scholarly journals Workshop: Health workforce meets HSR: Tackling regional inequalities in health service provision

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Services ◽  
Health Workforce ◽  
Health Care Professionals ◽  
Rural Areas ◽  
Hospital Care ◽  
Health Service Provision ◽  
Care Practices ◽  
Do So

Abstract Background Many countries across Europe are facing considerable challenges in providing accessible and high quality care regardless of where people live. A major element is the difficulty that countries face to attract and retain health care professionals to work in remote and rural areas. This applies to primary care services as well as to hospital care, and to the care provided by physicians and other health professionals, including nurses. A widely shared question is therefore how to safeguard access to health care in rural areas and to solve recruitment and retention problems in such regions, both of medical and nursing staff. The workshop will build on last year’s joint workshop of the Sections on HSR and HWR that ended with questions related to how to organize accessible and equitable health services including the workforces required to do so. Objectives This workshop will provide a snapshot of studies from across the European region, with a particular focus on differences between rural and urban health care practices and the types of solutions being used to reduce regional disparities in provision of care. This often refers to retention and recruitment strategies, but the session will also address other types of solutions in the organization of care that can help ensure accessible care, including in vulnerable regions and settings. Tackling this challenge will therefore require a joint approach, tapping into experience from health workforce research as well as wider health services research, bringing together research into the organization and management of healthcare and into the health human resources providing this care, operated from different angles and being informed by different research traditions and data sources. Based on statements, we will discuss the topic of how to organize accessible and equitable health services including the workforces required to do so after the presentations. Key messages Workforce policies should focus on retaining primary care workforce in rural areas and integrated policies should attract new primary care practices. Both in primary care and hospital care new solutions are being sought which should help resolve regional differences in access to care and attractiveness for the health workforce.

Regional shortages in a small country: how to provide the right care in the right place?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Hansen ◽  
R Batenburg ◽  
E Vis ◽  
L Van der Velden
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Professionals ◽  
Hospital Care ◽  
Ageing Population ◽  
Regional Collaboration ◽  
Care Workers ◽  
Vested Interests ◽  
More Care ◽  
The Right

Abstract Background The Netherlands, though being a relatively small and densely populated country, is faced with a similar challenge as other countries in terms of regional differences in access to care and attractiveness for care workers to build their careers. Both in primary care and hospital care new solutions are being sought which should help resolve these growing difficulties. Methods We conducted a literature review, survey and registry analysis, and held interviews with key stakeholders. Results Substantial differences exist between regions in the supply of both primary care and hospital care doctors. Particular and less populated regions appear to be hit in multiple ways, both with an extra ageing population requiring more care as well as by limited attractiveness for both primary care and hospital care workers. Solutions being used so far are mostly initiated by individual health care settings, such as strategic personnel management, redistribution of tasks and campaigns to increase the inflow of staff. Increasingly, solutions are also being explored at regional level, including a growing emphasis on regional collaboration, both in providing the right care in the right place as well as in terms of joint recruitment strategies. Still, such approaches only have a limited effect as a result of which new approaches are needed. Conclusions Strategies to improve the attractiveness of particular regions are now often fragmented, both between types of professions and sectors and different regions. In addition, innovative and new solutions appear to be hampered by vested interests of stakeholders. If new solutions are to be developed it is key that stakeholders are willing to compromise, be it when it comes to the autonomy of health care professionals and their associations and to the financial commitments required from government and insurer side.

scholarly journals Facilitating Guideline Implementation in Primary Health Care Practices

2020 ◽  
Vol 11 ◽  
pp. 215013272091626
Author(s):  
Sanne Peters ◽  
André Bussières ◽  
Bart Depreitere ◽  
Stijn Vanholle ◽  
Julie Cristens ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Care Setting ◽  
Primary Care Setting ◽  
Guideline Implementation ◽  
Multidisciplinary Teams ◽  
Primary Health ◽  
Care Practices

Introduction: Many patients continue to receive suboptimal services, inappropriate, unsafe, and costly care. Underutilization of research by health professionals is a common problem in the primary care setting. Although many theoretical frameworks can be used to help address such evidence-practice gaps, health care professionals may not be aware of the benefits of frameworks or of the most appropriate ones for their context and thus, may be faced with the challenge of selecting and using the most relevant one. Aim: The aim of this article was to describe the process used to adapt a knowledge translation framework to meet the local needs of health professionals working in one large primary care setting. Methods: The authors developed a 5-step approach for guideline implementation. This approach was informed by prior research and the authors’ experiences in supporting multidisciplinary teams of health care professionals during the implementation of evidence-based clinical guidelines into primary care practices. To ensure that the 5-step approach was practical and suitable for the context of guideline implementation by multidisciplinary teams in primary health care, the implementation team adapted the “knowledge-to-action” framework using a multistep process. Results: The implementation approach consisted of the following 5 steps: identification, context analysis, development of implementation plan, evaluation, and sustainability. All 5 steps were described alongside details about a national low back pain project. Discussion: This article describes a collaborative, grassroots process that addressed an identified need in one complex context by adapting a knowledge translation framework to meet the local needs of health professionals working in primary care settings. Existing implementation frameworks may be too complex or abstract for use in busy clinical contexts. The 5-step approach presented in this paper resulted in practical steps that are more readily understood by health care professionals and staff on “the ground.”

