Perspectives on the provision of urgent care services by family physicians

1993 ◽  
Vol 2 (6) ◽  
pp. 589-589
Author(s):  
W. A. Norcross
Keyword(s):  
Family Physicians ◽  
Urgent Care ◽  
Care Services

Effective safety netting in acute childhood illness: an important contribution to avoiding preventable deaths

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696893
Author(s):  
Sarah Neill ◽  
Damian Roland ◽  
Matthew Thompson ◽  
Sue Palmer-Hill ◽  
Natasha Bayes ◽  
...  
Keyword(s):  
Research Programme ◽  
Safety Net ◽  
Childhood Illness ◽  
Urgent Care ◽  
Video Capture ◽  
Delivery Modes ◽  
Care Services ◽  
The Right ◽  
Qualitative Exploration ◽  
Safety Netting

BackgroundChildren’s use of urgent care services continues to increase. If families are to access the right services at the right time they need access to information to inform their decision making. Providing a safety net of information has the potential to reduce morbidity and avoidable mortality and has been shown to reduce re-consultation safely.AimOur research programme aims to provide parents with information they can use to help them determine when to seek help for an acutely ill child.MethodOur programme includes: ASK SARA, a systematic review of existing interventions; ASK PIP, qualitative exploration of safety netting information used by parents and professionals; ASK SID, development of the content and delivery modes for the intervention; ASK ViC, video capture of children with acute illness; and ASK Petra, safety netting tool development using consensus methodology.ResultsThe ASK SNIFF programme findings demonstrate the need for professionally endorsed and co-produced safety netting resources focussing on symptoms of acute childhood illness. We now have consensus on the scripted content for a safety netting tool supported by video materials to enable parents to see symptoms for real.ConclusionSafety netting tools are a valuable aid to general practice enabling GPs to show parents what to look out for when their child is sick so that they know when to (re)consult. Recent reports of failure to recognise and appropriately safety net children with sepsis highlights the importance of such tools.

scholarly journals The Seniors’ Community Hub: An Integrated Model of Care for the Identification and Management of Frailty in Primary Care

Geriatrics ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 18
Author(s):  
Marjan Abbasi ◽  
Sheny Khera ◽  
Julia Dabravolskaj ◽  
Bernadette Chevalier ◽  
Kelly Parker
Keyword(s):  
Primary Care ◽  
Gait Speed ◽  
Family Physicians ◽  
Community Dwelling ◽  
Integrated Models ◽  
Care Services ◽  
Interprofessional Teamwork ◽  
Team Working ◽  
Centered Care

(1) Background: Integrated models of primary care deliver the comprehensive and preventative approach needed to identify and manage frailty in older people. Seniors’ Community Hub (SCH) was developed to deliver person-centered, evidence-informed, coordinated, and integrated care services to older community dwelling adults living with frailty. This paper aims to describe the SCH model, and to present patient-oriented results of the pilot. (2) Methods: SCH was piloted in an academic clinic with six family physicians. Eligible patients were community dwelling, 65 years of age and older, and considered to be at risk of frailty (eFI > 0.12). Health professionals within the clinic received training in geriatrics and interprofessional teamwork to form the SCH team working with family physicians, patients and caregivers. The SCH intervention consisted of a team-based multi-domain assessment with person-centered care planning and follow-up. Patient-oriented outcomes (EQ-5D-5L and EQ-VAS) and 4-metre gait speed were measured at initial visit and 12 months later. (3) Results: 88 patients were enrolled in the pilot from April 2016–December 2018. No statistically significant differences in EQ-5D-5L/VAS or the 4-metre gait speed were detected in 38 patients completing the 12-month assessment. (4) Conclusions: Future larger scale studies of longer duration are needed to demonstrate impacts of integrated models of primary care on patient-oriented outcomes for older adults living with frailty.

scholarly journals Rapid implementation of virtual neurology in response to the COVID-19 pandemic

