Call for Collaboration: The Role of Accreditation in the Transformation, Accountability, and Sustainability of Education in Social Determinants of Health.
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ABSTRACT:
SUBMITTER: Lee I
PROVIDER: S-EPMC8054596 | biostudies-literature | 2021 Apr
REPOSITORIES: biostudies-literature
Publications
Call for Collaboration: The Role of Accreditation in the Transformation, Accountability, and Sustainability of Education in Social Determinants of Health.
Lee Incho I Best Jennifer A JA
Journal of graduate medical education 20210416 2
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Project description:This study examined the accessibility, affordability, accountability, sustainability, and social justice of early childhood education (ECE) services in Shenzhen, China, using Li et al.'s (2017) '3A2S' framework. Government documents and secondary data during the past decade were collected and evaluated. The results indicated that: (1) the ECE services have improved in the dimensions of accessibility, affordability, accountability, sustainability, and social justice; (2) more efforts should be made in increasing fiscal budget into ECE services and ensuring the quality of the ECE services; and (3) the government needs to take up more responsibilities to strike a balance between market force and governmental regulation. Implications and suggestions are also included.
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Project description:BACKGROUND: Since 1965, Medicare has publically financed graduate medical education (GME) in the United States. Given public financing, various advisory groups have argued that GME should be more socially accountable. Several efforts are underway to develop accountability measures for GME that could be tied to Medicare payments, but it is not clear how to measure or even define social accountability. OBJECTIVE: We explored how GME stakeholders perceive, define, and measure social accountability. METHODS: Through purposive and snowball sampling, we completed semistructured interviews with 18 GME stakeholders from GME training sites, government agencies, and health care organizations. We analyzed interview field notes and audiorecordings using a flexible, iterative, qualitative group process to identify themes. RESULTS: THREE THEMES EMERGED IN REGARDS TO DEFINING SOCIAL ACCOUNTABILITY: (1) creating a diverse physician workforce to address regional needs and primary care and specialty shortages; (2) ensuring quality in training and care to best serve patients; and (3) providing service to surrounding communities and the general public. All but 1 stakeholder believed GME institutions have a responsibility to be socially accountable. Reported barriers to achieving social accountability included training time constraints, financial limitations, and institutional resistance. Suggestions for measuring social accountability included reviewing graduates' specialties and practice locations, evaluating curricular content, and reviewing program services to surrounding communities. CONCLUSIONS: Most stakeholders endorsed the concept of social accountability in GME, suggesting definitions and possible measures that could inform policy makers calls for increased accountability despite recognized barriers.
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Project description:Interprofessional education (IPE) is a prerequisite to building a collaborative practice environment and optimizing patient care. The purpose of this systematic review was to assess the impact of IPE on outcomes related to health-care pre-licensure learners and professionals, including: changes in attitudes/perceptions; acquisition of knowledge regarding other disciplines' roles and development of collaborative skills; and change in collaborative behavior. We searched PubMed, CINAHL, Embase, and ERIC for studies published from 2007 to 2017 in English; 19 studies were eligible. The Joanna Briggs Institute appraisal tool was used to assess the quality of the studies. Thirteen studies used a quasi-experimental design. The studies varied in terms of setting, teaching methods, assessment measures, and quality. Seventeen of the 19 studies (89%) that assessed change in attitudes toward other disciplines and value placed on a team-based approach for improving patient care, found statistically significant improvements. All seven of the studies that assessed change in collaborative behavior found statistically significant improvements. Among the 12 studies that assessed the development of collaborative skills, there were mixed results. Future directions include: conducting more studies among health-care professionals, assessing the long-term impact of IPE, objectively assessing change in collaborative behavior, and assessing the impact of IPE on patient-centered outcomes.
