Health Care Reforms at NSW
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This document discusses the health care reforms at NSW and the approach taken by Cleveland Clinic. It covers topics such as restructuring health care delivery, measurement of patient outcomes, patient experience, health care rationalization, information technology, and medical education. The document also provides recommendations for specific initiatives and potential implementation barriers.
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Health care reforms at NSW
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Table of Contents
Introduction................................................................................................................................3
Cleveland Clinic’s approach......................................................................................................3
Restructuring health care delivery.........................................................................................4
Measurement..........................................................................................................................4
Wellness..................................................................................................................................5
Patient experience..................................................................................................................5
Health care rationalization....................................................................................................6
Information technology..........................................................................................................6
Medical education..................................................................................................................6
Recommendation of specific initiatives incorporated in the Cleveland Clinic’s approach.......6
Health care restructuring delivery..........................................................................................7
Patient experience outcomes..................................................................................................7
Reorganizing eHealth as a future avenue in health care.........................................................7
Potential implementation barriers and methods to address these barriers.................................8
Cost of new technology..........................................................................................................8
Health workforce challenges towards restructuring health care.............................................8
Patient experience outcomes..................................................................................................9
Conclusion..................................................................................................................................9
References................................................................................................................................10
2
Introduction................................................................................................................................3
Cleveland Clinic’s approach......................................................................................................3
Restructuring health care delivery.........................................................................................4
Measurement..........................................................................................................................4
Wellness..................................................................................................................................5
Patient experience..................................................................................................................5
Health care rationalization....................................................................................................6
Information technology..........................................................................................................6
Medical education..................................................................................................................6
Recommendation of specific initiatives incorporated in the Cleveland Clinic’s approach.......6
Health care restructuring delivery..........................................................................................7
Patient experience outcomes..................................................................................................7
Reorganizing eHealth as a future avenue in health care.........................................................7
Potential implementation barriers and methods to address these barriers.................................8
Cost of new technology..........................................................................................................8
Health workforce challenges towards restructuring health care.............................................8
Patient experience outcomes..................................................................................................9
Conclusion..................................................................................................................................9
References................................................................................................................................10
2
Introduction
Cleveland Clinic is a multi-specialty health care unit based in Cleveland Ohio with key
branding platform of patient care and innovation. The clinic treats patients across various
states and countries. The patient population at the clinic entail 72% representing 6.4 million
patients from northeast Ohio, 15% in Ohio, 13% from other different states and 0.2% from
the international domain. Based on data available as of 2015, the Cleveland health care
system has 43,000 employees who include 3,200 staff physician, 10,965 nurses and about
1,710 affiliated community-based physicians. The clinic further has other 10 community
hospitals, 18 family and ambulatory health centers and 59 primary care centers near
Cleveland (Porter & Teisberg, 2009).
The clinic has adapted a Patients First approach across the entire organization. Effective
restructuring aspects has been undertaken to modify health care delivery and expand its
network. Further, the clinic has been endeavoring patient reporting outcomes in all its
practices, all the institutes were reorganized based on diseases and organ systems. Care
pathways were developed with dedicated multidisciplinary teams to guide the process (Porter
& Teisberg, 2009).
Cleveland Clinic’s approach
Cleveland Clinic was established in 1921 by a team of distinguished physicians with the aim
of outstanding patient care through establishing cooperation, compassion, and innovation.
The vision of these aspects rose from shared experience in the treatment care arena. The
clinic expanded gradually with success in the arena of coronary heart management
specialization. There was a continued improvement and measured patient outcomes over the
period with a key focus on patient care outcomes. This was established through initiating
patient registry centers for monitoring patient states after offering care (Porter & Teisberg,
2009).
The facility initiated public reporting outcomes after federal government public declaration
on mortality data for cardiac-related surgeries. This forced the Clinic to form its measures
and national risks adjusted databases. This enabled the beneficial effects of comparative data
across the physician and how best to improve care for the patients.
