Realising the health benefits of safe work - a continuing professional education for primary care practitioners

2014 ◽  
Vol 9 ◽  
Author(s):  
Kevin Sleigh
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Professional Education ◽  
Health Benefits ◽  
Continuing Professional Development ◽  
Local Staff ◽  
Safe Work ◽  
Education And Awareness ◽  
Awareness Raising ◽  
Practice Education

Background: General Practitioners complete around 91% of compensable certificates, and play a significant role in promoting the awareness of the health benefits of work. The Australasian Consensus Statement on the Health Benefits of Work developed by the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) has been endorsed by 100 organisations including the Royal Australian College of General Practitioners (RACGP). The Victorian WorkCover Authority and TAC has undertaken a program of work focussing on the delivery of a general practice education and awareness raising program.Objectives: The objectives of the program were to; engage Medicare Locals to undertake a general practice education and awareness raising program, develop training materials for Medicare Local staff to undertake practice liaison visits, recruit and train General Practice peer educators to deliver in-practice education and develop and deliver content for continuing professional development events in selected Medicare Locals.Methods: A suite of educational resources were developed and tailored to suit delivery in a General Practice setting. The Medicare Locals were targeted if they had high certification rates, the educational events were delivered in-practice settings and Principal findings The practice target was reached in all Medicare Locals, a total of 457 general practices across the five Medicare Locals were visited. The program was successful in raising awareness of the health benefits of work amongst GPs and practice staff.Discussion: The education has given general practitioners the impetus to talk to patients early about the health benefits of work and has the potential for GPs to be more confident in their clinical management of compensable patients.Conclusion: That the educational program continue with the Victorian WorkCover Authority and TAC working with key peak bodies and medical colleges to ensure education about the Health Benefits of Safe Work become a mandatory component of all GP postgraduate training.

scholarly journals Symbiotic relationships in patients' engagements with practice nurses

2021 ◽  
Author(s):  
◽  
Elsa Lally
Keyword(s):  
General Practice ◽  
Narrative Inquiry ◽  
General Practitioners ◽  
Professional Education ◽  
Well Being ◽  
Original Research ◽  
Practice Nurses ◽  
Symbiotic Relationships ◽  
Primary Health ◽  
Health And Well Being

<p>Practice nurses engaging with patients is a daily activity in general practice. However, there is little research to assess these relationships from a primary health care, general practice standpoint. The purpose of this new and original research was to explore from patients' perspectives what occurs in general practice, and to establish how the engagements patients have with practice nurses influences patients' health and well-being. The conceptualisation of symbiotic relationships between practice nurses, general practitioners receptionists and patients described in this study, shows how these relationships work in practice, and how they shaped patients' perspectives of their engagements in the general practice setting. Although each person’s role was independent and capable of existing without the other, a mutually beneficial close association was developed.  From the experiences of 15 patients from seven rural and urban general practices in New Zealand, using Narrative Inquiry methodology informed by life course theory and White’s (2010) dimensions of well-being, the co-constructed stories gathered from the participants were analysed applying a modification of McCormack’s (2001) multiple lens model. Findings from the individual participant stories revealed three major themes – general practice activity, health focused practice, and professional comforting. Each of these themes described aspects of the participants' relationships and engagements with practice nurses that contributed to their health and well-being. The co-constructed stories described participants' relationships and engagements, not only with practice nurses but also with general practitioners and receptionists. The presence of the (often unseen) overarching doctor and of practice nurses filling the gap in patients' care was evident. Patients described practice nurses as both support for the doctor and as autonomous practitioners. Ease of access to practice nurses significantly contributed to patients obtaining competent health promoting care. Particularly cogent were the findings that practice nurses directly contributed to patients' health and well-being through nurses' skilled compassion and skilled companionship. Nurses actively listened to patients' concerns, suggesting strategies to move patients forward, while at the same time, providing space for them to move at their own pace. Receptionists were viewed as the 'fronts people' of the practice who triaged patients' health concerns, making decisions relating to whom the patient consulted, the doctor or the nurse.  By building on existing theories in Narrative Inquiry methodology, data collection and analysis, this research makes an important contribution to nursing knowledge. It provides new perspectives about nurse-patient relationships, as well as other relationships within general practice. The research also demonstrates that while there has been a significant increase in collaboration between nurses and general practitioners over time, this collaboration is distinct from the symbiotic relationships described. The findings have implications for health professionals' everyday practice, and for Primary Health Organisations and District Health Boards when undertaking health professional education and funding reviews. Future research into patients' relationships with practice nurses, doctors and receptionists, and how these relationships contribute to patients' health and well-being is necessary.</p>

