General Practitioners’ Roles in Disaster Health Management: Perspectives of Disaster Managers

2021 ◽  
pp. 1-8
Author(s):  
Penelope L. Burns ◽  
Gerard J. FitzGerald ◽  
Wendy C. Hu ◽  
Peter Aitken ◽  
Kirsty A. Douglas
Keyword(s):  
Health Care ◽  
New Zealand ◽  
General Practitioners ◽  
Health Management ◽  
Health Care Systems ◽  
Health Resources ◽  
Local Health ◽  
Structured Interviews ◽  
Care Needs ◽  
Study Objective

Abstract Introduction: General Practitioners (GPs) are inevitably involved when disaster strikes their communities. Evidence of health care needs in disasters increasingly suggests benefits from greater involvement of GPs, and recent research has clarified key roles. Despite this, GPs continue to be disconnected from disaster health management (DHM) in most countries. Study Objective: The aim of this study was to explore the perspectives of disaster management professionals in two countries, across a range of all-hazard disasters, regarding the roles and contributions of GPs to DHM, and to identify barriers to, and benefits of, more active engagement of GPs in disaster health care systems. Methods: A qualitative research methodology using semi-structured interviews was conducted with a purposive sample of Disaster Managers (DMs) to explore their perspectives arising from experiences and observations of GPs during disasters from 2009 through 2016 in Australia or New Zealand. These involved all-hazard disasters including natural, man-made, and pandemic disasters. Responses were analyzed using thematic analysis. Results: These findings document support from DM participants for greater integration of GPs into DHM with New Zealand DMs reporting GPs as already a valuable integrated contributor. In contrast, Australian DMs reported barriers to inclusion that needed to be addressed before sustained integration could occur. The two most strongly expressed barriers were universally expressed by Australian DMs: (1) limited understanding of the work GPs undertake, restricting DMs’ ability to facilitate GP integration; and (2) DMs’ difficulty engaging with GPs as a single group. Other considerations included GPs’ limited DHM knowledge, limited preparedness, and their heightened vulnerability. Strategies identified to facilitate greater integration of GPs into DHM where it is lacking, such as Australia, included enhanced communication, awareness, and understanding between GPs and DMs. Conclusion: Experience from New Zealand shows systematic, sustained integration of GPs into DHM systems is achievable and valuable. Findings suggest key factors are collaboration between DMs and GPs at local, state, and national levels of DHM in planning and preparedness for the next disaster. A resilient health care system that maximizes capacity of all available local health resources in disasters and sustains them into the recovery should include General Practice.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

scholarly journals Experiences of Inuit in Canada who travel from remote settings for cancer care and impacts on decision making

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Janet Jull ◽  
◽  
Amanda J. Sheppard ◽  
Alex Hizaka ◽  
Gwen Barton ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Cancer Care ◽  
Health Care Systems ◽  
Steering Committee ◽  
Urban Setting ◽  
System Capacity ◽  
Structured Interviews ◽  
Study Objective ◽  
To Receive

Abstract Background Inuit experience the highest cancer mortality rates from lung cancer in the world with increasing rates of other cancers in addition to other significant health burdens. Inuit who live in remote areas must often travel thousands of kilometers to large urban centres in southern Canada and negotiate complex and sometimes unwelcoming health care systems. There is an urgent need to improve Inuit access to and use of health care. Our study objective was to understand the experiences of Inuit in Canada who travel from a remote to an urban setting for cancer care, and the impacts on their opportunities to participate in decisions during their journey to receive cancer care. Methods We are an interdisciplinary team of Steering Committee and researcher partners (“the team”) from Inuit-led and/or -specific organizations that span Nunavut and the Ontario cancer health systems. Guided by Inuit societal values, we used an integrated knowledge translation (KT) approach with qualitative methods. We conducted semi-structured interviews with Inuit participants and used process mapping and thematic analysis. Results We mapped the journey to receive cancer care and related the findings of client (n = 8) and medical escort (n = 6) (“participant”) interviews in four themes: 1) It is hard to take part in decisions about getting health care; 2) No one explains the decisions you will need to make; 3) There is a duty to make decisions that support family and community; 4) The lack of knowledge impacts opportunities to engage in decision making. Participants described themselves as directed, with little or no support, and seeking opportunities to collaborate with others on the journey to receive cancer care. Conclusions We describe the journey to receive cancer care as a “decision chain” which can be described as a series of events that lead to receiving cancer care. We identify points in the decision chain that could better prepare Inuit to participate in decisions related to their cancer care. We propose that there are opportunities to build further health care system capacity to support Inuit and enable their participation in decisions related to their cancer care while upholding and incorporating Inuit knowledge.

