Kompas Global Untuk Sistem Kesehatan Nasional
Abstract
Mengubah sistem kesehatan menjadi sistem pembelajaran semakin diakui sebagai kebutuhan untuk mendukung implementasi arah strategis nasional pada kualitas dengan fokus pada pengalaman garis depan. Pendekatan sistem pembelajaran yang menjembatani kesenjangan antara praktik dan kebijakan membutuhkan eksplorasi aktif. Tinjauan pelingkupan ini mengadaptasi kerangka metodologi untuk studi pelingkupan dari Arksey dan O'Malley. Pertanyaan penelitian utama berfokus pada tema umum untuk belajar meningkatkan kualitas layanan kesehatan di semua tingkat sistem kesehatan nasional, mulai dari kebijakan pemerintah hingga pemberian layanan di titik perawatan. Sebanyak 3507 catatan disaring, menghasilkan 101 artikel tentang pembelajaran strategis di seluruh sistem kesehatan: tingkat profesional kesehatan (19%), tingkat organisasi kesehatan (15%), tingkat subnasional/nasional (26%), berbagai tingkat (35%), dan tingkat global (6%). Tiga puluh lima dari artikel ini berfokus pada sistem pembelajaran di berbagai tingkat sistem kesehatan. Sistem pembelajaran nasional membutuhkan perhatian di tingkat organisasi, subnasional, dan nasional yang dipandu oleh kebutuhan pasien, keluarga, dan masyarakat. Kompas dari sistem pembelajaran nasional dipusatkan pada empat tema lintas sektor di seluruh sistem kesehatan: penyelarasan prioritas, kolaborasi seluruh sistem, transparansi dan akuntabilitas, dan berbagi pengetahuan tentang bukti dunia nyata yang dihasilkan di titik perawatan. Makalah ini mengusulkan sebuah pendekatan untuk membangun sistem pembelajaran nasional untuk meningkatkan kualitas pelayanan kesehatan. Penelitian di masa depan diperlukan untuk memvalidasi penerapan prinsip panduan ini dan melakukan perbaikan berdasarkan temuan.
References
Akhnif, E., Kiendrebeogo, J. A., Idrissi Azouzzi, A., Adam, Z., Makoutode, C. P., Mayaka Manitu, S., Njoumemi, Z., Gamble Kelley, A., & Meessen, B. (2018). Are our “UHC systems” learning systems? Piloting an assessment tool and process in six African countries. Health Research Policy and Systems, 16(1), 1–14. https://doi.org/10.1186/s12961-018-0340-y
Akhnif, E., Macq, J., Idrissi Fakhreddine, M. O., & Meessen, B. (2017). Scoping literature review on the learning organisation concept as applied to the health system. Health Research Policy and Systems, 15(1), 1–12. https://doi.org/10.1186/s12961-017-0176-x
Akhnif, E., Macq, J., & Meessen, B. (2019). The place of learning in a universal health coverage health policy process: the case of the RAMED policy in Morocco. Health Research Policy and Systems, 17(1). https://doi.org/10.1186/S12961-019-0421-6
Albritton, J. A., Fried, B., Singh, K., Weiner, B. J., Reeve, B., & Edwards, J. R. (2019). The role of psychological safety and learning behavior in the development of effective quality improvement teams in Ghana: An observational study. BMC Health Services Research, 19(1), 1–12. https://doi.org/10.1186/s12913-019-4234-7
Anagnostou VK. (2018). A longitudinal, collaborative, practice-based learning and improvement model to improve post-discharge heart failure outcomes - PubMed. Conn Med. https://pubmed.ncbi.nlm.nih.gov/24600779/
Arksey, H., & O’Malley, L. (2007). Scoping studies: towards a methodological framework. Https://Doi.Org/10.1080/1364557032000119616, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
