scholarly journals Should the healthcare compass in Australia point towards value-based primary healthcare?

2017 ◽  
Vol 41 (1) ◽  
pp. 98 ◽  
Author(s):  
Jodie Oliver-Baxter ◽  
Lynsey Brown ◽  
Paresh Dawda
Keyword(s):  
Quality Improvement ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Health Networks ◽  
Policy Makers ◽  
Primary Health ◽  
Australian Context

This paper provides an overview of quality improvement in healthcare in an Australian context. Specifically, the paper considers issues around defining, quantifying, recording and incentivising quality improvement and accountability in primary healthcare. The role of newly emerging Primary Health Networks provides a context for the discussion. The paper draws on international learnings that provide a framework for examining the important elements of quality improvement among reforming primary healthcare organisations in order to support healthcare providers and offer an evidence base for policy makers and peak bodies moving forward.

Positioning Nurses in Primary Health Care in Bhutan

2018 ◽  
Vol 4 (1) ◽  
pp. 33-41
Author(s):  
Diki Wangmo ◽  
Carol Windosr ◽  
Michele Clark
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nursing Education ◽  
Central Place ◽  
Policy Makers ◽  
Primary Health ◽  
Auxiliary Nurse ◽  
Nurses Role ◽  
The 1960S

Introduction: Nursing in Bhutan had its beginning in the early 1960s, approximately 20 years prior to the Alma Ata Conference. From basic nursing care and housekeeping roles, Bhutanese nurses have now occupied central place in nursing service, administration and management and education. Nursing education has progressed from certificate level in the 1960s to bachelor, master and PhD levels in 2014. Although nurses have been closely associated with Primary Health Care development in Bhutan, apart from the role of the Auxiliary Nurse Midwives, nurses have rarely been explicitly associated with this area of practice. Therefore, the objective of this study was to find out the role of Bhutanese Nurses in PHC. Methods: qualitative case study method was used to carry out focus group and in-depth interviews with 66 respondents that included policy makers, planners, educators, regulators and implementers. Data were analyzed through manifest and latent content analysis. Results: The centrality of the nursing role in the area of PHC has not been realized. Discharge of the PHC role was identified more in terms of the place of work and by title or designation of the nurses. Primary Health Care momentum appeared to have slowed down and nurses differed in their understanding of PHC concept. Conclusion: Although Nursing in Bhutan has made much progress, the uneven development of the nurses’ role in PHC in Bhutan and globally suggests a need to identify and implement strategies such as standardizing, role profiling, curricula review and leadership improvement to ensure progress in this area.

scholarly journals Pharmacogenomics for Primary Care: An Overview

Genes ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 1337 ◽  
Author(s):  
Victoria Rollinson ◽  
Richard Turner ◽  
Munir Pirmohamed
Keyword(s):  
Primary Care ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Academic Hospital ◽  
Direct To Consumer ◽  
Gradual Introduction ◽  
Barriers To Implementation ◽  
Primary Healthcare Providers ◽  
Future Practice

Most of the prescribing and dispensing of medicines happens in primary care. Pharmacogenomics (PGx) is the study and clinical application of the role of genetic variation on drug response. Mounting evidence suggests PGx can improve the safety and/or efficacy of several medications commonly prescribed in primary care. However, implementation of PGx has generally been limited to a relatively few academic hospital centres, with little adoption in primary care. Despite this, many primary healthcare providers are optimistic about the role of PGx in their future practice. The increasing prevalence of direct-to-consumer genetic testing and primary care PGx studies herald the plausible gradual introduction of PGx into primary care and highlight the changes needed for optimal translation. In this article, the potential utility of PGx in primary care will be explored and on-going barriers to implementation discussed. The evidence base of several drug-gene pairs relevant to primary care will be outlined with a focus on antidepressants, codeine and tramadol, statins, clopidogrel, warfarin, metoprolol and allopurinol. This review is intended to provide both a general introduction to PGx with a more in-depth overview of elements relevant to primary care.

scholarly journals Increasing identification of foot at risk of complications in patients with diabetes: a quality improvement project in an urban primary health centre in India

2020 ◽  
Vol 9 (3) ◽  
pp. e000893
Author(s):  
Abha Mehndiratta ◽  
Satish Chandra Mishra ◽  
Prashant Bhandarkar ◽  
Kunal Chhatbar ◽  
Francoise Cluzeau ◽  
...  
Keyword(s):  
At Risk ◽  
Quality Improvement ◽  
Diabetic Foot ◽  
Health Centre ◽  
Healthcare Providers ◽  
Primary Health Centre ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Primary Health ◽  
Patients With Diabetes

