What Are Integrated Delivery Systems?

Behavioral Healthcare Integration

Why Integrated Healthcare Delivery Is Inevitable

OneKey Integrated Health Systems

Integrated Delivery System - St. Charles Health System

Current and Future Healthcare Workforce Trends - HRO Forum

How to measure labour force in medical field?

According to New England journal of medicine; US spent in 2010 $2.6 trillion on healthcare, 56% of these expenditures went to wages. Moreover; 16.4 million represent 11.8 % of total employee labour force of US. The point as we mention here not how much the labour is important but we are referring to how their accomplishment measured. There are many studies and theories put numerous sophisticated barometers for all of their efforts but still the picture to identify the effort measurements among medical workers is hard to be declared. That because many indicators and work measurement indicators could not be able to identify the tasks with procedure cascade already implemented but also impossible to know exactly what time schedule in real or skills been followed within. In past; trying to draw task frame schedule to follow was not effective particularly if you even have no idea what human skills carried out of each. Task schedule frame work is more than effective with other scopes as military services and other on ground missions.

After many indicator study and analysis to the outcome of labour force measurement, I choose comparable indicator of work cascade procedures outcome. Calibration of the indicator is necessary regardless the field going to be applied. The effective nature of this indicator lies in drawing analytical comparable figures in order to determine the level of deviations from the work standards pathway already inserted in former work data. Subsequently; a process of comparable indicator calibration precisely applied with high data management particularly with registry. There are two sub-indicator of comparable measurement indicator;

First; single factor depending calibration method could work parallel to gross outcome& values added and that is the simplest form of comparable indicator calibration. The process determines the whole working steps in comparison with outcome or produced values. Clinicians and nurses the main category of field implementation ever than others and those who working directly to the public considered the most close ones. Received values and outcomes form together index called quantitative index of productivity measurement. That index would calculate mathematically depending on inserted data to assure the demanded level of calibration start point.

Second; multifactor depending calibration method that would more complicated related other inserts as capital, intermediate inputs and energy and more economically significant to multi-channels organization or providers and that more fit for integrated medical systems if authorized institutions would like to do proper calibrations to evaluate the capital productivity gain bench level to apply our main comparative indicator.

Comparative indicator of medical worker labour measurement is effective precisely and works well with integrated compound system layers to reach degree of standard deviation depending on previously introduced work calibration. There are many other work associated the whole process more than what written here but I prefer to keep it simple as possible. New modern technologies always forcing us to learn and teach new procedures of work evaluation trying to keep medical system sufficiently fit to medical society requirements. Full health J

Evaluation of labour force in integrated system

Healthcare labour force is not only important part of medical system integration, it is much more complicated than ever be imagined.  I am not exaggerate if call it hardest part in medical integrating process. Human is different than machines and also more complicated emotionally, spiritually and forced purposely. Within human psychology multiple bundles running together to produce this or that person depending on how he/ she react with internal and external environmental factors. Moreover; majority of human mindset craving to work with results than procedure and action leading to that results. In other word; task oriented nature of human being rather than action identification possible to lead into deviated roads particularly in medical work.

In some countries they must declare psychological stability of medical professional and nurses before they start to work with patients.  Bureaucratic thinking way of them could easily uncover training and fitness rehabilitation of them. If you do not see the powerful impact of human mentality with work, please tell me why many successful organizations and even governments ride downward trend although many and available resources might not available with poorer communities?!. World health organization has drawn many frames for medical labour force especially with whom dealing with public and elderly populations.

WHO declared that organization intervention regularly could be involved everywhere throughout whole healthcare service provision whereas direct contact with patient is necessary in form of training, reviewing obstacles and trying to melt barriers among working and support any innovative solutions for work and pattern performance improvement. Through licensing professional occupation, accredited universities& institutions, create cooperative constructive working policy and strategy more convenient with service provision nature and demands. Record and register the labour dynamic analysis could be most useful to eliminate and overcome the errors might be occurred due to human nature barrier melting inability. There is a chart published on WHO site explain how to measure work dynamic performance among medical workers in details with operational unites;

As a hint here to only measure on work dynamic among them is little poor efficient strategy but would be perfect if you enhance an empowerment spirit and let them take the responsibility of development and improvement by themselves.  Full health J

Accountability of medical professionals in integrated delivery systems 

Medical professionals are the core of medical cycle corner stone and the most valuable human asset in medical work. High significant role of practitioners and nurses could push the quality of medical services for the public. Therefore; the skills they have clearly discriminate and identify the performance pattern been taken. Although the definition of accountability has not clear viewpoint and differ according to working system but still general review outlines carries the core meaning value of medical worker accountabilities. Medical professional accountability can include individuals, hospitals, working systems and governmental operation unites. Many of us think that accountability refer only to legal liabilities as though, it is not only. It begins with personal ability to lead the patient knowledge and   redirect correction effort in compliance with needed outcomes. That would be difficult or easy for medical workers abut that distinguished personal requirements and demands in order overcome error pitfalls.

