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This accessible textbook introduces a wide spectrum of ideas,
approaches, and examples that make up the emerging field of
implementation science, including implementation theory, processes
and methods, data collection and analysis, brokering interest on
the ground, and sustainable implementation. Containing over 60
concise essays, each addressing the thorny problem of how we can
make care more evidence-informed, this book looks at how
implementation science should be defined, how it can be conducted,
and how it is assessed. It offers vital insight into how research
findings that are derived from healthcare contexts can help make
sense of service delivery and patient encounters. Each entry
concentrates on an important concept and examines the idea's
evidence base, root causes and effects, ideas and applications, and
methodologies and methods. Revealing a very human side to
caregiving, but also tackling its more complex and technological
aspects, the contributors draw on real-life healthcare examples to
look both at why things go right in introducing a new intervention
and at what can go wrong. Implementation Science: The Key Concepts
provides a toolbox of rich, contemporary thought from leading
international thinkers, clearly and succinctly delivered. This
comprehensive and enlightening range of ideas and examples brought
together in one place is essential reading for all students,
researchers, and practitioners with an interest in translating
knowledge into practice in healthcare.
This accessible textbook introduces a wide spectrum of ideas,
approaches, and examples that make up the emerging field of
implementation science, including implementation theory, processes
and methods, data collection and analysis, brokering interest on
the ground, and sustainable implementation. Containing over 60
concise essays, each addressing the thorny problem of how we can
make care more evidence-informed, this book looks at how
implementation science should be defined, how it can be conducted,
and how it is assessed. It offers vital insight into how research
findings that are derived from healthcare contexts can help make
sense of service delivery and patient encounters. Each entry
concentrates on an important concept and examines the idea's
evidence base, root causes and effects, ideas and applications, and
methodologies and methods. Revealing a very human side to
caregiving, but also tackling its more complex and technological
aspects, the contributors draw on real-life healthcare examples to
look both at why things go right in introducing a new intervention
and at what can go wrong. Implementation Science: The Key Concepts
provides a toolbox of rich, contemporary thought from leading
international thinkers, clearly and succinctly delivered. This
comprehensive and enlightening range of ideas and examples brought
together in one place is essential reading for all students,
researchers, and practitioners with an interest in translating
knowledge into practice in healthcare.
This book promotes an understanding of the purposeful muddling that
health care workers rely on to be better able to function and
operate in the multitude of complex ecosystems we call "health
care." The book argues the case for the importance of recognising
and understanding muddling behaviours, practices and activities in
order to create resilient care. The book demonstrates how resilient
health care principles can enable managers as well as those on the
frontlines to work more effectively towards interdisciplinary care
by gaining a deeper understanding of real-world practices that
manifest in everyday clinical settings. This is done by presenting
a set of case studies, theoretical chapters and applications that
relate experiences, bring forth ideas and illustrate practical
solutions. Primarily aimed at people who are directly involved in
the running and improvement of health care systems, it provides
practical guidance. It is also of direct interest to health care
professionals in clinical and managerial positions as well as
researchers. Jeffrey Braithwaite is Founding Director of the
Australian Institute of Health Innovation, Professor of Health
Systems Research and Director of the Centre for Healthcare
Resilience and Implementation Science, Macquarie University
(Australia). His research examines the changing nature of complex
health systems and he has received over 50 different national and
international awards for his teaching and research. Erik Hollnagel
is Senior Professor of Patient Safety at Joenkoeping University
(Sweden). He is a highly regarded international expert with
significant contributions to a variety of fields ranging from
nuclear power generation, aerospace and aviation to industry,
transportation and, most notably, health care. Garthe Hunte is a
Clinical Professor and Emergency Physician holding multiple
academic and clinical leadership appointments across Canada. His
research programme centres around how safety is created in complex
socio-technical systems, and in the application of resilience
engineering in health care.
