Early Childhood Councils: Effective Planning Processes for Health Systems Integration

The Colorado Trust launched its Early Childhood Council Health Integration grant strategy in 2008. Through this effort, the Early Childhood Councils developed strategies to better integrate health practitioners and health care services into their work, along with their already-established focus on early care and education, and family supports. The goal of this grant strategy was to support sustainable efforts by the Councils to change the way local resources were coordinated, reduce service duplication, increase access to health care services and contribute to improved health outcomes for children (ages 0-12 years) across the state. To realize this goal, The Colorado Trust provided the Councils with grant support and technical assistance to engage in the development of plans to achieve integrated childhood development systems in their communities. This case study discusses the successes, challenges and lessons learned from the Early Childhood Council Health Integration planning grant process. Using qualitative data collected through focus groups and key informant interviews, the report details how the planning process was structured, what worked and didn't work as the Councils developed their systems-building plans, and provides recommendations for funders to consider when conducting a systems-building planning process. Key themes include:Grantees learned about systems change and developed plans to achieve such change. The planning process provided Councils with the time, resources and guidance necessary to learn about and develop well-thought-out plans to build connections and develop the infrastructure to help support and sustain programs for children and families across multiple systems. Community-level data is essential in fostering collaboration and planning. Even as it was difficult to access key data for certain populations or geographic regions, many Councils were able to use local data as a tool to coalesce new partnerships and develop a shared vision for change. Integrating new partners into an established system requires planning. For many Councils, the planning process timeframe was essential in conducting outreach to local health partners, especially with regard to developing a shared vision and common language.Funders need to require and support systemic change. It was important that The Colorado Trust explicitly required grantees to engage in activities that supported effective implementation of high-quality programs and connections across systems as opposed to solely focusing the funding on individual programs. While this work was new to most of the Councils, they reported that having a funder willing to support systems-building was a welcome change that better enabled them to tackle a complex scope of work and to address unanticipated challenges

Improving identification and audit of disability within Child Health Services

This project was commissioned by the Department of Health to survey existing data collections regarding childhood disability across the domains of education, health and social care and to collect definitions of disability from across three domains. A systematic review was conducted which addressed the two aims. The findings were discussed in consultation of findings with key professionals from across the UK and with some contacts in Europe, both electronically and in a professional working focus group. The review of published academic and grey literature identified vast disparities between the way that data is collected, coded and used across the three domains. The disparities between the definitions of disability used across the domains further prevent the data being drawn together in a cohesive manner that may then be used to facilitate effective planning of services both locally and nationally. The project did, however, identify one coding system that may potentially offer a solution to these difficulties, the International Classification of Functioning, Disability and Health – Children and Youth Version (ICF-CY, World Health Organisation, 2007). This coding system has demonstrated a capacity to resolve issues with data collections in Europe and has been the subject of policy recommendations presented to the European Parliament on the 16th September 2008. It is proposed that while immediate change is not possible, a staged approach, beginning with a pilot study of the utility of the ICF-CY, should be conducted to test its efficiency in providing effective harmonisation of data collections across the three domains and its applicability in the identification of childhood disability. Alongside this, it is important for the ICF-CY considered by the project group overseeing the implementation of the Child Health, Maternity and CAMHS Care Records

Sustainable urban development in practice:the SAVE concept

The need for sustainable development of the urban environment presents the research community with a number of challenges and opportunities. A considerable volume of research has been undertaken into the constituent parts of this complex problem and a number of tool kits and methodologies have been developed to enable and encourage the application of specific aspects of research in practice. However, there is limited evidence of the holistic integration of the body of knowledge arising from the research within real-life decision-making practices. In this paper we present an overview of the existing body of knowledge relating to sustainable development of the urban environment and propose a generic framework for its integration within current practices. This framework recognises the need to: understand social, economic, and environmental issues; understand the decision-making processes; provide a means of measurement, assessment, or valuation of the issues; provide analytical methods for the comparative assessment of complex data to enable an evaluation of strategies and design options and to communicate effectively throughout the process with a wide range of stakeholders. The components of a novel sustainability assessment, visualisation and enhancement (SAVE) framework, developed by the authors to ‘operationalise’ the body of knowledge are presented and justified. These include: decision-mapping methods to identify points of intervention; indicator identification and measurement approaches; appropriate mathematical and analytical tools and an interactive simulation and visualisation platform which integrates and communicates complex multivariate information to diverse stakeholder groups. We report on the application of the SAVE framework to a major urban development project and reflect on its current and potential impact on the development. Conclusions are also drawn about its general applicability

National Mesothelioma Virtual Bank: A standard based biospecimen and clinical data resource to enhance translational research

