P127: Paramedics perception of working in Nova Scotia’s collaborative emergency centres

S. Whalen; J. Goldstein; R. Urquhart; A. Carter

doi:10.1017/cem.2017.329

P127: Paramedics perception of working in Nova Scotia’s collaborative emergency centres

CJEM ◽

10.1017/cem.2017.329 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S121

Author(s):

S. Whalen ◽

J. Goldstein ◽

R. Urquhart ◽

A. Carter

Keyword(s):

Health Care ◽

Nova Scotia ◽

Care Delivery ◽

Analysis Data ◽

Team Work ◽

Healthcare Team ◽

Telephone Interviews ◽

Leadership Support ◽

Data Collection And Analysis ◽

Constant Comparative Analysis

Introduction: The Collaborative Emergency Centre (CEC) model of health care delivery was implemented in rural Nova Scotia in July 2011 without an identifiable, directly comparable precedent. It features interprofessional teams working under one roof with the goal of providing improved access to timely primary health care, and appropriate access to 24/7 emergency care. One important component of the CEC model is overnight staffing by a paramedic/registered nurse team consulting with an offsite physician via telephone. Our objective was to ascertain the attitudes, feelings and experiences of paramedics working within the CEC construct. Methods: We conducted a qualitative study, guided by the principles of grounded theory. Semi-structured telephone interviews were carried out by the principal investigator with paramedics with experience working in a CEC in the province of Nova Scotia. Interviews were recorded, transcribed and analyzed. Analysis involved an inductive and deductive grounded approach using constant comparative analysis. Data collection and analysis continued until thematic saturation was reached. Results: Fourteen paramedics participated in the study. The majority were male (n=10, 71%), with a mean age of 44 years (STD=8.8) and mean experience as a paramedic of 14 years (STD=9.7). Four major themes were identified from the data: 1) leadership support, encompassing support from Emergency Health Services and Government prior to and after implementation of the model, 2) team work and collaboration, including interprofessional relationships among members of the healthcare team, 3) value to patients and the communities, and 4) professional and personal benefits of working in CECs. Conclusion: Paramedics have found working in CECs to be both professionally and personally rewarding. They perceive the CEC model to be of great value to the patients and communities it serves. Key lessons that might help future expansion of the model in Nova Scotia and other jurisdictions across the country include the importance of building and strengthening relationships between paramedics and nurses, and the need for greater feedback and support from leadership.

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The novel role of paramedics in collaborative emergency centres aligns with their professional identity: A qualitative analysis

CJEM ◽

10.1017/cem.2018.401 ◽

2018 ◽

Vol 20 (4) ◽

pp. 518-522 ◽

Cited By ~ 1

Author(s):

Stewart Whalen ◽

Judah Goldstein ◽

Robin Urquhart ◽

Alix J.E. Carter

Keyword(s):

Professional Identity ◽

Analysis Data ◽

The Novel ◽

Model Of Care ◽

Telephone Interviews ◽

Leadership Support ◽

Data Collection And Analysis ◽

Front Line Workers ◽

Constant Comparative Analysis

ABSTRACTObjectiveThe Collaborative Emergency Centre (CEC) model of care was implemented in Nova Scotia without an identifiable, directly comparable precedent. It features interprofessional teams working towards the goal of providing improved access to primary health care, and appropriate access to 24/7 emergency care. One important component of CEC functioning is overnight staffing by a paramedic and registered nurse (RN) team consulting with an off-site physician. Our objective was to ascertain the attitudes, feelings and experiences of paramedics working within Nova Scotia’s CECs.MethodsWe conducted a qualitative study informed by the principles of grounded theory. Semi-structured telephone interviews were conducted with paramedics with experience working in a CEC. Analysis involved an inductive grounded approach using constant comparative analysis. Data collection and analysis continued until thematic saturation was reached.ResultsFourteen paramedics participated in the study. The majority were male (n=10, 71%) with a mean age of 44 years and mean paramedic experience of 14 years. Four major themes were identified: 1) interprofessional relationships, 2) leadership support, 3) value to community and 4) paramedic identity.ConclusionsParamedics report largely positive interprofessional relationships in Nova Scotia’s CECs. They expressed enjoyment working in these centres and believe this work aligns with their professional identity. High levels of patient and community satisfaction were reported. Paramedics believe future expansion of the model would benefit from development of continuing education and improved communication between leadership and front-line workers.

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Preferences and expectations of graduates in nursing towards lifelong learning (Bulgaria, 2016-2019)

European Journal of Public Health ◽

10.1093/eurpub/ckz186.411 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

G Grancharova ◽

S Djulgerova ◽

S Aleksandrova-Yankulovska ◽

E Dimitrova

Keyword(s):