Human kind accountability carries different corner stones might be directly proportional with quality of services communication platforms that could received by patients. As long as medical workers take on their burden the power of change as a tool required for work tasks attainments, stunning outcome always be expected because they believe in development and prosperity. Revolution of accountability between service providers and patient takes different aspects in which there is personal ability to provide sound intact service provision regardless race, age, profession and friendship even. All these parameters determine quality and ability of medical professional for development and average up level of tasks. Technologies are not the key of success anymore because they without good accountable labour always leading to disasters. Labour force would not be skilful when they use last version of system without ability to use all resources available fairly among patients.

Some other prospect enumerate that provider accountability would not be enforce unless there is associated ethics running parallel to strictly constrict the times of deviation against. If there are ethics working with medical accountability acts that for sure would be help the worker to understand the requirements and needs of accountable healthcare labour and I agree with this perspective with little modification that such ethics would internal for each medical providers more close to the patient segments they serve. With this you could serve the certain segment of people according to their diseased cases, for instance; chronic disorders hospitals could not apply accountability training regime does not matching with patient segment they work with. On the other level; patients from the same segment awaited some rules and level of service matching with their diseases.  

Continuously reminding medical professionals with patients with their rights and internal entity instructions protocol that put the whole service quality within high standards category and to enhance the degree of satisfaction on both sides; patients and medical workers. Discipline accountability rules among medical labour provide powerful spiritual impact that remove personal habits could may or may not carries some setbacks without them. Full health J

Integrated theory of behaviour changes

The purpose from ‘integrated theory of health behaviour change ‘(ITHBC) that introduced by Polly Ryan to produce new descriptive concepts among individuals, communities regarding behaviour changes. As nurses and medical professionals responsible for proper identification of good and bad patients behaviours that put on shoulders change management and patient medical literate on parallel figure with process of switching to new health behaviours. In this post we explain the main purposes, concepts and final results of theory implementation. Behaviour changes take many prospects from healthcare professionals and also from the patient sides; management of patient behaviour in chronic illness differ from acute or emergency cases. The differences coherent to produce future behaviour could serve the patient effectiveness in higher level reflect the progress of modified theory implemented concepts.

But still the level of responsiveness among patients varies according to their level of acceptance and implanting changing management beliefs. Whereas that medical professionals need to put medical strategies for patients and tailing the separate procedures to adapt for each, there are many monitoring decision making factors should be embraced to improve future results of behaviour changes. Thus, behaviour resilience is crucial significant backbone strengthen the role of adaptive behavioural concept in order to get the desired result demanded by medical provider strategy. Actually; those who would exceed over this point of resilience could get more considered attains ever.

Moreover; behaviour changes connected closely to the health promotion tactics to improve health; living healthy intact life main urge for many through smoke less, drink less and build healthy feeding habits that concise point of restoration of soundness.  Clinicians and nurses use the theory concepts to keep monitoring and tracking the patient improvement with regular adaptable behaviours. Recent studies indicate that astute medical workers trying always to keep system complexity with whole performance integrity to push patient adjustment over.

Theory assumptions depending on fact that changes are dynamic parameter for behaviour adjustment associated with a desire and motivation eagerness for soundness and total behavioural integrity. Self accountability to get improved leads the patient toward positive patterns neglecting the subconscious former habits and hidden will of distraction. The main contextual form of ITHBC assumptions reflect wide range of preventive responsibilities coming through patient behaviour and medical adaptive adjustment deeply impregnated with strategic changes management pathway. Fostering knowledge and beliefs is the descriptive concept and proximal outcome of the theory that make the patient main stakeholder in the process of treatment and prevention. Level of behaviour changes depending on the personal beliefs engaged with introduced pattern of healthy lifestyle. Self regulation, self monitoring, improvement progress and self assessment play and reflect personal awareness and optimum working effort done by nurses and medical professionals.

