Showing posts with label Delivery. Show all posts
Showing posts with label Delivery. Show all posts

Wednesday, May 16, 2012

Self-management support should be routine part of primary health care delivery

Health Council of Canada releases report on self-management support for Canadians with chronic conditions

TORONTO, May 15, 2012 /CNW/ - Today the Health Council of Canada released Self-management support for Canadians with chronic health conditions: A focus for primary health care. The report explores how self-management support can improve patient outcomes and calls for health systems across Canada to provide self-management supports in a more systematic way. It profiles a range of practices and recommends targeted investments in self-management support strategies.

Chronic disease in Canada costs more than $90 billion a year in lost productivity and health care costs. And with half of Canadians reporting at least one chronic condition, these costs will continue to rise. Successful self-management can help save health resources and keep patients out of hospital for preventable incidences.

Self-management refers to the things a patient does to live well with chronic conditions, like monitoring symptoms, taking medication as prescribed, and recognizing what health-related behaviours will help manage their conditions. New research shows that patients who successfully self-manage tend to have reduced disease-related effects and may make better use of health services because they monitor symptoms effectively and can prevent or respond to problems before they become a crisis.

Self-management support includes education and health coaching and is key to ensuring patients manage their health successfully. In Canada, 95% of adults with multiple chronic conditions have a regular primary care provider - making this a clear area in which to anchor self-management support. Primary health care providers should be an ongoing source of self-management support to follow up with patients and link them to community services and specialists. The problem is that this support role is not yet a routine part of care in Canada.

The report discusses how primary health care providers can better assume this support role for patients with chronic conditions. Self-management support can start at routine primary care visits where providers can empower patients to confidently ask questions and get involved in making decisions about their health. The provider can assist with self-management education and technical skills, and can support personal goal-setting with the patient. Another important role for providers is to link patients to community-based programs. There are many promising programs that exist to support self-management, but patients may need their provider to point them in the right direction and follow up with them on their progress. Providers can also improve aspects of their practice environment in order to better serve patients with chronic conditions.  Making better use of all members of a health care team can ease time pressures on physicians and provide patients with the expertise and coaching they need. Health care professionals like nurses, social workers and pharmacists can play a role (especially when many family doctors only have 15 minutes, on average, to devote to patient visits). Offering group visits and integrating self-management support programs directly into primary care settings can also yield positive outcomes.

Given their access to Canadians with chronic-disease, primary health care providers need to be enabled to deliver self-management support. We must invest in ongoing education for providers in self-management support, and encourage the expansion of primary health care teams which can use a variety of health care providers to deliver self-management support. Supporting and creating better links between primary care providers and community-based self management programs will help increase participation and engagement by patients in their own care.

"Self-management has great potential for patients, providers and Canadians," said John G. Abbott, CEO, Health Council of Canada. "Patients and their families will enjoy better quality of life. Primary care providers will have the tools to help their patients succeed."

Investing in ongoing, long-term support for self-management support needs to be a key priority for governments. Collaboration among governments, health care providers and chronic disease organizations can help fill gaps in service and create an integrated, system-wide approach to self-management support. Further recommendations to enable self-management support in a more systematic way can be found in the report.

About the Health Council of Canada

Created by the 2003 First Ministers' Accord on Health Care Renewal, the Health Council of Canada is an independent national agency that reports on the progress of health care renewal. The Council provides a system-wide perspective on health care reform in Canada, and disseminates information on leading practices and innovation across the country. The Councillors are appointed by the participating provincial and territorial governments and the Government of Canada.

Image with caption: "Self-management support for Canadians with chronic health conditions: A focus for primary health care (CNW Group/Health Council of Canada)". Image available at: http://photos.newswire.ca/images/download/20120515_C7467_PHOTO_EN_13697.jpg

Audio with caption: "Podcast with Kelly McQuillen, Director, Acting Executive Director, B.C. Ministry of Health, and Connie Davis, a nurse practitioner and consultant on health care design". Audio available at: http://stream1.newswire.ca/media/2012/05/15/20120515_C7467_AUDIO_EN_13701.mp3


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Saturday, February 18, 2012

New Foundation Aims to Improve Health Care Delivery in Developing Countries

AMSTERDAM, THE NETHERLANDS and CAPE TOWN, SOUTH AFRICA and CHICAGO, IL--(Marketwire -02/17/12)- Three organizations from three different continents have taken the next step in their commitment and dedication to improve the safety and quality of health care provided in resource-restricted countries.

The South African-based Council for Health Service Accreditation of Southern Africa (COHSASA), the PharmAccess Foundation of the Netherlands, and U.S.-based Joint Commission International (JCI) have signed an agreement to establish the SafeCare Foundation (www.safe-care.org/).

SafeCare has grown out of a global initiative, launched in March 2011 in Cape Town, South Africa, to introduce a comprehensive quality improvement program using internationally recognized standards to improve health care delivery. The SafeCare Foundation is designed for health care providers in resource-poor settings to assist them in step-wise quality improvement and the delivery of safer care to their patients. As a new Foundation with its international board and its secretariat based in Amsterdam, SafeCare will be able to expand its knowledge and capacities even further and build on the concrete experience and skills of its founding organizations.