Neurology ◽  
2020 ◽  
Vol 94 (24) ◽  
pp. 1077-1087 ◽  
Author(s):  
Scott N. Grossman ◽  
Steve C. Han ◽  
Laura J. Balcer ◽  
Arielle Kurzweil ◽  
Harold Weinberg ◽  
...  
Keyword(s):  
Care Delivery ◽  
Mitigation Strategies ◽  
Urgent Care ◽  
Technology Infrastructure ◽  
Information Technology Infrastructure ◽  
Care Services ◽  
Global Pandemic ◽  
Specific Practice ◽  
Government Rules ◽  
Rapid Deployment

The COVID-19 pandemic is causing world-wide social dislocation, operational and economic dysfunction, and high rates of morbidity and mortality. Medical practices are responding by developing, disseminating, and implementing unprecedented changes in health care delivery. Telemedicine has rapidly moved to the frontline of clinical practice due to the need for prevention and mitigation strategies; these have been encouraged, facilitated, and enabled by changes in government rules and regulations and payer-driven reimbursement policies. We describe our neurology department's situational transformation from in-person outpatient visits to a largely virtual neurology practice in response to the COVID-19 pandemic. Two key factors enabled our rapid deployment of virtual encounters in neurology and its subspecialties. The first was a well-established robust information technology infrastructure supporting virtual urgent care services at our institution; this connected physicians directly to patients using both the physician's and the patient's own mobile devices. The second is the concept of one patient, one chart, facilitated by a suite of interconnected electronic medical record (EMR) applications on several different device types. We present our experience with conducting general teleneurology encounters using secure synchronous audio and video connections integrated with an EMR. This report also details how we perform virtual neurologic examinations that are clinically meaningful and how we document, code, and bill for these virtual services. Many of these processes can be used by other neurology providers, regardless of their specific practice model. We then discuss potential roles for teleneurology after the COVID-19 global pandemic has been contained.

Importance of good teamwork in urgent care services

2014 ◽  
Vol 22 (7) ◽  
pp. 32-36 ◽  
Author(s):  
Curtis Meier
Keyword(s):  
Urgent Care ◽  
Care Services

Effect of a Reduced Postpartum Length of Stay Program on Primary Care Services Use by Mothers and Infants

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_3) ◽  
pp. 937-941
Author(s):  
Kenneth D. Mandl ◽  
Charles J. Homer ◽  
Oren Harary ◽  
Jonathan A. Finkelstein
Keyword(s):  
Primary Care ◽  
Length Of Stay ◽  
Early Discharge ◽  
Urgent Care ◽  
Care Utilization ◽  
Care Services ◽  
Primary Care Services ◽  
Ambulatory Services ◽  
The Impact ◽  
Services Use

Objective. To determine the impact of reduced postpartum length of stay (LOS) on primary care services use. Methods. Design: Retrospective quasiexperimental study, comparing 3 periods before and 1 period after introducing an intervention and adjusting for time trends.Setting: A managed care plan.Intervention: A reduced obstetrical LOS program (ROLOS), offering enhanced education and services.Participants: mother-infant dyads, delivered during 4 time periods: February through May 1992, 1993, and 1994, before ROLOS, and 1995, while ROLOS was in effect.Independent Measures: Pre-ROLOS or the post-ROLOS year.Outcome Measures: Telephone calls, visits, and urgent care events during the first 3 weeks postpartum summed as total utilization events. Results. Before ROLOS, LOS decreased gradually (from 51.6 to 44.3 hours) and after, sharply to 36.5 hours. Although primary care use did not increase before ROLOS, utilization for dyads increased during ROLOS. Before ROLOS, there were between 2.37 and 2.72 utilization events per dyad; after, there were 4.60. Well-child visits increased slightly to .98 visits per dyad, but urgent visits did not. Conclusion. This program resulted in shortened stays and more primary care use. There was no increase in infant urgent primary care utilization. Early discharge programs that incorporate and reimburse for enhanced ambulatory services may be safe for infants; these findings should not be extrapolated to mandatory reduced LOS initiatives without enhancement of care.

