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Archives for Complex systems

A central feature of any high performing healthcare system or organisation includes best practice in medicines use and management. As all aspects of healthcare are under varying degrees of financial stress these days, cost controls and appropriate use of medicines must support the highest standards of clinical practice and safe patient care. Medicines optimisation is one strategy as the use of medicines influences the quality of healthcare across the whole patient treatment pathway. Failure to optimise the use of medicines across this pathway may arise from: misuse of medicines (failure to prescribe when appropriate, prescribing when not appropriate, prescribing the wrong medicine, failure to reconcile medicines use across clinical hand-offs; “clinical inertia” and failure to manage patients to goal (e.g. management of diabetes, and hypertension post aMI) [O’Connor PJ, SperlHillen JM, Johnson PE, Rush WA, Blitz WAR, Clinical inertia and outpatient medical errors, in Henriksen K, Battles JB, Marks ES et al, editors, Advances in Patient Safety: From Research to Implementation Vol 2: Concepts and Methodology), Agency for Healthcare Research and Quality, 2005]; failure to use or follow best-practice and rational prescribing guidance; lack of synchronisation between the use of medicines (demand) and procurement (supply), with an impact on inventory management and loss of cost control of the medicines budget. The essential challenge is ensuring that the healthcare system and its constituent parts are fit for purpose to address and avoid these failures or at least minimise their negative impact. Medicines costs are the fastest growing area of expenditure and comprise a major constituent of patient treatment and recovery. The cost of drug mortality was described in 1995 [Johnson JA, Bootman JL. Drug-related morbidity and mortality; a cost of illness model. Arch […]

Posted by Mike Tremblay

The King’s Fund, a UK health charity ran a scenario essay writing competition, and here is the link and of course congratulations to the winner: (winner, runner up and other scenarios, but not mine). My scenario builds on the notion of service unbundling and draws on strong and weak signals of changes likely to impact […]

Posted by Mike Tremblay

Ann Glover, as reported on Euractiv (here): But it appears she also found it difficult to disentangle the Commission’s evidence gathering processes from what she calls the “political imperative” that’s behind them. … To back its policy proposals, the Commission often outsources the evidence-gathering part of the job to external consulting firms, which provide ‘impact… » read more

Posted by EuroSante

The World Economic Forum meeting in Vienna this week will be grappling with the challenging problem of European innovation. The evidence is suggesting that rather than leading the world, Europe is worryingly backsliding. Worse, of course, is the public rhetoric is not backed up by actual real-world action by governments, who persist in the old… » read more

Posted by EuroSante