Developing the military GP using immersive simulation in specialty training

2021 ◽  
pp. bmjmilitary-2021-001964
Author(s):  
Kate King ◽  
M Smith
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Professional Education ◽  
Teaching Method ◽  
Training Programme ◽  
Specialty Training ◽  
Educational Design ◽  
Effective Learning ◽  
Programme Simulation ◽  
The Military

Military general practice requires wider knowledge and more diverse skillset than that defined by the Royal College of General Practitioners curriculum. Following completion of specialty training, military general practitioners (GPs) were returning from mostly civilian training environments feeling deskilled and ill-prepared for their military role. The Academic Department of Military General Practice defined the training gap and used co-creative curriculum development to incorporate military topics throughout the GP specialty training programme. Simulation was identified as a key teaching method employed throughout undergraduate and postgraduate health professional education, which could be used to improve the trainee’s learning. The resulting operational preparedness training week used layered teaching methods and feedback to build trainees’ knowledge and skills before a final major immersive simulation exercise. This article describes the educational design process in terms of the ‘10 goal conditions’ described by Issenberg for high-fidelity medical simulations leading to effective learning.

scholarly journals Symbiotic relationships in patients' engagements with practice nurses

2021 ◽  
Author(s):  
◽  
Elsa Lally
Keyword(s):  
General Practice ◽  
Narrative Inquiry ◽  
General Practitioners ◽  
Professional Education ◽  
Well Being ◽  
Original Research ◽  
Practice Nurses ◽  
Symbiotic Relationships ◽  
Primary Health ◽  
Health And Well Being

<p>Practice nurses engaging with patients is a daily activity in general practice. However, there is little research to assess these relationships from a primary health care, general practice standpoint. The purpose of this new and original research was to explore from patients' perspectives what occurs in general practice, and to establish how the engagements patients have with practice nurses influences patients' health and well-being. The conceptualisation of symbiotic relationships between practice nurses, general practitioners receptionists and patients described in this study, shows how these relationships work in practice, and how they shaped patients' perspectives of their engagements in the general practice setting. Although each person’s role was independent and capable of existing without the other, a mutually beneficial close association was developed.  From the experiences of 15 patients from seven rural and urban general practices in New Zealand, using Narrative Inquiry methodology informed by life course theory and White’s (2010) dimensions of well-being, the co-constructed stories gathered from the participants were analysed applying a modification of McCormack’s (2001) multiple lens model. Findings from the individual participant stories revealed three major themes – general practice activity, health focused practice, and professional comforting. Each of these themes described aspects of the participants' relationships and engagements with practice nurses that contributed to their health and well-being. The co-constructed stories described participants' relationships and engagements, not only with practice nurses but also with general practitioners and receptionists. The presence of the (often unseen) overarching doctor and of practice nurses filling the gap in patients' care was evident. Patients described practice nurses as both support for the doctor and as autonomous practitioners. Ease of access to practice nurses significantly contributed to patients obtaining competent health promoting care. Particularly cogent were the findings that practice nurses directly contributed to patients' health and well-being through nurses' skilled compassion and skilled companionship. Nurses actively listened to patients' concerns, suggesting strategies to move patients forward, while at the same time, providing space for them to move at their own pace. Receptionists were viewed as the 'fronts people' of the practice who triaged patients' health concerns, making decisions relating to whom the patient consulted, the doctor or the nurse.  By building on existing theories in Narrative Inquiry methodology, data collection and analysis, this research makes an important contribution to nursing knowledge. It provides new perspectives about nurse-patient relationships, as well as other relationships within general practice. The research also demonstrates that while there has been a significant increase in collaboration between nurses and general practitioners over time, this collaboration is distinct from the symbiotic relationships described. The findings have implications for health professionals' everyday practice, and for Primary Health Organisations and District Health Boards when undertaking health professional education and funding reviews. Future research into patients' relationships with practice nurses, doctors and receptionists, and how these relationships contribute to patients' health and well-being is necessary.</p>

scholarly journals General practice registrars' views on maternity care in general practice in New Zealand

