de datos, el análisis de contenido propuesto por Bardin y, El software NVivo 11 se utilizó para apoyar este proceso. Resultados: Los resultados mostraron que el proceso de gestión se caracteriza por la falta de experiencia, la búsqueda continua de conocimiento para actuar en el puesto y los mayores desafíos que enfrentaron fueron la burocratización del trabajo, la gestión personas y falta de autonomía. Consideraciones finales: El estudio refleja la necesidad de cambiar las prácticas en la Estrategia de Salud de la Familia, a fin de fortalecer la gestión compartida, la implementación de prácticas democráticas, colectivas y participativas. (AU)


Assuntos
Atenção Primária à Saúde , Administração de Serviços de Saúde , Estratégia Saúde da Família , Liderança
7.
Niger J Clin Pract ; 23(7): 988-994, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620730

RESUMO

Background: Tertiary hospitals are specialized institutions that provide managed care for patients. It has been shown that the productivity of any organization/institution is as good as the performance of its managers. Aim: This study assessed the management knowledge of Healthcare Managers in a tertiary hospital in Calabar, Nigeria. Methodology: This was a descriptive cross-sectional study that employed a structured questionnaire (adapted from the Health Leadership Alliance competency directory). Data were analyzed using SPSS version 20. Results: A total of 266 managers were included in this studywith a M: F ratio of 1.3:1. The knowledge rating of role of non-clinical professionals, regulatory agency standards, preparation of business communication, change process management and policy formulation and analysis varied significantly among the three levels of management (p < 0.05). Less than 50% of operational and middle managers rated themselves as experts in all the competency domains while majority (80%) of strategic managers rated themselves as more than proficient in most of the competency items. Conclusion: There is inadequate managerial knowledge at all levels of management in a typical tertiary hospital in Nigeria with the potential to impact negatively on quality healthcare delivery.


Assuntos
Administradores de Instituições de Saúde , Administração de Serviços de Saúde/normas , Gestão do Conhecimento , Liderança , Competência Profissional/normas , Adulto , Serviços de Saúde Comunitária , Estudos Transversais , Assistência à Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Competência Profissional/estatística & dados numéricos , Qualidade da Assistência à Saúde , Inquéritos e Questionários , Centros de Atenção Terciária , Gestão da Qualidade Total , Adulto Jovem
8.
Indian J Public Health ; 64(Supplement): S96-S98, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-532329

RESUMO

This commentary reviews the health systems preparedness during the COVID-19 epidemic in China and India. It provides insight into how nonmedical measures were employed to contain and control the epidemic in Wuhan which was the epicenter. The methods employed by the Chinese provided the roadmap for the countries as the epidemic became pandemic. It provides contrasts in health system preparedness between China and India.


Assuntos
Infecções por Coronavirus/epidemiologia , Planejamento em Desastres/organização & administração , Administração de Serviços de Saúde , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus , China , Reforma dos Serviços de Saúde , Humanos , Índia/epidemiologia
9.
Indian J Public Health ; 64(Supplement): S96-S98, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32496234

RESUMO

This commentary reviews the health systems preparedness during the COVID-19 epidemic in China and India. It provides insight into how nonmedical measures were employed to contain and control the epidemic in Wuhan which was the epicenter. The methods employed by the Chinese provided the roadmap for the countries as the epidemic became pandemic. It provides contrasts in health system preparedness between China and India.


Assuntos
Infecções por Coronavirus/epidemiologia , Planejamento em Desastres/organização & administração , Administração de Serviços de Saúde , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus , China , Reforma dos Serviços de Saúde , Humanos , Índia/epidemiologia
11.
Rev Saude Publica ; 54: 62, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32555977

RESUMO

OBJECTIVE To analyze the quality of the infrastructure and work process of the Family Health Strategy in the municipalities of Ceará between 2012 and 2014. METHODS Cross-sectional study, using secondary data from the external evaluation of the 1st (2012) and 2nd (2014) cycle of the National Program for Improvement of Access and Quality of Primary Care in Ceará. A total of 20 composite indicators were used to verify the quality of infrastructure and work process. RESULTS Data from 183 (99.4%) of the 184 municipalities of Ceará were collected in both cycles. A total of 1,441 teams were evaluated for the infrastructure and 800 for the work process. Among the 20 composite indicators evaluated, 18 presented an improvement, but in a non-homogeneous way, ranging between 0.0 and 413.5%. We observed that the lower the initial value of the indicator, the greater the variation in quality between 2012 and 2014. The indicators of infrastructure and work process were influenced by the regional health system and population size of the municipality, being more evident the influence on the variables of the work process. CONCLUSIONS We identified that quality improvements related to infrastructure and work process occurred in the period of implementation of the program in the state of Ceará in an equitable manner, being influenced by population size and regional health system, showing the influence of the context in the implementation of public policies of this nature.


