Impact of the Sierra Health Foundation's Clinic Capacity Building Program: Final Evaluation Report

Sierra Health Foundation (Sierra Health) launched the Clinic Capacity Building Program in 2013 as part of the Sacramento Region Health Care Partnership. The goal of the Clinic Capacity Building Program was to respond to the anticipated growth in demand (i.e., number of patients) created by the implementation of the Affordable Care Act by strengthening community health centers' administrative and operational capacity. The program aimed to improve clinic leadership, care quality and financial sustainability, thereby increasing the number of high performing Federally Qualified Health Centers in the region.In July 2014, Sierra Health contracted with the Center for Community Health and Evaluation (CCHE) to evaluate the effectiveness of its Clinic Capacity Building Program. The goal of the evaluation was to assess the effectiveness of the Clinic Capacity Building program and contribution of the program to changes in capacity among the five grantees. This is the Executive Summary of the final evaluation report, which was submitted to Sierra Health in December 2015

Integrated urgent care / NHS 111 workforce blueprint: workforce governance guide

This guide outlines the governance, both formal and informal, that will support the Integrated Urgent Care (IUC) / NHS 111 workforce to continue to deliver excellent frontline care to the public. It includes recommendations on appraisal, revalidation, supervision, and using audit to support these. In response to engagement exercises, it also touches on governance around recruitment, reducing attrition and on the physical environment that team members work in

Twice the Opportunity: Policy Recommendations to Support Expectant and Parenting Youth in Foster Care and Their Children

In 2011 the Center for the Study of Social Policy (CSSP), with funding from the Annie E. Casey Foundation, commenced an effort to draw attention to the urgent and unmet needs of one of the more vulnerable populations in our society: youth in foster care who are expectant or parenting their children. These young families face significant challenges to becoming healthy, stable and successful for both parents and their children. They also present policymakers and child welfare administrators with an opportunity to design a comprehensive set of policies and programs to reduce the poor and costly outcomes that these families too often experience and to instead positively support these two generations to thrive. As more states extend foster care beyond age 18, child welfare agencies will face an increase in the number of expectant and parenting youth in their system. This guide presents elements of a policy agenda for addressing the health, safety, permanency, educational, housing and financial needs of both the expectant and parenting youth and their children. It is based on CSSP's experience working for the past two years with four jurisdictions (New York City, Washington DC, Knox County, Tennessee and the State of Washington) to support their efforts to improve outcomes for these young families. The policy recommendations in this guide build on the on-the ground experiences of the four sites and are also informed by the advice CSSP received from a group of national experts on expectant and parenting youth in foster care. This publication is an update of a set of draft recommendations that CSSP published in 2011

Advancing Community Health Worker Practice and Utilization: The Focus on Financing

There is a growing interest in the use of community health workers in various roles in the US health care system. These workers go by various titles and names -- including promotora and community health advisor -- but all assist members of the communities they serve. As the role of these workers becomes more accepted and desirable in the overall system of care, they face the challenges of moving from being an exceptional add-on to the system to being more a part of the mainstream. Issues such as educational preparation, formal credentialing, licensure and compensation are all part of this process. In particular, various organizations are interested in but challenged by the need for sustainable financing of the CHW position. It is time to explore and develop viable financing arrangements that go beyond short-term grants.To address these concerns, this research was undertaken to study sustainable financing mechanisms for community health workers. The focus is on existing and emerging funding, reimbursement and payment policies for community health workers. The study seeks to identify promising examples and models of payment programs for community health workers generally in the United States. To the authors' knowledge, this is the first national project with this exclusive focus.The audiences for this report include community health workers, directors of programs that employ or work with community health workers, and administrators of public and private coverage programs such as health plans, insurance companies and state Medicaid programs seeking options for improving health care access and quality at the same or lower costs. Businesses, non-profit organizations and consumers exploring the possibilities of using the services community health workers could provide might also be interested in the findings

Technology Target Studies: Technology Solutions to Make Patient Care Safer and More Efficient

Presents findings on technologies that could enhance care delivery, including patient records and medication processes; features and functionality nurses require, including tracking, interoperability, and hand-held capability; and best practices

Protecting healthcare workers from COVID-19: learning from variation in practice and policy identified through a global cross-sectional survey.

