Accomplishing reform and systems improvement in international context: learning about change within and across the borders of 60 countries

Jeffrey Braithwaite, Kristiana Ludlow, Wendy James, Jess Herkes, Louise A. Ellis, Kate Churruca, Elise McPherson

Research output: Chapter in Book/Report/Conference proceedingConference proceeding contributionpeer-review


Much work about health reform and systems improvement in healthcare looks at shortcomings and problems that every system faces. Few comparative international studies of health systems include a sufficiently wide selection of low-, middle- and high-income countries in their analysis. We address these issues by examining recent work which involved the reform and improvement efforts of 60 countries, focused on them each providing a case study of success.
We use this extensive source material, a compendium of these success stories in a book to be published in 2018, and derive, through a grounded analysis of them, nine themes which have widespread application beyond the boundaries of any one health system: Improving policy, coverage and governance, Enhancing the quality of care, Keeping patients safe, Regulating standards and accreditation, Organizing care at the macro-level, Organizing care at the mesoand micro-level, Developing workforces and resources, Harnessing technology and IT, and Making collaboratives and partnerships work. These universal themes provide a model of what constitutes success across this wide sample of health systems, offering a store of knowledge about the way successful reforms and improvement initiatives can be articulated and used as a
source of learning about change across the borders of health systems. Whether low-, middle- or high-income countries, researchers, policymakers, managers and other stakeholders have a lot to learn from each other, across their bounded interests, about how to improve healthcare and health systems. This work acts as a counterbalance to the usual way of assessing reform and systems improvement, which is to critique progress, or study only one or a handful of countries. It is a more balanced approach to consider where achievements are being made across healthcare, and what we can do to replicate and spread successful exemplars internationally.
Original languageEnglish
Title of host publication11th Organizational Behaviour in Health Care (OBHC) Conference
Subtitle of host publicationProceedings
PublisherSociety for Studies in Organizing Healthcare
Number of pages26
Publication statusPublished - 2018
Event11th International Organisational Behaviour in Healthcare Conference 2018 - Montreal, Canada
Duration: 13 May 201816 May 2018


Conference11th International Organisational Behaviour in Healthcare Conference 2018

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