PubMed Health⌕ Search

Biomedical subjects

Rebeca Terraza Núñez

Publications and source records attributed to Rebeca Terraza Núñez.

3 recordsLinked to original sources

[Improving our mobility in Europe: The EHTAN Project].

To promote the mobility of nursing professionals among the countries members of the European Union may be an efficient measure to alleviate the shortage of nurses. An important limitation for this mobility consists in the lack of knowledge about the different cultures and with regards to the competencies, formation and nursing practices which exist in these distinct countries. At the present time, there is no method or instrument available which permits a comparison. The EHTAN, the European Healthcare Teaching and Accreditation Network, project proposes a methodology to evaluate and self-evaluate competencies by means of a tool, a competency matrix, developed for this purpose. In this article, the authors introduce the work carried out during the first phases of this project.

Career Mobility↗

[Coordination among healthcare levels: systematization of tools and measures].

Improving healthcare coordination is a priority in many healthcare systems, particularly in chronic health problems in which a number of professionals and services intervene. There is an abundance of coordination strategies and mechanisms that should be systematized so that they can be used in the most appropriate context. The present article aims to analyse healthcare coordination and its instruments using the organisational theory. Coordination mechanisms can be classified according to two basic processes used to coordinate activities: programming and feedback. The optimal combination of mechanisms will depend on three factors: the degree to which healthcare activities are differentiated, the volume and type of interdependencies, and the level of uncertainty. Historically, healthcare services have based coordination on skills standardization and, most recently, on processes standardization, through clinical guidelines, maps, and plans. Their utilisation is unsatisfactory in chronic diseases involving intervention by several professionals with reciprocal interdependencies, variability in patients' response to medical interventions, and a large volume of information to be processed. In this case, mechanisms based on feedback, such as working groups, linking professionals and vertical information systems, are more effective. To date, evaluation of healthcare coordination has not been conducted systematically, using structure, process and results indicators. The different strategies and instruments have been applied mainly to long-term care and mental health and one of the challenges to healthcare coordination is to extend and evaluate their use throughout the healthcare continuum.

Delivery of Health Care↗

[Integrated health care organizations: guideline for analysis].

There has been a tendency recently to abandon competition and to introduce policies that promote collaboration between health providers as a means of improving the efficiency of the system and the continuity of care. A number of countries, most notably the United States, have experienced the integration of health care providers to cover the continuum of care of a defined population. Catalonia has witnessed the steady emergence of increasing numbers of integrated health organisations (IHO) but, unlike the United States, studies on health providers' integration are scarce. As part of a research project currently underway, a guide was developed to study Catalan IHOs, based on a classical literature review and the development of a theoretical framework. The guide proposes analysing the IHO's performance in relation to their final objectives of improving the efficiency and continuity of health care by an analysis of the integration type (based on key characteristics); external elements (existence of other suppliers, type of services' payment mechanisms); and internal elements (model of government, organization and management) that influence integration. Evaluation of the IHO's performance focuses on global strategies and results on coordination of care and efficiency. Two types of coordination are evaluated: information coordination and coordination of care management. Evaluation of the efficiency of the IHO refers to technical and allocative efficiency. This guide may have to be modified for use in the Catalan context.

Continuity of Patient Care↗