The book demonstrates how Resilient Health Care principles can
enable those on the frontline to work more effectively towards
interdisciplinary care by gaining a deeper understanding of the
boundaries that exist in everyday clinical settings. This is done
by presenting a set of case studies, theoretical chapters and
applications that relate experiences, bring forth ideas and
illustrate practical solutions. The chapters address many different
issues such as resolving conflict, overcoming barriers to
patient-flow management, and building connections through
negotiation. They represent a range of approaches, rather than a
single way of solving the practical problems, and have been written
to serve both a scientific and an andragogical purpose. Working
Across Boundaries is primarily aimed at people who are directly
involved in the running and improvement of health care systems,
providing them with practical guidance. It will also be of direct
interest to health care professionals in clinical and managerial
positions as well as researchers. Presents the latest work of the
lauded Resilient Health Care Net group, developing applications of
Resilience Engineering to health care, furthering safety thinking
and generating applicable solutions that will benefit patient
safety worldwide Enables health care professionals to become aware
of the boundaries that affect their work so that they are able to
use their strengths and overcome their weaknesses Written from a
Safety-II perspective, where the purpose is to make sure that as
much as possible goes well and the focus therefore is on everyday
work rather than on failures. There are at present no other books
that adopt this perspective nor which go into the practical details
Provides a concise presentation of the state of resilient health
care as a science, in terms of major theoretical issues and
practical methods and techniques on the overarching and important
topics of boundary-crossing and integration of care settings
The book demonstrates how Resilient Health Care principles can
enable those on the frontline to work more effectively towards
interdisciplinary care by gaining a deeper understanding of the
boundaries that exist in everyday clinical settings. This is done
by presenting a set of case studies, theoretical chapters and
applications that relate experiences, bring forth ideas and
illustrate practical solutions. The chapters address many different
issues such as resolving conflict, overcoming barriers to
patient-flow management, and building connections through
negotiation. They represent a range of approaches, rather than a
single way of solving the practical problems, and have been written
to serve both a scientific and an andragogical purpose. Working
Across Boundaries is primarily aimed at people who are directly
involved in the running and improvement of health care systems,
providing them with practical guidance. It will also be of direct
interest to health care professionals in clinical and managerial
positions as well as researchers. Presents the latest work of the
lauded Resilient Health Care Net group, developing applications of
Resilience Engineering to health care, furthering safety thinking
and generating applicable solutions that will benefit patient
safety worldwide Enables health care professionals to become aware
of the boundaries that affect their work so that they are able to
use their strengths and overcome their weaknesses Written from a
Safety-II perspective, where the purpose is to make sure that as
much as possible goes well and the focus therefore is on everyday
work rather than on failures. There are at present no other books
that adopt this perspective nor which go into the practical details
Provides a concise presentation of the state of resilient health
care as a science, in terms of major theoretical issues and
practical methods and techniques on the overarching and important
topics of boundary-crossing and integration of care settings
Health care is under tremendous pressure regarding efficiency,
safety, and economic viability. It has responded by adopting
techniques that have been useful in other industries, such as
quality management, lean production, and high reliability -
although with limited, and all-too-often disappointing, results.
The Resilient Health Care Network (RHCN) has worked since 2011 to
facilitate the interaction and collaboration among practitioners
and researchers interested in applying concepts from resilience
engineering to health care and patient safety. This has met with
considerable success, not least because the focus from the start
was on developing concrete ways to complement a Safety-I
perspective with a Safety-II perspective. Building on previous
volumes, Delivering Resilient Health Care presents documented
experiences and practical guidance on how to bring Resilient Health
Care into practice. It provides concrete advice on how to prepare a
study, how to choose the right data, how to collect it, how to
analyse the data, and how to interpret the results. This fourth
book in the Resilient Healthcare series contains contributions from
international experts in health care, organisational studies and
patient safety, as well as resilience engineering. This book
provides a practical guide for delivering resilient healthcare,
particularly for clinicians on the frontline of care unsure how to
incorporate resilience into their everyday work, managers
coordinating care, and for policymakers hoping to steer the system
in the right direction. Other groups - patients, the media, and
researchers - will also find much of interest here.
This book is the 3rd volume in the Resilient Health Care series.
Resilient health care is a product of both the policy and
managerial efforts to organize, fund and improve services, and the
clinical care which is delivered directly to patients. This volume
continues the lines of thought in the first two books. Where the
first volume provided the rationale and basic concepts of RHC and
the second teased out the everyday clinical activities which adjust
and vary to create safe care, this book will look more closely at
the connections between the sharp and blunt ends. Doing so will
break new ground, since the systematic study in patient safety to
date with few exceptions has been limited.
