Networks: a key to the future of health services

Southon, Gray; Perkins, Rod; Galler, David

doi:10.1071/ah050317

Cited by 30 publications

(28 citation statements)

References 20 publications

(16 reference statements)

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“…These networks vary in their origins, degree of formality, exclusivity of membership, and methods used to achieve their goals. What unites them is that they are "complexes of links between individuals and organisations, driven largely by the interests of those parties and their recognition of the value of working together" (Southon et al 2005). …”

Section: A Clinical Community-based Approach To Qi In Healthcarementioning

confidence: 99%

Quality improvement through clinical communities: eight lessons for practice

Aveling

Martin

Armstrong

et al. 2012

Journal of Health Organization and Management

119

161

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Purpose: Approaches to quality improvement in healthcare based on clinical communities are founded in practitioner networks, peer influence and professional values. Evidence for the value of this approach, and how to make it effective, is spread across multiple disciplines. We review and synthesise relevant literature to provide practical lessons on how to use clinical community-based approaches to improve quality.Design/methodology/approach: Diverse literatures were identified, analysed and synthesised in a manner which accounted for the heterogeneity of methods, models and contexts they covered.Findings: A number of overlapping but distinct clinical community-based approaches can be identified in the literature, each suitable for different problems. The evidence for the effectiveness of these is mixed, but there is some agreement on the challenges that those adopting such approaches need to address, and how these can be surmounted. Practical implications:Key lessons include: the need for coordination and leadership alongside the lateral influence of peers; advantages of starting with a clear programme theory of change; the need for training and resources; dealing with conflict and marginalisation; fostering a sense of community; appropriate use of data in prompting behavioural change; the need for balance between 'hard' and 'soft' strategies; and the role of context. Originality/value: The paper brings together diverse literatures with important implications for community-based approaches to quality improvement, drawing on these to offer practical lessons for those engaged in improving healthcare quality in practice.3

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Section: A Clinical Community-based Approach To Qi In Healthcarementioning

confidence: 99%

Quality improvement through clinical communities: eight lessons for practice

Aveling

Martin

Armstrong

et al. 2012

Journal of Health Organization and Management

119

161

View full text Add to dashboard Cite

show abstract

“…In particular, as P4P needs to be clinician-led, clinician networks, collaborations or large group practices may be the preferred vehicles to operationalise P4P, given their potential to enable rapid program implementation, access to large numbers of clinicians working in different settings, consistency of measurement and economies of scale, and testing and revision of program methods. Clinician-led service networks (CSNs) and Divisions of General Practice networks (DGPNs) have become popular in recent times, both in Australia 52,53 and elsewhere, 54 as agents of service change and improvement across wide jurisdictions, with some acting as budget-holders and assuming purchaser-provider functions. Recent studies suggest that tightly structured CSNs can reduce hospital costs 55 and improve quality of care.…”

Section: Principle 8 Use Existing Organisational Structures To Implementioning

confidence: 99%

Pay for performance programs in Australia: a need for guiding principles

Scott¹

2008

Aust. Health Review

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Pay-for-performance (P4P) programs which reward clinical providers with incentive payments based on one or more measures of quality of care are now common in the United States and the United Kingdom and it is likely they will attract increasing interest in Australia. However, empirical evidence demonstrating effectiveness of such programs is limited and many existing programs have not had rigorous outcome evaluation. To maximise success, future P4P programs should incorporate the lessons and insights obtained from previous experience. Based on a review of published trials, program evaluations and position statements, the following principles that may guide future program design and implementation were synthesised: 1) formulate a rationale and a business case for P4P; 2) use established evidencebased performance measures; 3) use rigorous and verifiable methods of data collection and analysis; 4) define performance targets using absolute and relative thresholds; 5) use rewards that are sufficient, equitable and transparent; 6) address appropriateness of provider responses and avoid perverse incentives; 7) implement communication and feedback strategies; 8) use existing organisational structures to implement P4P programs; 9) attribute credit for performance to participants in ways that foster population-based perspectives; and 10) invest in outcomes and health service research. Recommendations flowing from these principles relevant to Australian

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“…8 Yet for more effective change-management, clinicians need to be an active and involved part of the reform process. [2][3][4][5][6][7][8][9] Reform requires not only concepts but the capacity to implement the changes. 10 This can be particularly challenging when dealing with entrenched cultures, as may be found in clinical fields, leading to a dismissal of the evidence when it conflicts with their underlying beliefs.…”

Section: The Importance Of a Formal Structure For Clinical Input To Tmentioning

confidence: 99%

“…1 There is a wealth of experience and intelligence within the clinical workforce that can contribute to finding solutions to the many complex issues facing the health system. 2 This experience and intelligence is expressed in advice on the clinician' s specific areas of expertise and often within their own environment.…”

mentioning

confidence: 99%

Great debate: how clinicians make their views heard in health reform

Blackwell¹,

Gibson²,

Combs³

et al. 2009

Aust. Health Review

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PUBLIC HEALTH SYSTEMS in Australia and internationally are faced with the need to implement significant reforms. These reforms are driven by the need to balance the delivery of best practice clinical care with rapidly spiralling cost pressures. With much of the agenda for reform driven by managerial, administrative and even political priorities, clinicians have often felt sidelined from the reform process. Indeed, there is some evidence that clinicians have had decreased enthusiasm for their work in recent years, coinciding with a greater role of nonmedical managers and more restrictions on resources.1 There is a wealth of experience and intelligence within the clinical workforce that can contribute to finding solutions to the many complex issues facing the health system.2 This experience and intelligence is expressed in advice on the clinician?s specific areas of expertise and often within their own environment. This may work against the clinician having an effective impact on the reform agenda at the macro level. In that context, the establishment of a Clinical Senate in Western Australia to inform the health reform process by debating major issues that impact across the system is innovative. The Clinical Senate requires that Senators adopt a broad view, set aside their particular clinical allegiances and debate the issues in the best interests of the community. The Clinical Senate is a forum that allows clinicians to influence statewide-level processes through formally recognised channels. This article examines the rationale, processes and operation of the Clinical Senate in WA as a mechanism for effective clinician input into health reform.

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Networks: a key to the future of health services

Cited by 30 publications

References 20 publications

Quality improvement through clinical communities: eight lessons for practice

Quality improvement through clinical communities: eight lessons for practice

Pay for performance programs in Australia: a need for guiding principles

Great debate: how clinicians make their views heard in health reform

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