Assuntos
Administração de Serviços de Saúde , Programas Nacionais de Saúde/organização & administração , Atenção Primária à Saúde/organização & administração , Análise de Variância , Brasil , Cidades , Estudos Transversais , Humanos , Densidade Demográfica , Avaliação de Programas e Projetos de Saúde , Melhoria de Qualidade , Qualidade da Assistência à Saúde/estatística & dados numéricos , Fatores de Tempo
12.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47476

RESUMO

As competências do enfermeiro para a gestão do cuidado requerem conhecimentos, habilidades e atitudes compatíveis para o exercício do papel de gestor e líder nas Instituições de Saúde. O importante papel do enfermeiro ao responsabilizar-se pela gestão do cuidado e/ou de serviços de enfermagem e de saúde, lhe requer planejamento, organização e proatividade nas ações, perspicácia nos negócios e qualidades de liderança no atendimento clínico e gerencial. A comunicação e as habilidades interpessoais são igualmente vitais ao exercício da gestão do cuidado, por auxiliarem no cuidado ao paciente/usuário/cliente/trabalhador e impactarem na qualidade e segurança dos processos assistenciais.


Assuntos
Administração de Serviços de Saúde , Gestão em Saúde , Estratégia Saúde da Família , Enfermagem Primária , Atenção Primária à Saúde
13.
PLoS Negl Trop Dis ; 14(5): e0008369, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32453800

RESUMO

BACKGROUND: Buruli ulcer is a chronic ulcerating skin condition, with the highest burden found in Central and West Africa where it disproportionately affects the most vulnerable populations. Treatment is demanding, comprising eight-weeks of daily antibiotics, regular wound care and possible surgical intervention. Treatment completion is key to optimising outcomes, however the degree of and barriers to this are not well understood. Recent change from injectable treatment (SR8) to oral treatment (CR8) has made it feasible to further decentralise care, potentially improving treatment access and completion. However, the impact of this and of other demographic and clinical influences on treatment completion must be explored first to ensure appropriate models of care are developed. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective clinical notes review and secondary data analysis of records from patients diagnosed between 1 January 2006-31 December 2018 at four district hospital clinics in the Ashanti and Central Regions, Ghana. Univariable analyses and multivariable logistic regression were performed to assess the association between explanatory variables and treatment completion. There were 931 patient episodes across the four clinics with overall treatment completion of 84.4%. CR8 was associated with higher treatment completion compared to SR8 (OR 4.1, P = 0.001). There was no statistically significant association found between distance from patient residence to clinic and treatment completion. CONCLUSIONS/SIGNIFICANCE: Improved treatment completion with CR8 supports its use as first line therapy and may enable decentralisation to fully community-based care. We did not find an association between distance to care and treatment completion, though analyses were limited by data availability. However, we did find evidence that distance to care continues to be associated with more severe forms of disease, which may reflect the higher costs of accessing care and lower awareness of the condition the further a patient lives. Decentralised care must therefore also continue to support community engagement and active outreach to identify cases early.