3
Cleveland Clinic is a multi-specialty health care unit based in Cleveland Ohio with key
branding platform of patient care and innovation. The clinic treats patients across various
states and countries. The patient population at the clinic entail 72% representing 6.4 million
patients from northeast Ohio, 15% in Ohio, 13% from other different states and 0.2% from
the international domain. Based on data available as of 2015, the Cleveland health care
system has 43,000 employees who include 3,200 staff physician, 10,965 nurses and about
1,710 affiliated community-based physicians. The clinic further has other 10 community
hospitals, 18 family and ambulatory health centers and 59 primary care centers near
Cleveland (Porter & Teisberg, 2009).
The clinic has adapted a Patients First approach across the entire organization. Effective
restructuring aspects has been undertaken to modify health care delivery and expand its
network. Further, the clinic has been endeavoring patient reporting outcomes in all its
practices, all the institutes were reorganized based on diseases and organ systems. Care
pathways were developed with dedicated multidisciplinary teams to guide the process (Porter
& Teisberg, 2009).
Cleveland Clinic’s approach
Cleveland Clinic was established in 1921 by a team of distinguished physicians with the aim
of outstanding patient care through establishing cooperation, compassion, and innovation.
The vision of these aspects rose from shared experience in the treatment care arena. The
clinic expanded gradually with success in the arena of coronary heart management
specialization. There was a continued improvement and measured patient outcomes over the
period with a key focus on patient care outcomes. This was established through initiating
patient registry centers for monitoring patient states after offering care (Porter & Teisberg,
2009).
The facility initiated public reporting outcomes after federal government public declaration
on mortality data for cardiac-related surgeries. This forced the Clinic to form its measures
and national risks adjusted databases. This enabled the beneficial effects of comparative data
across the physician and how best to improve care for the patients.
3
Further, back ago, Cleveland clinic formed networks of care services offering various health
services due to the Clinton administration reforms agenda. The clinic formed a regional hub
center where they acquired other hospitals and increased the range of services it offered.
Further, on matters quality, Cleveland Clinic founded quality institute aimed at enhancing
care quality and assessing outcomes through information sharing to the patients and medical
practitioners. The clinic has further improved on information technology through the creation
of a unified electronic health system having a single database around patients (Porter &
Teisberg, 2009).
There have been numerous transformations and clinical approaches which the Cleveland
clinic has adopted such as restructuring care delivery, measurement of patient outcomes,
patient experience assessment, health care system rationalization, payments, information
technology, medical education, avenues for growth and international al expansion.
Restructuring health care delivery
The reorganizing health care delivery at the Cleveland clinic was its priority approach.
Recognition of patient’s first approach was an essential aspect for the entire organization.
Staffs were given tags labeled Patients First. The clinic was reorganized into
multidisciplinary units based on a patient organ system and diseases. The units were referred
to as institutes, this called for outpatient and inpatient services being grouped. A case
example of an institute developed was the Neuroscience institute which comprised of various
units such as the neurology, neurosurgery, and psychiatry. As time goes by various units were
reconstituted forming institutes. In addition to these, support institutes dealing with finance,
legal, human resources, and marketing were established. Further information technology
developed an information system to support the institute. Leadership teams at the institute
developed shared outcomes measures which allowed the teams to jointly account on and
identify skills which brought together various consultative services (Porter & Teisberg,
2009).
Thereafter office of the chief strategy was established aimed at improving outcomes, patient
experience, and care paths were initiated. This model established under this framework
entailed Cleveland Clinic Integrated Model, which served as a patient-centered model for
which entrenched valued based care. Clinic leaders were appointed and served to enable
patient movement towards care continuum (Porter & Teisberg, 2009).
4
services due to the Clinton administration reforms agenda. The clinic formed a regional hub
center where they acquired other hospitals and increased the range of services it offered.
Further, on matters quality, Cleveland Clinic founded quality institute aimed at enhancing
care quality and assessing outcomes through information sharing to the patients and medical
practitioners. The clinic has further improved on information technology through the creation
of a unified electronic health system having a single database around patients (Porter &
Teisberg, 2009).
There have been numerous transformations and clinical approaches which the Cleveland
clinic has adopted such as restructuring care delivery, measurement of patient outcomes,
patient experience assessment, health care system rationalization, payments, information
technology, medical education, avenues for growth and international al expansion.
Restructuring health care delivery
The reorganizing health care delivery at the Cleveland clinic was its priority approach.
