Task Shifting and Health System Design: Report of the Expert
Panel on effective ways of investing in Health (EXPH)

Task Shifting and Health System Design: Report of the Expert Panel on effective ways of investing ... Tato aplikace je zatím určena pro spuštění na stolním počítači. Na tomto mobilním zařízení je také funkční, ale zatím plně nevyužívá jeho možností.

Tato aplikace je zatím určena pro spuštění na stolním počítači. Na tomto mobilním zařízení je také funkční, ale zatím plně nevyužívá jeho možností.

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DE MAESENEER, Jan, Aleš BOUREK, Martin MCKEE and Werner BROUWER. Task Shifting and Health System Design: Report of the Expert Panel on effective ways of investing in Health (EXPH). 1st ed. Luxembourg: Publications Office of the European Union, 2019, 81 pp. EXPERT PANEL ON EFFECTIVE WAYS OF INVESTING IN HEALTH Scientific Opinions. ISBN 978-92-76-08892-9.

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TY  - BOOK
ID  - 39057
AU  - De Maeseneer, Jan - Bourek, Aleš - McKee, Martin - Brouwer, Werner
PY  - 2019
TI  - Task Shifting and Health System Design: Report of the Expert Panel on effective ways of investing in Health (EXPH)
VL  - EXPERT PANEL ON EFFECTIVE WAYS OF INVESTING IN HEALTH Scientific Opinions
PB  - Publications Office of the European Union
CY  - Luxembourg
SN  - 9789276088929
KW  - healthcare
KW  - task shifting
KW  - health systems design
KW  - evidence
KW  - scientific opinion
UR  - https://ec.europa.eu/health/expert_panel/sites/expertpanel/files/023_taskshifting_en.pdf
N2  - Imagine a health professional in any European country who fell asleep in 1960 and awoke in a health facility in 2019. Much of what the observer saw would be quite different. There would be many more patients who were surviving into old age thanks to advances in therapy. Many of the treatments that they were receiving would be much more complex, involving radically new techniques such as laparoscopic or even robotic surgery, and they would be amazed by the advances in diagnostic capacity. Yet, in many health systems, some things would have changed very little. Among them would be the traditional roles of different types of health worker, with responsibility for certain task being reserved for those with particular qualifications based on custom and practice rather than on evidence. This opinion argues that this situation must change. There is now an impressive body of evidence that things can often be done differently. This does not mean that they should be. Change is only appropriate where it helps to achieve the goals of the health system and allows it to provide better care in ways that are more responsive to the needs of users. Tasks can be shifted from health workers to patients and their carers, to machines, and to other health workers. Where these shifts have been evaluated, they often, but not always, are associated with outcomes that are as good or even better than with the status quo. However, the results are often context dependent, and it cannot be assumed that what works in one situation will apply equally to another. What matters is the evidence, rather than traditional, but often obsolete rules. If a health system can ensure that tasks are being undertaken by those most appropriate to do them, it will enhance patient care. However, change is often difficult. Those involved must be convinced of the rationale for change and must be supported in implementing it. This should recognise that any change in roles will have implication for their status and thus existing hierarchies. It may also be necessary to challenge outdated legislative or regulatory barriers. Finally, it is essential the changes are evaluated, results are documented, and lessons are learned, both in relation to what works and in what circumstances. Task shifting, where it is based on robust evidence and implemented effectively, can make a major contribution to health outcomes and to the sustainability of health systems. It is not, however, a panacea for all of the challenges health systems face.
ER  -

Basic information
Original name	Task Shifting and Health System Design: Report of the Expert Panel on effective ways of investing in Health (EXPH)
Name in Czech	EXPH (Expertní Panel na efektivní investice do zdraví), Přesun činností a kompetencí v kontextu tvorby zdravotních systémů
Authors	DE MAESENEER, Jan (528 Netherlands), Aleš BOUREK (203 Czech Republic, guarantor, belonging to the institution), Martin MCKEE (826 United Kingdom of Great Britain and Northern Ireland) and Werner BROUWER (528 Netherlands).
Edition	1. vyd. Luxembourg, 81 pp. EXPERT PANEL ON EFFECTIVE WAYS OF INVESTING IN HEALTH Scientific Opinions, 2019.
Publisher	Publications Office of the European Union

Other information
Original language	English
Type of outcome	Book on a specialized topic
Country of publisher	Luxembourg
Confidentiality degree	is not subject to a state or trade secret
Publication form	printed version "print"
WWW	URL
RIV identification code	RIV/00216224:14110/19:00112934
Organization	Lékařská fakulta – Repository – Repository
ISBN	978-92-76-08892-9
Keywords (in Czech)	zdravotnictví; přesun kompetencí; přesun činností; tvorba zdravontích systémů; vědecky podložený názor
Keywords in English	healthcare; task shifting; health systems design; evidence; scientific opinion
Changed by	Changed by: RNDr. Daniel Jakubík, učo 139797. Changed: 10/9/2020 17:11.

