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Development of the Tiers of Service framework to support system and operational planning for children’s healthcare services

BACKGROUND: Providing access to pediatric healthcare services in British Columbia, Canada, presents unique challenges given low population densities spread across large geographic distances combined with a lack of availability of specialist providers in remote areas, leading to quality of care short...

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Autores principales: Waibel, Sina, Williams, Janet, Tuff, Yasmin, Shum, Joanne, Scarr, Jennifer, O’Donnell, Maureen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276838/
https://www.ncbi.nlm.nih.gov/pubmed/34256768
http://dx.doi.org/10.1186/s12913-021-06616-9
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author Waibel, Sina
Williams, Janet
Tuff, Yasmin
Shum, Joanne
Scarr, Jennifer
O’Donnell, Maureen
author_facet Waibel, Sina
Williams, Janet
Tuff, Yasmin
Shum, Joanne
Scarr, Jennifer
O’Donnell, Maureen
author_sort Waibel, Sina
collection PubMed
description BACKGROUND: Providing access to pediatric healthcare services in British Columbia, Canada, presents unique challenges given low population densities spread across large geographic distances combined with a lack of availability of specialist providers in remote areas, leading to quality of care shortcomings and inequalities in care delivery. The study objective was to develop a framework that provides a common language and methodology for defining and planning child and youth healthcare services across the province. METHODS: The framework was developed in two phases. In Phase 1, a literature and jurisdictional review was completed using the following inclusion criteria: (i) description of a framework focusing on organizing service delivery systems (ii) that supports health service planning, (iii) includes specialty or subspecialty services and (iv) has been published since 2008. In Phase 2, a series of meetings with key provincial stakeholders were held to receive feedback on the developed Tiers of Service framework versions that were based on the literature and jurisdictional review and adjusted to the British Columbian health care context. The final version was endorsed by the Child Health BC Steering Committee. RESULTS: Ten medical articles and thirteen jurisdictional papers met the established selection criteria and were included in this study. Most frameworks were developed by the Australian national or state jurisdictions and published in jurisdictional papers (n = 8). Frameworks identified in the medical literature were mainly developed in Canada (n = 3) and the US (n = 3) and focused on maternity, neonatal, critical care and oncology services. Based on feedback received from the expert group, the framework was expanded to include community-based services, prevention and health determinants. The final version of the Tiers of Service framework describes the specific services to be delivered at each tier, which are categorized as Tier 1 (community services) through Tier 6 (sub-specialized services). Two consecutive steps were identified to effectively use the framework for operational and system planning: (i) development of a ‘module’ outlining the responsibilities and requirements to be delivered at each tier; and (ii) assessment of services provided at the health care facility against those described in the module, alignment to a specific tier, identification of gaps at the local, regional and provincial level, and implementation of quality improvement initiatives to effectively address the gaps. CONCLUSIONS: The benefits of the Tiers of Service framework and accompanying modules for health service planning are being increasingly recognized. Planning and coordinating pediatric health services across the province will help to optimize flow and improve access to high-quality services for children living in British Columbia. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06616-9.
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spelling pubmed-82768382021-07-14 Development of the Tiers of Service framework to support system and operational planning for children’s healthcare services Waibel, Sina Williams, Janet Tuff, Yasmin Shum, Joanne Scarr, Jennifer O’Donnell, Maureen BMC Health Serv Res Research BACKGROUND: Providing access to pediatric healthcare services in British Columbia, Canada, presents unique challenges given low population densities spread across large geographic distances combined with a lack of availability of specialist providers in remote areas, leading to quality of care shortcomings and inequalities in care delivery. The study objective was to develop a framework that provides a common language and methodology for defining and planning child and youth healthcare services across the province. METHODS: The framework was developed in two phases. In Phase 1, a literature and jurisdictional review was completed using the following inclusion criteria: (i) description of a framework focusing on organizing service delivery systems (ii) that supports health service planning, (iii) includes specialty or subspecialty services and (iv) has been published since 2008. In Phase 2, a series of meetings with key provincial stakeholders were held to receive feedback on the developed Tiers of Service framework versions that were based on the literature and jurisdictional review and adjusted to the British Columbian health care context. The final version was endorsed by the Child Health BC Steering Committee. RESULTS: Ten medical articles and thirteen jurisdictional papers met the established selection criteria and were included in this study. Most frameworks were developed by the Australian national or state jurisdictions and published in jurisdictional papers (n = 8). Frameworks identified in the medical literature were mainly developed in Canada (n = 3) and the US (n = 3) and focused on maternity, neonatal, critical care and oncology services. Based on feedback received from the expert group, the framework was expanded to include community-based services, prevention and health determinants. The final version of the Tiers of Service framework describes the specific services to be delivered at each tier, which are categorized as Tier 1 (community services) through Tier 6 (sub-specialized services). Two consecutive steps were identified to effectively use the framework for operational and system planning: (i) development of a ‘module’ outlining the responsibilities and requirements to be delivered at each tier; and (ii) assessment of services provided at the health care facility against those described in the module, alignment to a specific tier, identification of gaps at the local, regional and provincial level, and implementation of quality improvement initiatives to effectively address the gaps. CONCLUSIONS: The benefits of the Tiers of Service framework and accompanying modules for health service planning are being increasingly recognized. Planning and coordinating pediatric health services across the province will help to optimize flow and improve access to high-quality services for children living in British Columbia. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06616-9. BioMed Central 2021-07-13 /pmc/articles/PMC8276838/ /pubmed/34256768 http://dx.doi.org/10.1186/s12913-021-06616-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Waibel, Sina
Williams, Janet
Tuff, Yasmin
Shum, Joanne
Scarr, Jennifer
O’Donnell, Maureen
Development of the Tiers of Service framework to support system and operational planning for children’s healthcare services
title Development of the Tiers of Service framework to support system and operational planning for children’s healthcare services
title_full Development of the Tiers of Service framework to support system and operational planning for children’s healthcare services
title_fullStr Development of the Tiers of Service framework to support system and operational planning for children’s healthcare services
title_full_unstemmed Development of the Tiers of Service framework to support system and operational planning for children’s healthcare services
title_short Development of the Tiers of Service framework to support system and operational planning for children’s healthcare services
title_sort development of the tiers of service framework to support system and operational planning for children’s healthcare services
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276838/
https://www.ncbi.nlm.nih.gov/pubmed/34256768
http://dx.doi.org/10.1186/s12913-021-06616-9
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