Values and behaviours: using the Ten Essential Shared Capabilities to support policy reform in mental health practice

This paper will review aspects of current policy in mental health with specific reference to policy that has a values focus. In this context, values refers to the standards and expectations we hold and which we use to guide aspects of practice performance. Service users state that core values that support, respect choice, collaboration, and customer service are critical foundation stones of a trusting therapeutic relationship. Attending to these foundations for practice has merit in ensuring the quality of care delivery in mental health. This paper will analyse what this means for the mental health workforce in their engagement with service users and delivery of policy priorities. Finally, the paper will explore resources, such as the Ten Essential Shared Capabilities (see Appendix 1), which support engagement and ongoing promotion of person-centred mental health care

Improvement of Possibilities of Treating Pneumonias in Patients on the Background of Acute Myeloblast Leucosis in the Aspect of Immunoresistance Mechanisms

Aim: to analyze the influence of the immunomodeling preparation glutamyl-cysteinyl-glycine disodium (glutoxim) on indices of cellular and humoral immunity in patients with pneumonias on the background of acute myeloblast leucosis to form new approaches to the improvement of treating pneumonias in patients with immunity disorders.Materials and methods. The research group - 37 patients with pneumonia on the background of acute myeloblast leucosis, who underwent the program treatment on the base of the hematological center “MI city multi-profile clinical hospital №4” Dnipro city, 2014-2015. The age of patients from 23 to 45 years old; 10 women and 27 men. The diagnosis of leucosis and pneumonia forms was verified corresponding to modern conventional clinical and morphological criteria. Patients from the main research group (n = 18) were prescribed with glutamyl-cysteinyl-glycine disodium by the scheme 2 ml of 3 % (60 mg) i/v № 10 in mornings, summary dose - 300 mg. Indications of immunograms were studied: Т-lymphocytes, В-lymphocytes and their subpopulation composition (CD3 +, CD4 +, CD8 +, CD19 +, CD19-, CD16 +, CD56+) using the flowing laser cytofluorimetry. Immunoglobulin levels were determined by the method of immunoturbometry. Indications of immunograms were assessed in the treatment dynamics. The statistical processing – using packages of applied programs «Excel» and «Statistic 10».Results. According to the analysis of indices of the cellular and humoral immunity of patients with pneumonia on the background of acute myeloblast leucosis, the process of glutamyl-cysteinyl-glycine disodium use proved the statistically reliable activation of phagocytosis and anti-infectious defense indices. The dynamics of humoral immunity indices also proved the positive influence on the state of the immune reactivity of the organism with the reliable increase of ІgА and Іg М, responsible for neutralization of infectious agents and bacterial toxins.Conclusions: The use of the ummunomodeling preparation glutamyl-cysteinyl-glycine disodium (glutoxim) in patients with pneumonia on the background of acute myeloblast leucosis results in the improvement of indices of cellular and humoral immunity and phagocytosis activation. The research results prove the possibility of optimization of approaches to treating pneumonias in patients with severe immunity disorders by using immunomedeling therapy by glutamyl-cysteinyl-glycine disodium (glutoxim)

Health Improvement Initiative: Final Evaluation Report

Summarizes an evaluation of an initiative to create health systems change at the community level. Outlines the partnerships' goals of service integration, results-based budgeting, data integration, and policy development; impact; and elements of success

Measuring and Improving Health Care Quality for Children in Medicaid and CHIP: A Primer for Child Health Stakeholders

A large body of evidence shows that, compared to low-income uninsured children, Medicaid has been highly successful in providing children with a usual source of care and regular well-child care while significantly reducing unmet or delayed needs for medical care, dental care, and prescription drugs due to costs. Nonetheless, quality improvement centers on the notion that systematic and continuous actions lead to measurable improvement in health care services and health status. To this end, health care quality improvement efforts in Medicaid and the Children's Health Insurance Program (CHIP) have accelerated significantly in the past several years largely due to the CHIP Reauthorization Act of 2009 (CHIPRA) and the Affordable Care Act of 2010 (ACA). In May 2015, the Centers for Medicaid and Medicare Services (CMS) also proposed a major modernization of federal rules regarding Medicaid managed care. If enacted, the regulations will have sweeping implications for state quality strategies that extend to all health care delivery mechanisms, including fee-for-service. Provisions in the new rules call for transparency and for states to engage stakeholders in planning and implementation.Given the acceleration in health care quality improvement and opportunities for stakeholder engagement, this brief is intended as a primer for child health policy and advocacy organizations that want to focus their efforts beyond coverage to ensure that every child enrolled in Medicaid and CHIP receives high quality health care. The goal is to help stakeholders better understand the current state of quality measurement and improvement, specifically as it pertains to children enrolled in Medicaid and CHIP. It covers a brief history of health care quality efforts, explains the basics of quality measurement and improvement, discusses the challenges in data collection and analysis, and describes how quality improvement initiatives work. Importantly, it discusses the key roles that child health policy and advocacy organizations can play in making sure that our public coverage programs for children deliver high quality health care that advances health outcomes and strives for continuous improvement

The organisation and delivery of health improvement in general practice and primary care: a scoping study

Background This project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities. Aims The aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice. Methods We undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff. Findings Many of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely. Future Research Future research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc

Gundersen Lutheran Health System: Performance Improvement Through Partnership

Highlights Fund-defined attributes of an ideal system and best practices such as using data for benchmarking, increasing transparency, and driving improvement; investing in primary care and disease management; and hiring engineers to improve operations

Health Status of the Uninsured: Opportunities for Improvement

Provides estimates of the geographic variations in the rates of self-reported fair or poor health status, asthma, and hypertension among uninsured children and adults in California

Improving mental health outcomes: achieving equity through quality improvement

Objective. To investigate equity of patient outcomes in a psychological therapy service, following increased access achieved by a quality improvement (QI) initiative. Design. Retrospective service evaluation of health outcomes; data analysed by ANOVA, chi-squared and Statistical Process Control. Setting. A psychological therapy service in Westminster, London, UK. Participants. People living in the Borough of Westminster, London, attending the service (from either healthcare professional or self-referral) between February 2009 and May 2012. Intervention(s). Social marketing interventions were used to increase referrals, including the promotion of the service through local media and through existing social networks. Main Outcome Measure(s). (i) Severity of depression on entry using Patient Health Questionnaire-9 (PHQ9). (ii) Changes to severity of depression following treatment (ΔPHQ9). (iii) Changes in attainment of a meaningful improvement in condition assessed by a key performance indicator. Results. Patients from areas of high deprivation entered the service with more severe depression (M = 15.47, SD = 6.75), com-pared with patients from areas of low (M = 13.20, SD = 6.75) and medium (M = 14.44, SD = 6.64) deprivation. Patients in low

Mental health

PHN Discussion Paper #2 – Mental Health notes a key role for Primary Health Networks in realising effective and lasting improvement in mental health outcomes, through adopting a person-centred approach in service design and enabling integration across service providers in local health systems. The 2014 National Mental Health Commission report noted that “They (PHNs) can work in partnership and apply targeted, value-for-money interventions across the whole continuum of mental wellbeing and ill-health to meet the needs of their communities.” Notwithstanding this, there are challenges and barriers to be resolved in order to effect meaningful and sustainable improvement in mental health outcomes and health system performance.  Further exploration of the challenges and barriers is warranted in order to enable PHNs to deliver on their objectives.&nbsp