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Sustainability in Health care by Allocating Resources Effectively (SHARE) 11: reporting outcomes of an evidence-driven approach to disinvestment in a local healthcare setting
- Source :
- BMC Health Services Research, Vol 18, Iss 1, Pp 1-23 (2018), BMC Health Services Research
- Publication Year :
- 2018
- Publisher :
- BMC, 2018.
-
Abstract
- Background This is the final paper in a thematic series reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was established to explore a systematic, integrated, evidence-based organisation-wide approach to disinvestment in a large Australian health service network. This paper summarises the findings, discusses the contribution of the SHARE Program to the body of knowledge and understanding of disinvestment in the local healthcare setting, and considers implications for policy, practice and research. Discussion The SHARE program was conducted in three phases. Phase One was undertaken to understand concepts and practices related to disinvestment and the implications for a local health service and, based on this information, to identify potential settings and methods for decision-making about disinvestment. The aim of Phase Two was to implement and evaluate the proposed methods to determine which were sustainable, effective and appropriate in a local health service. A review of the current literature incorporating the SHARE findings was conducted in Phase Three to contribute to the understanding of systematic approaches to disinvestment in the local healthcare context. SHARE differed from many other published examples of disinvestment in several ways: by seeking to identify and implement disinvestment opportunities within organisational infrastructure rather than as standalone projects; considering disinvestment in the context of all resource allocation decisions rather than in isolation; including allocation of non-monetary resources as well as financial decisions; and focusing on effective use of limited resources to optimise healthcare outcomes. Conclusion The SHARE findings provide a rich source of new information about local health service decision-making, in a level of detail not previously reported, to inform others in similar situations. Multiple innovations related to disinvestment were found to be acceptable and feasible in the local setting. Factors influencing decision-making, implementation processes and final outcomes were identified; and methods for further exploration, or avoidance, in attempting disinvestment in this context are proposed based on these findings. The settings, frameworks, models, methods and tools arising from the SHARE findings have potential to enhance health care and patient outcomes. Electronic supplementary material The online version of this article (10.1186/s12913-018-3172-0) contains supplementary material, which is available to authorized users.
- Subjects :
- Process management
Debate
Decision Making
de-list
Disinvestment
Context (language use)
Health informatics
Health administration
Resource Allocation
Body of knowledge
03 medical and health sciences
0302 clinical medicine
Health care
Medicine
Humans
030212 general & internal medicine
Investments
Decision Making, Organizational
Health Services Administration
de-adopt
Evidence-Based Medicine
business.industry
030503 health policy & services
Health Policy
Nursing research
lcsh:Public aspects of medicine
Australia
Community Participation
Health technology
lcsh:RA1-1270
Health Services
de-implement
Implementation
Decommission
0305 other medical science
business
TCP
Delivery of Health Care
Decision-making
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 18
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....7dd84eaf2604fda9db87d7aba5e43114