scholarly journals Disrupting the present to build a stronger health workforce for the future: a three-point agenda

2018 ◽  
Vol 10 (1) ◽  
pp. 6 ◽  
Author(s):  
Robin Gauld
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Professional ◽  
Health Workforce ◽  
Health Care Professionals ◽  
High Income ◽  
Workforce Training ◽  
Work Organisation ◽  
The Future ◽  
Care Systems

ABSTRACT The health professional workforce in high-income countries is trained and organised today largely as it has been for decades. Yet health care professionals and their patients of the present and future require a different model for training and working. The present arrangements need a serious overhaul: not just change, but disruption to the institutions that underpin training and work organisation. This article outlines a three-point agenda for this, including: the need to reorganise workforce and care systems for multimorbidity; to reorient workforce training to build genuine inter-professionalism; and to place primary care at the apex of the professional hierarchy.

scholarly journals Telemedicine

2014 ◽  
Vol 5 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Nicholas J. Cannon ◽  
Kimberly Jurski ◽  
Gregory W. Ulferts
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Health Services ◽  
Health Care Professionals ◽  
Rural Areas ◽  
Care Delivery ◽  
Geographic Area ◽  
Quantitative Evidence ◽  
Number Of Patients ◽  
Rural Patients

Telemedicine has been advocated as a solution to overcome barriers to access health services faced by rural patients. The almost 60 million Americans living in rural areas are significantly underserved by the nation’s physicians and rural communities have traditionally experienced a shortage of physicians. Compounding this problem of physician shortage is the fact that services must be provided to patients over a wide geographic area. Telemedicine programs are being used to address health services shortages in rural areas by applying telecommunications technology to deliver health services similar to those which would be provided in face-to-face consultations between patients and health care professionals. Adoption of telemedicine as an option for delivery of services has been slow and is largely limited to specialty services. Where adopted, telemedicine has been received positively by both patients and physicians. Telemedicine can improve access to care for rural patients by increasing the number of patients who can access care and by providing services usually unavailable to rural patients. Despite evidence of the effectiveness of telemedicine programs, wider adoption of a telemedicine alternative suffers from a lack of reliable financial data for implementation, ongoing management, and for comparison to traditional delivery systems. Telemedicine is poised to become an important method of rural health care delivery, but as the trend toward the application of technology to the delivery of health services gains greater momentum, health managers require serious quantitative evidence on which to base resource allocation and management decisions. 

Genetic Competencies Essential for Health Care Professionals in Primary Care

2005 ◽  
Vol 50 (3) ◽  
pp. 177-183 ◽  
Author(s):  
Janet L. Engstrom ◽  
Marlene G. S. Sefton ◽  
Jolie Kim Matheson ◽  
Kristine M. Healy
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Professionals

Perceptions of Canadian Armed Forces Health Services health care professionals on cognitive assessment processes

2021 ◽  
pp. e20200066
Author(s):  
Chelsea Jones ◽  
Lorraine Smith-MacDonald ◽  
Suzette Brémault-Phillips
Keyword(s):  
Health Care ◽  
Health Services ◽  
Cognitive Functioning ◽  
Health Care Professionals ◽  
Brain Injuries ◽  
Armed Forces ◽  
Canadian Armed Forces ◽  
Qualitative Thematic Analysis ◽  
Cognitive Screen ◽  
And Function

Lay Summary Canadian Armed Forces (CAF) Service Members (SMs) experience mild traumatic brain injuries (mTBI), which can affect cognitive functioning. Adequate cognitive functioning is needed to perform military duties safely and function in all aspects of life. A standardized process that includes cognitive screen/assessment within a mTBI rehabilitation strategy is not widely used within Canadian Forces Health Services (CFHS). A qualitative thematic analysis nested within an implementation science approach was used to explore the experiences of 17 CFHS health care professionals who perform cognitive screens/assessments. Perceived facilitators, barriers, and recommendations for improving cog-nitive assessment practices for injured CAF-SMs were identified within 5 themes. Development and implementation of cognitive screen/assessment policies and protocols will enable CFHS to best assess and treat cognitive dysfunction among CAF-SMs.