2015 ◽  
Vol 7 (4) ◽  
pp. 316 ◽  
Author(s):  
Hanna Preston ◽  
Chrystal Jaye ◽  
Dawn Miller
Keyword(s):  
General Practice ◽  
New Zealand ◽  
General Practitioners ◽  
Maternity Care ◽  
Shared Care ◽  
Online Questionnaire ◽  
Maternity Services ◽  
Training Support ◽  
Learning Platform ◽  
Practice Education

INTRODUCTION: The number of general practitioners (GPs) providing maternity care in New Zealand has declined dramatically since legislative changes of the 1990s. The Ministry of Health wants GPs to provide maternity care again. AIM: To investigate New Zealand general practice registrars' perspectives on GPs' role in maternity care; specifically, whether maternity services should be provided by GPs, registrars' preparedness to provide such services, and training opportunities available or required to achieve this. METHODS: An anonymous online questionnaire was distributed to all registrars enrolled in The Royal New Zealand College of General Practitioners' (RNZCGP's) General Practice Education Programme (GPEP) in 2012, via their online learning platform OWL. RESULTS: 165 of the 643 general practice registrars responded (25.7% response rate). Most (95%) believe that GPs interested and trained in maternity care should consider providing antenatal, postnatal or shared care with midwives, and 95% believe women should be able to access maternity care from their general practice. When practising as a GP, 90% would consider providing antenatal and postnatal care, 47.3% shared care, and 4.3% full pregnancy care. Professional factors including training and adequate funding were most important when considering providing maternity care as a GP. DISCUSSION: Ninety-five percent of general practice registrars who responded to our survey believe that GPs should provide some maternity services, and about 90% would consider providing maternity care in their future practice. Addressing professional issues of training, support and funding are essential if more GPs are to participate in maternity care in New Zealand. KEYWORDS: General practice; education; maternity care; New Zealand; rural health services

scholarly journals ‘Motivational work’: a qualitative study of preventive health dialogues in general practice

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie Broholm-Jørgensen ◽  
Siff Monrad Langkilde ◽  
Tine Tjørnhøj-Thomsen ◽  
Pia Vivian Pedersen
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Support System ◽  
Preventive Intervention ◽  
Digital Health ◽  
Clinical Encounter ◽  
Preventive Health ◽  
Structured Interviews ◽  
General Practices ◽  
Municipal Health

Abstract Background The aim of this article is to explore preventive health dialogues in general practice in the context of a pilot study of a Danish primary preventive intervention ‘TOF’ (a Danish acronym for ‘Early Detection and Prevention’) carried out in 2016. The intervention consisted of 1) a stratification of patients into one of four groups, 2) a digital support system for both general practitioners and patients, 3) an individual digital health profile for each patient, and 4) targeted preventive services in either general practice or a municipal health center. Methods The empirical material in this study was obtained through 10 observations of preventive health dialogues conducted in general practices and 18 semi-structured interviews with patients and general practitioners. We used the concept of ‘motivational work’ as an analytical lens for understanding preventive health dialogues in general practice from the perspectives of both general practitioners and patients. Results While the health dialogues in TOF sought to reveal patients’ motivations, understandings, and priorities related to health behavior, we find that the dialogues were treatment-oriented and structured around biomedical facts, numeric standards, and risk factor guidance. Overall, we find that numeric standards and quantification of motivation lessens the dialogue and interaction between General Practitioner and patient and that contextual factors relating to the intervention framework, such as a digital support system, the general practitioners’ perceptions of their professional position as well as the patients’ understanding of prevention —in an interplay—diminished the motivational work carried out in the health dialogues. Conclusion The findings show that the influence of different kinds of context adds to the complexity of prevention in the clinical encounter which help to explain why motivational work is difficult in general practice.

scholarly journals Improving TB infection control in a regional hospital in the Eastern Cape, South Africa

2019 ◽  
Vol 8 (1) ◽  
pp. bmjoq-2018-000347 ◽  
Author(s):  
Ilsa Louisa Haeusler ◽  
Felicity Knights ◽  
Vishaal George ◽  
Andy Parrish
Keyword(s):  
South Africa ◽  
Eastern Cape ◽  
Post Intervention ◽  
Hospital Policy ◽  
Staff Members ◽  
Root Cause ◽  
Number Of Patients ◽  
Service Training ◽  
Education And Awareness ◽  
Awareness Raising

