By identifying a configuration of factors that impact the degree reform implementation, this article offers more accurate view local government’s implementation capacity than earlier studies. Fuzzy-set qualitative comparative analysis in 11 governments was used to test how organizational jointly produced right context for implementation. The results indicate is largely dependent on following fa...

BACKGROUND Health care in the United States is in the midst of a near perfect storm: strong cost pressures, dramatic redesign efforts like patient-centered medical homes and accountable care organizations, and a broad series of payment and eligibility reforms. To date, alternative models of care intended to reduce costs and improve outcomes have shown mixed effects in the U.S., in part due to t...

MFO1 /PCO1 Plus Postage. *Educational Assessment; *Educational Change; Educational Quality; Elementary Secondary Education; Models; Jrganizational Development; *Organizational Effectiveness; School Restructuring; *Systems Analysis; *Systems Approach Although educational reformers frequently use the words "system," "systemic change," and "sys.temic approach," many lack a fundamental understandin...

In 1997 the publication of the first "Bassanini law" [1] gave rise to a general reform process of the Italian government, mainly based on devolution, restructuring, simplification and on the information/communication technology (ICT) leverage. Our attention is pointed to the last hinge of the Bassanini reform, which introduces the radically new concepts of interconnected administration offices ...

Management theory teaches that successful innovation requires concomitant changes among the system ’ s components to achieve congruence or fi t . 1 Similar thinking has been applied to changing the U.S. health care system. 2 In recent years, there has been growing recognition that payment reform of the U.S. health care system must be accompanied by corresponding reforms in the delivery system. ...

BACKGROUND Public health services in the Soviet Union and its satellite states in Central and Eastern Europe were delivered through centrally planned and managed networks of sanitary-epidemiological (san-epid) facilities. Many countries sought to reform this service following the political transition in the 1990s. In this paper we describe the major themes within these reforms. METHODS A revi...

BACKGROUND Research on pressing health services and policy issues requires access to complete, accurate, and timely patient and organizational data. AIM This paper describes how administrative and health records (including electronic medical records) can be linked for comparative effectiveness and health services research. MATERIALS AND METHODS We categorize the major agents (i.e., who owns...

health reform is the outcome of dispersed policy initiatives in different sectors, at different levels and across time. policy work which can drive coherent health reform needs to operate across the governance structures as well as the institutions that comprise healthcare systems. building policy capacity to support health reform calls for clarity regarding the nature of such policy work and t...

BACKGROUND Medical educators have used the hidden curriculum concept for over three decades to make visible the effects of tacit learning, including how culture, structures, and institutions influence professional identity formation. In response to calls to see more humanistic-oriented training in medicine, the authors examined how the hidden curriculum construct has been applied in the English...