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Project description:BackgroundDespite the importance of hospital accreditation, its sustainability is jeopardized. This is due to the disparity between the rapid changes in the health sector and the accreditation standards that remain unchanged. This study aims to examine what improvements are important in enhancing the sustainability of the hospital accreditation model in Saudi Arabia.MethodsAll quality managers in accredited Saudi Arabian hospitals were invited to participate in a cross-sectional questionnaire-based study in July-August 2022. A structured questionnaire was developed, tested, piloted, and factorially validated using exploratory factor analysis. On a 5-point Likert scale, respondents were asked to rate the importance of recommended changes that are proposed to enhance the sustainability of accreditation policies, standards development, evaluation methods, and the evaluation team. The importance of the recommendations, according to the respondents, was described using the relative importance index, while multivariate linear regression was used to analyse the association with independent variables.ResultsA total of 158 valid questionnaires (64% response rate) were included in the analysis. On average, participants had 6.9 (SD 2.1) years of experience in quality management. The overall mean importance attached to improving standards development, accreditation policies, evaluation team, and evaluation methods were 3.55, 3.43, 3.41, and 3.21, on a 5-point scale, respectively. Shifting the focus of accreditation standards from structure and compliance to outcomes and improvement (mean importance = 4.47), updating standards periodically to reflect current best practices and research (mean importance = 4.41), and integrating consumer perspectives in all aspects of accreditation (mean importance = 4.37) were the most important perceived recommendations. Multivariate regression analysis yielded that managers with more years of experience had significantly higher mean scores on the importance of improving accreditation policies (β = 0.120, P = .037), standards development (β = 0.246, P < .001), evaluation methods (β = 0.268, P < .001), and the evaluation team (β = 0.369, P < .001).ConclusionsImproving accreditation policies, standards development, evaluation methods, and the evaluation team are important in enhancing the sustainability of hospital accreditation programmes. This study offers insights to assist policymakers and other stakeholders in redesigning traditional accreditation models to make them more sustainable and that can supplement other performance improvement tools in improving the quality of healthcare services.
| S-EPMC11908374 | biostudies-literature
Project description:BackgroundThe majority of empirical studies focus on a single Social Determinant of Health (SDH) when analysing health inequalities. We go beyond this by exploring how the combination of education (micro level) and household arrangements (mezzo level) is associated with self-perceived health.MethodsOur data source is the 2014 cross-sectional data from the European Survey of Living Conditions (EU-SILC). We calculate the predicted probabilities of poor self-perceived health for the middle-aged European population (30-59 years) as a function of the combination of the two SDHs. This is done separately for five European country groups (dual-earner; liberal; general family support; familistic; and post-socialist transition) and gender.ResultsWe observe a double health gradient in all the country groups: first, there is a common health gradient by education (the higher the education, the lower the probability of poor health); second, household arrangements define a health gradient within each educational level according to whether or not the individual lives with a partner (living with a partner is associated with a lower probability of poor health). We observe some specificity in this general pattern. Familistic and post-socialist transition countries display large differences in the predicted probabilities according to education and household arrangements when compared with the other three country groups. Familistic and post-socialist transition countries also show the largest gender differences.ConclusionsHealth differences in European populations seem to be defined, first, by education and, second, by living or not living with a partner. Additionally, different social contexts (gender inequalities, educational profile, etc.) in European countries change the influences on health of both the SDHs for both women and men.
| S-EPMC6555096 | biostudies-literature
Project description:Currently, accreditation in medical education is a priority for many countries worldwide. The World Federation for Medical Education’s (WFME) launch of its 1st trilogy of standards in 2003 was a seminal event promoting accreditation in basic medical education (BME) globally. In parallel, the WFME also actively spearheaded a project to recognize accrediting agencies within individual countries. The introduction of competency-based medical education (CBME), with the 2 key concepts of entrusted professional activity and milestones, has enabled researchers to identify the relationships between patient outcomes and medical education. The recent data-driven approach to CBME has been used for ongoing quality improvement of trainees and training programs. The accreditation goal has shifted from the single purpose of quality assurance to balancing quality assurance and quality improvement. Although there are many types of postgraduate medical education (PGME), it may be possible to accredit resident programs on a global scale by adopting the concept of CBME. It will also be possible to achieve accreditation alignment for BME and PGME, which center on competency. This approach may also make it possible to measure accreditation outcomes against patient outcomes. Therefore, evidence of the advantages of costly and labor-consuming accreditation processes will be available soon, and quality improvement will be the driving force of the accreditation process.
| S-EPMC7605903 | biostudies-literature
Project description:With cities sprawling and populations booming in developing regions, ensuring social sustainability in urban areas has become more urgent. This study investigates the challenges of implementing social sustainability initiatives for cities in developing countries, focusing on Dhaka as a representative city. A mixed-method approach involving structured questionnaire surveys and key informant interviews was used to collect quantitative and qualitative data. The study identified eighteen challenges to implementing social sustainability initiatives in Dhaka city, including a lack of poor urban governance, an inefficient city management system, a lack of political stability, a long delay in the planning approval process, etc. Additionally, experts identified additional challenges that require attention. The study offers empirical evidence to assist government officials, policymakers, and urban planners overcome these challenges and implement social sustainability effectively. To address the identified challenges, the study recommends revisiting the Structure Plan, Urban Area Plan, Detailed Area Plan, and Urban Sector Policy-2011. It highlights the crucial role of community social workers in mitigating specific issues in socially sustainable urban development. Eventually, the study will contribute to the implementation of SDG-11 in the 2030 Agenda for Sustainable Development by bridging the gap between urbanization and socially sustainable cities.