This quality improvement (QI) work was carried out in Cecilia Makiwane Hospital (CMH), a regional public hospital in the Eastern Cape, South Africa (SA). SA has among the highest incidence of tuberculosis (TB) in the world and this is a leading cause of death in SA. Nosocomial infection is an important source of TB transmission. Adherence to TB infection prevention control (IPC) measures in the medical inpatient department was suboptimal at CMH. The overall aim of this QI project was to make sustainable improvements in TB IPC. A multidisciplinary team was formed to undertake a root cause analysis and develop a strategy for change. The main barriers to adherence to IPC measures were limited knowledge of IPC methods and stigma associated with TB. Specifically, the project aimed to increase the number of: ‘airborne precaution’ signs placed above patients’ beds, patients correctly isolated and patients wearing surgical face masks. Four Plan-Do-Study-Act cycles were used. The strategy for change involved education and awareness-raising in different formats, including formal in-service training delivered to nurses and doctors, a hospital-wide TB awareness week with engaging activities and competitions, and a World TB Day provincial solidarity march. Data on adherence to the three IPC measures were collected over an 8-month period. Pre-intervention (October 2016), a mean of 2% of patients wore face masks, 22% were correctly isolated and 12% had an airborne precaution sign. Post-intervention (May 2017), the compliance improved to 17%, 50% and 25%, respectively. There was a large variation in compliance to each measure. Improvement was greatest in the number of patients correctly isolated. We learnt it is important to work with, not in parallel to, existing teams or structures during QI work. On-the-ground training of nurses and clinicians should be undertaken alongside engagement of senior staff members and managers. This improves the chance of change being adopted into hospital policy.

scholarly journals How to set up a postmortem facility in a farm animal practice

Livestock ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 196-201
Author(s):  
John F Mee ◽  
Rhona Ley
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Diagnostic Tool ◽  
Small Ruminants ◽  
Farm Animal ◽  
Small Animals ◽  
Animal Medicine ◽  
Set Up ◽  
Postmortem Examinations

Postmortem examinations can be a useful diagnostic tool in farm animal medicine; however, they are often avoided in general practice because of a lack of appropriate facilities and expertise/familiarity with techniques. This article describes the setting up of a basic facility to allow general practitioners to perform postmortem examinations of calves, small ruminants and other small animals, e.g. poultry.

scholarly journals Quality improvement in general practice: what do GPs and practice managers think? Results from a nationally representative survey of UK GPs and practice managers

2021 ◽  
Vol 10 (2) ◽  
pp. e001309
Author(s):  
Jennifer Gosling ◽  
Nicholas Mays ◽  
Bob Erens ◽  
David Reid ◽  
Josephine Exley
Keyword(s):  
General Practice ◽  
Quality Improvement ◽  
General Practitioners ◽  
Service Improvement ◽  
Protected Time ◽  
Routine Work ◽  
Professional Interest ◽  
Quality And Outcomes ◽  
Nationally Representative ◽  
The Uk

BackgroundThis paper presents the results of the first UK-wide survey of National Health Service (NHS) general practitioners (GPs) and practice managers (PMs) designed to explore the service improvement activities being undertaken in practices, and the factors that facilitated or obstructed that work. The research was prompted by growing policy and professional interest in the quality of general practice and its improvement. The analysis compares GP and PM involvement in, and experience of, quality improvement activities.MethodsThis was a mixed-method study comprising 26 semistructured interviews, a focus group and two surveys. The qualitative data supported the design of the surveys, which were sent to all 46 238 GPs on the Royal College of General Practitioners (RCGP) database and the PM at every practice across the UK (n=9153) in July 2017.ResultsResponses from 2377 GPs and 1424 PMs were received and were broadly representative of each group. Ninety-nine per cent reported having planned or undertaken improvement activities in the previous 12 months. The most frequent related to prescribing and access. Key facilitators of improvement included ‘good clinical leadership’. The two main barriers were ‘too many demands from external stakeholders’ and a lack of protected time. Audit and significant event audit were the most common improvement tools used, but respondents were interested in training on other quality improvement tools.ConclusionGPs and PMs are interested in improving service quality. As such, the new quality improvement domain in the Quality and Outcomes Framework used in the payment of practices is likely to be relatively easily accepted by GPs in England. However, if improving quality is to become routine work for practices, it will be important for the NHS in the four UK countries to work with practices to mitigate some of the barriers that they face, in particular the lack of protected time.

