Browsing by Subject "Capacity Building"
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Item Open Access Building Capacity to Care for Refugees.(Family practice management, 2017-07) Walden, Jeffrey; Valdman, Olga; Mishori, Ranit; Carlough, MarthaItem Open Access Implications of long-term care capacity response policies for an aging population: a simulation analysis.(Health policy (Amsterdam, Netherlands), 2014-05) Ansah, John P; Eberlein, Robert L; Love, Sean R; Bautista, Mary Ann; Thompson, James P; Malhotra, Rahul; Matchar, David BIntroduction
The demand for long-term care (LTC) services is likely to increase as a population ages. Keeping pace with rising demand for LTC poses a key challenge for health systems and policymakers, who may be slow to scale up capacity. Given that Singapore is likely to face increasing demand for both acute and LTC services, this paper examines the dynamic impact of different LTC capacity response policies, which differ in the amount of time over which LTC capacity is increased, on acute care utilization and the demand for LTC and acute care professionals.Methods
The modeling methodology of System Dynamics (SD) was applied to create a simplified, aggregate, computer simulation model for policy exploration. This model stimulates the interaction between persons with LTC needs (i.e., elderly individuals aged 65 years and older who have functional limitations that require human assistance) and the capacity of the healthcare system (i.e., acute and LTC services, including community-based and institutional care) to provide care. Because the model is intended for policy exploration, stylized numbers were used as model inputs. To discern policy effects, the model was initialized in a steady state. The steady state was disturbed by doubling the number of people needing LTC over the 30-year simulation time. Under this demand change scenario, the effects of various LTC capacity response policies were studied and sensitivity analyses were performed.Results
Compared to proactive and quick adjustment LTC capacity response policies, slower adjustment LTC capacity response policies (i.e., those for which the time to change LTC capacity is longer) tend to shift care demands to the acute care sector and increase total care needs.Conclusions
Greater attention to demand in the acute care sector relative to demand for LTC may result in over-building acute care facilities and filling them with individuals whose needs are better suited for LTC. Policymakers must be equally proactive in expanding LTC capacity, lest unsustainable acute care utilization and significant deficits in the number of healthcare professionals arise. Delaying LTC expansion could, for example, lead to increased healthcare expenditure and longer wait lists for LTC and acute care patients.Item Open Access Partnership Conference(Annals of Global Health, 2017-10-27) Bartlett, JA; Cao, S; Mmbaga, B; Qian, X; Merson, M; Kramer, R© 2017 Icahn School of Medicine at Mount Sinai. Background: The Duke Global Health Institute (DGHI) was founded in 2006 with a goal to foster interdisciplinary global health education and research across Duke University and Duke Medical Center. Critical to achieving this goal is the need to develop and sustain strong international partnerships. Objective: To host a conference with multiple international partners and strengthen existing relationships. Methods: After a deliberate year-long planning process, DGHI convened a Partnership Conference with its international partners on the Duke University campus in conjunction with its 10th Anniversary Celebration. The Partnership Conference sought to promote an exchange of novel ideas in support of global health education and research, explore new collaborations in South-South relationships, and identify and facilitate pursuit of new educational and research opportunities. Findings: A total of 25 partners from 10 countries and 46 DGHI faculty members participated in the 3-day event in October 2016. Activities included workshops on preselected research topics, educational symposia on novel teaching methods and harnessing technological advances, introduction of the Health Humanities Laboratory to prepare students and trainees for fieldwork, and discussions of research infrastructure and training needs. Surveys from visiting partners revealed a high degree of satisfaction. Proposed action items include methods to realize improved communications, enhancement of mutual education opportunities, support and mentoring to build local research capacity, and more exchange of faculty and students between partnering institutions. Conclusions: With careful planning from all parties, a multilateral partnership conference including both university and medical center faculty can be a productive forum for exchange on global health education and research. Sustaining such partnerships is vital to the success of global health scholarship.Item Open Access Proposed Method to Evaluate the Impact on Health Outcomes of Capacity Building for Maintenance and Repair of Medical Equipment in Rwanda(2012) Penumetcha, Neeraja RajuIt has been shown that training biomedical equipment technicians (BMETs) improves healthcare, but it is unclear if capacity building for repair and maintenance of medical equipment leads to improved patient health outcomes, and whether that relationship between equipment service and health can be measured.
Health indicators are identified that may be used to measure an impact on patient health outcomes of Engineering World Health's biomedical equipment repair and maintenance training program in Rwanda.
Fieldwork was conducted for 9 weeks in country to identify these indicators. Providers and administrators in twelve hospitals in Rwanda were interviewed about patient health outcomes, equipment use, and procedure preference based on equipment availability for selected clinical focus areas. Equipment availability and status were also surveyed. From the existing literature, expected health outcomes were compared between procedure preferences to estimate how patients would be affected by the availability of functional medical equipment.
Neonatal jaundice treatment with phototherapy lamps, neonatal thermoregulation with incubators, and oxygen provision for acute respiratory management were identified as areas where the relationship between equipment service training and health could be measured. It is recommended that some of these areas be studied in the field to confirm and quantify the connection.
Item Open Access The Support for People Community Programs Evaluation Project(2014-04-25) Childers, DarrylPOLICY QUESTION How should Triangle Community Foundation (TCF) evaluate effectiveness of the strategy implemented through the Support for People portion of its discretionary grantmaking, and how should that evaluation be implemented? EXECUTIVE SUMMARY The Triangle Community Foundation (TCF) is located in Durham, NC and serves a four county area. TCF assets of more than $175 million are spread among over 750 funds. The Foundation awards grants to nonprofit organizations that total about $14 million a year. The amount that is available for the Foundation’s discretionary grantmaking, however, is less than $1 million a year. TCF has created a Fund for the Triangle, meant to attract donors to give more to the Foundation’s discretionary grantmaking efforts, with the rationale that these dollars will be used in a more strategic way. In order to support the claim of the discretionary grantmaking being a way to have a more strategic impact on the community, the Foundation needs a way to evaluate and continually improve the effectiveness of this new approach. Additionally, given that discretionary grantmaking still has a limited pool of resources to draw from, it is even more important that TCF’s staff is able to maximize the impact of their grants. Based on interviews with experts in the field and TCF stakeholders, including Foundation staff, board members, and grantees, the researcher was able to identify an evaluation framework [pgs. 19] that will support the Foundation’s strategic plan. These interviews also provided insight into the challenges and benefits of evaluation that the researcher should consider in designing the framework [pg. 11]. These efforts resulted in an evaluation vision and framework for the Foundation’s discretionary grantmaking activities. This vision [pg.18] and framework are aligned with the values of the TCF strategic plan, and encourage positive funder-grantee relationships, and continuous learning on the part of all stakeholders. The framework begins with the recommendation that TCF staff create a theory of change for the discretionary grantmaking, and present that theory of change to grantees in one-on-one meetings or to the entire cohort in a group presentation. If the Foundation chooses to present the theory of change in one-on-one meetings, TCF staff could use the opportunity to complete the next step in the framework, getting feedback from current grantees individually. The framework continues by following the timeline of the current grant cycle, providing the vital information (the evaluation question, data collection method, main activities, person(s) responsible, date to be completed, and frequency) needed to complete each step. Each step of the framework is described in more detail in the pages that follow the framework tables [pgs. 21]. This vision and framework represent a first step of evaluation planning for the new grantmaking approach. The dates in the timeline, for example, will need to be adjusted as more information is available. Other parts of the vision and framework will also need to be adjusted and improved upon as the Foundation moves forward and learns from its grantmaking activities.