Influences on general practitioner referral to allied health professionals for fall prevention in primary care

2019 ◽  
Vol 39 (1) ◽  
Author(s):  
Jeannine Liddle ◽  
Lindy Clemson ◽  
Lynette Mackenzie ◽  
Meryl Lovarini ◽  
Amy Tan ◽  
...  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Jeannine Liddle ◽  
Meryl Lovarini ◽  
Lindy Clemson ◽  
Lynette Mackenzie ◽  
Amy Tan ◽  
...  

2008 ◽  
Vol 188 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Michele M Foster ◽  
Geoffrey Mitchell ◽  
Terry Haines ◽  
Sean Tweedy ◽  
Petrea Cornwell ◽  
...  

2020 ◽  
Author(s):  
Jacinta Sheehan ◽  
Kate Laver ◽  
Anoo Bhopti ◽  
Miia Rahja ◽  
Tim Usherwood ◽  
...  

Abstract Background There is a compelling rationale that effective communication between hospital allied health professionals and primary care practitioners could improve quality and continuity of patient care. It is not known which methods of communication are used, nor how effectively they facilitate the transition of care when a patient is discharged home from hospital. Our systematic review aims to investigate the methods and effectiveness of communication between hospital allied health professionals and primary care practitioners. Method Systematic review of quantitative and qualitative studies with narrative synthesis. Medline, CINAHL, EMBASE, PsycInfo and Proquest Nursing and Allied Health Sources were searched from January 2003 until January 2020 for studies that examined hospital allied health professionals communicating with primary care practitioners. Risk of bias in the different study designs were appraised using recognised tools and a content analysis conducted of the methodologies used. Results From the located 12,281 papers (duplicates removed), 24 studies met the inclusion criteria with hospital allied health professionals communicating in some form with primary care practitioners. There was, however, limited literature investigating the methods and/or the effectiveness of communication between hospital allied health professionals and primary care practitioners.Conclusion There is currently no 'gold standard' method or measure of communication between hospital allied health professionals and primary care practitioners. There is an urgent need to develop and evaluate multidisciplinary communication with enhanced health information technologies to improve collaboration across healthcare settings and facilitate continuity of integrated people-centred care.Registration: www.crd.york.uk PROSPERO CRD42019120410


2019 ◽  
Vol 69 (682) ◽  
pp. e304-e313 ◽  
Author(s):  
Bethany F Anthony ◽  
Alun Surgey ◽  
Julia Hiscock ◽  
Nefyn H Williams ◽  
Joanna M Charles

BackgroundPrevious systematic reviews have found that nurses and pharmacists can provide equivalent, or higher, quality of care for some tasks performed by GPs in primary care. There is a lack of economic evidence for this substitution.AimTo explore the costs and outcomes of role substitution between GPs and nurses, pharmacists, and allied health professionals in primary care.Design and settingA systematic review of economic evaluations exploring role substitution of allied health professionals in primary care was conducted. Role substitution was defined as ‘the substitution of work that was previously completed by a GP in the past and is now completed by a nurse or allied health professional’.MethodThe following databases were searched: Ovid MEDLINE, CINAHL, Cochrane Library, National Institute for Health and Care Excellence (NICE), and the Centre for Reviews and Dissemination. The review followed guidance from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).ResultsSix economic evaluations were identified. There was some limited evidence that nurse-led care for common minor health problems was cost-effective compared with GP care, and that nurse-led interventions for chronic fatigue syndrome and pharmacy-led services for the medicines management of coronary heart disease and chronic pain were not. In South Korea, community health practitioners delivered primary care services for half the cost of physicians. The review did not identify studies for other allied health professionals such as physiotherapists and occupational therapists.ConclusionThere is limited economic evidence for role substitution in primary care; more economic evaluations are needed.


