False Dawns and New Horizons in Patient Safety Research and Practice
Russell
Mannion
Health Services Management Centre, University of Birmingham, Birmingham,
UK
author
Jeffrey
Braithwaite
Institute of Health Innovation, Macquarie University, Sydney, NSW,
Australia
author
text
article
2017
eng
In response to a weight of evidence that patients are frequently harmed as a result of their care, there have been concerted efforts to make healthcare safer, with health systems across the globe investing significant resources in policies and programmes designed to reduce adverse events. Yet, despite extensive efforts, improvements in safety have proved difficult to sustain and spread, with studies confirming there has been no measurable, systemslevel improvement in the overall rates of preventable harm. Here, we highlight the limitations of the thinking which underpins current efforts to make healthcare systems safer and point to new and emerging approaches to understanding and addressing patient safety in complex, dynamic health systems.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
6
v.
12
no.
2017
685
689
https://www.ijhpm.com/article_3419_1f9e627250723874fa4fc415f43ec15e.pdf
dx.doi.org/10.15171/ijhpm.2017.115
Governing Collaborative Healthcare Improvement: Lessons From an Atlantic Canadian Case
Meghan
Rossiter
Canadian Foundation for Healthcare Improvement, Ottawa, ON, Canada
author
Jennifer
Verma
Canadian Foundation for Healthcare Improvement, Ottawa, ON, Canada
author
Jean-Louis
Denis
Canada Research Chair on Governance and Transformation in Health Care
Organizations and Systems, Université de Montréal-CRCHUM, Montreal, QC,
Canada
author
Stephen
Samis
Canadian Foundation for Healthcare Improvement, Ottawa, ON, Canada
author
Richard
Wedge
Health Prince Edward Island, Charlottetown, PE, Canada
author
Chris
Power
Canadian
Patient Safety Institute, Ottawa, ON, Canada
author
text
article
2017
eng
The Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease (AHC) Quality Improvement Collaborative (QIC) in Eastern Canada provided an approach to spur system-level reform across multiple health systems for patients and families living with chronic disease. Developed and led by senior executives with a unique governance approach and involving clinical front-line teams, the AHC serves as a practical example of leadership creating and driving momentum for achieving success in collaborative health system improvements.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
6
v.
12
no.
2017
691
694
https://www.ijhpm.com/article_3365_8a2a5047184c2eeeee757909c0184521.pdf
dx.doi.org/10.15171/ijhpm.2017.60
Does Scale of Public Hospitals Affect Bargaining Power? Evidence From Japan
Konosuke
Noto
Graduate School of Media and Governance, Keio University, Kanagawa,
Japan
author
Takao
Kojo
Center for Community Medicine, Jichi Medical University, Tochigi,
Japan
author
Ichiro
Innami
Faculty of Policy Management, Keio University, Kanagawa, Japan
author
text
article
2017
eng
Background Many of public hospitals in Japan have had a deficit for a long time. Japanese local governments have been encouraging public hospitals to use group purchasing of drugs to benefit from the economies of scale, and increase their bargaining power for obtaining discounts in drug purchasing, thus improving their financial situation. In this study, we empirically investigate whether or not the scale of public hospitals actually affects their bargaining power. Methods Using micro-level panel data on public hospitals, we examine the effect of the scale of public hospitals (in terms of the number of occupancy beds) on drug purchasing efficiency (DPE) (the average discount rate in purchasing drugs) as a proxy variable of the bargaining power. Additionally, we evaluate the effect of the presence or absence of management responsibility in public hospital for economic efficiency as the proxy variable of an economic incentive and its interaction with the hospital scales on the bargaining power. In the estimations, we use the fixed effects model to control the heterogeneity of each hospital in order to estimate reliable parameters. Results The scale of public hospitals does not positively correlate with bargaining power, whereas the management responsibility for economic efficiency does. Additionally, scale does not interact with management responsibility. Conclusion Giving management responsibility for economic efficiency to public hospitals is a more reliable way of gaining bargaining power in drug purchasing, rather than promoting the increase in scale of these public hospitals.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
6
v.
12
no.
2017
695
700
https://www.ijhpm.com/article_3337_8fe30c2506bb9405b2bedce9206dc838.pdf
dx.doi.org/10.15171/ijhpm.2017.29
Should Employers Be Permitted not to Hire Smokers? A Review of US Legal Provisions
Rishi R.