Aromataris, E., Fernandez, R., Godfrey, C. M., Holly, C., Khalil, H., & Tungpunkom, P. (2015). Summarizing systematic reviews: Methodological development, conduct and reporting of an umbrella review approach. International Journal of Evidence-Based Healthcare, 13(3), 132–140. https://doi.org/10.1097/XEB.0000000000000055
Braithwaite, J. (2018). Changing how we think about healthcare improvement. BMJ (Clinical Research Ed.), 361. https://doi.org/10.1136/BMJ.K2014
Budrionis, A., & Bellika, J. G. (2016). The Learning Healthcare System: Where are we now? A systematic review. Journal of Biomedical Informatics, 64, 87–92. https://doi.org/10.1016/J.JBI.2016.09.018
Bunniss, S., Gray, F., & Kelly, D. (2012). Collective learning, change and improvement in health care: trialling a facilitated learning initiative with general practice teams. Journal of Evaluation in Clinical Practice, 18(3), 630–636. https://doi.org/10.1111/J.1365-2753.2011.01641.X
Butler, J. M., Anderson, K. A., Supiano, M. A., & Weir, C. R. (2017). “it feels like a lot of extra work”: Resident attitudes about quality improvement and implications for an effective learning health care system. Academic Medicine, 92(7), 984–990. https://doi.org/10.1097/ACM.0000000000001474
Chen, C. A., Park, R. J., Hegde, J. V., Jun, T., Christman, M. P., Yoo, S. M., Yamasaki, A., Berhanu, A., Vohra-Khullar, P., Remus, K., Schwartzstein, R. M., & Weinstein, A. R. (2016). How we used a patient visit tracker tool to advance experiential learning in systems-based practice and quality improvement in a medical student clinic. Medical Teacher, 38(1), 36–40. https://doi.org/10.3109/0142159X.2014.975193
Cleary, P. D., Gross, C. P., Zaslavsky, A. M., & Taplin, S. H. (2012). Multilevel Interventions: Study Design and Analysis Issues. Journal of the National Cancer Institute Monographs, 44(44), 49–55. https://doi.org/10.1093/jncimonographs/lgs010
Ferlie, E. B., & Shortell, S. M. (2001). Improving the Quality of Health Care in the United Kingdom and the United States: A Framework for Change. The Milbank Quarterly, 79(2), 281. https://doi.org/10.1111/1468-0009.00206
Fowler, T. O., Wise, H. H., Mauldin, M. P., Ragucci, K. R., Scheurer, D. B., Su, Z., Mauldin, P. D., Bailey, J. R., & Borckardt, J. J. (2018). Alignment of an interprofessional student learning experience with a hospital quality improvement initiative. Journal of Interprofessional Care, 1–10. https://doi.org/10.1080/13561820.2018.1455649
Hovlid, E., Bukve, O., Haug, K., Aslaksen, A. B., & Von Plessen, C. (2012). Sustainability of healthcare improvement: What can we learn from learning theory? BMC Health Services Research, 12(1). https://doi.org/10.1186/1472-6963-12-235
Huntington, J. T., Dycus, P., Hix, C., West, R., McKeon, L., Coleman, M. T., Hathaway, D., McCurren, C., & Ogrinc, G. (2009). A standardized curriculum to introduce novice health professional students to practice-based learning and improvement: A multi-institutional pilot study. Quality Management in Health Care, 18(3), 174–181. https://doi.org/10.1097/QMH.0B013E3181AEA218
Kataoka, S. H., Podell, J. L., Zima, B. T., Best, K., Sidhu, S., & Jura, M. B. (2014). MAP as a model for practice-based learning and improvement in child psychiatry training. Journal of Clinical Child and Adolescent Psychology : The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 43(2), 312–322. https://doi.org/10.1080/15374416.2013.848773