Recognition of patient’s first approach was an essential aspect for the entire organization.
Staffs were given tags labeled Patients First. The clinic was reorganized into
multidisciplinary units based on a patient organ system and diseases. The units were referred
to as institutes, this called for outpatient and inpatient services being grouped. A case
example of an institute developed was the Neuroscience institute which comprised of various
units such as the neurology, neurosurgery, and psychiatry. As time goes by various units were
reconstituted forming institutes. In addition to these, support institutes dealing with finance,
legal, human resources, and marketing were established. Further information technology
developed an information system to support the institute. Leadership teams at the institute
developed shared outcomes measures which allowed the teams to jointly account on and
identify skills which brought together various consultative services (Porter & Teisberg,
2009).
Thereafter office of the chief strategy was established aimed at improving outcomes, patient
experience, and care paths were initiated. This model established under this framework
entailed Cleveland Clinic Integrated Model, which served as a patient-centered model for
which entrenched valued based care. Clinic leaders were appointed and served to enable
patient movement towards care continuum (Porter & Teisberg, 2009).
4
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Measurement
With the key message being Patients First, the demand for measurable assessment of quality
for improvement of overall structural aspects of process and outcomes were initiated. The
aspects measurement entailed upholding patient dignity, excellence in housekeeping affairs
and being concerned with patients emotional well being and experience of care. The
fundamental measure of patient outcomes was quality. Staffs are required to assess the health
outcomes and declare publicly their state. Every team was tasked with how to improve
patients’ health state.
The fundamental purpose of measuring outcomes entailed enabling an effective learning and
quality improvement care for the patients’ states. The key effect of driving measurement was
creating and enabling transparency. Every institute was tasked at assessing and defining
practices of their patients rather than focusing on procedures. Measurements assessment
extended to cots assessment of medical supplies. Critical steps were undertaken to assess
deficiencies and surplus occasioned in hospital supplies. Different cost approaches were
implemented due to this, a great improvement in money was saved from unnecessary medical
supplies purchases (Porter & Teisberg, 2009).
Wellness
Clinic approach shifted to wellness from its employees. Health promotion initiatives were
undertaken. Directives were implemented and policies formulated concerning staffing issues.
No new personnel with smoking habits were recruited into the facility. This approach led to
the majority of the employees undertaking health risks appraisal and programs which were
geared towards behavior change and weight reduction programs. This improved the overall
employee status through the reduction of healthcare-related costs. This was viewed as a way
of assessing the overall Clinic ability to manage future population and associated accountable
care contracts (Porter & Teisberg, 2009).
Patient experience
The clinic appointed a chief experience officer. The key rationale was that patients’
perceptions were affected largely by care experience. Focused shifted on patient post-care
services on how they could be served better. The clinic leaders were of the view of
establishing and instilling the culture of everyone being responsible for patient experience.
Surveys were undertaken which later used to address and seek solutions on how to improve
the engagement of employees towards improving patient experiences. Further, as part of the
5
With the key message being Patients First, the demand for measurable assessment of quality
for improvement of overall structural aspects of process and outcomes were initiated. The
aspects measurement entailed upholding patient dignity, excellence in housekeeping affairs
and being concerned with patients emotional well being and experience of care. The
fundamental measure of patient outcomes was quality. Staffs are required to assess the health
outcomes and declare publicly their state. Every team was tasked with how to improve
patients’ health state.
The fundamental purpose of measuring outcomes entailed enabling an effective learning and
quality improvement care for the patients’ states. The key effect of driving measurement was
creating and enabling transparency. Every institute was tasked at assessing and defining
practices of their patients rather than focusing on procedures. Measurements assessment
extended to cots assessment of medical supplies. Critical steps were undertaken to assess
deficiencies and surplus occasioned in hospital supplies. Different cost approaches were
implemented due to this, a great improvement in money was saved from unnecessary medical
supplies purchases (Porter & Teisberg, 2009).
Wellness
Clinic approach shifted to wellness from its employees. Health promotion initiatives were
undertaken. Directives were implemented and policies formulated concerning staffing issues.