Professional Development ◽

Health Care ◽

Lifelong Learning ◽

Care Delivery ◽

Vital Role ◽

Team Work ◽

Global Perspective ◽

Cross Sectional ◽

Educational Degree ◽

Level Of Significance

Abstract Background Nurses have a vital role to play in provision of high quality and safety health care in a global perspective. This is extremely valid for Bulgaria with the lowest nurses to doctors’ ratio 1.1. The future nursing generations should be motivated for lifelong learning (LLL), irrespectively of scarce human and financial resources in health care. The aim of the study was to explore preferences, expectations and motivation of graduates in nursing towards LLL. Methods A cross-sectional descriptive study was conducted among 174 bachelors in nursing (152 women and 22 men) before their graduation in 2016-2019 at the Faculty of Health Care in MU-Pleven. Anonymous self-administered questionnaire was used to collect information about graduates’ work preferences, expectations and motivation for LLL (response rate 95%). Data processing was performed by SPSS v.24 using descriptive statistics and correlations. The accepted level of significance was p < 0.05. Results Most of the graduates prefer high-technology clinics with only 13.2% for outpatient care and community centres; 50% plan to get higher educational degree; 81.5% will need a clinical mentor to start practicing. LLL is appraised by 82% as ultimate for nursing. It should be directed to developing skills and knowledge for effective team work (29.9%), capacity for self-directed practice and adaption to innovations (24.1%), skills to cope with critical situations (14.1%). The first motivating factors for LLL are professional development (44.3%) and better payment (37.4%). The most common demotivating factors: financial reasons (37.9), health problems (21.3), absence from home (13.8%), employer permission (13.8%). All the results have p=.000 for one sample x2 test. Conclusions The graduates understand the crucial role and have realistic expectations of LLL for their professional development. Prevailing motives and demotivating factors correlate to the whole Bulgarian health system problems. Key messages The graduates in nursing at the Faculty of Health care in Pleven Medical University highly appreciate the role of LLL for their professional development and prestige. The schools in nursing should continue working to further motivation for LLL as indispensable requirements for contemporary effective and efficient nursing care delivery.

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Perceptions, practice, and “ownership:” experiences in continuity of the patient-doctor relationship in a family medicine residency

Canadian Medical Education Journal ◽

10.36834/cmej.42288 ◽

2017 ◽

Vol 8 (4) ◽

pp. e74-85 ◽

Cited By ~ 1

Author(s):

Ann Lee ◽

Sandra Kennett ◽

Sheny Khera ◽

Shelley Ross

Keyword(s):

Health Care ◽

Family Medicine ◽

Health Care Delivery ◽

Care Delivery ◽

Structured Interviews ◽

Descriptive Research ◽

Provider Experiences ◽

Significant Barrier ◽

Qualitative Descriptive ◽

Constant Comparative Analysis

Background: The objective of this mixed-methods study was to determine interpersonal continuity (the ongoing therapeutic relationship between patient and health care provider) experiences of family medicine residents and preceptors, and explore their perceptions of interpersonal continuity.Methods: Quantitative data on resident and preceptor encounters were extracted from the electronic medical record (EMR). Opportunities for developing interpersonal continuity were determined using the Usual Provider Continuity (UPC) Index. A qualitative descriptive research method was used for the qualitative portion. Semi-structured interviews were conducted and constant comparative analysis was used to determine emerging themes.Results: Residents were found to have low UPC rates; preceptor rates were higher. Qualitative findings showed variable experiences with interpersonal continuity not apparent from UPC rates. Both preceptors and residents expressed perception of “ownership” of patients as a significant barrier to interpersonal continuity. Conclusion: This study suggests that a perceived lack of individual “ownership” of a patient panel was a significant barrier to developing interpersonal continuity. This might conflict with current changes towards team-based health care delivery. Understanding perceptions and changing them through a multi-faceted approach including resident teaching and faculty development might help improve interpersonal continuity which are core to both family medicine curricula and current models of health care delivery.

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Patients’ Stories of Interprofessional Whole-Person Care

International Journal of Whole Person Care ◽

10.26443/ijwpc.v1i1.24 ◽

2014 ◽

Vol 1 (1) ◽

Author(s):

Kateryna Aksenchuk ◽

Jasna K Schwind ◽

Sherry Espin ◽

Beth McCay ◽

Jacqui Gingras

Keyword(s):

Health Care ◽

Health Care Providers ◽

Care Delivery ◽

Structured Interview ◽

Point Of View ◽

Team Work ◽

Care Providers ◽

Interprofessional Team ◽

Whole Person ◽

Patient Health

Objectives: Interprofessional whole-person care has been depicted as being able to enhance patient health outcomes, increase health care provider satisfaction with care delivery, lower health care spending and decrease wait times for receiving care. Limited research has been conducted into exploring patients’ experiences of being recipients of this type of care. The objective of this oral presentation is to disseminate findings of a Master of Nursing study through patients’ stories of experience receiving care on aunit where inter professional care is practiced.Methods: Three participants underwent a two step data collection process: a one hour semi-structured interview and a 30 minute symbolic image artistic exercise, as adapted from Schwind’s Narrative Reflective Process. Participants were invited to describe how they experienced receivingcare from an interprofessional team and whether or not they believed whole-person care was delivered to them. Collected data are being analyzed using Clandinin and Connelly’s Narrative Inquiry approach of three dimensionalspace, temporality, sociality and place.Results: The emerging results suggest that participants express satisfaction with the care they received from the interprofessional team on their unit. Their stories indicate that strong interprofessional team-work can contribute to patient satisfaction in care received. For these teams to be successful, from the patients’ point of view, there needs to be: better communication between care providers, greater involvement of the patient in decision making, proper identification of who comprises the teams, andconsistency in team composition.Conclusion: By acknowledging experiences and feelings ofpatients who have received care from an interprofessional team, there is potential to increase sustainability of these teams. The data generated through this study can potentially help health care providers, who are members of interprofessional teams, to deliver more effective, comprehensive whole-personcare within health care institutions.

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