Kenaszchuk, C., Rykhoff, M., Collins, L., McPhail, S., & van Soeren, M. (2012). Positive and null effects of interprofessional education on attitudes toward interprofessional learning and collaboration. Advances in Health Sciences Education, 17(5), 651–669. https://doi.org/10.1007/S10459-011-9341-0/METRICS
Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S. V., English, M., Elorrio, E. G., Guanais, F., Gureje, O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., … Pate, M. (2018). High-quality health systems in the Sustainable Development Goals era: time for a revolution. The Lancet. Global Health, 6(11), e1196–e1252. https://doi.org/10.1016/S2214-109X(18)30386-3
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ, 339. https://doi.org/10.1136/BMJ.B2700
Liu, V. X., Morehouse, J. W., Baker, J. M., Greene, J. D., Kipnis, P., & Escobar, G. J. (2016). Data that drive: Closing the loop in the learning hospital system. Journal of Hospital Medicine, 11 Suppl 1(Suppl 1), S11–S17. https://doi.org/10.1002/JHM.2651
Lyman, B., Jacobs, J. D., Hammond, E. L., & Gunn, M. M. (2019). Organizational learning in hospitals: A realist review. Journal of Advanced Nursing, 75(11), 2352–2377. https://doi.org/10.1111/JAN.14091
Makady, A., de Boer, A., Hillege, H., Klungel, O., & Goettsch, W. (2017). What Is Real-World Data? A Review of Definitions Based on Literature and Stakeholder Interviews. Value in Health, 20(7), 858–865. https://doi.org/10.1016/j.jval.2017.03.008
McNamara, D. A., Rafferty, P., & Fitzpatrick, F. (2016). An improvement model to optimise hospital interdisciplinary learning. International Journal of Health Care Quality Assurance, 29(5), 550–558. https://doi.org/10.1108/IJHCQA-10-2015-0131
Moore, D. E., & Pennington, F. C. (2003). Practice-based learning and improvement. The Journal of Continuing Education in the Health Professions, 23 Suppl 1(May), S73–S80. https://doi.org/10.1002/chp.1340230411
National Academies of Sciences, E. and M. (2018). Crossing the Global Quality Chasm: Improving Health Care Worldwide. Crossing the Global Quality Chasm. https://doi.org/10.17226/25152
Nembhard, I. M., Cherian, P., & Bradley, E. H. (2014). Deliberate Learning in Health Care. Medical Care Research and Review, 71(5), 450–471. https://doi.org/10.1177/1077558714536619
Nembhard, I. M., & Tucker, A. L. (2016). Applying Organizational Learning Research to Accountable Care Organizations. Http://Dx.Doi.Org/10.1177/1077558716640415, 73(6), 673–684. https://doi.org/10.1177/1077558716640415
Nyström, M. (2009). Characteristics of health care organizations associated with learning and development: Lessons from a pilot study. Quality Management in Health Care, 18(4), 285–294. https://doi.org/10.1097/QMH.0B013E3181BEE19E
Nyström, M. E., Höög, E., Garvare, R., Andersson Bäck, M., Terris, D. D., & Hansson, J. (2018). Exploring the potential of a multi-level approach to improve capability for continuous organizational improvement and learning in a Swedish healthcare region. BMC Health Services Research, 18(1), 1–19. https://doi.org/10.1186/s12913-018-3129-3
O’Connor, E. S., Mahvi, D. M., Foley, E. F., Lund, D., & McDonald, R. (2010). Developing a practice-based learning and improvement curriculum for an academic general surgery residency. Journal of the American College of Surgeons, 210(4), 411–417. https://doi.org/10.1016/J.JAMCOLLSURG.2010.01.017
O’Sullivan, M. J. (1999). Strategic learning in healthcare organizations. Hospital Topics, 77(3), 13–21. https://doi.org/10.1080/00185869909596526
Organization, W. H. (2018). Delivering quality health services. http://apps.who.int/bookorders.
