Tag Archives: library

A Case Study of Cross-Jurisdiction Resource Sharing: The Merger of Two Tuberculosis Clinics in East Tennessee

Cross-jurisdiction resource sharing is considered a possible means to improve efficiency and effectiveness of public health service delivery. A merger of the tuberculosis (TB) clinics of a rural and a metropolitan jurisdiction in East Tennessee provided an opportunity to study service provision changes in real time. A mixed methods approach was used, including quantitative data on latent TB treatment outcomes and qualitative data from staff interviews, as well as documentation of changes in staffing time in TB services. Results showed a mix of efficiency changes, indicating probable increased pressure on key service providers after the merger, in addition to expected improvements of economies of scale such as a reduction in overall staff time. Mechanisms found beneficial in coping with the merger, such as face-to-face meetings between coworkers and management of the different jurisdictions were identified at interview. The clinic merger was associated with a balance of efficiency changes, problems and advantages, and this balance is likely to change as new working arrangements become more routine.

Available online: http://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1118&context=frontiersinphssr

It is included in the CJS Resource Library under the categories listed below. Select a link to find other resources in that category.

  • Consolidation of Services: The authors evaluate consolidation of rural and metropolitan tuburculosis clinics operated through a public health service delivery system and find benefits from the merger. This may offer an example of benefits of consolidating some public health services.
  • Research and Evaluation: Authors of this article used mixed methods to evaluate a sharing arrangement and found a mix of efficiency changes. This article may serve as an example for others interested in evaluation.

 
This resource is also linked to the Roadmap. Select a link below to read more about each area.

  • Monitoring and Improving / Phase Three: Authors of this article used mixed methods to evaluate a sharing arrangement and found a mix of efficiency changes. This article may serve as an example for others interested in evaluation.

 

A Roadmap for Government Transformation

This report provides the results of facilitated research and discussion about ways for governmental leaders to transform governmental service delivery within Wisconsin by 1) determining whether having fewer governments is truly more efficient and cost effective than having more local governments; 2) understanding how existing regional government organizations synthesize local and regional interest to get things done; 3) identifying services that are proven to be delivered more efficiently through local government cooperative action; and 4) recommending an approach to facilitate the definition of local versus regional interest.

Available online (pdf):  http://www.localgovinstitute.org/sites/default/files/LGI%20Roadmap%20Final%20Report_0.pdf

It is included in the CJS Resource Library under the categories listed below. Select a link to find other resources in that category.

  • Fiscal and Service Issues: This report suggests that positive fiscal impacts are more commonly seen in two general areas: cost avoidance and Reduced Annual Expenditure Increases.
  • Governance: This report addresses governance issues in Wisconsin related to public health by looking at layers of government.
  • Legal Issues: This report looks at the intergovernmental cooperation continuum level of difficulty and required investment.
  • Rural / Small Jurisdictions: This report looks at the intergovernmental cooperation continuum level of difficulty and required investment.

 
This resource is also linked to the Roadmap. Select a link below to read more about each area.

  • Fiscal / Phase Two: This report suggests that positive fiscal impacts are more commonly seen in two general areas: cost avoidance and Reduced Annual Expenditure Increases.
  • Service Implications / Phase Two: This report suggests that positive fiscal impacts are more commonly seen in two general areas: cost avoidance and Reduced Annual Expenditure Increases.
  • Governance / Phase Two: This report addresses governance issues in Wisconsin related to public health by looking at layers of government.

 
Baker Tilly Virchow Krause, LLP. (2010). A Roadmap for Government Transformation. Madison, WI: Local Government Institute of Wisconsin.