No new personnel with smoking habits were recruited into the facility. This approach led to
the majority of the employees undertaking health risks appraisal and programs which were
geared towards behavior change and weight reduction programs. This improved the overall
employee status through the reduction of healthcare-related costs. This was viewed as a way
of assessing the overall Clinic ability to manage future population and associated accountable
care contracts (Porter & Teisberg, 2009).
Patient experience
The clinic appointed a chief experience officer. The key rationale was that patients’
perceptions were affected largely by care experience. Focused shifted on patient post-care
services on how they could be served better. The clinic leaders were of the view of
establishing and instilling the culture of everyone being responsible for patient experience.
Surveys were undertaken which later used to address and seek solutions on how to improve
the engagement of employees towards improving patient experiences. Further, as part of the
5
rationalization plan, all employees were given caregivers status. This led to the discussion
surrounding to mission, vision, values and patient experiences of the clinic. This led to
improved patient experience and patients complain declined significantly. Communication
workshops were further enhanced to improve physical, patients and caregivers relationships
(Porter & Teisberg, 2009).
Health care rationalization
The ultimate goal of the health care system rationalization entailed defining Cleveland clinic
as one. Various units were streamlined to become one entity. This saw the concentration of
community facilities being merged with outpatient services and urgent care. Psychiatry
services were merged into one community hospital and rehabilitation. Further trauma centers
were reduced drastically. The overall Cleveland clinic was rationalized and reduced in size.
With time, efforts were undertaken to coordinate care across the different locations. The goal
was aimed at having multi-sectoral teams use various available resources to deliver the right
care at the right place for the patients at the right time using the right costing application. The
network was integrated into having one system with medical records, common outcomes,
reporting and unison medical staff planning and purchases (Porter & Teisberg, 2009).
Information technology
Adoption of integrated information technology was crucial for the Clinic. There was a unified
database management system for the hospital for accessing medical records system. This was
enhanced by the usage of a single common data warehouse system which was organized
longitudinally on the patient. There was a transformation of the health information system.
Patient records were available electronically. Instant access to information based on lab
computers and medical reports were able to be accessed. Various packages were introduced
which enhanced the process of information sharing and payment access and ease
communication process for the medical teams in reviewing patient status (Porter & Teisberg,
2009).
Medical education
The Cleveland Clinic had a long history of entrenching medical education programs and
training avenues for medical practitioners. The program initiated training students in clinical
care and research. The clinic also partners with other organizations in improving community-
based care and reduced the shortage of primary care physicians (Porter & Teisberg, 2009).
6
surrounding to mission, vision, values and patient experiences of the clinic. This led to
improved patient experience and patients complain declined significantly. Communication
workshops were further enhanced to improve physical, patients and caregivers relationships
(Porter & Teisberg, 2009).
Health care rationalization
The ultimate goal of the health care system rationalization entailed defining Cleveland clinic
as one. Various units were streamlined to become one entity. This saw the concentration of
community facilities being merged with outpatient services and urgent care. Psychiatry
services were merged into one community hospital and rehabilitation. Further trauma centers
were reduced drastically. The overall Cleveland clinic was rationalized and reduced in size.
With time, efforts were undertaken to coordinate care across the different locations. The goal
was aimed at having multi-sectoral teams use various available resources to deliver the right
care at the right place for the patients at the right time using the right costing application. The
network was integrated into having one system with medical records, common outcomes,
reporting and unison medical staff planning and purchases (Porter & Teisberg, 2009).
Information technology
Adoption of integrated information technology was crucial for the Clinic. There was a unified
database management system for the hospital for accessing medical records system. This was
enhanced by the usage of a single common data warehouse system which was organized
longitudinally on the patient. There was a transformation of the health information system.
Patient records were available electronically. Instant access to information based on lab
computers and medical reports were able to be accessed. Various packages were introduced
which enhanced the process of information sharing and payment access and ease
communication process for the medical teams in reviewing patient status (Porter & Teisberg,
2009).
Medical education
The Cleveland Clinic had a long history of entrenching medical education programs and
training avenues for medical practitioners. The program initiated training students in clinical
care and research. The clinic also partners with other organizations in improving community-
based care and reduced the shortage of primary care physicians (Porter & Teisberg, 2009).