Assuntos
Antibacterianos/administração & dosagem , Úlcera de Buruli/terapia , Acesso aos Serviços de Saúde , Cooperação do Paciente , Pacientes Desistentes do Tratamento , Gana , Administração de Serviços de Saúde , Humanos , Estudos Retrospectivos
14.
Epidemiol Psychiatr Sci ; 29: e127, 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32389151

RESUMO

Effective health information systems are essential to the delivery of high-quality community-based care for chronic disease which will be needed to address the changing healthcare needs of populations in low and middle-income country settings. Health management information systems (health service data collected at facility level) and electronic health records (data organised by individual patients) may support the measurement-based, collaborative approach that is central to the chronic care model, which has been adopted as the basis for task-shared models of care for mental health and non-communicable disease. We used the performance of routine information systems management to guide our commentary on the evidence-base about information systems to support chronic care. We found that, despite an appetite for using the information to support decision-making around service planning, this rarely happens in practice, reasons include that data is not perceived to be of good quality or fit for purpose. There is often a mismatch between technology design and the availability of specialised knowledge and infrastructure. However, when data collection is designed in collaboration with local stakeholders, there is some evidence of success, demonstrated by completion and accuracy of data forms. Whilst there are global targets for the development of health information systems and progress on these is undoubtedly being made, indicators for chronic disease are seldom prioritised by national governments and there is insufficient decentralisation to facilitate local data-driven decision-making. Our recommendations for future research and development, therefore, focus upon the need to integrate context into the design of information systems: through building strong multisectoral partnerships, ensuring newly developed indicators are well aligned to service models and using technology that is a good fit with local infrastructure. This approach will be necessary if information systems are to deliver on their potential to drive improvements in care for chronic disease.


Assuntos
Serviços Comunitários de Saúde Mental/organização & administração , Assistência à Saúde/organização & administração , Sistemas de Informação Administrativa , Atenção Primária à Saúde/organização & administração , Qualidade da Assistência à Saúde , Doença Crônica , Países em Desenvolvimento , Administração de Serviços de Saúde , Humanos
15.
PLoS One ; 15(5): e0232827, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32379839

RESUMO

INTRODUCTION: Although Italy's NHS is funded through general taxation, the private sector plays an important role in health service provision and financing. The aim of this paper was to identify the sociodemographic and health service organizational factors associated with the propensity to seek specialist care in the private sector. MATERIALS AND METHODS: Data were retrieved from the national Istat survey "Health conditions and use of health services" carried out in 2012-2013. We selected adults with a specialty visit in the previous 12 months in the four most frequent medical specialties: ophthalmology, cardiology, obstetrics/gynecology and orthopedics. The study outcome was the choice to use a private service. In order to investigate the determinants of private use, we adopted the socio-behavioral model by Andersen and Newman, making a distinction between sociodemographic and healthcare organizational factors. The associations with the outcome were analyzed using chi-squared test, t-test and multivariable logistic regression analysis. RESULTS AND DISCUSSION: Use of private care varied widely, from 26.3% for cardiology to 53.6% for obstetrics/gynecology. Females, patients with higher educational levels and patients with higher self-reported economic resources sought more frequently private healthcare for all specialties; younger patients and employed patients were more likely to seek private care for ophthalmic conditions. Exemption from copayment for public services reduced more than half the propensity to seek private care. Trust in this healthcare service was the main reason for private users (52.5%) followed by waiting time (26.7%) and physician choice (20.1%). CONCLUSION: The attitude of the population to use private services for specialist visits is linked both to sociodemographic and health services organizational factors: the former are unmodifiable while the latter are susceptible to managerial and health policy actions. In a public-financed, universal coverage system, policy makers may act upon the organizational factors that make private health facilities more attractive in order to reduce private care use.


Assuntos
Administração de Serviços de Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Acesso aos Serviços de Saúde , Hospitais Privados , Hospitais Públicos , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Prática Privada , Setor Privado , Setor Público , Fatores Socioeconômicos , Adulto Jovem
16.
J Paediatr Child Health ; 56(8): 1219-1224, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32364301

RESUMO

AIMS: COVID-19 is now a global pandemic. At the time of survey, fewer than 150 children in Australia and New Zealand had documented infection. The aim of this study was to assess attitudes, readiness and confidence in the early stages of the COVID-19 pandemic through an online survey of paediatric physicians and sub-specialists across Australia and New Zealand. METHODS: Multiple email list groups were used to contact paediatric physicians to undertake an online Likert scale survey between 17 and 24 March. Respondents' specialty, experience and work setting were recorded. Ordinal logistic regression was used to determine respondent factors. RESULTS: There were 542 respondents from across Australia and New Zealand: an estimated 11% of the paediatric physician workforce. A minority (36.6%) agreed that their national response had been well coordinated; the majority (92.7%) agreed that senior-level hospital administrators were taking the situation seriously. Most reported a good understanding of the natural history of COVID-19 in children, and knowledge of where to find local information. A large proportion of physicians (86.1%) were worried about becoming infected through their work; few (5.8%) reported that they would not come to work to avoid infection. Closure of school and childcares would reduce the ability to continue work at current capacity for 23.6% of respondents. CONCLUSION: Despite limited experience in pandemics, most paediatric physicians felt informed. Concern about exposure at work is common; most were willing to work regardless. The closure of schools and daycares may have an impact on staffing. Coordination and leadership will be critical.