2017 ◽  
Vol 67 (664) ◽  
pp. e757-e763 ◽  
Author(s):  
Fanny McKellips ◽  
Erin Keely ◽  
Amir Afkham ◽  
Clare Liddy

BackgroundAllied health services are an important part of providing effective team-based care. The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service facilitates quick and secure communication between primary care providers (PCPs) and allied health professionals (AHPs).AimTo assess the eConsult service’s ability to improve access to advice from AHPs.Design and settingA cross-sectional study was carried out on all cases submitted to AHPs through the eConsult service between April 2011 and May 2016. The service covers Ottawa, Canada, and its surrounding rural communities.MethodA descriptive overview of all cases submitted to allied health services was conducted. Utilisation and survey metrics for AHP eConsults were compared with those sent to medical specialties, in order to understand the potential differences and generalisability of eConsult access beyond the traditional medical specialty referral.ResultsPCPs submitted 127 cases to nine allied health specialties during the study period. The most popular specialty was clinical pharmacist, which received an average of 1.5 cases per month. The median specialist response time was 2.1 days (interquartile range [IQR] 0.7–5.3 days, range 0.01–14.2 days) versus 0.9 days (IQR 0.2–3.4 days, range 0–49.5 days) for medical specialties. PCPs received advice for a new or additional course of action in 70% (versus 58% for medical specialties) of cases. They rated the service as being of high or very high value for their patients in 88% of cases (versus 93% for medical specialties), and for themselves in 89% (94% for medical specialties) of cases.ConclusionThe eConsult service has demonstrated the ability to support prompt communication between PCPs and AHPs, improving patients’ access to AHP care. Given the importance of AHPs in providing primary care, allied health services should be offered in the menu of specialties available through electronic consultation services.


2020 ◽  
Vol 26 (5) ◽  
pp. 383
Author(s):  
Aidan Borthwick ◽  
Peter Higgs

Advance care planning is increasingly common practice in contemporary health care for individuals living with a chronic condition. Currently, limited research has been conducted into how newly adopted legislation in Victoria, Australia, facilitates advance care planning. The purpose of this study was to explore the uptake of the Medical Treatment Planning and Decisions Act 2016 in the primary care setting. The study also aimed to explore barriers that allied health professionals encounter when practicing advance care planning with patients. Four interdisciplinary focus groups and two in-depth interviews with participants were conducted and thematically analysed using an interpretivist inquiry paradigm. Analysis revealed two key themes: promoting client wellbeing and scope of practice. The data suggest that advance care planning by allied health professionals in the primary care setting is limited. Focussing on enhancing clients’ wellbeing was more important than the development of advanced care directives. Attempting to promote the wellbeing of patients may foster hesitation to commence advance care planning in primary care. This study demonstrated that knowledge of the fundamental legislative changes are evident among allied health professionals which provides a foundation for successful development of advance care planning post implementation of the new Act.


2017 ◽  
Vol 41 (1) ◽  
pp. 111 ◽  
Author(s):  
Kajtek Kielich ◽  
Lynette Mackenzie ◽  
Meryl Lovarini ◽  
Lindy Clemson

Objective The study aimed to explore Australian general practitioners’ (GPs) perceptions of falls risk screening, assessment and their referral practices with older people living in the community, and to identify any barriers or facilitators to implementing evidence-based falls prevention practice. Methods Hardcopy surveys and a link to an online survey were distributed to 508 GPs working at one Medicare Local (now part of a Primary Care Network) located in Sydney, Australia. Data were analysed using descriptive statistics and key themes were identified from open text responses. Results A total of 37 GPs returned the survey. Only 10 (27%) GPs routinely asked older people about falls, and five (13.5%) asked about fear of falls during clinical consultations. Barriers to managing falls risk were identified. GPs estimated that they made few referrals to allied health professionals for falls interventions. Conclusions GPs were knowledgeable about falls risk factors but this did not result in consistent falls risk screening, assessment or referral practices. Due to the small sample, further research is needed with a larger sample to augment these results. What is known about the topic? Falls are a common and serious health issue for older people and fall prevention is vital, especially in the primary care setting. General practitioners (GPs) are key health professionals to identify older people at risk of falls and refer them to appropriate health professionals for intervention. Evidence-based falls prevention interventions exist but are not easily or routinely accessed by older people. What does this paper add? GPs believe that previous falls are an important falls risk factor but they do not routinely ask about falls or fear of falls in clinical practice with older people. GP referral rates to allied health professionals for falls prevention are low, despite evidence-based falls prevention interventions being provided by allied health professionals. There are several barriers to GPs providing falls prevention assessment and intervention referrals, particularly using the current primary health systems. What are the implications for practitioners? GPs need to recognise their potential significant contribution to falls prevention in the community and may require tailored training. Sustainable evidence-based referral pathways need to be developed so that older people can be referred to allied health professionals for falls prevention interventions in the primary care setting, and better local networks need to be developed to allow this to occur. Policy makers may have to address the identified barriers to multidisciplinary practice and funding of services to facilitate effective falls prevention programs in primary care.