6
Recommendation of specific initiatives incorporated in the Cleveland Clinic’s approach
The three fundamental approaches which could be in cooperated into NSW creating high
values care program entails;
Health care restructuring delivery
There is a need for greater authority at the local health districts and to have clinician-led pillar
agencies. There is a need for change in the health department since it plays an important role
in the day to day operations. Fundamental reorganization entails future planning in terms of
increasing the capacity of the hospitals, increasing and advance technology and enhancing
workforce competence concerning the state and national health priorities. Further, there is a
need for stimulating and initiating system-wide initiatives which aim at improving the quality
and efficiency for the critical mass of economies of scale and usage of shared electronic
medical records access. Further creation of front line services among clinical leaders across
NSW, with a commitment to their time and expertise through clinical excellence
reorganization. This calls for the department of health to adopt various relationship based on
a clear performance specification with planning frameworks which supports the delivery of
safe and effective clinical services (Dwyer& Duckett, 2016).
Patient experience outcomes
There is a need for recognizing the need for both staffs, clinical and nonclinical staff as
fundamental access points for the delivery of patient-centered care process. The working
framework is complex but requires an emphatic and skillful leadership. Empowering the staff
through appropriate skills is fundamental ain improving patient outcomes (Hennessey & Fry,
2016).
There is a need to establish health education and training institute which will entrench
undergraduate clinical placements, vocational education training, management, leadership
opportunities and clinical education programs. The institute will foster continuous medical
education and medical training. The approach to be used in this should be innovative and
provide high-quality training which is cost-effective, accessible and be able to meet both
individual local health district needs (NSW, 2008).
Reorganizing eHealth as a future avenue in health care
The current ICT at the NSW is halfway with various functions and staff being spread
between various departments and have its bases at cluster levels. This ICT framework was
rolled out across the nation which calls for support through pervasive clinical framework at
7
The three fundamental approaches which could be in cooperated into NSW creating high
values care program entails;
Health care restructuring delivery
There is a need for greater authority at the local health districts and to have clinician-led pillar
agencies. There is a need for change in the health department since it plays an important role
in the day to day operations. Fundamental reorganization entails future planning in terms of
increasing the capacity of the hospitals, increasing and advance technology and enhancing
workforce competence concerning the state and national health priorities. Further, there is a
need for stimulating and initiating system-wide initiatives which aim at improving the quality
and efficiency for the critical mass of economies of scale and usage of shared electronic
medical records access. Further creation of front line services among clinical leaders across
NSW, with a commitment to their time and expertise through clinical excellence
reorganization. This calls for the department of health to adopt various relationship based on
a clear performance specification with planning frameworks which supports the delivery of
safe and effective clinical services (Dwyer& Duckett, 2016).
Patient experience outcomes
There is a need for recognizing the need for both staffs, clinical and nonclinical staff as
fundamental access points for the delivery of patient-centered care process. The working
framework is complex but requires an emphatic and skillful leadership. Empowering the staff
through appropriate skills is fundamental ain improving patient outcomes (Hennessey & Fry,
2016).
There is a need to establish health education and training institute which will entrench
undergraduate clinical placements, vocational education training, management, leadership
opportunities and clinical education programs. The institute will foster continuous medical
education and medical training. The approach to be used in this should be innovative and
provide high-quality training which is cost-effective, accessible and be able to meet both
individual local health district needs (NSW, 2008).
Reorganizing eHealth as a future avenue in health care
The current ICT at the NSW is halfway with various functions and staff being spread
between various departments and have its bases at cluster levels. This ICT framework was
rolled out across the nation which calls for support through pervasive clinical framework at
7
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the local level having various testing of systems before implementation. eHealth has the
potential of transforming the delivery of care through efficiency improvements, reduction of
medical errors, increased empowerment and convenience (Saunders & Crater, 2017).
Establishment of ICT and transferring to NSW is essential in transforming the services of
care. The adoption of eHealth will be essential system for NSW health information systems
planning and delivery. Development of an integrated information systems strategic plan is
essential for care deliverable so roles and achieving realistic timelines proper clinical
engagement. The overall outlay of the system is to focus on patient outcomes, offering
support to clinical intelligence and supporting overall health infrastructure (Gauld, 2016).