Assuntos
Atitude do Pessoal de Saúde , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Administração de Serviços de Saúde , Pandemias/prevenção & controle , Pediatras , Pneumonia Viral/epidemiologia , Austrália/epidemiologia , Assistência à Saúde/organização & administração , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Nova Zelândia/epidemiologia , Pediatria
17.
J. nurs. health ; 10(2): 20102001, mai.2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1099702

RESUMO

Objetivo: conhecer na literatura benefícios e limitações da Sistematização da Assistência de Enfermagem na gestão em saúde. Métodos: revisão integrativa, realizada nas bases de dados eletrônicas Base de Dados de Enfermagem e Literatura Latino-Americana e do Caribe em Ciências da Saúde, com artigos originais, disponíveis na íntegra, publicados entre 2007 a 2017, em idioma português. Resultados: foram incluídos 10 artigos que abordam as principais contribuições da sistematização da assistência de enfermagem na gestão em saúde (organização do serviço, qualidade assistencial, controle de gastos, melhor avaliação e fiscalização da assistência, maior autonomia profissional e aumento da segurança do paciente) e limitações encontradas (falta de profissionais, sobrecarga de trabalho, desconhecimento da equipe e ausência de capacitações). Conclusões: considera-se uma excelente ferramenta para a gestão em saúde, por apresentar benefícios às instituições, qualificando o cuidado e melhorando os processos de gestão.(AU)


Objective: to know in the literature the benefits and limitations of the Systematization of Nursing Assistance in health management. Methods: an integrative review, carried out in the electronic databases Database of Nursing and Latin American and Caribbean Literature in Health Sciences, with original articles, available in full, published between 2007 and 2017, in Portuguese. Results: 10 articles were included that address the main contributions of the systematization of nursing care in health management (service organization, care quality, cost control, better assessment and inspection of care, greater professional autonomy and increased patient safety) and limitations found (lack of professionals, work overload, lack of knowledge of the team and lack of training). Conclusions: it is considered an excellent tool for health management, for presenting benefits to institutions, qualifying care and improving management processes.(AU)


Objetivo: conocer en la literatura los beneficios y las limitaciones de la Sistematización de la Asistencia de Enfermería en la gestión de la salud. Métodos: revisión integradora, realizada en Base de datos de enfermería y literatura latinoamericana y caribeña en ciencias de la salud, con artículos originales, disponibles en su totalidad, publicados entre 2007 y 2017, en portugués. Resultados: se incluyeron 10 artículos que abordan principales contribuciones de la sistematización de la atención de enfermería en la gestión de la salud (organización del servicio, calidad de la atención, control de costos, mejor evaluación e inspección de atención, mayor autonomía profesional y mayor seguridad del paciente) y limitaciones encontradas (falta de profesionales, sobrecarga de trabajo, falta de conocimiento del equipo y falta de capacitación). Conclusiones: se considera una excelente herramienta para la gestión en salud, ya que presenta beneficios para las instituciones, califica la atención y mejora los procesos de gestión.(AU)


Assuntos
Humanos , Administração de Serviços de Saúde , Enfermagem , Gestão em Saúde , Processo de Enfermagem , Equipe de Enfermagem
18.
PLoS One ; 15(4): e0231350, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32287296