Patel
College of Medicine, University of Kentucky, Lexington, KY, USA
author
Harald
Schmidt
Department
of Medical Ethics and Health Policy, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA, USA
author
text
article
2017
eng
Background Increasingly, healthcare and non-healthcare employers prohibit or penalize the use of tobacco products among current and new employees in the United States. Despite this trend, and for a range of different reasons, around half of states currently legally protect employees from being denied positions, or having employment contracts terminated, due to tobacco use. Methods We undertook a conceptual analysis of legal provisions in all 50 states. Results We found ethically relevant variations in terms of how tobacco is defined, which employee populations are protected, and to what extent they are protected. Furthermore, the underlying ethical rationales for smoker protection differ, and can be grouped into two main categories: prevention of discrimination and protection of privacy. Conclusion We critically discuss these rationales and the role of their advocates and argue that enabling equality of opportunity is a more adequate overarching concept for preventing employers from disadvantaging smokers.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
6
v.
12
no.
2017
701
706
https://www.ijhpm.com/article_3339_aef1b4d3c55ee837559af05def049918.pdf
dx.doi.org/10.15171/ijhpm.2017.33
How Are New Vaccines Prioritized in Low-Income Countries? A Case Study of Human Papilloma Virus Vaccine and Pneumococcal Conjugate Vaccine in Uganda
Lauren
Wallace
Department of Anthropology, McMaster University, Hamilton, ON, Canada
author
Lydia
Kapiriri
Department of Health, Aging and Society, McMaster University, Hamilton, ON,
Canada
author
text
article
2017
eng
Background To date, research on priority-setting for new vaccines has not adequately explored the influence of the global, national and sub-national levels of decision-making or contextual issues such as political pressure and stakeholder influence and power. Using Kapiriri and Martin’s conceptual framework, this paper evaluates priority setting for new vaccines in Uganda at national and sub-national levels, and considers how global priorities can influence country priorities. This study focuses on 2 specific vaccines, the human papilloma virus (HPV) vaccine and the pneumococcal conjugate vaccine (PCV). Methods This was a qualitative study that involved reviewing relevant Ugandan policy documents and media reports, as well as 54 key informant interviews at the global level and national and sub-national levels in Uganda. Kapiriri and Martin’s conceptual framework was used to evaluate the prioritization process. Results Priority setting for PCV and HPV was conducted by the Ministry of Health (MoH), which is considered to be a legitimate institution. While respondents described the priority setting process for PCV process as transparent, participatory, and guided by explicit relevant criteria and evidence, the prioritization of HPV was thought to have been less transparent and less participatory. Respondents reported that neither process was based on an explicit priority setting framework nor did it involve adequate representation from the districts (program implementers) or publicity. The priority setting process for both PCV and HPV was negatively affected by the larger political and economic context, which contributed to weak institutional capacity as well as power imbalances between development assistance partners and the MoH. Conclusion Priority setting in Uganda would be improved by strengthening institutional capacity and leadership and ensuring a transparent and participatory processes in which key stakeholders such as program implementers (the districts) and beneficiaries (the public) are involved. Kapiriri and Martin’s framework has the potential to guide priority setting evaluation efforts, however, evaluation should be built into the priority setting process a priori such that information on priority setting is gathered throughout the implementation cycle.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
6
v.
12
no.
2017
707
720
https://www.ijhpm.com/article_3345_40701a0d54e73e4754465f0c1431ec7c.pdf
dx.doi.org/10.15171/ijhpm.2017.37
New Health Technologies: A UK Perspective; Comment on “Providing Value to New Health Technology: The Early Contribution of Entrepreneurs, Investors, and Regulatory Agencies”
Nassim
Parvizi
Oxford University Hospitals NHS Foundation Trust, Oxford, UK
author
Sahar
Parvizi
Moorfields
Eye Hospital NHS Foundation Trust, London, UK
author
text
article
2017
eng
New health technologies require development and evaluation ahead of being incorporated into the patient care pathway. In light of the recent publication by Lehoux et al who discuss the role of entrepreneurs, investors and regulators in providing value to new health technologies, we summarise the processes involved in making new health technologies available for use in the United Kingdom.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
6
v.
12
no.
