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How to not revert to type: Complexity-informed learnings from the pandemic response for health system reform and universal access to integrated care

This article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict’. BACKGROUND: COVID-19 has highlighted existing health inequalities and health system deficiencies both in Ireland and internationally; however, understanding of the critical opport...

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Autores principales: Parker, Sarah, Mac Conghail, Luisne, Siersbaek, Rikke, Burke, Sara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9996344/
https://www.ncbi.nlm.nih.gov/pubmed/36908402
http://dx.doi.org/10.3389/fpubh.2023.1088728
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author Parker, Sarah
Mac Conghail, Luisne
Siersbaek, Rikke
Burke, Sara
author_facet Parker, Sarah
Mac Conghail, Luisne
Siersbaek, Rikke
Burke, Sara
author_sort Parker, Sarah
collection PubMed
description This article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict’. BACKGROUND: COVID-19 has highlighted existing health inequalities and health system deficiencies both in Ireland and internationally; however, understanding of the critical opportunities for health system change that have arisen during the pandemic is still emerging and largely descriptive. This research is situated in the Irish health reform context of Sláintecare, the reform programme which aims to deliver universal healthcare by strengthening public health, primary and community healthcare functions as well as tackling system and societal health inequities. AIMS AND OBJECTIVES: This study set out to advance understanding of how and to what extent COVID-19 has highlighted opportunities for change that enabled better access to universal, integrated care in Ireland, with a view to informing universal health system reform and implementation. METHODS: The study, which is qualitative, was underpinned by a co-production approach with Irish health system leadership. Semi-structured interviews were conducted with sixteen health system professionals (including managers and frontline workers) from a range of responses to explore their experiences and interpretations of social processes of change that enabled (or hindered) better access to universal integrated care during the pandemic. A complexity-informed approach was mobilized to theorize the processes that impacted on access to universal, integrated care in Ireland in the COVID-19 context. FINDINGS: A range of circumstances, strategies and mechanisms that created favorable system conditions in which new integrated care trajectories emerged during the crisis. Three key learnings from the pandemic response are presented: (1) nurturing whole-system thinking through a clear, common goal and shared information base; (2) harnessing, sharing and supporting innovation; and (3) prioritizing trust and relationship-building in a social, human-centered health system. Policy and practice implications for health reform are discussed.
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spelling pubmed-99963442023-03-10 How to not revert to type: Complexity-informed learnings from the pandemic response for health system reform and universal access to integrated care Parker, Sarah Mac Conghail, Luisne Siersbaek, Rikke Burke, Sara Front Public Health Public Health This article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict’. BACKGROUND: COVID-19 has highlighted existing health inequalities and health system deficiencies both in Ireland and internationally; however, understanding of the critical opportunities for health system change that have arisen during the pandemic is still emerging and largely descriptive. This research is situated in the Irish health reform context of Sláintecare, the reform programme which aims to deliver universal healthcare by strengthening public health, primary and community healthcare functions as well as tackling system and societal health inequities. AIMS AND OBJECTIVES: This study set out to advance understanding of how and to what extent COVID-19 has highlighted opportunities for change that enabled better access to universal, integrated care in Ireland, with a view to informing universal health system reform and implementation. METHODS: The study, which is qualitative, was underpinned by a co-production approach with Irish health system leadership. Semi-structured interviews were conducted with sixteen health system professionals (including managers and frontline workers) from a range of responses to explore their experiences and interpretations of social processes of change that enabled (or hindered) better access to universal integrated care during the pandemic. A complexity-informed approach was mobilized to theorize the processes that impacted on access to universal, integrated care in Ireland in the COVID-19 context. FINDINGS: A range of circumstances, strategies and mechanisms that created favorable system conditions in which new integrated care trajectories emerged during the crisis. Three key learnings from the pandemic response are presented: (1) nurturing whole-system thinking through a clear, common goal and shared information base; (2) harnessing, sharing and supporting innovation; and (3) prioritizing trust and relationship-building in a social, human-centered health system. Policy and practice implications for health reform are discussed. Frontiers Media S.A. 2023-02-17 /pmc/articles/PMC9996344/ /pubmed/36908402 http://dx.doi.org/10.3389/fpubh.2023.1088728 Text en Copyright © 2023 Parker, Mac Conghail, Siersbaek and Burke. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Parker, Sarah
Mac Conghail, Luisne
Siersbaek, Rikke
Burke, Sara
How to not revert to type: Complexity-informed learnings from the pandemic response for health system reform and universal access to integrated care
title How to not revert to type: Complexity-informed learnings from the pandemic response for health system reform and universal access to integrated care
title_full How to not revert to type: Complexity-informed learnings from the pandemic response for health system reform and universal access to integrated care
title_fullStr How to not revert to type: Complexity-informed learnings from the pandemic response for health system reform and universal access to integrated care
title_full_unstemmed How to not revert to type: Complexity-informed learnings from the pandemic response for health system reform and universal access to integrated care
title_short How to not revert to type: Complexity-informed learnings from the pandemic response for health system reform and universal access to integrated care
title_sort how to not revert to type: complexity-informed learnings from the pandemic response for health system reform and universal access to integrated care
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9996344/
https://www.ncbi.nlm.nih.gov/pubmed/36908402
http://dx.doi.org/10.3389/fpubh.2023.1088728
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