Stakeholder perspectives about general practice pharmacists in the Australian Capital Territory: a qualitative pilot study

2018 ◽  
Vol 24 (3) ◽  
pp. 263 ◽  
Author(s):  
Louise S. Deeks ◽  
Sam Kosari ◽  
Mark Naunton ◽  
Gabrielle Cooper ◽  
Julie Porritt ◽  
...  
Keyword(s):  
General Practice ◽  
Improve Patient Safety ◽  
Community Pharmacists ◽  
Patient Questionnaire ◽  
Australian Capital Territory ◽  
Structured Interviews ◽  
Practice Staff ◽  
Australian Capital ◽  
Stakeholder Perspectives ◽  
Improve Patient

Previous studies have found that integrating non-dispensing pharmacists in general practice may improve patient safety, improve patient outcomes, deliver health system efficiencies and generate savings. However, the employment of pharmacists in general practice is not common in Australia. A naturalistic study was conducted in the Australian Capital Territory with three general practices, each employing a part-time pharmacist for 12 months. This study reports on stakeholder perspectives of the benefits, barriers and enablers for integrating pharmacists into general practice. Patients, practice staff and community pharmacists that had interacted with a practice pharmacist were asked to complete a self-administered questionnaire. Patient questionnaire respondents (n=44) reported that a practice pharmacist was beneficial and wanted to see this continue. Practice pharmacists were also perceived beneficial by primary healthcare employees surveyed (n=42). Opinions were further explored by individual semi-structured interviews (n=20). The qualitative data explored five themes: perception of the practice pharmacist, collaboration with doctors, pharmacist roles, sustainability and community pharmacy aspects. Patients welcomed improved understanding about their medication, whereas general practice staff appreciated pharmaceutical advice about patients with chronic conditions. Participants discussed options to fund practice pharmacists longer term, which was identified as the main barrier to widespread roll out.

scholarly journals Engagement with and delivery of the ‘parkrun practice initiative’ in general practice: a mixed methods study

2020 ◽  
Vol 70 (697) ◽  
pp. e573-e580
Author(s):  
Joanna Fleming ◽  
Carol Bryce ◽  
Joanne Parsons ◽  
Chrissie Wellington ◽  
Jeremy Dale
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
Focus Group ◽  
Online Survey ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Practice Staff ◽  
Health And Wellbeing ◽  
Positive Effects ◽  
Improve Patient

BackgroundThe parkrun practice initiative, a joint collaboration between parkrun and the Royal College of General Practitioners, was launched to encourage general practices to improve the health and wellbeing of patients and staff through participating in local 5 km parkrun events. Why and how practices engage with the initiative is unknown.AimTo investigate engagement with and delivery of the parkrun practice initiative in general practice.Design and settingMixed methods study conducted from April–July 2019 comprising an online survey of all registered parkrun practices, and interviews and a focus group with practice staff in the West Midlands.MethodThe designated contacts at 780 registered parkrun practices were invited to complete an online survey. A purposive sample of parkrun practice staff and non-registered practice staff took part either in semi-structured interviews or a focus group, with transcripts analysed thematically.ResultsOf the total number of parkrun practices, 306 (39.2%) completed the survey. Sixteen practice staff (from nine parkrun practices and four non-registered practices) took part in either semi-structured interviews (n = 12) or a focus group (n = 4). Key motivators for becoming a parkrun practice were: to improve patient and staff health and wellbeing, and to become more engaged with the community and enhance practice image. Practices most commonly encouraged patients, carers, and staff to take part in parkrun and displayed parkrun flyers and posters. Challenges in implementing activities included lack of time (both personal and during consultations) and getting staff involved. Where staff did engage there were positive effects on morale and participation. Non-registered practices were receptive to the initiative, but had apprehensions about the commitment involved.ConclusionPractices were keen to improve patient and staff health. Addressing time constraints and staff support needs to be considered when implementing the initiative.

scholarly journals The challenges of integrating signposting into general practice: qualitative stakeholder perspectives on care navigation and social prescribing in primary care

