Principles For Improving Health Care Around World
Principles for improving health Care Around world : Commonalities in problems encountered suggest that solutions or at least principles underlying those solutions may also be generalize. NYC Health + Hospitals leaders developed a strategy around population health that draws on this.
Principles for Improving Health Care Around
Four principles under gird the strategy, identifying and stratifying an attributed population; grounding in high quality, community based care; meeting patients where they are, both physically and in terms of their health trajectory; and using data to guide care delivery and drive improvement.
First
First, local health systems must identify the group of patients for whom they are accountable. While this attribution of patients to clinicians for instance through “accountable care organizations” in the United States may seem straightforward or mundane, it is fundamental to systems setting up care models that are not solely contingent on patient visits.
For example, what is the right locus of accountability for patients who only seek acute care, such as through the emergency department, or who do not seek needed care at all, whether because of discrimination, or unaffordability, or lack of health literacy?
For instance, as part of a general move toward regionally interrelated care in the United Kingdom, a clinical alliance in Nottingham shire uses predictive modeling to identify patients at elevated risk for hospitalization and provides them with preventative care, such as “virtual wards” providing multidisciplinary, intensive outpatient services.
Second
Second, effective health systems are increasingly grounded in high quality community based care. Of the 218 essential, cost effective interventions identified by the Disease Control Priorities Network, 140 are delivered through primary care centers or community and population based approaches, rather than through hospitals, In Xi amen, a city in southeastern China, the growing prevalence of chronic diseases led to a new model for growing prevalence of chronic diseases led to a new model for primary care known as Joint Management by Three Professionals:
Specialists who determine care pathways, generalists who implement them, and community health workers responsible for health education, including through home visits. Community health worker programs are particularly emblematic of convergent evolution, having arisen in diverse contexts, including as primary care extenders in India and sub Saharan Africa;
Community members of family health teams in Brazil and Cost
Rica; promoters de salad (health promoters) at the Mexican border; and as a standardized intervention to reduce hospitalizations for low income patients in the United States.
Third
Third, and in part due to the evolution toward community based care, health systems around the world are starting to “meet patients where they are,” both physically and in terms of their health trajectory.
Technology particularly health such as text messaging and phone or video consultations enables the delivery of care remotely. Technology particularly health such as text messaging and phone or video consultations enables the delivery of care remotely.
For example, mobile technology supports thousands of community health workers delivering perinatal care across rural Liberia, facilitating escalation of childbirth care to the nearest health facility when indicated. Meeting patients where they are also refers to integrating physical health services with behavioral health and social services.
Fourth
The fourth principle common to convergent health systems is using data to guide care delivery and drive improvement. Valid, actionable data is lifeblood for health systems to both motivate change at the front lines of care and to monitor overall performance. One example is the use of “data cascades” to illuminate gaps across a care continuum.
And health systems can leverage the cascading of data in different sense.
Conclusion
Yet the global principles enumerated above can help forge common solutions in some cases allowing for a salutatory effect in places like. There may be an opportunity to leapfrog health financing pitfalls encountered in high income countries; for instance, setting up reimbursement schemes that discourage low value care, such as overuse of imaging for back pain.