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Research project aims to identify, evaluate, and integrate new healthcare roles for improved patient outcomes and care integration. The study includes data collection, economic evaluation, and policy impact analysis.
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Project Aims • Identify the most important (numbers and contribution) of the new professional roles • Detail the nature, scope and contribution of these new professional roles • Evaluate their impact on clinical practice and outcomes and identify their scope to improve the integration of care • Conduct economic evaluation to identify the cost effectiveness of the new professional roles • Identify optimal models for delivery of health care • Explore consequences of these for management of human resources and workforce planning
Phase 1. Mapping Health System Integration, Skill Mix and Competencies WP 1 and WP 2 • Gather data for the countries of the EU, associate and applicant countries, to: • Detail the key features of the health delivery systems • Detail skill mix of health workforce in primary and secondary care sectors • Identify new professional roles: numbers, clinical areas of employment • Identify contribution of new professional roles to the delivery of health care • Identify and evaluate a framework for mapping the skills and competencies of the health workforce • Collect secondary data required for the economic evaluation in WP8
Phase 2. Methodology and Study Design WP 3 • Select two care pathways as the focus of subsequent research • Conduct case studies to inform construction of the questionnaires used in WP 5, 6, and 7. WP 4 • Develop the empirical framework: • Develop the questionnaires, accompanying documentation and sampling frames • Finalise the detailed study protocol: submitted to either national or local ethical committees (as appropriate) for approval.
Phase 3. Data Collection, Data Management and Analysis WP 5 • Conduct questionnaire survey of health care professionals and managers • Extract, process and analyse data generated and build databases • Produce report ‘The impact of the new professional roles on clinical practice and the organisation of care’. WP 6 • Conduct a questionnaire survey of patient’s to distinguish experience and satisfaction • Extract, process and analyse data generated and build databases • Produce report 'The impact of the new professional roles on patient experience and satisfaction'.
Phase 3. Data Collection, Data Management and Analysis WP 7 • Collect and analyse new data on hospital processes, productivity and health outcomes which can be used to assess the impact of the new professional roles • Construct a detailed study protocol which will be submitted to either national or local ethical committees (as appropriate) for approval. • Produce report Hospital processes, productivity and health outcomes WP 8 • Economic evaluation to model the costs and effects associated with the new professional roles. • Investigate balance of cost and benefits and to identify incentives for an increased role for the new professional roles.
Phase 4. Translation into Policy: Delivering Impact WP 9 • Synthesise the results of the previous analysis • Detail how the new professional roles might be employed to improve the integration of care within care pathways. • Describe new optimal models of care for the selected care pathways • Identify solutions to barriers identified at organisational and team level informed by examples of good practice • Produce examples of care integration and of the costs associated with financing these pathways
Phase 4. Translation into Policy: Delivering Impact WP 10 • Build workforce planning model for each care pathway • Construct a skill mix benchmark for optimal models of care to enable service providers to evaluate efficiency of existing skill mix • Detail improvements in data on skill mix and methods required for improved workforce planning
Partners Germany, TechnischeUniversitat Berlin Prof. Reinhard Busse, Reinhard is Head of the Department of Health Care Management at the Berlin University of Technology, Germany. The Netherlands, Erasmus University Rotterdam Antoinette de Bont, Antoinette is associate professor of Health Governance. She has more than 10 years experience of evaluation studies of care innovation and published many scientific publication about the new roles of professions in health care organizations. She has coordinated many interdisciplinary research projects. Last year, she worked as a Harkness Fellow at Kaiser Permanente where she studied integrated ambulatory care.
Partners Italy, Universita Cattolica Del Sacro Cuore Prof Matteo Ruggeri, Matteo Ruggeri is a Health Economist at the UniversitàCattolica del SacroCuore. He gained a PhD in Health Economics and Management at the UniversitàCattolica del SacroCuore and a MSc in Economics, a MA in Business Engineering and a Laurea (BA) in Economics at the Universitàdi Roma “Tor Vergata”. His main research interest focuses on economic evaluation and experimental economics. Poland, Uniwersytet Warszawski Michal Mijal, Assistant Professor, specialises in social aspects of management and determinants of Organisational activities. Author of many articles on labour migration, proprietary issues, corporate social responsibility and games and simulations in management, co-author of book on bibliometry, projectmanager of an EU-funded research project (Human Capital Operational Program).