Ortega, A., Sánchez-Manzanares, M., Gil, F., & Rico, R. (2013). Enhancing team learning in nursing teams through beliefs about interpersonal context. Journal of Advanced Nursing, 69(1), 102–111. https://doi.org/10.1111/J.1365-2648.2012.05996.X
Pham, M. T., Rajić, A., Greig, J. D., Sargeant, J. M., Papadopoulos, A., & Mcewen, S. A. (2014). A scoping review of scoping reviews: Advancing the approach and enhancing the consistency. Research Synthesis Methods, 5(4), 371–385. https://doi.org/10.1002/JRSM.1123
Platt, J. E., Raj, M., & Wienroth, M. (2020). An Analysis of the Learning Health System in Its First Decade in Practice: Scoping Review. Journal of Medical Internet Research, 22(3). https://doi.org/10.2196/17026
Portney, L., Johnson, A. F., & Knab, M. (2017). Preparing Future Health Professionals for Interprofessional Collaborative Practice Part 1: The Context for Learning. Seminars in Speech and Language, 38(5), 335–341. https://doi.org/10.1055/S-0037-1607344
Shamshirsaz, A. A., Fox, K. A., Erfani, H., Clark, S. L., Salmanian, B., Baker, B. W., Coburn, M., Shamshirsaz, A. A., Bateni, Z. H., Espinoza, J., Nassr, A. A., Popek, E. J., Hui, S. K., Teruya, J., Tung, C. S., Jones, J. A., Rac, M., Dildy, G. A., & Belfort, M. A. (2017). Multidisciplinary team learning in the management of the morbidly adherent placenta: outcome improvements over time. American Journal of Obstetrics and Gynecology, 216(6), 612.e1-612.e5. https://doi.org/10.1016/j.ajog.2017.02.016
Smith, K. L., Ashburn, S., Rule, E., & Jervis, R. (2012). Residents contributing to inpatient quality: Blending learning and improvement. Journal of Hospital Medicine, 7(2), 148–153. https://doi.org/10.1002/JHM.945
Soklaridis, S. (2014). Improving hospital care: are learning organizations the answer? Journal of Health Organization and Management, 28(6), 830–838. https://doi.org/10.1108/JHOM-10-2013-0229/FULL/XML
Syed, S. B., Leatherman, S., Mensah-Abrampah, N., Neilson, M., & Kelley, & E. (2018). Improving the quality of health care across the health system. Bull World Health Organ. https://doi.org/10.2471/BLT.18.226266
Tomolo, A. M., Lawrence, R. H., Watts, B., Augustine, S., Aron, D. C., & Singh, M. K. (2019). Pilot Study Evaluating a Practice-Based Learning and Improvement Curriculum Focusing on the Development of System-Level Quality Improvement Skills. https://doi.org/10.4300/JGME-D-10-00104.1
Wehbe-Janek, H., Markova, T., Polis, R. L., Peters, M., & Liu, Y. (2018). Preparing Academic Medical Centers for the Clinical Learning Environment Review: Alliance of Independent Academic Medical Centers National Initiative IV Outcomes and Evaluation.
Wittich, C. M., Reed, D. A., McDonald, F. S., Varkey, P., & Beckman, T. J. (2010). Perspective: Transformative learning: A framework using critical reflection to link the improvement competencies in graduate medical education. Academic Medicine, 85(11), 1790–1793. https://doi.org/10.1097/ACM.0B013E3181F54EED
Wong, A. K. C., Wong, F. K. Y., Chan, L. K., Chan, N., Ganotice, F. A., & Ho, J. (2017). The effect of interprofessional team-based learning among nursing students: A quasi-experimental study. Nurse Education Today, 53, 13–18. https://doi.org/10.1016/J.NEDT.2017.03.004
Wysham, N. G., Howie, L., Patel, K., Cameron, C. B., Samsa, G. P., Roe, L., Abernethy, A. P., & Zaas, A. (2016). Development and Refinement of a Learning Health Systems Training Program. EGEMs, 4(1), 23. https://doi.org/10.13063/2327-9214.1236
Yazdani, S., Farajpour, A., & Shakerian, S. (2017). Practice-based learning and improvement (PBLI) from the perspective of Iranian medical education experts: A thematic content analysis. Iranian Red Crescent Medical Journal, 19(7). https://doi.org/10.5812/ircmj.55664
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