INTRODUCTION

PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. ii-ii
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Child Development ◽  
Health Services ◽  
Cultural Sensitivity ◽  
Health Care Professionals ◽  
Research Policy ◽  
The United States ◽  
Policy Formulation ◽  
Full Account

In June 1992, 35 health care professionals, child and disability advocates, researchers, clinicians, and parents met at Wingspread Center in Racine, Wisconsin, for an invitational conference on Culture and Chronic Illness in Childhood. The meeting had as its goal the identification of the state of knowledge on the interface between culture, chronic illness, child development, and family functioning so as to lay the foundations for "culturally appropriate" health policy formulation, "culturally sensitive" services, and "culturally competent" clinicians. The purpose of this special supplement is to establish a national agenda for research, policy, service delivery, and training in addressing the needs of all children with chronic illnesses and disabilities that takes the family, ethnicity, socioeconomic status, and culture into full account. To meet this task, five papers were commissioned. The first, by Newacheck et al, addresses the changes in incidence and prevalence of chronic illness and disability among children and youth by ethnic group. The second paper, by McManus et al, focuses on the trends in health services organization, delivery, and financing as they vary among ethnic groups in the United States. What emerges is a rhetoric of cultural sensitivity not paralleled in the organization or financing of health services. Groce and Zola's paper addresses how cultural attitudes and beliefs are the foundations of our perceptions about health and illness. Those perceptions at times are predisposed to conflict with a health care professional who, coming from a different culture, may hold different norms and beliefs. Brookins grounds her discussion within the context of child development and argues that for a child of color or one whose ethnic heritage is other than mainstream, the key to developmental success is bicultural competence—the ability to walk in and between two worlds.

COMMON HEALTH PROBLEMS AND UTILIZATION OF PRIMARY HEALTH CARE SERVICES IN THE RURAL AREAS OF THUA THIEN HUE PROVINCE

2020 ◽  
pp. 62-71
Author(s):  
Tuan Duong Quang ◽  
Anh Le Ho Thi Quynh ◽  
Hung Nguyen Nam ◽  
Tam Nguyen Minh
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Status ◽  
Rural Areas ◽  
Health Problems ◽  
Care Utilization ◽  
Mountainous Area ◽  
Geography Information System ◽  
Care Services ◽  
Geography Information

Although health status in Vietnam has been much improved, people living in rural areas have faced several challenges, including a rapid increase of the aging population, inadequate capacity of health system, and problems of inequities in access to the healthcare system. Objectives: This study aimed to explore the common health problems and health care utilization of people living in the rural areas of Thua Thien Hue province. Methods: A cross-sectional study and geography information system application were carried out. A total of 2.631 individuals in 599 households of a lowland area and a mountainous area was interviewed with a structured questionnaire regarding to health status and health care utilization during the last 6 months. Geography information system software was used to visualize these data of household. Results: 32.8% of participants reported at least an episode of illness within 6 months prior to the interviews. Most of illness people lived in mountainous area. Fever, uncomplicated hypertension, cough, and headache were reported as the most common health problems among participants. Most of participants preferred to visit commune health centers and district hospitals. People in different areas have a significant difference trend from another in choosing health facilities. Conclusion: Residents in difficult-to-reach areas had high prevalence of health problems and experienced social and structural barriers of healthcare services access. It is necessary to improve the availability and quality of primary care services to improve the health status and accessibility of disadvantaged people. Keywords: primary care, utilization, rural areas, health care acessibility

Advanced Care Planning for Persons With Dementia in Primary Care: Attitudes and Barriers Among Health-Care Professionals

2018 ◽  
Vol 34 (4) ◽  
pp. 248-254 ◽  
Author(s):  
Linda Lee ◽  
Loretta M. Hillier ◽  
Jason Locklin ◽  
Jennifer Lee ◽  
Karen Slonim
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Family Practice ◽  
Health Care Professionals ◽  
Comfort Level ◽  
Care Planning ◽  
Memory Clinic ◽  
Point Scale ◽  
Collaborative Memory ◽  
Regular Family

Background: Advance care planning (ACP) provides clarity on goals and preferences for future health-care decisions, the timeliness of which is critical for persons with dementia. Aim: This study assessed Primary Care Collaborative Memory Clinic (PCCMC) health-care practitioners’ desire for more education on ACP, capacity for and attitudes toward ACP, and current ACP practices in their regular family practice and in their PCCMC. Methods: Primary Care Collaborative Memory Clinic health-care professionals completed a questionnaire in which they rated their interest in learning various ACP-related topics (5-point scale: not at all to very much so), attitudes toward ACP, and the importance of and perceived degree of responsibility for ACP (5-point scale: not at all to extremely). Respondents estimated ACP completion in regular family practice and PCCMC. Results: Two hundred and sixty one surveys were completed. Mean knowledge ratings were moderate (M = 3.0) and mean ratings of interest in ACP topics were all high (median ≥ 4). Despite the perception that ACP is very important (M = 4.9) and the responsibility of PCCMCs (M = 3.7), the majority of respondents estimated that 40% or fewer patients have had ACP. Ratings of willingness to conduct ACP (M = 3.7) and comfort level (M = 3.4) were moderate but significantly exceeded ratings of ability (M = 2.9), comfort (M = 3.5), and confidence (M = 2.8). Conclusion: There was a striking disconnect between perceptions of the importance of completing ACP for persons with dementia and actual ACP completion rates. Primary Care Collaborative Memory Clinics may be in an ideal position to support ACP discussions; however, there is a need to improve health-care professionals’ knowledge and attitudes toward ACP.

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