2021 ◽  
Author(s):  
Lisa Brunton ◽  
Abigail Tazzyman ◽  
Jane Ferguson ◽  
Damian Hodgson ◽  
Pauline A Nelson
Keyword(s):  
Primary Care ◽  
General Practice ◽  
National Policy ◽  
Professional Services ◽  
Structured Interviews ◽  
Practice Staff ◽  
Social Prescribing ◽  
Stakeholder Perspectives ◽  
Wide Range ◽  
The Right

Abstract Background A national policy focus in England to address general practice workforce issues has led to a commitment to employ significant numbers of non-GP roles to redistribute workload. This paper focuses on two such roles: the care navigation (CN) and social prescribing link worker (SPLW) roles, which both aim to introduce ‘active signposting’ into primary care, to direct patients to the right professional/services at the right time and free up GP time. There is a lack of research exploring staff views of how these roles are being planned and operationalised into general practice and how signposting is being integrated into primary care. Methods The design uses in-depth qualitative methods to explore a wide range of stakeholder staff views. We generated a purposive sample of 34 respondents who took part in 17 semi-structured interviews and one focus group (service leads, role holders and host general practice staff). We analysed data using a Template Analysis approach. Results Three key themes highlight the challenges of operationalising signposting into general practice: 1) Role perception – signposting was made challenging by the way both roles were perceived by others (e.g. among the public, patients and general practice staff) and highlighted inherent tensions in the expressed aims of the policy of active signposting.; 2) Role preparedness – a lack of training meant that some receptionist staff felt unprepared to take on the CN role as expected and raised patient safety issues; for SPLW staff, training affected the consistency of service offer across an area; 3) Integration and co-ordination of roles – a lack of planning and co-ordination across components of the health and care system challenged the success of integrating signposting into general practice. Conclusions This study provides new insights from staff stakeholder perspectives into the challenges of integrating signposting into general practice, and highlights key factors affecting the success of signposting in practice. Clarity of role purpose and remit (including resolving tensions inherent the dual aims of ‘active signposting’), appropriate training and skill development for role holders and adequate communication and engagement between stakeholders/partnership working across services, are required to enable successful integration of signposting into general practice.

Pharmacists in general practice: a qualitative process evaluation of the General Practice Pharmacist (GPP) study

2020 ◽  
Vol 37 (5) ◽  
pp. 711-718
Author(s):  
Oscar James ◽  
Karen Cardwell ◽  
Frank Moriarty ◽  
Susan M Smith ◽  
Barbara Clyne
Keyword(s):  
General Practice ◽  
Process Evaluation ◽  
Controlled Trial ◽  
Qualitative Approach ◽  
Structured Interviews ◽  
Practice Staff ◽  
Practice Nurses ◽  
Practice Team ◽  
Prescribing Quality ◽  
Descriptive Qualitative

Abstract Background There is some evidence to suggest that pharmacists integrated into primary care improves patient outcomes and prescribing quality. Despite this growing evidence, there is a lack of detail about the context of the role. Objective To explore the implementation of The General Practice Pharmacist (GPP) intervention (pharmacists integrating into general practice within a non-randomized pilot study in Ireland), the experiences of study participants and lessons for future implementation. Design and setting Process evaluation with a descriptive qualitative approach conducted in four purposively selected GP practices. Methods A process evaluation with a descriptive qualitative approach was conducted in four purposively selected GP practices. Semi-structured interviews were conducted, transcribed verbatim and analysed using a thematic analysis. Results Twenty-three participants (three pharmacists, four GPs, four patients, four practice nurses, four practice managers and four practice administrators) were interviewed. Themes reported include day-to-day practicalities (incorporating location and space, systems and procedures and pharmacists’ tasks), relationships and communication (incorporating GP/pharmacist mode of communication, mutual trust and respect, relationship with other practice staff and with patients) and role perception (incorporating shared goals, professional rewards, scope of practice and logistics). Conclusions Pharmacists working within the general practice team have potential to improve prescribing quality. This process evaluation found that a pharmacist joining the general practice team was well accepted by the GP and practice staff and effective interprofessional relationships were described. Patients were less clear of the overall benefits. Important barriers (such as funding, infrastructure and workload) and facilitators (such as teamwork and integration) to the intervention were identified which will be incorporated into a pilot cluster randomized controlled trial.