2017
721
722
https://www.ijhpm.com/article_3358_eaa713a92c3148cf2ace72933620b97c.pdf
dx.doi.org/10.15171/ijhpm.2017.59
This Is My (Post) Truth, Tell Me Yours; Comment on “The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy”
Martin
Powell
Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK
author
text
article
2017
eng
This is a commentary on the article ‘The rise of post-truth populism in pluralist liberal democracies: challenges for health policy.’ It critically examines two of its key concepts: populism and ‘post truth.’ This commentary argues that there are different types of populism, with unclear links to impacts, and that in some ways, ‘post-truth’ has resonances with arguments advanced in the period at the beginning of the British National Health Service (NHS). In short, ‘post-truth’ populism’ may be ‘déjà vu all over again,’ and there are multiple (post) truths: this is my (post) truth, tell me yours.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
6
v.
12
no.
2017
723
725
https://www.ijhpm.com/article_3363_3169f9f32899ad8da1dba4da7a07784f.pdf
dx.doi.org/10.15171/ijhpm.2017.58
Innovative Use of the Law to Address Complex Global Health Problems; Comment on “The Legal Strength of International Health Instruments - What It Brings to Global Health Governance?”
Helen L.
Walls
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
author
Gorik
Ooms
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
author
text
article
2017
eng
Addressing the increasingly globalised determinants of many important problems affecting human health is a complex task requiring collective action. We suggest that part of the solution to addressing intractable global health issues indeed lies with the role of new legal instruments in the form of globally binding treaties, as described in the recent article of Nikogosian and Kickbusch. However, in addition to the use of international law to develop new treaties, another part of the solution may lie in innovative use of existing legal instruments. A 2015 court ruling in The Hague, which ordered the Dutch government to cut greenhouse gas emissions by at least 25% within five years, complements this perspective, suggesting a way forward for addressing global health problems that critically involves civil society and innovative use of existing domestic legal instruments.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
6
v.
12
no.
2017
727
728
https://www.ijhpm.com/article_3367_0f58df3a282877c5647a214d32a25627.pdf
dx.doi.org/10.15171/ijhpm.2017.62
Ensuring HIV Data Availability, Transparency and Integrity in the MENA Region; Comment on “Improving the Quality and Quantity of HIV Data in the Middle East and North Africa: Key Challenges and Ways Forward”
Kayvon
Modjarrad
U.S. Military HIV Research Program, Walter Reed Army Institute of Research,
Silver Spring, MD, USA
author
Sten H.
Vermund
Yale School of Public Health, Yale University, New Haven, CT, USA
author
text
article
2017
eng
In this commentary, we elaborate on the main points that Karamouzian and colleagues have made about HIV data scarcity in Middle Eastern and North African (MENA) countries. Without accessible and reliable data, no epidemic can be managed effectively or efficiently. Clearly, increased investments are needed to bolster capabilities to capture and interpret HIV surveillance data. We believe that this enhanced capacity can be achieved, in part, by leveraging and repurposing existing data platforms, technologies and patient cohorts. An immediate modest investment that capitalizes on available infrastructure can generate data on the HIV burden and spread that can be persuasive for MENA policy-makers to intensify efforts to track and contain the growing HIV epidemic in this region. A focus on key populations will yield the most valuable data, including among men who have sex with men (MSM), transgender women and men, persons who inject drugs (PWIDs), female partners of high risk men and female sex workers.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
6
v.
12
no.
2017
729
732
https://www.ijhpm.com/article_3368_1f76ebc6e725cc898b4248f2ad715756.pdf
dx.doi.org/10.15171/ijhpm.2017.53
Should Priority Setting Also Be Concerned About Profound Socio-Economic Transformations? A Response to Recent Commentary
Brayan V.
Seixas
School of Population and Public Health, University of British Columbia,
Vancouver, BC, Canada
author
Craig
Mitton
School of Population and Public Health, University of British Columbia,
Vancouver, BC, Canada
author
Marion
Danis
National Institutes of Health, Bethesda, MD, USA
author
Iestyn
Williams
University of Birmingham, Birmingham, UK
author
Marthe
Gold
New York Academy of Medicine,
New York City, NY, USA
author
Rob
Baltussen
Radboud
University Medical Center, Nijmegen, The Netherlands
author
text
article
2017
eng
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
6
v.
12
no.
2017
733
734
https://www.ijhpm.com/article_3390_f7198e4f4157aff28db3c49b2b4cb28a.pdf
dx.doi.org/10.15171/ijhpm.2017.85