The majority of foot amputations are preventable in people with diabetes. Guidelines recommend that people with diabetes should receive a foot examination for risk assessment, at least annually. In an audit at a primary health centre (PHC) in Mumbai, India, no patient with diabetes was offered preventive foot assessment in preceding 12 months. Problem analysis identified a lack of clinic policy, training and equipment for foot assessment. There was no standardised referral pathway for patients identified with foot at risk of diabetes complications. Furthermore, limited data review, high patient volumes and little time available with healthcare providers were important constraints. A quality improvement project was carried out at the PHC from January to September 2017. The project aimed at increasing compliance to standardised foot assessment in patients with diabetes presenting to the PHC from a baseline of 0% to 100% over 6 months. This would help identify patients having a foot at risk of complications due to diabetes. The Quality Standard on foot assessment was adopted from the Ministry of Health and Family Welfare Diabetic Foot Guideline. The electronic medical record (EMR) was standardised, health providers were trained, PHC processes and referral pathways were redesigned. Plan-Do-Study-Act was used to address barriers with weekly data review. 88.2% (848) of patients with diabetes visiting the PHC during the study period received a foot examination. Out of these, 11% (95) were identified to have a foot at risk and referred to a specialist foot centre. 57% of referred patients followed with specialised foot protection services. Training of healthcare providers, standardisation of processes and regular data feedback can improve diabetic foot care. Integrating quality indicators in the EMR helps monitor compliance. The inability to use doctor’s time efficiently was the biggest challenge and sustaining the change will require organisational changes with suitable task shifting.

Putting urban Aboriginal and Torres Strait Islander food insecurity on the agenda

2017 ◽  
Vol 23 (5) ◽  
pp. 415 ◽  
Author(s):  
Leigh Bramwell ◽  
Wendy Foley ◽  
Tanya Shaw
Keyword(s):  
Food Insecurity ◽  
Torres Strait Islander ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Torres Strait Islander People ◽  
Social Wellbeing ◽  
Primary Health ◽  
Health Advice ◽  
Torres Strait ◽  
Primary Healthcare Providers

Food insecurity adversely affects diet quality, physical, mental and social wellbeing and the capacity to act on health advice recommended by primary healthcare providers. In this article, an overview of the neglected issue of food insecurity in urban Aboriginal and Torres Strait Islander communities is provided. Policy and action on food security for urban Aboriginal and Torres Strait Islander people is reviewed, and it is argued that for primary health care to better address food insecurity, an evidence base is needed to understand the experiences of individuals and households and how to work effectively to support food insecure clients.

scholarly journals Dementia risk reduction in practice: the knowledge, opinions and perspectives of Australian healthcare providers

2021 ◽  
Vol 27 (2) ◽  
pp. 136
Author(s):  
Lidan Zheng ◽  
Kali Godbee ◽  
Genevieve Z. Steiner ◽  
Gail Daylight ◽  
Carolyn Ee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Reduction ◽  
Primary Healthcare ◽  
Online Survey ◽  
Healthcare Providers ◽  
System Level ◽  
Free Text ◽  
Health Networks ◽  
Dementia Risk ◽  
Primary Healthcare Providers

This study examined Australian primary healthcare providers’ knowledge about dementia risk factors and risk reduction and their perspectives on barriers and enablers to risk reduction in practice. Primary healthcare providers were recruited through Primary Health Networks across Australia (n=51). Participants completed an online survey that consisted of fixed-responses and free-text components to assess their knowledge, attitudes and current practices relating to dementia risk factors and risk reduction techniques. The results showed that Australian primary healthcare providers have good knowledge about the modifiable risk factors for dementia; however, face several barriers to working with patients to reduce dementia risk. Commonly reported barriers included low patient motivation and healthcare system level limitations. The most commonly reported recommendations to helping primary healthcare providers to work with patients to reduce dementia risk included increasing resources and improving dementia awareness and messaging. While the results need to be interpreted in the context of the limitations of this study, we conclude that collaborative efforts between researchers, clinicians, policy makers and the media are needed to support the uptake of risk reduction activities in primary care settings.

scholarly journals The Role of Primary Health Networks and General Practitioners in Disasters: Nepean Blue Mountains Primary Health Network’s Preparedness Guide

2019 ◽  
Vol 34 (s1) ◽  
pp. s67-s67
Author(s):  
Lizz Reay ◽  
Penny Burns
Keyword(s):  
Emergency Management ◽  
Natural Disaster ◽  
General Practitioners ◽  
Emergency Preparedness ◽  
Lessons Learned ◽  
Health Networks ◽  
Blue Mountains ◽  
Response System ◽  
Primary Health

