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Development of the Tiers of Service framework to support system and operational planning for children’s healthcare services
- Source :
- BMC Health Services Research, BMC Health Services Research, Vol 21, Iss 1, Pp 1-13 (2021)
- Publication Year :
- 2021
- Publisher :
- BioMed Central, 2021.
-
Abstract
- 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.
- Subjects :
- medicine.medical_specialty
Process management
Quality management
Adolescent
Service delivery framework
Review
Health informatics
Pediatrics
Health administration
03 medical and health sciences
0302 clinical medicine
Population Groups
Pregnancy
030225 pediatrics
Health care
medicine
Operational planning
Delivery of health care
Humans
030212 general & internal medicine
Quality improvement
Child
British Columbia
business.industry
Health Policy
Nursing research
Public health
Research
Australia
Infant, Newborn
Rural health services
Health Services
Health planning
Quality of health care
Female
Public aspects of medicine
RA1-1270
business
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....2bea1109c2a1c120398c1a72a369b4ed