Navigating the path: a qualitative exploration of New Zealand general practitioners’ views on integration of care with acupuncturists

2020 ◽  
pp. 096452842092934
Author(s):  
Kate Roberts ◽  
Debra Betts ◽  
Jing-Bao Nie ◽  
Anthony Dowell
Keyword(s):  
Health Care ◽  
New Zealand ◽  
General Practitioners ◽  
Conventional Medicine ◽  
Well Being ◽  
The Body ◽  
Patient Choice ◽  
Structured Interviews ◽  
Integration Of Care ◽  
Interprofessional Communication

Background Increasingly, many patients believe that a combined approach of complementary and alternative medicine (CAM), including acupuncture, and conventional medicine is better than either on its own, and more patients now have the desire to discuss CAM with well-informed general practitioners (GPs). However, to our knowledge, the interaction and collaboration between GPs and acupuncturists specifically in relation to shared care have not been investigated. This research explored interprofessional communication between GPs and acupuncturists in New Zealand. This article specifically reports the GPs’ viewpoints. Methods This study was part of a larger mixed-methods research project. Semi-structured interviews of 14 purposively sampled GP participants were conducted and analysed using thematic analysis. Results The data analysis identified both facilitators of and barriers to integrative health care . Facilitators included the willingness of GPs to engage in communication and a recognition of the importance of patient choice. Barriers included the limited opportunities for sharing information and the lack of current established pathways for communication or direct referrals. GPs also highlighted the confusion around scopes of practice in terms of the different styles of and approaches to acupuncture. Conclusion This research contributes to the body of knowledge concerning interprofessional communication and collaboration between GPs and acupuncturists and suggests that while there are significant barriers to collaboration, there is also the potential to impact provider satisfaction and patient well-being. It provides context within a New Zealand health care setting and also provides additional insights regarding acupuncture, specifically through the disaggregation of specific CAM modalities.

scholarly journals Restructuring Graduate Medical Education to Meet the Health Care Needs of Emirati Citizens

2013 ◽  
Vol 5 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Sawsan Abdel-Razig ◽  
Hatem Alameri
Keyword(s):  
Health Care ◽  
Medical Education ◽  
United Arab Emirates ◽  
Graduate Medical Education ◽  
Health Care Systems ◽  
Abu Dhabi ◽  
Care Needs ◽  
Graduate Medical ◽  
Comprehensive Health ◽  
The Government

Abstract Many nations are struggling with the design, implementation, and ongoing improvement of health care systems to meet the needs of their citizens. In the United Arab Emirates, a small nation with vast wealth, the lives of average citizens have evolved from a harsh, nomadic existence to enjoyment of the comforts of modern life. Substantial progress has been made in the provision of education, housing, health, employment, and other forms of social advancement. Having covered these basic needs, the government of Abu Dhabi, United Arab Emirates, is responding to the challenge of developing a comprehensive health system to serve the needs of its citizens, including restructuring the nation's graduate medical education (GME) system. We describe how Abu Dhabi is establishing GME policies and infrastructure to develop and support a comprehensive health care system, while also being responsive to population health needs. We review recent progress in developing a systematic approach for developing GME infrastructure in this small emirate, and discuss how the process of designing a GME system to meet the needs of Emirati citizens has benefited from the experience of “Western” nations. We also examine the challenges we encountered in this process and the solutions adopted, adapted, or specifically developed to meet local needs. We conclude by highlighting how our experience “at the GME drawing board” reflects the challenges encountered by scholars, administrators, and policymakers in nations around the world as they seek to coordinate health care and GME resources to ensure care for populations.