Introduction:Disasters are part of the Australian landscape. Bushfires, floods, cyclones, and drought reoccurring consistently across the continent. Primary Health Networks (PHNs) and general practitioners (GPs) are scattered across Australia and are inevitably involved when disasters strike their local communities. Limited guidance exists to guide their systematic involvement within the broader disaster response system. In October 2013, large bushfires swept through the NSW Blue Mountains. The response was unusual in its inclusion of NSW general practice networks within the response system, most crucially the local (now) Nepean Blue Mountains Primary Health Network (NBMPHN).Methods:The lessons learned by GPs and NBMPHN during the fires highlighted the need for GP preparedness to improve recovery outcomes. This led to the development of a living discussion document “Emergency management: the role of the GP,” created with input from the various GP groups. More recently, a PHN emergency preparedness guide aimed at strengthening communication and formalizing the role of the PHNs and GPs before, during, and after a natural disaster.Results:Clarity and implementation of a process for disaster preparedness have enabled a more proactive and coordinated approach to local emergency management with a distinct role for both the PHN and local GPs when responding to a natural disaster.Discussion:This presentation discusses lessons learned and the preparedness strategy now in place in the Nepean Blue Mountains PHN region, and launches the emergency preparedness guide that can be used and adapted by GPs and other PHNs across Australia.

scholarly journals To what degree do patients actively choose their healthcare provider at the point of referral by their GP? A video observation study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Amy J. C. Potappel ◽  
Maartje C. Meijers ◽  
Corelien Kloek ◽  
Aafke Victoor ◽  
Janneke Noordman ◽  
...  
Keyword(s):  
Healthcare Provider ◽  
Healthcare Providers ◽  
Patient Choice ◽  
Health Insurer ◽  
Video Observation ◽  
Managed Competition ◽  
Observation Study ◽  
Policy Makers ◽  
Observation Protocol

Abstract Background Many countries in Europe have implemented managed competition and patient choice during the last decade. With the introduction of managed competition, health insurers also became an important stakeholder. They purchase services on behalf of their customers and are allowed to contract healthcare providers selectively. It has, therefore, become increasingly important to take one’s insurance into account when choosing a provider. There is little evidence that patients make active choices in the way that policymakers assume they do. This research aims to investigate, firstly, the role of patients in choosing a healthcare provider at the point of referral, then the role of the GP and, finally, the influence of the health insurer/insurance policies within this process. Methods We videotaped a series of everyday consultations between Dutch GPs and their patients during 2015 and 2016. In 117 of these consultations, with 28 GPs, the patient was referred to another healthcare provider. These consultations were coded by three observers using an observation protocol which assessed the role of the patient, GP, and the influence of the health insurer during the referral. Results Patients were divided into three groups: patients with little or no input, patients with some input, and those with a lot of input. Just over half of the patients (56%) seemed to have some, or a lot of, input into the choice of a healthcare provider at the point of referral by their GP. In addition, in almost half of the consultations (47%), GPs inquired about their patients’ preferences regarding a healthcare provider. Topics regarding the health insurance or insurance policy of a patient were rarely (14%) discussed at the point of referral. Conclusions Just over half of the patients appear to have some, or a lot of, input into their choice of a healthcare provider at the point of referral by their GP. However, the remainder of the patients had little or no input. If more patient choice continues to be an important aim for policy makers, patients should be encouraged to actively choose the healthcare provider who best fits their needs and preferences.

scholarly journals The Role of Incentives in Deciding to Receive the Available COVID-19 Vaccine in Israel

Vaccines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 77
Author(s):  
Liora Shmueli
Keyword(s):  
Health Policy ◽  
Online Survey ◽  
Healthcare Providers ◽  
Monetary Incentives ◽  
Policy Makers ◽  
Monetary Rewards ◽  
Health Related ◽  
To Receive ◽  
Sense Of Urgency

This study aimed to assess the Israeli public’s intention to get vaccinated immediately after the COVID-19 vaccine became available, and to determine the role of incentives beyond socio-demographic, health-related and behavioral factors, in predicting this intention. An online survey was conducted among adults in Israel (n = 461), immediately after the first COVID-19 vaccine became available (22 December 2020 to 10 January 2021). Two regressions were performed to investigate determinants of intention to receive the available COVID-19 vaccine and sense of urgency to receive the vaccine. Although many adults were willing to receive available COVID-19 vaccine, only 65% were willing to immediately receive the vaccine, 17% preferred to wait 3 months and 18% preferred to wait a year. The sense of urgency to get vaccinated differed by age, periphery level, perceived barriers, cues to action and availability. Incentives such as monetary rewards or the green pass did not increase the probability of getting vaccination immediately. Providing data on the role of incentives in increasing the intention to immediately receive the available COVID-19 vaccine is important for health policy makers and healthcare providers. Our findings underscore the importance of COVID-19 vaccine accessibility. Health policy makers should consider allocating funds for making the vaccine accessible and encourage methods of persuasion, instead of investing funds in monetary incentives.

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