Background: Advances in translational research have led to the need for well characterized biospecimens for research. The National Mesothelioma Virtual Bank is an initiative which collects annotated datasets relevant to human mesothelioma to develop an enterprising biospecimen resource to fulfill researchers' need. Methods: The National Mesothelioma Virtual Bank architecture is based on three major components: (a) common data elements (based on College of American Pathologists protocol and National North American Association of Central Cancer Registries standards), (b) clinical and epidemiologic data annotation, and (c) data query tools. These tools work interoperably to standardize the entire process of annotation. The National Mesothelioma Virtual Bank tool is based upon the caTISSUE Clinical Annotation Engine, developed by the University of Pittsburgh in cooperation with the Cancer Biomedical Informatics Grid™ (caBIG™, see http://cabig.nci.nih.gov). This application provides a web-based system for annotating, importing and searching mesothelioma cases. The underlying information model is constructed utilizing Unified Modeling Language class diagrams, hierarchical relationships and Enterprise Architect software. Result: The database provides researchers real-time access to richly annotated specimens and integral information related to mesothelioma. The data disclosed is tightly regulated depending upon users' authorization and depending on the participating institute that is amenable to the local Institutional Review Board and regulation committee reviews. Conclusion: The National Mesothelioma Virtual Bank currently has over 600 annotated cases available for researchers that include paraffin embedded tissues, tissue microarrays, serum and genomic DNA. The National Mesothelioma Virtual Bank is a virtual biospecimen registry with robust translational biomedical informatics support to facilitate basic science, clinical, and translational research. Furthermore, it protects patient privacy by disclosing only de-identified datasets to assure that biospecimens can be made accessible to researchers. © 2008 Amin et al; licensee BioMed Central Ltd

Planning strategically, designing architecturally : a framework for digital library services

In an era of unprecedented technological innovation and evolving user expectations and information seeking behaviour, we are arguably now an online society, with digital services increasingly common and increasingly preferred. As a trusted information provider, libraries are in an advantageous position to respond, but this requires integrated strategic and enterprise architecture planning, for information technology (IT) has evolved from a support role to a strategic role, providing the core management systems, communication networks, and delivery channels of the modern library. Further, IT components do not function in isolation from one another, but are interdependent elements of distributed and multidimensional systems encompassing people, processes, and technologies, which must consider social, economic, legal, organisational, and ergonomic requirements and relationships, as well as being logically sound from a technical perspective. Strategic planning provides direction, while enterprise architecture strategically aligns and holistically integrates business and information system architectures. While challenging, such integrated planning should be regarded as an opportunity for the library to evolve as an enterprise in the digital age, or at minimum, to simply keep pace with societal change and alternative service providers. Without strategy, a library risks being directed by outside forces with independent motivations and inadequate understanding of its broader societal role. Without enterprise architecture, it risks technological disparity, redundancy, and obsolescence. Adopting an interdisciplinary approach, this conceptual paper provides an integrated framework for strategic and architectural planning of digital library services. The concept of the library as an enterprise is also introduced

Management information systems in social safety net programs : a look at accountability and control mechanisms

This paper is intended to provide task managers and World Bank Group clients working on Social Safety Net (SSN) programs with practical and systematic ways to use information management practices to mitigate risks by strengthening control and accountability mechanisms. It lays out practices and options to consider in the design and implementation of the Management Information System (MIS), and how to evaluate and mitigate operational risks originating from running a MIS. The findings of the paper are based on the review of several Conditional Cash Transfer (CCT) programs in the Latin American Region and various World Bank publications on CCTs. The paper presents a framework for the implementation of MIS and cross-cutting information management systems that is based on industry standards and information management practices. This framework can be applied both to programs that make use of information and communications technology (ICT) and programs that are paper based. It includes examples of MIS practices that can strengthen control and accountability mechanisms of SSN programs, and presents a roadmap for the design and implementation of an MIS in these programs. The application of the framework is illustrated through case studies from three fictitious countries. The paper concludes with some considerations and recommendations for task managers and government officials in charge of implementing CCTs and other safety nets program, and with a checklist for the implementation and monitoring of MIS.E-Business,Technology Industry,Education for Development (superceded),Labor Policies,Knowledge Economy

All-Payer Claims Database Development Manual: Establishing a Foundation for Health Care Transparency and Informed Decision Making

With support from the Gary and Mary West Health Policy Center, the APCD Council has developed a manual for states to develop all-payer claims databases. Titled All-Payer Claims Database Development Manual: Establishing a Foundation for Health Care Transparency and Informed Decision Making, the manual is a first-of its-kind resource that provides states with detailed guidance on common data standards, collection, aggregation and analysis involved with establishing these databases

On the Road to Better Value: State Roles in Promoting Accountable Care Organizations

Outlines how accountable care organizations can deliver value through incentives to manage utilization, improve quality, and curb cost growth. Profiles states supporting the model with data, new payment methods, accountability measures, and other efforts