scholarly journals Structure and process: the relationship between practice management and actual clinical performance in general practice

1998 ◽  
Vol 15 (4) ◽  
pp. 354-362 ◽  
Author(s):  
P. Ram ◽  
R. Grol ◽  
P. van den Hombergh ◽  
J. J. Rethans ◽  
C. van der Vleuten ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Performance ◽  
Practice Management ◽  
The Relationship

“Experience Isn’t Everything”: How Emotion Affects the Relationship Between Experience and Cue Utilization

2018 ◽  
Vol 60 (5) ◽  
pp. 685-698 ◽  
Author(s):  
Monique Frances Crane ◽  
Sue Brouwers ◽  
Mark William Wiggins ◽  
Thomas Loveday ◽  
Kirsty Forrest ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Experience Level ◽  
Cue Utilization ◽  
Practice Experience ◽  
Negative Arousal ◽  
Range Anxiety ◽  
Research Findings ◽  
Post Hoc ◽  
The Relationship

Objective: This research examined whether negative and positive arousal emotions modify the relationship between experience level and cue utilization among anesthetists. Background: The capacity of a practitioner to form precise associations between clusters of features (e.g., symptoms) and events (e.g., diagnosis) and then act on them is known as cue utilization. A common assumption is that practice experience allows opportunities for cue acquisition and cue utilization. However, this relationship is often not borne out in research findings. This study investigates the role of emotional state in this relationship. Method: An online tool (EXPERTise 2.0) was used to assess practitioner cue utilization for tasks relevant to anesthesia. The experience of positive and negative arousal emotions in the previous three days was measured, and emotion clusters were generated. Experience was measured as the composite of practice years and hours of practice experience. The moderating role of emotion on the relationship between experience and cue utilization was examined. Results: Data on 125 anesthetists (36% female) were included in the analysis. The predicted interaction between arousal emotions and the experience level emerged. In particular, post hoc analyses revealed that anxiety-related emotions facilitated the likelihood of high cue utilization in less experienced practitioners. Conclusion: The findings suggest a role for emotions in cue use and suggest a functional role for normal range anxiety emotions in a simulated work-relevant task. Application: This research illustrates the importance of understanding the potentially functional effects common negative arousal emotions may have on clinical performance, particularly for those with less experience.

Incidence of diabetes in a general practice population: a database cohort study on the relationship with haloperidol, olanzapine, risperidone or quetiapine exposure

2005 ◽  
Vol 20 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Emilio Sacchetti ◽  
Cesare Turrina ◽  
Giovanni Parrinello ◽  
Ovidio Brignoli ◽  
Giovanni Stefanini ◽  
...  
Keyword(s):  
General Practice ◽  
Cohort Study ◽  
Practice Population ◽  
The Relationship

scholarly journals Datasets collected in general practice: an international comparison using the example of obesity

2018 ◽  
Vol 42 (5) ◽  
pp. 563 ◽  
Author(s):  
Elizabeth Sturgiss ◽  
Kees van Boven
Keyword(s):  
Primary Care ◽  
General Practice ◽  
The Netherlands ◽  
Care Management ◽  
Clinical Care ◽  
International Comparisons ◽  
Health Condition ◽  
Practice Management ◽  
Number Of Patients ◽  
Primary Care Management

International datasets from general practice enable the comparison of how conditions are managed within consultations in different primary healthcare settings. The Australian Bettering the Evaluation and Care of Health (BEACH) and TransHIS from the Netherlands collect in-consultation general practice data that have been used extensively to inform local policy and practice. Obesity is a global health issue with different countries applying varying approaches to management. The objective of the present paper is to compare the primary care management of obesity in Australia and the Netherlands using data collected from consultations. Despite the different prevalence in obesity in the two countries, the number of patients per 1000 patient-years seen with obesity is similar. Patients in Australia with obesity are referred to allied health practitioners more often than Dutch patients. Without quality general practice data, primary care researchers will not have data about the management of conditions within consultations. We use obesity to highlight the strengths of these general practice data sources and to compare their differences. What is known about the topic? Australia had one of the longest-running consecutive datasets about general practice activity in the world, but it has recently lost government funding. The Netherlands has a longitudinal general practice dataset of information collected within consultations since 1985. What does this paper add? We discuss the benefits of general practice-collected data in two countries. Using obesity as a case example, we compare management in general practice between Australia and the Netherlands. This type of analysis should start all international collaborations of primary care management of any health condition. Having a national general practice dataset allows international comparisons of the management of conditions with primary care. Without a current, quality general practice dataset, primary care researchers will not be able to partake in these kinds of comparison studies. What are the implications for practitioners? Australian primary care researchers and clinicians will be at a disadvantage in any international collaboration if they are unable to accurately describe current general practice management. The Netherlands has developed an impressive dataset that requires within-consultation data collection. These datasets allow for person-centred, symptom-specific, longitudinal understanding of general practice management. The possibilities for the quasi-experimental questions that can be answered with such a dataset are limitless. It is only with the ability to answer clinically driven questions that are relevant to primary care that the clinical care of patients can be measured, developed and improved.