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Project description:A high burden of TB mortality persists despite the long-term availability of the bacillus Calmette-Guérin (BCG) vaccine, whose efficacy has been highly variable across populations. Innovative and alternative approaches to TB prevention are urgently needed while optimal biomedical tools continue to be developed. We call for new interdisciplinary collaborations to expand and integrate our understanding of how social determinants influence the biological processes that lead to TB disease, how this translates into differential BCG efficacy and, ultimately, how social protection interventions can play a role in reducing the global burden of TB. After providing an overview of the immune pathways important for the establishment of a response to the BCG vaccine, we outline how social determinants and psychosocial stressors can contribute to the observed variation in BCG efficacy above and beyond these biological factors. We conclude by proposing a new interdisciplinary research model based on the integration of social epidemiology theories with biomedical knowledge.
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Project description:Mental health is impacted by social, economic, and environmental factors, the Social Determinants of Health (SDH). Migrants experiencing precarious living and working conditions may be more at risk of poor mental health than the majority population.This paper aims to evaluate the relationship of educational attainment and other SDH with depressive symptoms among the resident population, including Italians and migrants.This study examined the respondents to the Italian "Progressi delle Aziende Sanitarie per la Salute in Italia" (PASSI) surveillance system, 2014-18. The sample of 144.055 respondents is composed of the resident working adults aged 25-69 with Italian citizenship (n = 136.514) and foreign citizenship (n = 7.491).Findings show that among Italians high level of education appears to be a protective factor for mental health, in accordance with the international evidence (adjPR: tertiary education 0,74 p-value = 0.000). However, among immigrants high level of education is associated with the presence of depressive symptoms (adjPR: tertiary education: 1.61 p-value = 0.006), particularly for men (adjPR: tertiary education: 2.40 p-value = 0.006). The longer the length of stay in Italy for immigrants the higher the risk of depressive symptoms: adjPR for 10+ years: 2.23 p-value = 0.005.The data show that high education could represent a risk factor for mental health of immigrants. Moreover, among migrants there are some significant mental health inequities between male and female related to the duration of stay in Italy, economic activity and educational level.Considering that health is related to the nature of society as well as to access to technical solutions, multicultural societies require culturally oriented interventions for tackling health inequities. This means developing evidence-based policies in order to tackle health inequalities in the population as a whole, including culturally oriented measures in the larger framework of developing diversity sensitive services.
| S-EPMC9400202 | biostudies-literature
Project description:BackgroundThe purpose of this study was to (1) explore evidence provided by Canadian health and social care (HASC) academic programs in meeting their profession-specific interprofessional education (IPE)-relevant accreditation standards; (2) share successes, exemplars, and challenges experienced by HASC academic programs in meeting their IPE-relevant accreditation standards; and (3) articulate the impacts of IPE-relevant accreditation standards on enabling interprofessional learning to the global HASC academic community.MethodsProfession-specific (bilingual, if requested) surveys were developed and emailed to the Deans/Academic Program Directors of eligible academic programs with a request to forward to the individual who oversees IPE accreditation. Responses were collated collectively and by profession. Open-ended responses associated with our first objective were deductively categorized to align with the five Accreditation of Interprofessional Health Education (AIPHE) standards domains. Responses to our additional questions associated with our second and third objectives were inductively categorized into themes.Results/discussionOf the 270 HASC academic programs surveyed, 30% (n = 24) partially or completely responded to our questions. Of the 106 IPE-relevant standards where evidence was provided, 62% (n = 66) focused on the Educational Program, 88% of which (n = 58) were either met or partially met, and 47% (n = 31) of which focused on practice-based IPE. Respondents cited various exemplars and challenges in meeting IPE-relevant standards.ConclusionsThe overall sentiment was that IPE accreditation was a significant driver of the IPE curriculum and its continuous improvement. The array of exemplars described in this paper may be of relevance in advancing IPE implementation and accreditation across Canada and perhaps, more importantly, in countries where these processes are yet emerging.
| S-EPMC9412779 | biostudies-literature