Health care as a worldwide concern. Insights on the Italian and Indian health care systems and PPPs from a VSA perspective

2014 ◽  
Vol 9 (2) ◽  
pp. 198-220 ◽  
Author(s):  
Marialuisa Saviano ◽  
Ratri Parida ◽  
Francesco Caputo ◽  
Saroj Kumar Datta
Keyword(s):  
Health Care ◽  
Systems Approach ◽  
Health Care Systems ◽  
Theoretical Perspective ◽  
Service Systems ◽  
Potential Contribution ◽  
Care Needs ◽  
Content Type ◽  
Indian Health ◽  
Theoretical Approaches

Purpose – Health is a fundamental populations’ need and an integral part of the socio-economic development of a country. However, it is required to explain the growing role of the private sectors in addressing various health care needs. The purpose of this paper is to analyse potential contribution, criticalities and conditions of success of public-private partnership (PPP) as a strategy to face the complexity of nationally relevant Italian and Indian service systems. Design/methodology/approach – The methodology is built upon the basis of the viable systems approach (VSA) integrated with the fundamental interpretative elements of service science and service-dominant logic to contextualize interpretation to the management of service systems benefitting from recent advances in these research fields. Findings – A VSA-based general framework of reference is built that is useful for analysing any relational context in which different aims and expectations need to be harmonized to make the collaboration effective. On the basis of this framework, first insights on Italian and Indian health care PPPs are proposed, highlighting key elements of analysis and criticalities that may challenge a positive conclusion on health care PPPs. Practical implications – The implications of the study are both theoretical and practical. From a theoretical perspective, the study contributes to the scholarly understanding of complex health care system in Italy as well as in India with particular reference to the public-private collaboration phenomenon. It also suggests theoretical approaches in the form of a generic VSA-based framework as applicable. From a practical perspective, the study stimulates managers to a critical reflection about current health care management approaches which are reflected in the adoption of PPPs solutions. Originality/value – The paper discusses relevant worldwide decision-making challenges, such as the equality in the populations’ access to health service, suggesting managers the way to create conditions of consonance among the diverse stakeholders for a successful health care PPPs.

Assessment of older people in the community: lessons from Britain’s ‘75-and-over checks’

1999 ◽  
Vol 9 (4) ◽  
pp. 305-316 ◽  
Author(s):  
Steve Iliffe ◽  
Mari Gould ◽  
Paul Wallace
Keyword(s):  
Health Care ◽  
Older People ◽  
General Practitioners ◽  
Unmet Need ◽  
Health Assessment ◽  
Health Care Needs ◽  
Care Needs ◽  
Contractual Obligation ◽  
Assessment Programme ◽  
The World

Research carried out in the 1950s and early 1960s indicated that there was considerable unmet need amongst older people in Britain. This work prompted research into ways of meeting the health care needs of older people, a task made more important by the aging of the population at the end of this century. This focus resulted in the introduction in 1990 of a nationwide health assessment programme for older people, as a contractual obligation for general practitioners. The programme, the first in the world, remains in force but is widely ignored. This paper describes:

scholarly journals ‘By the way….how’s your sex life?’ – A descriptive study reporting primary health care registered nurses engagement with youth about sexual health

2017 ◽  
Vol 9 (1) ◽  
pp. 22 ◽  
Author(s):  
Rhiannon Martel ◽  
Ruth Crawford ◽  
Helen Riden
Keyword(s):  
Health Care ◽  
New Zealand ◽  
Sexual Health ◽  
Registered Nurses ◽  
Online Survey ◽  
Ethical Issues ◽  
Descriptive Study ◽  
Health Providers ◽  
Cultural Issues ◽  
Structured Interviews

ABSTRACT INTRODUCTION Youth rates of sexually transmitted infections in New Zealand are among the highest in the Organisation for Economic Cooperation and Development. Registered nurses employed in primary healthcare settings (PHC RNs) may lack confidence engaging with youth about their sexual health. AIM To identify what facilitates PHC RNs to discuss sexual health with youth. METHODS This descriptive study was undertaken in two phases. In phase one, 23 PHC RNs completed an online survey. Phase two followed up the survey with semi-structured interviews with seven PHC RNs. RESULTS Most PHC RNs are female, aged between 40 and 60 years old and identify with New Zealand or other European ethnicity. Participants identified specific educational needs relating to youth sexual health that are not being met: legal and ethical issues (65%); cultural issues (65%); youth sexual (44%) and psychological (52%) development; and working with gay, lesbian, bisexual or transsexual youth (48%). Lack of time was cited as a barrier to engaging with youth about sexual health by 30% of the participants. Ongoing support practices such as regular debriefing, reflections of practice and case reviews with colleagues (74%); support from other sexual health providers (87%); and access to educational materials about youth sexual health aimed at health professionals (100%) were perceived to be useful to increase confidence in discussing sexual health with youth. DISCUSSION The PHC RNs lacked knowledge and confidence engaging with youth about sexual health. PHC RNs need resourcing to provide culturally safe, effective sexual health care to youth.