This book offers a global perspective on healthcare reform and its
relationship with efforts to improve quality and safety. It looks
at the ways reforms have developed in 30 countries, and
specifically the impact national reform initiatives have had on the
quality and safety of care. It explores how reforms drive quality
and safety improvement, and equally how they act to negate such
goals. Every country included in this book is involved in a reform
and improvement process, but each takes place in a particular
social, cultural, economic and developmental context, leading to
differing emphases and varied progress. Methods for tackling common
problems - financing, efficiencies, effectiveness, evidence-based
practice, institutional reforms, quality improvement, and patient
safety initiatives - also differ. Representatives from each nation
provide a chapter to convey their own situation. The editors draw a
conclusion from these numerous contributions and synthesize the
themes emerging into a coherent 'lessons learned' summary that
delivers value to the numerous stakeholders. Healthcare Reform,
Quality and Safety forms a compendium of the current 'state of the
art' in global healthcare reform. This is the first book of its
type, and offers a unique opportunity for cross-fertilization of
ideas to the mutual benefit of countries involved in the project.
The content will be of interest to governments, policymakers,
managers and leaders, clinicians, teaching academics, researchers
and students.
Health care is everywhere under tremendous pressure with regard to
efficiency, safety, and economic viability - to say nothing of
having to meet various political agendas - and has responded by
eagerly adopting techniques that have been useful in other
industries, such as quality management, lean production, and high
reliability. This has on the whole been met with limited success
because health care as a non-trivial and multifaceted system
differs significantly from most traditional industries. In order to
allow health care systems to perform as expected and required, it
is necessary to have concepts and methods that are able to cope
with this complexity. Resilience engineering provides that capacity
because its focus is on a system's overall ability to sustain
required operations under both expected and unexpected conditions
rather than on individual features or qualities. Resilience
engineering's unique approach emphasises the usefulness of
performance variability, and that successes and failures have the
same aetiology. This book contains contributions from acknowledged
international experts in health care, organisational studies and
patient safety, as well as resilience engineering. Whereas current
safety approaches primarily aim to reduce or eliminate the number
of things that go wrong, Resilient Health Care aims to increase and
improve the number of things that go right. Just as the WHO argues
that health is more than the absence of illness, so does Resilient
Health Care argue that safety is more than the absence of risk and
accidents. This can be achieved by making use of the concrete
experiences of resilience engineering, both conceptually (ways of
thinking) and practically (ways of acting).
This book offers a global perspective on healthcare reform and its
relationship with efforts to improve quality and safety. It looks
at the ways reforms have developed in 30 countries, and
specifically the impact national reform initiatives have had on the
quality and safety of care. It explores how reforms drive quality
and safety improvement, and equally how they act to negate such
goals. Every country included in this book is involved in a reform
and improvement process, but each takes place in a particular
social, cultural, economic and developmental context, leading to
differing emphases and varied progress. Methods for tackling common
problems - financing, efficiencies, effectiveness, evidence-based
practice, institutional reforms, quality improvement, and patient
safety initiatives - also differ. Representatives from each nation
provide a chapter to convey their own situation.
In this book, we invited 146 authors with expertise in health
policy, systems design, management, research, or practice, from
each of the countries included, to consider health reforms or
systems improvements in their country or region. The resulting case
studies, of 52 individual countries and five regional groupings,
cover 152 countries or territories, or three-quarters of the
world's nations. Each chapter author was asked to think 5-15 years
into the future and make a prediction on how their health system
could be strengthened as a result of the successful unfolding of
their case study. The types of projects our authors have chosen to
explicate into the future are wide-ranging. They vary from
e-consultation services in Estonia, achieving universal health
coverage in Argentina and Mexico, reforming long-term care in the
Netherlands, reassessing care for the aging population and the
frail elderly in Australia, streamlining the health system through
Lean Thinking in Nigeria, using regulation to improve care in South
Africa, developing a new accreditation model in Turkey, through to
a critique of physician specialization in Russia and applying IT
initiatives to improve care in China, Lebanon, Taiwan, Papua New
Guinea, the United Arab Emirates, Venezuela and Wales. Chapter
writers recognized that the improvement work they were doing was
part of a moving target. There was general agreement that the
effective use of limited resources and overcoming hurdles and
constraints were crucial to enhancing health systems in order to
deliver better care over the medium term. While some initiatives
required considerable funding, many were relatively inexpensive.