To date, the SafeCare program has been successfully initiated in more than 107 clinics in six countries -- Kenya, Nigeria, Tanzania, Ghana, Lesotho and South Africa.

The facilities participating in SafeCare have committed to improve the quality of their services as part of their participation in various insurance and medical credit programs. The first 10 of these facilities recently obtained "Certificates of Improvement," which were awarded based on reaching pre-defined levels of standard compliance. Placed in the African context, where many facilities face resource challenges and a high disease burden, this establishes the principle of graded improvement which many African facilities will follow in the years to come.

The analysis of SafeCare certification data will allow stakeholders (e.g. governments, investors, insurers and donors) in developing countries to support feasible, cost-effective and structured quality improvement rollouts in facilities. The Foundation will build and maintain a database of organizations using its standards and keep track of their progress as well as the progress of the facilities that are represented.

In summary, the SafeCare Foundation will offer large-scale quality improvement programs through automation of data entry, verification analysis and computerized web-based reporting. The impact of interventions by the SafeCare Foundation will be monitored through data analysis, and operational research and findings will be published in peer-reviewed journals.

In certain situations, the SafeCare Foundation will collaborate with other organizations to apply for the funding of quality improvement trajectories in resource-poor settings.

To achieve these objectives and to stimulate health care quality and patient safety, the SafeCare Foundation will arrange regular conferences to promote quality standards and health care quality issues. SafeCare Foundation will also publish information on the tools, goals and results of the program and will make information and standards publicly available through its website.

In addition to the above, under the umbrella of the SafeCare Foundation, a SafeCare Knowledge Institute will be established. As an operational research entity, the Knowledge Institute will provide health intelligence data on health care quality improvement in Africa, provide benchmarks, perform gaps analyses, and study the associations between quality improvement certification and medical output and outcome. These vital analyses can be used to inform donors and governments about the status of health care in specific regions or countries.

SafeCare
The SafeCare methodology combines the respective knowledge, expertise, skills, tools and experience of all three organizations -- COHSASA, JCI and PharmAccess -- to issue a graded "Certificate of Improvement" to different categories of health care facilities ranging from nurse-driven health clinics to district hospitals. Certificates range from level 1 to 5, which allows for demonstrating incremental achievement in compliance with the SafeCare Foundation Standards.

Health care facilities are rewarded with a "Certificate of Improvement" every time they reach the next pre-defined SafeCare step. If executed completely (SafeCare Level 5), this qualifies a facility for formal accreditation trajectories for example through COHSASA or JCI. The uniqueness is that the SafeCare route is all about relative improvement and does not demotivate African facilities with unreachable international absolute quality norms. Instead, SafeCare offers a step-wise approach, confronting facilities with incremental challenges with respect to quality and patient safety and eventually rewarding and motivating these facilities with recognition through its certification system. This step-wise improvement process can thus be used by governments, donors and companies to implement performance-based financing incentives. In addition, SafeCare can be offered in combination with various capacity building interventions, like access to affordable loans through the Medical Credit Fund (www.medicalcreditfund.org/) or inclusion in innovative insurance programs like those supported by the Health Insurance Fund (www.hifund.org).

About the founding organizations
Two of the SafeCare founding organizations, COHSASA and JCI, have been accredited by the International Society for Quality in Health Care (ISQua), thus conferring upon them the authority required to assess health care clinics. ISQua is the only international program that "Accredits the Accreditors."

COHSASA - Based in Cape Town, South Africa, COHSASA (www.cohsasa.co.za/) is the only accreditation body for healthcare in Africa that is internationally accredited by the International Society for Quality in Health Care (ISQua) as a competent healthcare evaluation body and its standards are recognised as meeting the principles set out by ISQua. COHSASA has been working in the field of quality improvement and accreditation for over 17 years. During this time, COHSASA has worked in a range of over 580 different types of facilities -- from tertiary hospitals to basic clinics -- in the public and private sectors in South Africa, the SADC (Southern African Development Community) region and other parts of Africa. Countries in which programs are running are the RSA, Swaziland, Lesotho, Namibia, Botswana, Zambia, Rwanda and Nigeria.

Joint Commission International - (www.jointcommissioninternational.org) Joint Commission International (JCI) was established in 1997, and is the international arm of The Joint Commission. Through international accreditation, consultation, publications and education programs, JCI extends The Joint Commission's mission worldwide by helping to improve the quality of patient care. JCI assists international health care organizations, public health agencies, health ministries and others in more than 90 countries.

PharmAccess Foundation - PharmAccess Foundation (www.pharmaccess.org/) is a Dutch not-for-profit organization dedicated to the strengthening of health systems in sub-Saharan Africa. Its ultimate goal is to improve access to quality basic health care including the treatment of HIV/AIDS. PharmAccess supports programs and offers services in the areas of medical and administrative capacity building, health insurance, HIV/AIDS and healthcare workplace programs, health investments and health intelligence. PharmAccess has experience in over 10 countries in Africa in upgrading and quality improvement of basic health care providers such as clinics and district hospitals. In addition PharmAccess improves the financial situation of health clinics by introducing insurance programs for secured income and by providing business training to get access to affordable financing mechanisms, including loans and investments.

View the multi-media news release


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