2004 ◽  
Vol 10 (1) ◽  
pp. 72 ◽  
Author(s):  
Jane Sims ◽  
Theonie Tacticos ◽  
Maria Patiriadis ◽  
Lucio Naccarella

The General Practice Education, Support and Community Linkages Program was introduced to formally support implementation and appropriate use of the Enhanced Primary Care Medicare Benefits Schedule items. This paper reports upon the Program?s implementation from the allied health professional?s perspective. Semi-structured interviews were conducted in 2002 with healthcare staff trained under the Program. While interviewees noted achievements in the items? uptake during the Program, allied health involvement in case conferencing and care planning had been impeded by GPs? limited adoption of the items. Allied health professionals were broadly interested in participating in care planning and case conferencing with GPs. The General Practice Education, Support and Community Linkages Program supported implementation and appropriate use of the Enhanced Primary Care Medicare Benefits Schedule items. While allied health professionals are generally interested in participating in care planning and case conferencing with GPs, such activity requires ongoing systems support and relationship building. Ample scope remains for awareness raising, relationship building and joint activities across the sector. Future item usage will need to be supported by resources and continued relationship building.


2010 ◽  
Vol 34 (1) ◽  
pp. 25 ◽  
Author(s):  
Jemma Skeat ◽  
Angela Morgan ◽  
Tristan Nickless

Background.Allied health professionals have provided services under Enhanced Primary Care (EPC) since 2004; however, the experiences and views of AHPs about the initiative and how it has been utilised have not been well explored. Objective.We examined speech pathologists’ views and experiences under EPC. Methods.A survey of speech pathologists in private practice who provide services under EPC was undertaken. Results.Speech pathologists provide EPC services to a wide range of clients with communication and swallowing disorders. The five EPC sessions provide a ‘starting point’ for therapy for some clients, and supplement existing therapy for others. Speech pathologists expressed concern about the accessibility of the program, and its understanding and use in practice, but noted that the program can be valuable for clients who are able to negotiate the hurdles, and for themselves in terms of increased referrals and collaboration with general practitioners. Conclusions.Education around eligibility, access, and reporting requirements is needed for clients, GPs and allied health professionals in order to reduce the frustrating aspects of this program, and support its ongoing use. What is known about the topic?The Enhanced Primary Care (EPC) program relies on collaboration between general practitioners and allied health professionals, and aims to improve the management of chronic and complex conditions in the community. The experiences and views of allied health professionals (AHPs) in implementing the EPC program since 2004 are important to inform evaluation of the effectiveness, usefulness and value of the program. What does this paper add?We explored speech pathologists’ perspectives on EPC, including their experiences and views about the program. The paper informs understanding of the use of EPC in practice, for example, how sessions are provided to clients over the 12-month period, as well as how those who use it – allied health professionals – perceive the value and practicality of this program. What are the implications for practitioners?Education for GPs, clients and AHPs is needed to facilitate a more efficient and effective use of EPC. Policy makers should consider the views and experiences of AHPs when reviewing the EPC initiative, in order to understand aspects such as the accessibility of the programs for clients, and the perceived value for AHPs.


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