These case studies demonstrate ways in which fruitful application
of partnerships and creativity can make considerable gains in
strengthening healthcare delivery systems. Features The third book
in a series on international health reform Involves 146
contributing authors, five regional editors, a series editor and a
highly skilled support team to explore sustainable improvement in
health systems in the future Encompasses a time horizon of the next
5-15 years Covers 152 countries or territories, with 52 individual
countries and an analysis of five regional groupings comprising 100
countries
Drawing on the knowledge and experiences of world-renowned
scientists and healthcare professionals, this important book brings
together academic, medical and health systems accounts of the
impact of applying qualitative research methods to transform
healthcare behaviours, systems and services. It demonstrates the
translation of tried-and-tested and new interventions into
high-quality care delivery, improved patient pathways, and enhanced
systems management. It melds social theory, health systems analysis
and research methods to address real-life healthcare issues in a
rich and realistic fashion. The systems and services examined
include those affecting patient care and patient and professional
wellbeing, and the roles and responsibilities of people providing
and receiving care. Some chapters delve deeply into the human
psyche, examining the very private face of health and illness.
Others concentrate on public health and how people's needs can be
met through health promotion and new investments. From real-time
case studies to narratives on illness to theories of change, there
is something here for everybody. Transforming health systems needs
ingenuity - and the drive of individuals, the staying power of
systems and above all the involvement of patients. Full of novel
ideas and innovative solutions from around the world, all
underpinned by qualitative methods and methodologies, this book is
a key contribution for advanced students, practitioners and
academics interested in health services research, research methods
and the sociology of health and illness.
Following on from 2015's Healthcare Reform, Quality and Safety:
Perspectives, Participants, Partnerships and Prospects in 30
Countries, this book encompasses a global perspective on healthcare
while shifting the focus from reform to showcasing success stories
of healthcare systems worldwide. It provides explanations of why
various facets of healthcare systems work well in different
contexts and offers the reader alternative models for
consideration. The book features contributions from 60 countries,
going much further than the common practice of focusing on affluent
Western nations, to provide a comprehensive exploration of the
success of healthcare systems globally. The majority of literature
on health-sector improvement attempts to address the problems
within systems, relating the errors that can and do occur, for
example, and offering solutions and preventative strategies. This
book of country case studies will approach the enhancement of
health systems, patient safety and the quality of care in a new and
innovative way, comprehensively surveying and synthesizing the
success stories of healthcare systems around the world, utilizing
Hollnagel's Safety-II approach to acknowledge the importance of
exploring what goes right, what works well, and why it works. These
success stories may include reference to macro, meso or micro
levels of healthcare systems, various sectors (e.g., aged care,
acute care or primary care), or specific programs or projects.
Health System Improvement Across the Globe: Success Stories from 60
Countries is unprecedented in terms of both reach and positive
emphasis, and as such will be instrumental in changing ways of
thinking about and guiding health-sector improvement.
Health care is everywhere under tremendous pressure with regard to
efficiency, safety, and economic viability - to say nothing of
having to meet various political agendas - and has responded by
eagerly adopting techniques that have been useful in other
industries, such as quality management, lean production, and high
reliability. This has on the whole been met with limited success
because health care as a non-trivial and multifaceted system
differs significantly from most traditional industries. In order to
allow health care systems to perform as expected and required, it
is necessary to have concepts and methods that are able to cope
with this complexity. Resilience engineering provides that capacity
because its focus is on a system's overall ability to sustain
required operations under both expected and unexpected conditions
rather than on individual features or qualities. Resilience
engineering's unique approach emphasises the usefulness of
performance variability, and that successes and failures have the
same aetiology. This book contains contributions from acknowledged
international experts in health care, organisational studies and
patient safety, as well as resilience engineering. Whereas current
safety approaches primarily aim to reduce or eliminate the number
of things that go wrong, Resilient Health Care aims to increase and
improve the number of things that go right. Just as the WHO argues
that health is more than the absence of illness, so does Resilient
Health Care argue that safety is more than the absence of risk and
accidents. This can be achieved by making use of the concrete
experiences of resilience engineering, both conceptually (ways of
thinking) and practically (ways of acting).
Health care is under tremendous pressure regarding efficiency,
safety, and economic viability. It has responded by adopting
techniques that have been useful in other industries, such as
quality management, lean production, and high reliability -
although with limited, and all-too-often disappointing, results.