scholarly journals Safety Performance in Acute Medical Care: A Qualitative, Explorative Study on the Perspectives of Healthcare Professionals

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1543
Author(s):  
Lina Heier ◽  
Donia Riouchi ◽  
Judith Hammerschmidt ◽  
Nikoloz Gambashidze ◽  
Andreas Kocks ◽  
...  
Keyword(s):  
Patient Safety ◽  
Nursing Students ◽  
Healthcare Professionals ◽  
Improve Patient Safety ◽  
Safety Performance ◽  
Structured Interviews ◽  
Performance Skills ◽  
Work Environment Factors ◽  
Improve Patient

Healthcare professionals need specific safety performance skills in order to maintain and improve patient safety. The purpose of this study is to get a deeper understanding of healthcare professionals’ perspective in acute care on the topic of safety performance. This study was conducted using a qualitative approach. Healthcare professionals working in nursing were interviewed using semi-structured interviews. Using content analyzing, categories were identified which present aspects of safety performance; subcategories were developed deductively. A total of 23 healthcare professionals were interviewed, of which 15 were registered nurses, five were nursing students and three were pedagogical personnel. Nine (39.1%) were <30 years old, 17 (73.9%) were female, and 9 (39.1%) had a leadership function. Results highlight the importance of safety performance as a construct of occupational health rather than of patient safety, and the role of the organization, as well as the self-responsibility of healthcare professionals. Healthcare professionals should be more conscious of their role, have a deeper understanding of the interaction of individual, team, patient, organization and work environment factors.

scholarly journals ReCAP: Comparison of Independent Error Checks for Oral Versus Intravenous Chemotherapy

2016 ◽  
Vol 12 (2) ◽  
pp. 168-169 ◽  
Author(s):  
Melissa C. Griffin ◽  
Rachel E. Gilbert ◽  
Larry H. Broadfield ◽  
Anthony E. Easty ◽  
Patricia L. Trbovich ◽  
...  
Keyword(s):  
Patient Safety ◽  
Nova Scotia ◽  
Improve Patient Safety ◽  
Real Life ◽  
Community Pharmacists ◽  
The United States ◽  
Oral Chemotherapy ◽  
Cancer Center ◽  
Community Pharmacies ◽  
Improve Patient

QUESTION ASKED: In the United States, research has found that oral chemotherapy is subject to fewer safeguards than are in routine use for intravenous (IV) chemotherapy; however, less is known about the Canadian context. The objective of this study was to determine whether similar safeguards, in the form of independent checks, existed to identify potential errors related to IV and oral chemotherapy formulations in a particular cancer system. SUMMARY ANSWER: In the cancer system studied, a total of 57 systematic checks were identified for IV chemotherapy, whereas only six systematic checks were identified for oral chemotherapy. Community pharmacists were the only qualified professionals involved in independent, systematic checking of oral chemotherapy, which occurred during ordering and dispensing. METHODS: Human factors specialists conducted observations and interviews in cancer center clinics, a cancer center pharmacy, and four community pharmacies across Nova Scotia. Processes were analyzed to determine whether an independent check was performed, which qualified provider completed the check, and at what point of the process the check occurred. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: This study had some limitations. Although there are many forms of safeguards (eg, preprinted orders), only one type of safeguard (ie, independent checks) was examined in the cancer system studied. We chose to focus on independent checks because they were observable and were defined in the cancer center’s policies. Another limitation was that just a single jurisdiction (Nova Scotia), and four community pharmacies were examined. We examined each community pharmacy in detail, and sites were chosen to be representative (eg, rural versus urban). Further, the model used to deliver oral chemotherapy in Nova Scotia is not unique; a number of other provinces share similar models. REAL-LIFE IMPLICATIONS: There is an enormous opportunity for pharmacists and other qualified professionals to take on an expanded role in improving patient safety for oral chemotherapy. Oral chemotherapy, like IV chemotherapy, is known to be potentially hazardous, but in the cancer system studied, there were dramatically fewer independent checks associated with all aspects of oral chemotherapy–related processes. Greater involvement of pharmacists, both in the clinic environment and the community, would facilitate increased systematic checking, which could improve patient safety related to oral chemotherapy. [Figure: see text]