scholarly journals General practice management of rotator cuff related shoulder pain: A reliance on ultrasound and injection guided care

PLoS ONE ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. e0227688 ◽  
Author(s):  
Josh Naunton ◽  
Christopher Harrison ◽  
Helena Britt ◽  
Terrence Haines ◽  
Peter Malliaras
Keyword(s):  
General Practice ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Practice Management

Care planning and adherence to diabetes process guidelines: Medicare data analysis

2013 ◽  
Vol 37 (1) ◽  
pp. 83 ◽  
Author(s):  
Akuh Adaji ◽  
Peter Schattner ◽  
Kay Margaret Jones ◽  
Bronwyn Beovich ◽  
Leon Piterman
Keyword(s):  
General Practice ◽  
Strong Association ◽  
Hdl Cholesterol ◽  
Practice Management ◽  
Care Plan ◽  
Care Planning ◽  
Process Measures ◽  
Care Plans ◽  
Management Plans ◽  
Chi Square Analysis

Objective. To test the association, in patients with a diagnosis of diabetes I and II, between having or not having a care plan, (i.e. General Practice Management Plans (GPMPs),Team Care Arrangements (TCAs)), and having the recommended number of biochemical checks according to the diabetes Annual Cycle of Care guideline. The checks comprised HbA1c, HDL cholesterol and urinary microalbumin. Methods. Chi-square analysis of retrospective group data obtained from the Medicare database (from ‘billing’ patterns only). Results. The creation of GPMPs was associated with general practitioners (GPs) requesting checks for HbA1c (59.7%), HDL cholesterol (36.9%) and microalbumin (50.8%) for diabetes patients in accordance with guideline recommendations. Although the introduction of multidisciplinary care via a TCA was associated with an increase in the frequency of HbA1c checks (61.3%) in accordance with the guidelines, there was a reduction in the number of HDL cholesterol (23.7%) and microalbumin (36.8%) checks. The group with no care plans had the lowest association with HbA1c (47.8%), HDL cholesterol (19.7%) and microalbumin (29.3%) checks that met guideline requirements for diabetes. Conclusions. The use of GPMPs showed strong association with increased testing of process measures that met guideline requirements for diabetes. Further research is needed to understand the value and benefits of TCAs in promoting adherence to diabetes guidelines. What is known about the topic? Research suggests that care planning is associated with increased adherence by GPs to some of the processes of care stipulated in diabetes guidelines. What does the paper add? This study examines Australia-wide data obtained from Medicare. The findings demonstrated strong association between care planning and the process measures examined in this study. In contrast to previous studies, multidisciplinary team involvement via a TCA appeared to be less important than a GPMP in promoting adherence to process measures. What are the implications for practitioners? GPs should continue to provide structure care to patients via General Practice Management Plans.

Does TeamSTEPPS affect psychological status?

2019 ◽  
Vol 32 (1) ◽  
pp. 11-20 ◽  
Author(s):  
Yoshinori Fukushima ◽  
Atsushi Yamada ◽  
Naruaki Imoto ◽  
Toshiaki Iba
Keyword(s):  
Psychological Stress ◽  
Team Performance ◽  
Clinical Performance ◽  
Nervous Activity ◽  
Psychological Status ◽  
Small Scale ◽  
Content Type ◽  
Student Teams ◽  
Study Results ◽  
The Relationship

Purpose The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program is known to improve team and clinical performance, but the relationship to psychological stress has not been clarified. The purpose of this paper is to evaluate team performance, clinical performance and psychological stress simultaneously in a simulation-based training combined with or without the TeamSTEPPS program. Design/methodology/approach This randomized, controlled, prospective pilot study was performed to reveal TeamSTEPPS impact on psychological stress. The course included an emergency care training course, the TeamSTEPPS program, and a scenario simulation. Ten medical student teams were randomly allocated two groups: a TeamSTEPPS group and a non-TeamSTEPPS group. Team performance, clinical performance and psychological stress were evaluated simultaneously in the course; i.e., questionnaire evaluation and an observational evaluation for team performance; an assessor’s evaluation and a simulator’s evaluation for clinical performance. Autonomic nervous activity, represented by salivary amylase levels and heart rate variability, were measured as psychological stress indicators. Findings Team performance and clinical performance were significantly better in the TeamSTEPPS group, while psychological stress did not differ between the groups. Originality/value This is the first study to examine the relationship between TeamSTEPPS and psychological stress. Although only preliminary conclusions can be drawn from this small-scale study, results suggest that the TeamSTEPPS program improved team and clinical performance without increasing psychological stress.

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