Remote communities face several challenges concerning health care. For instance, communication with health care professionals, transportation, availability of doctors, and shortage of doctors. Literature review to identify and review new methods of improving access to health, quality of care, and improving the effectiveness of delivering health care services in remote Alaskan villages. MEDLINE, EMBASE, and CINAHL databases that index health research were used along with Artic health databases. Abstracts and full articles were reviewed and categorized into four sections. Organizational structure of health services, Telehealth, E-health, and medical transportation. “Despite the challenges facing rural and remote regions, there is a distinctly positive message from this broad literature review.
Evidence-based initiatives exist across a range of areas – which include operational efficiency and integration, access to care, organizational structure, public health, continuing education and workforce composition that have the potential to positively impact health care quality and health-related outcomes” (Masucci, Mitton, & Dionne, 2011). The literature review did not identify any past research associated with new ideas to improve access, quality, and efficiency in the organizational structures and delivery of health care services in northern rural and remote and rural populations. This review was directed toward the redesign of health care systems in Nunavut territory in Canada.
When conducting research in an academic or professional setting, it is important to display ethical responsibility throughout the research study. For instance, Researchers conducting the study and collecting data should obtain permission from individuals who are involved in the study in any way. Researchers must ensure subjects involved in the study are not in any physical or emotional harm, such as asking difficult questions or using insensitive words. One very important consideration for researchers to remember when conducting any form of data collection is to be sure to maintain their own personal biases and opinions so they do not get in the way of the research. Research such as questionaries’ or observations should be conducted under the assumption that findings are kept anonymous. It is important to let the research subject know whether the research results will be anonymous or not.
Research subjects should be chosen based on what and who will be most beneficial to the research. And last, when reporting results from the research study the results must be accurately represented from what he or she was told or what you observed. For example, do not discuss parts of observations without putting them in appropriate context. Research has found that telehealth and ehealth has been effective in providing information of health professions with educational opportunities to in these rural populations that would not have been provided without telehealth and ehealth. Therefore, telehelath and ehealth system have a significant impact on improving access and quality care. The research also identified the use of medical air transport when needed services are not available as well as transportation to and from rural and remote regions.
The study affirmed the importance of medical air transport in rural and remote regions while indicating such concerns are not unusual. Second, there are no evidence-based guidelines indicating which services to provide in local regions as opposed to having access by medical air transport or procedures in selecting which patients to select for emergency are transported. Currently no framework exists to determine the over or underutilization of medical air transport. Researchers found that the regions with the largest potential impact in remote regions are public health where several programs have been implemented, and analyzed indicating high degree of success. For example, health promotion programs such as alcohol and smoking cessation, obesity, exercise, dental care, hygiene, and suicide prevention. The literature strongly indicates these programs have positive impacts.
Therefore, the regions in the research study have opportunity to improve the delivery and organization structure of health care services. This particular research study was not a systematic review. According to Masucci, Mitton, and Dionne (2011) “The purpose of the article was not to find literature on a wide range of topics but rather to find exemplary articles that could speak to the topics at hand. However, the caution is that while we attempted to provide both sides of any given story, in some cases important papers may have been missed which could suggest important alternative courses of action.” (p. 470). The research team relied on an advisory board that gave advice on their work. Review of only found positive solutions in which history politics, structures, and behavior contribute to improvement the key factor is action ability. This information will be crucial to enhancing care in the targeted regions as well as other remote and rural regions nationwide.
The research study identifies several challenges that northern rural remote regions face. The literature review found several evidence based initiative from operational efficiency, integration, applying telehealth, applying ehealth, organizational structure, public health, continuing education, and workforce composition have potential to have a positive impact on health outcomes in rural and remote northern regions. The only area of research that indicated not to have a positive impact was medical air transport indicating further research is needed. The research study has provided an extensive survey from literate regarding innovations in the organizational structure and delivery of health serveries in northern rural and remote regions.
This study did not find any conflicts of interest regarding the improvement of health care in these rural and remote regions. Specific ideas and strategies found to improving access, quality, and efficiency in the organization structure and delivery of health care services in rural and remote northern regions are palliative model, which performed most effective for patients on weekly case conferences, on-call nursing, patient held records, shared protocols, and procedures. Reference:
Masucci, L., Mitton, C., & Dionne, F. (2011). ) Innovations in health service organization and delivery in northern rural and remote regions: a review of the literature. International Journal of Circumpolar Health, 70(5), 460-472.
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