scholarly journals ABC of prescribing exercise as medicine: a narrative review of the experiences of general practitioners and patients

2021 ◽  
Vol 7 (2) ◽  
pp. e001050
Author(s):  
Andrew O'Regan ◽  
Michael Pollock ◽  
Saskia D'Sa ◽  
Vikram Niranjan
Keyword(s):  
Physical Activity ◽  
General Practice ◽  
General Practitioners ◽  
Exercise Prescription ◽  
Narrative Review ◽  
System Support ◽  
Physician Characteristics ◽  
Cochrane Reviews ◽  
Type Of Exercise ◽  
User Friendly

BackgroundExercise prescribing can help patients to overcome physical inactivity, but its use in general practice is limited. The purpose of this narrative review was to investigate contemporaneous experiences of general practitioners and patients with exercise prescribing.MethodPubMed, Scopus, Science Direct and Cochrane reviews were reviewed using the terms ‘exercise prescription’, ‘exercise prescribing’, ‘family practice’, ‘general practice’, ‘adults’ and ‘physical activity prescribing’.ResultsAfter screening by title, abstract and full paper, 23 studies were selected for inclusion. Qualitative, quantitative and mixed-methods studies revealed key experiences of general practitioners and patients. Barriers identified included: physician characteristics, patients’ physical and psychosocial factors, systems and cultural failures, as well as ambiguity around exercise prescribing. We present a synthesis of the key strategies to overcome these using an ABC approach: A: assessment of physical activity: involves asking about physical activity, barriers and risks to undertaking an exercise prescription; B: brief intervention: advice, written prescription detailing frequency, intensity, timing and type of exercise; and C: continued support: providing ongoing monitoring, accountability and progression of the prescription. Multiple supports were identified: user-friendly resources, workshops for doctors, guidelines for specific illnesses and multimorbidity, electronic devices, health system support and collaboration with other healthcare and exercise professionals.DiscussionThis review has identified levers for facilitating exercise prescribing and adherence to it. The findings have been presented in an ABC format as a guide and support for general practitioners to prescribe exercise.

scholarly journals How well did Norwegian general practice prepare to address the COVID-19 pandemic?

2020 ◽  
Vol 8 (4) ◽  
pp. e000512
Author(s):  
Ingvild Vatten Alsnes ◽  
Morten Munkvik ◽  
W Dana Flanders ◽  
Nicolas Øyane
Keyword(s):  
General Practice ◽  
Quality Improvement ◽  
General Practitioners ◽  
Home Page ◽  
Quality Improvements ◽  
Geographical Differences ◽  
Home Office ◽  
Isolation Room ◽  
Improvement Measures ◽  
The Mean

ObjectivesWe aimed to describe the quality improvement measures made by Norwegian general practice (GP) during the COVID-19 pandemic, evaluate the differences in quality improvements based on region and assess the combinations of actions taken.DesignDescriptive study.SettingParticipants were included after taking part in an online quality improvement COVID-19 course for Norwegian GPs in April 2020. The participants reported whether internal and external measures were in place: COVID-19 sign on entrance, updated home page, access to video consultations and/or electronic written consultations, home office solutions, separate working teams, preparedness for home visits, isolation rooms, knowledge on decontamination, access to sufficient supplies of personal protective equipment (PPE) and COVID-19 clinics.ParticipantsOne hundred GP offices were included. The mean number of general practitioners per office was 5.63.ResultsMore than 80% of practices had the following preparedness measures: COVID-19 sign on entrance, updated home page, COVID-19 clinic in the municipality, video and written electronic consultations, knowledge on how to use PPE, and home office solutions for general practitioners. Less than 50% had both PPE and knowledge of decontamination. Lack of PPE was reported by 37%, and 34% reported neither sufficient PPE nor a dedicated COVID-19 clinic. 15% reported that they had an isolation room, but not enough PPE. There were no geographical differences.ConclusionsNorwegian GPs in this study implemented many quality improvements to adapt to the COVID-19 pandemic. Overall, the largest potentials for improvement seem to be securing sufficient supply of PPE and establishing an isolation room at their practices.

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