The Resilient Health Care Network (RHCN) has worked since 2011 to
facilitate the interaction and collaboration among practitioners
and researchers interested in applying concepts from resilience
engineering to health care and patient safety. This has met with
considerable success, not least because the focus from the start
was on developing concrete ways to complement a Safety-I
perspective with a Safety-II perspective. Building on previous
volumes, Delivering Resilient Health Care presents documented
experiences and practical guidance on how to bring Resilient Health
Care into practice. It provides concrete advice on how to prepare a
study, how to choose the right data, how to collect it, how to
analyse the data, and how to interpret the results. This fourth
book in the Resilient Healthcare series contains contributions from
international experts in health care, organisational studies and
patient safety, as well as resilience engineering. This book
provides a practical guide for delivering resilient healthcare,
particularly for clinicians on the frontline of care unsure how to
incorporate resilience into their everyday work, managers
coordinating care, and for policymakers hoping to steer the system
in the right direction. Other groups - patients, the media, and
researchers - will also find much of interest here.
This book is the 3rd volume in the Resilient Health Care series.
Resilient health care is a product of both the policy and
managerial efforts to organize, fund and improve services, and the
clinical care which is delivered directly to patients. This volume
continues the lines of thought in the first two books. Where the
first volume provided the rationale and basic concepts of RHC and
the second teased out the everyday clinical activities which adjust
and vary to create safe care, this book will look more closely at
the connections between the sharp and blunt ends. Doing so will
break new ground, since the systematic study in patient safety to
date with few exceptions has been limited.
Following on from 2015's Healthcare Reform, Quality and Safety:
Perspectives, Participants, Partnerships and Prospects in 30
Countries, this book encompasses a global perspective on healthcare
while shifting the focus from reform to showcasing success stories
of healthcare systems worldwide. It provides explanations of why
various facets of healthcare systems work well in different
contexts and offers the reader alternative models for
consideration. The book features contributions from 60 countries,
going much further than the common practice of focusing on affluent
Western nations, to provide a comprehensive exploration of the
success of healthcare systems globally. The majority of literature
on health-sector improvement attempts to address the problems
within systems, relating the errors that can and do occur, for
example, and offering solutions and preventative strategies. This
book of country case studies will approach the enhancement of
health systems, patient safety and the quality of care in a new and
innovative way, comprehensively surveying and synthesizing the
success stories of healthcare systems around the world, utilizing
Hollnagel's Safety-II approach to acknowledge the importance of
exploring what goes right, what works well, and why it works. These
success stories may include reference to macro, meso or micro
levels of healthcare systems, various sectors (e.g., aged care,
acute care or primary care), or specific programs or projects.
Health System Improvement Across the Globe: Success Stories from 60
Countries is unprecedented in terms of both reach and positive
emphasis, and as such will be instrumental in changing ways of
thinking about and guiding health-sector improvement.
In this book, we invited 146 authors with expertise in health
policy, systems design, management, research, or practice, from
each of the countries included, to consider health reforms or
systems improvements in their country or region. The resulting case
studies, of 52 individual countries and five regional groupings,
cover 152 countries or territories, or three-quarters of the
world's nations. Each chapter author was asked to think 5-15 years
into the future and make a prediction on how their health system
could be strengthened as a result of the successful unfolding of
their case study. The types of projects our authors have chosen to
explicate into the future are wide-ranging. They vary from
e-consultation services in Estonia, achieving universal health
coverage in Argentina and Mexico, reforming long-term care in the
Netherlands, reassessing care for the aging population and the
frail elderly in Australia, streamlining the health system through
Lean Thinking in Nigeria, using regulation to improve care in South
Africa, developing a new accreditation model in Turkey, through to
a critique of physician specialization in Russia and applying IT
initiatives to improve care in China, Lebanon, Taiwan, Papua New
Guinea, the United Arab Emirates, Venezuela and Wales. Chapter
writers recognized that the improvement work they were doing was
part of a moving target. There was general agreement that the
effective use of limited resources and overcoming hurdles and
constraints were crucial to enhancing health systems in order to
deliver better care over the medium term. While some initiatives
required considerable funding, many were relatively inexpensive.
These case studies demonstrate ways in which fruitful application
of partnerships and creativity can make considerable gains in
strengthening healthcare delivery systems. Features The third book
in a series on international health reform Involves 146
contributing authors, five regional editors, a series editor and a
highly skilled support team to explore sustainable improvement in
health systems in the future Encompasses a time horizon of the next
5-15 years Covers 152 countries or territories, with 52 individual
countries and an analysis of five regional groupings comprising 100
countries
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