AIMS: The COVID-19 pandemic presents an unprecedented burden on global healthcare systems, and existing infrastructures must adapt and evolve to meet the challenge. With health systems reliant on the health of their workforce, the importance of protection against disease transmission in healthcare workers (HCWs) is clear. This study collated responses from several countries, provided by clinicians familiar with practice in each location, to identify areas of best practice and policy so as to build consensus of those measures that might reduce the risk of transmission of COVID-19 to HCWs at work. METHODS: A cross-sectional descriptive survey was designed with ten open and closed questions and sent to a representative sample. The sample was selected on a convenience basis of 27 senior surgeons, members of an international surgical society, who were all frontline workers in the COVID-19 pandemic. This study was reported according to the Standards for Reporting Qualitative Research (SRQR) checklist. RESULTS: Responses were received by all 27 surgeons from 22 countries across six continents. A number of the study respondents reported COVID-19-related infection and mortality in HCWs in their countries. Differing areas of practice and policy were identified and organized into themes including the specification of units receiving COVID-19 patients, availability and usage of personal protective equipment (PPE), other measures to reduce staff exposure, and communicating with and supporting HCWs. Areas more specific to surgery also identified some variation in practice and policy in relation to visitors to the hospital, the outpatient department, and in the operating room for both non-urgent and emergency care. CONCLUSION: COVID-19 presents a disproportionate risk to HCWs, potentially resulting in a diminished health system capacity, and consequently an impairment to population health. Implementation of these recommendations at an international level could provide a framework to reduce this burden

The Case for Developing and Deploying an Open Source Electronic Logistics Management Information System

Summarizes efforts to strengthen health information systems in low- and lower-middle-income countries, including development of common requirements. Outlines models for collaboration among stakeholders, national leaders, and health information users

National Security Space Launch

The United States Space Force’s National Security Space Launch (NSSL) program, formerly known as the Evolved Expendable Launch Vehicle (EELV) program, was first established in 1994 by President William J. Clinton’s National Space Transportation Policy. The policy assigned the responsibility for expendable launch vehicles to the Department of Defense (DoD), with the goals of lowering launch costs and ensuring national security access to space. As such, the United States Air Force Space and Missile Systems Center (SMC) started the EELV program to acquire more affordable and reliable launch capability for valuable U.S. military satellites, such as national reconnaissance satellites that cost billions per satellite. In March 2019, the program name was changed from EELV to NSSL, which reflected several important features: 1.) The emphasis on “assured access to space,” 2.) transition from the Russian-made RD-180 rocket engine used on the Atlas V to a US-sourced engine (now scheduled to be complete by 2022), 3.) adaptation to manifest changes (such as enabling satellite swaps and return of manifest to normal operations both within 12 months of a need or an anomaly), and 4.) potential use of reusable launch vehicles. As of August 2019, Blue Origin, Northrop Grumman Innovation Systems, SpaceX, and United Launch Alliance (ULA) have all submitted proposals. From these, the U.S. Air Force will be selecting two companies to fulfill approximately 34 launches over a period of five years, beginning in 2022. This paper will therefore first examine the objectives for the NSSL as presented in the 2017 National Security Strategy, Fiscal Year 2019, Fiscal Year 2020, and Fiscal Year 2021 National Defense Authorization Acts (NDAA), and National Presidential Directive No. 40. The paper will then identify areas of potential weakness and gaps that exist in space launch programs as a whole and explore the security implications that impact the NSSL specifically. Finally, the paper will examine how the trajectory of the NSSL program could be adjusted in order to facilitate a smooth transition into new launch vehicles, while maintaining mission success, minimizing national security vulnerabilities, and clarifying the defense acquisition process.No embargoAcademic Major: EnglishAcademic Major: International Studie