Potential implementation barriers and methods to address these barriers
Cost of new technology
A higher burden of rising health care costs related to advance technology platforms.
Application of improved technology and information system calls for appropriate adoption of
devices such as biological therapeutics, prostheses, and minimally invasive procedures which
come at a considerable cost. These systems need full integration into the health care system.
An avenue of managing this challenge entails listing for subsidy program under the Medicare
benefits scheme. This a single most measure which ensures that there is improved access to
health care across the health care system, at NSW (Tejativaddhana, Briggs & Tonglor, 2016).
Health workforce challenges towards restructuring health care
The need for streamlining health care workforce needs to take into considerate perspective
for health force for the medical staff available. The challenges often arise with the
willingness for medical staff to work extended work hours. The work, educational and social
aspirations for health care professional is hampering the overall delivery of health care. These
combined lead to problems in the supply and distribution of the medical workforce which
affect the overall restructuring (Briggs, 2017).
Thus as a way of mitigating these challenges, there is a need to enhance the professional
development of the staff and motivating them through professional setups in the restructuring
plan of health care. Meeting the concerns of the medical staff and merging with patient
outcomes is essential for the overall delivery of care (Figueroa, Harrison, Chauhan & Meyer,
2019).
8
potential of transforming the delivery of care through efficiency improvements, reduction of
medical errors, increased empowerment and convenience (Saunders & Crater, 2017).
Establishment of ICT and transferring to NSW is essential in transforming the services of
care. The adoption of eHealth will be essential system for NSW health information systems
planning and delivery. Development of an integrated information systems strategic plan is
essential for care deliverable so roles and achieving realistic timelines proper clinical
engagement. The overall outlay of the system is to focus on patient outcomes, offering
support to clinical intelligence and supporting overall health infrastructure (Gauld, 2016).
Potential implementation barriers and methods to address these barriers
Cost of new technology
A higher burden of rising health care costs related to advance technology platforms.
Application of improved technology and information system calls for appropriate adoption of
devices such as biological therapeutics, prostheses, and minimally invasive procedures which
come at a considerable cost. These systems need full integration into the health care system.
An avenue of managing this challenge entails listing for subsidy program under the Medicare
benefits scheme. This a single most measure which ensures that there is improved access to
health care across the health care system, at NSW (Tejativaddhana, Briggs & Tonglor, 2016).
Health workforce challenges towards restructuring health care
The need for streamlining health care workforce needs to take into considerate perspective
for health force for the medical staff available. The challenges often arise with the
willingness for medical staff to work extended work hours. The work, educational and social
aspirations for health care professional is hampering the overall delivery of health care. These
combined lead to problems in the supply and distribution of the medical workforce which
affect the overall restructuring (Briggs, 2017).
Thus as a way of mitigating these challenges, there is a need to enhance the professional
development of the staff and motivating them through professional setups in the restructuring
plan of health care. Meeting the concerns of the medical staff and merging with patient
outcomes is essential for the overall delivery of care (Figueroa, Harrison, Chauhan & Meyer,
2019).
8
Patient experience outcomes
There is a growing changing pattern on the demographic and disease patterns of population in
NSW. The aging population continues to have challenges in health services and maintenance
do health and well being in NSW. There is a need for improvement of the wellbeing of the
population at large. This affects the experience of patient outcomes at large for the general
population. There is a need for adoption of health prevention awareness beginning with the
staff transforming to the general population and patient at large. Enabling staff to be of good
health status allows the patients to experience improved health outcomes as they act as an
enabler towards good health status (AIHW, 2014).
Conclusion
In conclusion, there is a need for restructuring health care services at NSW, the key
fundamental approaches for this to be effective is the establishment of appropriate aspects
with regards to health restructuring, focusing on patient outcome and enhancing information
technology system which offers effective avenues for care delivery for patients. Adopting
these approaches is essential towards realizing and transforming the health sector at NSW.