The importance of the partnership between the public and private healthcare institutions to improve interhospital patient transfers

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rimantas Stašys ◽  
Gintautas Virketis ◽  
Daiva Labanauskaitė
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Public Health Care ◽  
Urgent Care ◽  
Private Health Care ◽  
Content Type ◽  
Patient Transfers ◽  
Care Services ◽  
Interhospital Transfer ◽  
Health Care Institutions

Purpose The purpose of this study/paper is to identify the importance of the partnership between the public and private health-care institutions to improve interhospital patient transfers. Scientific research and statistical data show the increased number of interhospital transportation services; therefore, timely and qualified patient transportation between different health-care institutions must be considered, the activity that directly and significantly impacts the patient’s health status and overall quality of the health-care services. The successful patient transportation from the smaller hospitals to the health-care institutions with advanced intensive care or urgent care units can be enhanced through the partnership between private and public health-care institutions. Design/methodology/approach The methodology included quantitative method, statistical data analysis and theoretical data generalization. Both primary and secondary data were collected and analyzed during the research. Expert quantification was performed using the survey research method. The survey was conducted in Lithuania. The respondents were selected to be the general managers of the health-care and urgent care institutions, the chief doctors of the reanimation and intensive care department also the chief doctors of the emergency department. Findings Because of the centralization and regionalization of health-care services, the number of patients transferred between hospitals by the emergency medical services (EMS) and personal health-care institutions has increased. University hospitals are not sufficiently prepared to accept an increasing flow of patients in accordance with the Ministry of Health orders. Not all regional or district hospitals have the right to provide such assistance, which increases transportation time and costs as well as requires additional human resources. The five EMS categories could be used to improve the patient transfer between different levels of health-care institutions. To increase partnership between private and public health-care organizations, incentives should be provided for the development of private health-care organizations, as well as encouraging actions should be taken to increase the demand for private health-care services by Lithuanian patients. Practical implications Five EMS categories identified in this paper could be used to ensure a smooth mechanism for the patient transfer between different levels of the personal health-care institutions. The proposed categories should also be used in the pre-stationary emergency phase (for reducing the interhospital patient transportation amount). Social implications Properly organized secondary and tertiary interhospital patient transfers influence the availability and quality of the EMS and reduce inequalities in the provided services and social exclusion. Originality/value This paper presents the classification of the interhospital transfer issues, determines the main reasons for the patient interhospital transfer, creates the model for the EMS patient process flows and defines five EMS categories for the assessment of patient conditions. Therefore, the research conducted and the results obtained have both theoretical and social-practical value.

Urgent Care Centers

2014 ◽  
pp. 63-85
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Occupational Medicine ◽  
Urgent Care ◽  
Care Services ◽  
Primary Care Services ◽  
Per Capita ◽  
Urgent Care Centers ◽  
Care Costs

This chapter focuses on urgent care centers as a unique innovation that has been in the making for the last 30 years. Urgent care centers provide unscheduled or walk-in care, are open for extended hours on weeknights and weekends, and provide services that go beyond what primary care physicians provide, such as occupational medicine, laboratory tests, and fracture care such as splinting and casting, with some providing intravenous fluids, routine immunizations, and primary care services. This chapter describes in-depth the history and growth, operations, and stakeholders of urgent care centers, and overviews the research that relates to quality of care, costs, and patient satisfaction in these centers. Given the expanding industry, strong growth in company numbers, greater employment opportunities, and rising per-capita usage of urgent care centers, the author argues that the urgent care industry is in the growth phase of its life cycle.

Obstetric emergencies

2016 ◽  
Keyword(s):  
Emergency Department ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Urgent Care ◽  
Medical Problems ◽  
Nursing Assessment ◽  
Care Services ◽  
Obstetric Emergencies ◽  
In Pregnancy

Women often present to emergency and urgent care services with problems or concerns relating to their pregnancy. Additionally, women who are pregnant may also present with acute medical problems or suffer from a range of injuries. Problems in early pregnancy are common and are often a reason for attendance to the emergency department. This chapter provides detailed information regarding the assessment of pregnant women and the differences to that of non-pregnant patients. A range of emergency obstetric problems are covered, including emergency delivery. The nursing assessment and management of medical problems in pregnancy are also covered.

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