The determination of data collection tools that can measure and document the cooperation of local health care providers

2020 ◽  
Author(s):  
Beáta Erika Nagy ◽  
Róza Oláh ◽  
Erika Zombor ◽  
Péter Boris ◽  
Anna Szabina Szele
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Health Improvement ◽  
Local Health ◽  
Care Providers ◽  
Structured Interviews ◽  
Daily Work ◽  
Local Health Care ◽  
Institutional Relations

Abstract Background The overall objective of the study is to improve the mental health of the age group below 18 years through the investigation of the intra-and inter-sectoral cooperation between local suppliers and to make the intensity and quality of collaborations measurable. In this paper, based on Hungarian and international literature, we aim at describing the current and future optimal cooperation between the members of the mental health care system and examine the possibilities for documenting and measuring cooperation. Methods Semi-structured interviews were recorded with the leaders or representatives of 12 public educational institutions, six social and six health institutions involvement of the relevant experts (N = 24). Results The function of the institutions belonging to these systems, as well as the daily work of the professionals working there, have a significant impact on the mental health of children in either positive or negative directions. After exploring the current situation, the cooperation of local suppliers and inter-institutional relations can highly increase the mental health improvement of the youth. Conclusion According to the results, the developing progress can be more effective through organising the different forms of care, sectors and professionals together to achieve a common goal.

scholarly journals General practitioners’ views of pharmacists’ current and potential contributions to medication review and prescribing in New Zealand

2013 ◽  
Vol 5 (3) ◽  
pp. 223 ◽  
Author(s):  
Ernieda Hatah ◽  
Rhiannon Braund ◽  
Stephen Duffull ◽  
June Tordoff
Keyword(s):  
New Zealand ◽  
General Practitioners ◽  
Medication Review ◽  
Skills Training ◽  
Structured Interviews ◽  
Medical Practitioners ◽  
Pharmacist Prescribing ◽  
Adherence Support ◽  
Primary Health Care Professional ◽  
Medication Reviews

INTRODUCTION: Internationally, non-medical practitioners are increasingly involved in tasks traditionally undertaken by general practitioners (GPs), such as medication review and prescribing. This study aims to evaluate GPs’ perceptions of pharmacists’ contributions to those services. METHODS: Semi-structured interviews were carried out in two localities with GPs whose patients had and had not undergone a pharmacist-led adherence support Medication Use Review (MUR). GPs were asked their opinions of pharmacists’ provision of MUR, clinical medication review and prescribing. Data were analysed thematically using NVivo 8 and grouped by strengths, weaknesses, opportunities and threats (SWOT) category. FINDINGS: Eighteen GPs were interviewed. GPs mentioned their own skills, training and knowledge of clinical conditions. These were considered GPs’ major strengths. GPs’ perceived weaknesses were their time constraints and heavy workloads. GPs thought pharmacists’ strengths were their knowledge of pharmacology and having more time for in-depth medication review than GPs. Nevertheless, GPs felt pharmacist-led medication reviews might confuse patients, and increase GP workloads. GPs were concerned that pharmacist prescribing might include pharmacists making a diagnosis. This is not the proposed model for New Zealand. In general, GPs were more accepting of pharmacists providing medication reviews than of pharmacist prescribing, unless appropriate controls, close collaboration and co-location of services took place. CONCLUSION: GPs perceived their own skills were well suited to reviewing medication and prescribing, but thought pharmacists might also have strengths and skills in these areas. In future, GPs thought that working together with pharmacists in these services might be possible in a collaborative setting. KEYWORDS: Community pharmacy services; general practitioners; New Zealand; primary health care; professional role

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