9
There is a growing changing pattern on the demographic and disease patterns of population in
NSW. The aging population continues to have challenges in health services and maintenance
do health and well being in NSW. There is a need for improvement of the wellbeing of the
population at large. This affects the experience of patient outcomes at large for the general
population. There is a need for adoption of health prevention awareness beginning with the
staff transforming to the general population and patient at large. Enabling staff to be of good
health status allows the patients to experience improved health outcomes as they act as an
enabler towards good health status (AIHW, 2014).
Conclusion
In conclusion, there is a need for restructuring health care services at NSW, the key
fundamental approaches for this to be effective is the establishment of appropriate aspects
with regards to health restructuring, focusing on patient outcome and enhancing information
technology system which offers effective avenues for care delivery for patients. Adopting
these approaches is essential towards realizing and transforming the health sector at NSW.
9
References
AIHW, Australia's Health 2014. The 14th biennial health report of the Australian Institute of
Health and Welfare no. 14. Cat. AUS 178. Canberra. A vailable from
http://www.aihw .gov.au/publicationdetail/?id=60129547205
Briggs, D., Cruickshank, M. and Paliadelis, P., 2012. Health managers and health reform.
Journal of Management & Organization, 18(5), pp.641-658.
Dwyer, J.M. and Duckett, S.J., 2016. Restructuring primary health care in Australia. The
Medical Journal of Australia, 205(10), pp.435-436.
Figueroa, C.A., Harrison, R., Chauhan, A. and Meyer, L., 2019. Priorities and challenges for
health leadership and workforce management globally: a rapid review. BMC health services
research, 19(1), p.239.
Gauld, R., 2016. Healthcare System Restructuring in New Zealand: problems and proposed
solutions. Asia-Pacific Journal of Health Management, 11(3), pp.75-80.
Hennessey, C.E. and Fry, M., 2016. Improving patient and staff outcomes using practice
development. International journal of health care quality assurance, 29(8), pp.853-863.
NSW Health 2008. Special Commission of Inquiry into Acute Care Services in New South W
ales Hospitals: Sydney; NSW Health
Porter, M.E. and Teisberg, E.O., 2009. Cleveland Clinic: Transformation and Growth 2015.
Saunders, C. and Carter, D.J., 2017. Is health systems integration being advanced through
Local Health District planning?. Australian Health Review, 41(2), pp.154-161.
Tejativaddhana, P., Briggs, D. and Tonglor, R., 2016. From global to local: strengthening
district health systems management as entry point to achieve health-related sustainable
development goals. Asia-Pacific Journal of Health Management, 11(3), pp.81-86.
10
AIHW, Australia's Health 2014. The 14th biennial health report of the Australian Institute of
Health and Welfare no. 14. Cat. AUS 178. Canberra. A vailable from
http://www.aihw .gov.au/publicationdetail/?id=60129547205
Briggs, D., Cruickshank, M. and Paliadelis, P., 2012. Health managers and health reform.
Journal of Management & Organization, 18(5), pp.641-658.
Dwyer, J.M. and Duckett, S.J., 2016. Restructuring primary health care in Australia. The
Medical Journal of Australia, 205(10), pp.435-436.
Figueroa, C.A., Harrison, R., Chauhan, A. and Meyer, L., 2019. Priorities and challenges for
health leadership and workforce management globally: a rapid review. BMC health services
research, 19(1), p.239.
Gauld, R., 2016. Healthcare System Restructuring in New Zealand: problems and proposed
solutions. Asia-Pacific Journal of Health Management, 11(3), pp.75-80.
Hennessey, C.E. and Fry, M., 2016. Improving patient and staff outcomes using practice
development. International journal of health care quality assurance, 29(8), pp.853-863.
NSW Health 2008. Special Commission of Inquiry into Acute Care Services in New South W
ales Hospitals: Sydney; NSW Health
Porter, M.E. and Teisberg, E.O., 2009. Cleveland Clinic: Transformation and Growth 2015.
Saunders, C. and Carter, D.J., 2017. Is health systems integration being advanced through
Local Health District planning?. Australian Health Review, 41(2), pp.154-161.
Tejativaddhana, P., Briggs, D. and Tonglor, R., 2016. From global to local: strengthening
district health systems management as entry point to achieve health-related sustainable
development goals. Asia-Pacific Journal of Health Management, 11(3), pp.81-86.
10
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