Abstract

Imagine a health professional in any European country who fell asleep in 1960 and awoke in a health facility in 2019. Much of what the observer saw would be quite different. There would be many more patients who were surviving into old age thanks to advances in therapy. Many of the treatments that they were receiving would be much more complex, involving radically new techniques such as laparoscopic or even robotic surgery, and they would be amazed by the advances in diagnostic capacity. Yet, in many health systems, some things would have changed very little. Among them would be the traditional roles of different types of health worker, with responsibility for certain task being reserved for those with particular qualifications based on custom and practice rather than on evidence. This opinion argues that this situation must change. There is now an impressive body of evidence that things can often be done differently. This does not mean that they should be. Change is only appropriate where it helps to achieve the goals of the health system and allows it to provide better care in ways that are more responsive to the needs of users. Tasks can be shifted from health workers to patients and their carers, to machines, and to other health workers. Where these shifts have been evaluated, they often, but not always, are associated with outcomes that are as good or even better than with the status quo. However, the results are often context dependent, and it cannot be assumed that what works in one situation will apply equally to another. What matters is the evidence, rather than traditional, but often obsolete rules. If a health system can ensure that tasks are being undertaken by those most appropriate to do them, it will enhance patient care. However, change is often difficult. Those involved must be convinced of the rationale for change and must be supported in implementing it. This should recognise that any change in roles will have implication for their status and thus existing hierarchies. It may also be necessary to challenge outdated legislative or regulatory barriers. Finally, it is essential the changes are evaluated, results are documented, and lessons are learned, both in relation to what works and in what circumstances. Task shifting, where it is based on robust evidence and implemented effectively, can make a major contribution to health outcomes and to the sustainability of health systems. It is not, however, a panacea for all of the challenges health systems face.

Abstract (in Czech)

Představte si zdravotnického odborníka v kterékoli evropské zemi, který usnul v roce 1960 a probudil se ve zdravotnickém zařízení v roce 2019. Hodně z toho, co by pozorovatel viděl, by bylo úplně jiné. Bylo by mnohem více pacientů, kteří přežili do stáří díky pokrokům v terapii. Mnoho z ošetření, které dostávali, by bylo mnohem složitější, zahrnovalo radikálně nové techniky, jako je laparoskopická nebo dokonce robotická chirurgie, a byl by ohromen pokrokem v diagnostickém rozsahu. Přesto by se v mnoha zdravotnických systémech některé věci změnily jen velmi málo. Mezi nimi by byly tradiční role různých typů zdravotnických pracovníků, přičemž odpovědnost za určitý úkol by byla vyhrazena těm, kteří mají zvláštní kvalifikaci založenou spíše na zvyklostech a praxi než na důkazech. Toto stanovisko tvrdí, že se tato situace musí změnit. Nyní existuje impozantní soubor důkazů, že věci lze často dělat jinak. To neznamená, že by měli být jinak dělány. Změna je vhodná pouze tam, kde pomáhá dosahovat cílů zdravotnického systému a umožňuje jí poskytovat lepší péči způsoby, které lépe reagují na potřeby uživatelů. Úkoly lze převádět ze zdravotnických pracovníků na pacienty a jejich pečovatele, na stroje a další zdravotnické pracovníky. Tam, kde byly tyto posuny vyhodnoceny, jsou často, ale ne vždy, spojeny s výsledky, které jsou stejně dobré nebo dokonce lepší než za současného stavu. Výsledky jsou však často závislé na kontextu a nelze předpokládat, že to, co funguje v jedné situaci, se bude vztahovat stejně na jiné. Důležitý je důkaz spíše než tradiční, ale často zastaralá pravidla. Pokud zdravotní systém může zajistit, že osoby, které jsou pro ně nejvhodnější, plní správně alokované úkoly, zlepší se péče o pacienty. Změna je však často obtížná. Zúčastněné strany musí být přesvědčeny o důvodech změny a musí být podporovány při jejich provádění. Musí uznat, že každá změna rolí bude mít dopad na jejich stav, a tedy na existující hierarchie. Může být také třeba změnit zastaralé legislativní nebo regulační překážky. Nakonec je nezbytné, aby byly změny vyhodnoceny, výsledky zdokumentovány a vedly k ponaučení, co funguje a za jakých okolností. Posun úkolů, činností a kompetencí, pokud je založen na spolehlivých důkazech a je účinně prováděn, může významně přispět k lepším výsledkům v oblasti zdraví a k udržitelnosti zdravotních systémů. Nejedná se však o všelék na všechny výzvy, kterým zdravotnické systémy čelí.

Type	Name	Uploaded/Created by	Uploaded/Created
	023_taskshifting_en.pdf		15/8/2020
Properties Name 023_taskshifting_en.pdf Address within IS https://repozitar.cz/auth/repo/39057/874263/ Address for the users outside IS https://repozitar.cz/repo/39057/874263/ Address within Manager https://repozitar.cz/auth/repo/39057/874263/?info Address within Manager for the users outside IS https://repozitar.cz/repo/39057/874263/?info Uploaded/Created Sat 15/8/2020 09:32 Rights Right to read anyone on the Internet Right to upload Right to administer: a concrete person Mgr. Lucie Vařechová, uco 106253 a concrete person RNDr. Daniel Jakubík, uco 139797 a concrete person Mgr. Jolana Surýnková, uco 220973 Attributes

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