Ultimately; integrated theory of behaviour changes help all parties of healthcare whether worker or patients to understand the value of working together on the ground of knowledge to reach mutual caring goals. Full health J

Public psychological habits of integration

We refer to word ‘public’ here to our wonderful patients who are the core of medical system and end receiver value.  Many years already passed with working integration experiments worldwide from Far East to the far north and many of positives and negatives came out on the surface referring to human nature of work that could not ever setbacks avoidable although still with many valuable achievements and attainments. As long as patient used to get new access regime to healthcare on the spot of integration to numerous operational unites grids with minimum physical effort movement that undoubtedly has a role in patient behaviour changes.  As a rule; when personal medical purposes are the same and the companion actions differ that create some sort of convenience commit with new modern technologies of communications. This convenience are pushing patient psychologically to be more productive and cooperative with healthcare providers more than ever.  Moreover, there is formation of indirect hidden personal self-esteem figure and satisfaction as a result of modern technologies acclimatization then lately easier and acceptable to introduce ‘CareMore’ business model to get more new services through healthcare grids and undoubtedly exaggerate end revenues.

CareMore is medical business model applied in California. Providers over there targeting seniors, one of its primary working goals to study behaviour changes in order to encourage optimum level of service provision toward chronic conditions. Beyond ordinary traditional clinician- patients interaction, centred medical provision been supported to offer most of services within integrating systems. On the other side; clinicians should adopt patient centered approach to begin subconscious programming of public and shifting their vision from the traditional way of received values to modern integrated gates.

There are many shift patient behaviours could be considered during a process of system integration;

Re-orienting health systems into prevention focused model rather than disease treatment models through monitoring, adjustment, follow up and self data processing by the patient.

Long term management through self training and personal management programmes to rehabilitate the patients with self monitoring and management options.

Adoption patient centred approaches and exaggerate personal medical literate with regular training to reach lowest level of disease complications and crises.

Prevention focusing model with patient carries multiple benefits and remove government burden; how to save medications of existed diseased individuals than care more intensively of healthy ones. From different side; it is much better to look after healthy than supply remedy to diseased, this prospect never make us forget our parents and families members who seriously need medications and regular remedies for chronic cases but this way of thinking fit for strategic decisions to prepare and build strong healthy community members. As we think to provide our patients with convenient, available, effective care services also we never forget our new generations and trying to keep them far away from healthcare medications dilemma and with best wishes always to full health happy life. J

Conflicts resolutions within integrated systems

Conflicts in past were between people, tribes and communities reflect a point of difference or greedy mindset while conflicts in medical systems reflect high dynamic level of innovation and insistence to succeed. This eagerness to succeed and prove your point creates parallel analytical mentality that could not pass through without actually. When we are talking about system conflicts (errors) that uncover the setback may formerly was not appear in lack of working rush therefore, conflicts help to investigate the systems carefully and put questions for future development. May be this is not much significant for implementer but the most for data architect designers. Human being is completely different because none wants exactly where the key and how was the trigger of it while in most situations they have come due to personal causes not directly related to the work procedures. In funny way; I..Complex plays very important role in this and for more explanation I advice our generous reader to check previous post.

But we have still a question how we avoid conflicts under proper umbrella of communication channels? The 1^st point leads to 2^nd one; how if you have effective communication channels under umbrella of equity and fairness depending on work performance. You are going to pay much less to correct any organization conflicts whereas traditional ways of resolution take more effort and time with limited result in general. Society professional of dispute resolution (SPIDR) has drawn the main guide line of conflict system management. This guide help organizations leader to overcome the main ordinary causes of dispute and reach appropriate resolution fast.

The guide lines of conflicts dispute management programme indicating accountable point of dispute clearly identified and easily appeared. Also to minimize the cost of resolution and investigation and time consuming much considered. In order to point out effective conflicts management systems, we should consider. SPIDR describes in details characteristics and elements required to build most effect dispute management system;

The elements involved including leadership support from top managers, work flow overview to enable managers investigate the real cause of conflict, regular evaluation process that would service the final objective organization yield, training the employees to overcome and handle topics systematically and formerly prepared answers, central coordination and reviewing results tools, effective communication channels & adequate or incentives for early resolutions.

The main characters of conflict management system; promote option to identify and preventing conflicts during working hours through highly effective channel of negotiations. Training the employees to accept differences and solve the conflicts in early stage as possible. Exaggerate multiple access points throughout the organization or enterprise to overview all workers movements and behaviours. Empower the workers to hold the hand of solutions in front of work conflicts to minimize the effect of ordering reflexes.

My advice to managers, avoid power mechanism to solve the work problems because this will result more negatives just keep it simple and try always to know the cause not only dealing with the behaviours neglecting the reasons. Nobody wants to be part of problem but on the other hand; it is not acceptable to many feel vulnerable in working place. Employees are the biggest asset in the organization they can make a lot whether with positive or also negative so, try to keep your asset safe. Full healthJ