Partners Czech Republic, Univerzita Karlova V Praze Hana Svobodová, Hana Svobodová is a graduate of the School of Philosophy, Charles University Prague (teaching – care of patients, Mgr.), and PhD student in the Medical School, Charles University Prague (medical ethics). She has long practice as a coronary unit nurse in Vinohrady University Hospital and as a teacher of nursing clinical practice at Nursing School Ruská, Prague Economic Policy Research Foundation of Turkey Dr ÜmitÖzlale, ÜmitÖzlale (Project Leader) is an Economist. He earned his PhD degree in Economics in Boston College in 2001 and joined Bilkent University, Department of Economics. He received his associate professor degree from The Council of Higher Education in 2006. In addition to his academic studies, he worked as a consultant in the Central Bank of Republic of Turkey and did several projects with Ministry of Finance and the World Bank
Partners Norway, Uni Research Norway Jan Erik Askildsen, Jan Erik Askildsen is Director of the Stein Rokkan Centre for Social Studies, Uni Research, (UniRokkan Centre) and Professor of Economics at the Department of Economics, University of Bergen. He has been the research manager of HEB from its start until 2007, when he became the director of UniRokkan Centre. England, University of Manchester Prof Matt Sutton, Matt Sutton is Professor of Health Economics and current leader of the “Health Sciences Research Group” on which the new Institute of Population Health will be founded in September 2012. He is associate editor of Health Economics and a member of the Medical Research Council College of Experts.
Progress to Date: Seven months in.. • Expert Advisory Board, Project Management Team, Project Coordinating Centre established • Country Expert Advisory Groups established • First General Assembly held Erasmus January 2013 • Web-site established • Template for Engagement and Dissemination in Draft • Presentations at various research institutes and government departments
Progress to Date: Seven months in.. WP1 and WP 2 • Initial data collection completed • Literature review underway • Developing analytical framework for data analysis WP3 • Prague Workshop to distinguish care pathways in September 2013
Impact: we said “The project is expected to have a major impact on health policy in Europe. It will produce evidence of the contribution of the new professional roles to delivering health services in Europe and it will for the first time produce robust evidence of their impact on practice, outcomes and costs, to allow evaluation of their clinical and cost effectiveness. At a time when health service budgets are under severe pressure more cost effective workforce models are key to continued high quality service delivery”.
Engaging the policy and practitioner community........ • Establishing a high level Expert Advisory Board, to facilitate and advise on high level engagement with key European stakeholders and International Organisations including the EC. • Establishing Country Expert Advisory Groups (CEAGs),and a Country Impact and Dissemination Plan (CIDP) for each partner. • Engaging key stakeholders through a series of Practitioner and Policy Workshops • Engaging stakeholders in each partner country through Country Stakeholder Workshops • Disseminating key results of the research through International Conferences and presenting at the leading scientific conferences
Engaging the policy and practitioner community........ And through: • Policy Briefings • Project Briefing Papers • Developing a Project web-site • Publication in leading scientific journals • Linking with other EU projects
Country Expert Advisory Groups (CEAGs) Comprise 4-5 key stakeholders and policy makers drawn from among: • Workforce Planners; • representatives from key professional groups (e.g. Doctors, Nurses, APNs etc) central to study; • HR experts; • Patient representatives and; • Human Resource Managers in health services Remit to ensure research: • Is conducted appropriately for local context • Is effectively disseminated at country level • Is relevant to local policy • Interprets research findings to meet country needs • Identifies factors that might impede the impact of findings
Acknowledgements We thank • European Commission for funding this research programme ‘Health Care Reform: The iMpact on practice, oUtcomes and cost of New ROles for health profeSsionals (MUNROS), under the European Community’s Seventh Framework Programme (FP7 HEALTH-2012-INNOVATION-1) grant agreement number HEALTH-F3-2012-305467EC .