scholarly journals Development of the Prototype Concise Safe Systems Checklist Tool for General Practice

2020 ◽  
Author(s):  
Ian J Litchfield ◽  
Rachel Spencer ◽  
Brian Bell ◽  
Anthony Avery ◽  
Katherine Perryman ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Safety ◽  
Primary Care Patient ◽  
Safety Information ◽  
Care Patient ◽  
Ease Of Use ◽  
Structured Interviews ◽  
Practice Staff ◽  
Safety Issues

Abstract Background In the course of producing a patient safety toolkit for primary care, we identified the need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. This paper describes the development of a prototype checklist designed to be used in busy general practice environments to provide an overview of key patient safety related processes and prompt practice wide-discussion. Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the results, summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing, and use of IT systems from which a 13 item checklist was trialled in 16 practices resulting in a nine item prototype checklist, which was tested in eight practices. Qualitative data on the utility and usability of the prototype was collected through a series of semi-structured interviews.Results In testing the prototype four of nine items on the checklist were achieved by all eight practices. Three items were achieved by seven of eight practices and two items by six of eight practices. Participants welcomed the brevity and ease of use of the prototype, that it might be used within time scales at their discretion and its ability to engage a range of practice staff in relevant discussions on the safety of existing processes. The items relating to prescribing safety were considered particularly useful. Conclusions As a result of this work the concise patient safety checklist tool, specifically designed for general practice, has now been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Senior practice staff such as practice managers and GP partners should find it a useful tool to understand the safety of less explored yet important safety processes within the practice.

scholarly journals General practice responses to opioid prescribing feedback: a qualitative process evaluation

2021 ◽  
pp. BJGP.2020.1117
Author(s):  
Su Wood ◽  
Robbie Foy ◽  
T. A. Willis ◽  
Paul Carder ◽  
Stella Johnson ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Process Evaluation ◽  
High Achievers ◽  
Normalisation Process Theory ◽  
Structured Interviews ◽  
Feedback Intervention ◽  
Practice Staff ◽  
Opioid Prescribing ◽  
Qualitative Process Evaluation

Background: The rise in opioid prescribing in primary care represents a significant public health challenge, associated with increased psychosocial problems, hospitalisations and mortality. We developed and implemented an evidence-based bi-monthly feedback intervention to reduce opioid prescribing targeting 316 general practices in West Yorkshire over one year. Aim: To understand how general practice staff received and responded to the feedback intervention. Design and Setting: Qualitative process evaluation involving semi-structured interviews, guided by Normalisation Process Theory (NPT), of primary care healthcare professionals targeted by feedback. Method: We purposively recruited participants according to baseline opioid prescribing levels and degree of change following feedback. Interview data were coded to NPT constructs, and thematically analysed. Results: We interviewed 21 staff from 20 practices. Reducing opioid prescribing was recognised as a priority. Whilst high achievers had clear structures for quality improvement, feedback encouraged some less structured practices to embed changes. The non-prescriptive nature of the feedback reports allowed practices to develop strategies consistent with their own ways of working and existing resources. Practice concerns were allayed by the credibility of the reports and positive experiences of reducing opioid prescribing. The scale, frequency and duration of feedback may have ensured a good overall level of practice population reach. Conclusion: The intervention engaged general practice staff in change by targeting an issue of emerging concern and allowing adaption to different ways of working. Practice efforts to reduce opioid prescribing were reinforced by regular feedback, credible comparative data showing progress, and shared experiences of patient benefit.