RESUMO

Patients often have difficulty comprehending or recalling information given to them by their healthcare providers. Use of 'teach-back' has been shown to improve patients' knowledge and self-care abilities, however there is little guidance for healthcare services seeking to embed teach-back in their setting. This review aims to synthesize evidence about the translation of teach-back into practice including mode of delivery, use of implementation strategies and effectiveness. We searched Ovid Medline, CINAHL, Embase and The Cochrane Central Register of Controlled Trials for studies reporting the use of teach-back as an educational intervention, published up to July 2019. Two reviewers independently extracted study data and assessed methodologic quality. Implementation strategies were extracted into distinct categories established in the Implementation Expert Recommendations for Implementing Change (ERIC) project. Overall, 20 studies of moderate quality were included in this review (four rated high, nine rated moderate, seven rated weak). Studies were heterogeneous in terms of setting, population and outcomes. In most studies (n = 15), teach-back was delivered as part of a simple and structured educational approach. Implementation strategies were infrequently reported (n = 10 studies). The most used implementation strategies were training and education of stakeholders (n = 8), support for clinicians (n = 6) and use of audits and provider feedback (n = 4). Use of teach-back proved effective in 19 of the 20 studies, ranging from learning-related outcomes (e.g. knowledge recall and retention) to objective health-related outcomes (e.g. hospital re-admissions, quality of life). Teach-back was found to be effective across a wide range of settings, populations and outcome measures. While its mode of delivery is well-defined, strategies to support its translation into practice are not often described. Use of implementation strategies such as training and education of stakeholders and supporting clinicians during implementation may improve the uptake and sustainability of teach-back and achieve positive outcomes.


Assuntos
Serviços de Saúde , Avaliação de Resultados em Cuidados de Saúde , Bases de Dados Factuais , Pessoal de Saúde/educação , Administração de Serviços de Saúde/economia , Humanos
19.
WHO South East Asia J Public Health ; 9(1): 52-54, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32341223

RESUMO

Basic packages of health services (BPHSs) are often envisaged primarily as political statements of intent to provide access to care, in an era of commitment to universal health coverage. They are often produced with little attention paid to health systems' capacity to deliver these benefit packages or other implementation challenges. Many countries of the World Health Organization (WHO) South-East Asia Region have invested in developing BPHSs. This perspective paper reflects on the issues that do not receive enough attention when packages are developed, which can often jeopardize their implementation. Countries of the region refer to burden-of-disease assessments and consider the cost-effectiveness of the listed interventions during their BPHS design processes. Some also conduct a costing study to generate "price tags" that are used for resource mobilization. However, important implementation challenges such as weak supply-side readiness, limited scope for reallocation of existing resources and management not geared for accountability are too often ignored. Implementation and its monitoring is further hampered by the limitations of existing health information systems, which are often not ready to collect and analyse data on emerging interventions such as noncommunicable disease management. Among the countries of the WHO South-East Asia Region, those with better chances of executing their BPHSs have adapted their packages to their implementation, financing and monitoring capacities, and have considered the need for a modified service delivery model able to provide the agreed services.


Assuntos
Assistência à Saúde/organização & administração , Acesso aos Serviços de Saúde , Administração de Serviços de Saúde , Ásia Sudeste , Humanos , Organização Mundial da Saúde
20.
BMC Health Serv Res ; 20(1): 281, 2020 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-32252749

RESUMO

BACKGROUND: To improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps. The aims of the study were to develop an understanding of the characteristics and training experience of hospital managers in one major Chinese city, explore the difficulties they experience and relate them to their perceived importance of management competencies and the perceived level of their management competency. METHODS: A cross-sectional, descriptive study with a three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n = 498) from three categories of hospital in Jinan, Shandong Province, China. RESULTS: The survey confirmed that formal and informal management training amongst participants before commencing their management positions was inadequate. The core competencies identified in the Australia context were applicable to the management roles in Chinese hospitals. In addition, the senior executives had low levels of confidence in their management competence. Furthermore, the data showed significant differences between hospital categories and management levels in terms of their commitment to formal and informal training and self-perceived management competence. CONCLUSIONS: The study suggests that management training and support should be provided using a systematic approach with specific consideration to hospital types and management levels and positions. Such an approach should include clear competency requirements to guide management position recruitment and performance management.


Assuntos
Assistência à Saúde , Instituições Associadas de Saúde , Administradores Hospitalares , Adulto , Austrália , China , Estudos Transversais , Feminino , Administração de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Competência Profissional , Desenvolvimento de Pessoal , Inquéritos e Questionários
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