Achieving high immunisation rates amongst children in the Australian Capital Territory: a collaborative effort

2011 ◽  
Vol 35 (1) ◽  
pp. 104 ◽  
Author(s):  
Anthony M. Moore ◽  
Sandra Burgess ◽  
Hailey Shaw ◽  
Carolyn Banks ◽  
Irene Passaris ◽  
...  
Keyword(s):  
General Practice ◽  
Vaccine Delivery ◽  
Successful Implementation ◽  
Collaborative Effort ◽  
Australian Capital Territory ◽  
Immunisation Coverage ◽  
Childhood Immunisation ◽  
Australian Capital ◽  
Age Cohort ◽  
Coverage Rates

Background. In September 2008 the ACT achieved the highest childhood coverage rates in Australia with rates of 93.5% (12–15-month age cohort), 94.9% (24–27-month age cohort) and 90.58% (60–63-month age cohort). Purpose. To analyse the key contributing factors and policy initiatives that have likely to have led to high childhood immunisation rates in the ACT. Methods. Data used in this report were sourced from the Australian Childhood Immunisation Register (ACIR) held at Medicare Australia, General Practice Immunisation Incentives (GPII) ‘calculation’ data held at ACT Division of General Practice and internal immunisation databases held at Health Protection Service. Outcomes. Although the reasons for the high coverage rates seen in children are multi factorial (including national and consumer factors), key reasons locally in the ACT include: (a) the implementation of an ACT-wide immunisation strategy; (b) proactive follow up of children overdue for immunisation; (c) more sustainable provision of immunisation services across both public and private health providers; and (d) a centralised vaccine delivery service and ‘cold chain’ monitoring system. Conclusions. Although nationwide immunisation policy has been successful in increasing childhood coverage rates across all Australian jurisdictions, it is important to also acknowledge local factors that have likely to have contributed to the successful implementation of the Immunise Australia Program at the coal face. What is known about the topic? Childhood immunisation rates have risen significantly in Australia since the mid 1990s following a plethora of initiatives at both a national and state and territory level. This article examines in depth the various factors over the past decade that have likely to have contributed to the high childhood immunisation rates currently seen in the Australian Capital Territory What does this paper add? The ACT changed its strategic thinking towards immunisation provision in 2004 with an increased focus on immunisation delivery in general practice. Immunisation coverage rates improved in the ACT between 2005 and 2008 with general practice increasing their contribution to immunisation provision from 35 to 57% during this time period. This was despite of a drop in full-time equivalent general practices (GPs) in the ACT between 2003 and 2008. At face value the initial decision to increase immunisation provision through general practice in the face of a dwindling GP workforce appeared counter intuitive. What this article illustrates is the importance of having the right mix and proportion of providers delivering immunisation (public clinics v. general practice) as well as having well resourced support systems for vaccine delivery, provider education and data analysis. More importantly this paper illustrates that any disruption in any component of immunisation provision is likely to have a negative effect on coverage rates (examples provided in the article). What are the implications for practitioners? Achieving high immunisation in the ACT has been a collaborative effort by a range of immunisation stakeholders. These groups have formed strong partnerships to raise awareness of the value of immunisation and the importance of receiving vaccinations at the correct time. It is this collective effort across the health portfolio that is likely to have contributed to the ACT achieving high immunisation coverage rates amongst children. It is important for immunisation practitioners to retain strong professional networks with clear delineation of roles in order to maintain high immunisation rates. Such networks must also be adequately prepared for challenges on the horizon (i.e. change in government policy, loss of personnel, change in consumer attitudes towards immunisation, etc.) that may pose a threat towards high immunisation rates.

scholarly journals The Australian Capital Territory (ACT) General Practice Biothreat Preparedness Survey

2005 ◽  
Vol 20 (S1) ◽  
pp. 10-10
Author(s):  
A. Geysen ◽  
A. Herceg ◽  
C. Guest ◽  
R. Bialkowski
Keyword(s):  
General Practice ◽  
Australian Capital Territory ◽  
Australian Capital
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