Barriers and enablers to health service access amongst people with diabetes: An exploration of the perceptions of health care staff in regional Australia

Author(s):  
Elizabeth L. Kennedy ◽  
Brett A. Gordon ◽  
Ashley H. Ng ◽  
Gillian Smith ◽  
Adrienne K. Forsyth
10.2196/15380 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e15380 ◽  
Author(s):  
Micheal O'Cathail ◽  
M Ananth Sivanandan ◽  
Claire Diver ◽  
Poulam Patel ◽  
Judith Christian

Background The National Health Service (NHS) Long-Term Plan has set out a vision of enabling patients to access digital interactions with health care professionals within 5 years, including by video link. Objective This review aimed to examine the extent and nature of the use of patient-facing teleconsultations within a health care setting in the United Kingdom and what outcome measures have been assessed. Methods We conducted a systematic scoping review of teleconsultation studies following the Joanna Briggs Institute methodology. PubMed, Scopus, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched up to the end of December 2018 for publications that reported on the use of patient-facing teleconsultations in a UK health care setting. Results The search retrieved 3132 publications, of which 101 were included for a full review. Overall, the studies were heterogeneous in design, in the specialty assessed, and reported outcome measures. The technology used for teleconsultations changed over time with earlier studies employing bespoke, often expensive, solutions. Two-thirds of the studies, conducted between 1995 and 2005, used this method. Later studies transitioned to Web-based commercial solutions such as Skype. There were five outcome measures that were assessed: (1) technical feasibility, (2) user satisfaction, (3) clinical effectiveness, (4) cost, (5) logistical and operational considerations. Due to the changing nature of technology over time, there were differing technical issues across the studies. Generally, teleconsultations were acceptable to patients, but this was less consistent among health care professionals. However, among both groups, face-to-face consultations were still seen as the gold standard. A wide range of clinical scenarios found teleconsultations to be clinically useful but potentially limited to more straightforward clinical interactions. Due to the wide array of study types and changes in technology over time, it is difficult to draw definitive conclusions on the cost involved. However, cost savings for health care providers have been demonstrated by the goal-directed implementation of teleconsultations. The integration of technology into routine practice represents a complex problem with barriers identified in funding and hospital reimbursement, information technologies infrastructure, and integration into clinicians’ workflow. Conclusions Teleconsultations appear to be safe and effective in the correct clinical situations. Where offered, it is likely that patients will be keen to engage, although teleconsultations should only be offered as an option to support traditional care models rather than replace them outright. Health care staff should be encouraged and supported in using teleconsultations to diversify their practice. Health care organizations need to consider developing a digital technology strategy and implementation groups to assist health care staff to integrate digitally enabled care into routine practice. The introduction of new technologies should be assessed after a set period with service evaluations, including feedback from key stakeholders.


2005 ◽  
Vol 6 (2) ◽  
pp. 32-36
Author(s):  
D. T. Cowan

This paper discusses the role, responsibilities and practices of anaesthetic practitioners in the Netherlands in relation to their counterparts in the United Kingdom (UK), these practitioners representing an important yet overlooked section of the health care workforce. This takes place in the context of the UK National Health Service (NHS) modernisation agenda and the European Commission's (EC) aim to enhance the mobility of health care staff throughout the European Union (EU) through standardisation of variations in qualifications, skill levels, methods and working practices (Bologna, 1999; Lisbon Strategy, 2000; EHTAN, 2005).It is clear that significant disparities remain between anaesthetic practitioners in both countries and that we need to explore ways of arriving at compatibility between the different grades. However, this does not currently appear to be happening at EU level. Despite the huge responsibilities on these practitioners, this sector of the EU health care workforce remains largely invisible and there appears to be no concerted attempt at EU level to develop appropriate competencies for them. Further research is required into this area, including: evaluative studies of policies for service redesign and new roles, professional regulation and the impact on outcomes for health service users.


Author(s):  
Shuen-Fu Weng ◽  
Azis Malik ◽  
Utoomporn Wongsin ◽  
Franziska Michaela Lohmeyer ◽  
Li-Fong Lin ◽  
...  

The number of migrant workers in Taiwan increases annually. The majority is from Indonesia and most of them are female caregivers. This study aims to determine the access to health services and the associated factors among Indonesian female domestic workers in Taiwan. In this cross-sectional study, data were collected from February to May 2019, using a structured questionnaire. Subsequently, multiple logistic regression was used to examine the association between socio-demographic factors and health service access. Two hundred and eighty-four domestic migrant workers were interviewed. Eighty-five percent of the respondents declared sickness at work, but only 48.8% seek health care services. Factors associated with health service access were marital status, income, and the availability of an attendant to accompany the migrant workers to the healthcare facilities. Language barrier and time flexibility were the main obstacles. Further research and an effective health service policy are needed for the domestic migrant workers to better access health care services.


2019 ◽  
Author(s):  
Micheal O'Cathail ◽  
M Ananth Sivanandan ◽  
Claire Diver ◽  
Poulam Patel ◽  
Judith Christian

BACKGROUND The National Health Service (NHS) <i>Long-Term Plan</i> has set out a vision of enabling patients to access digital interactions with health care professionals within 5 years, including by video link. OBJECTIVE This review aimed to examine the extent and nature of the use of patient-facing teleconsultations within a health care setting in the United Kingdom and what outcome measures have been assessed. METHODS We conducted a systematic scoping review of teleconsultation studies following the Joanna Briggs Institute methodology. PubMed, Scopus, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched up to the end of December 2018 for publications that reported on the use of patient-facing teleconsultations in a UK health care setting. RESULTS The search retrieved 3132 publications, of which 101 were included for a full review. Overall, the studies were heterogeneous in design, in the specialty assessed, and reported outcome measures. The technology used for teleconsultations changed over time with earlier studies employing bespoke, often expensive, solutions. Two-thirds of the studies, conducted between 1995 and 2005, used this method. Later studies transitioned to Web-based commercial solutions such as Skype. There were five outcome measures that were assessed: (1) technical feasibility, (2) user satisfaction, (3) clinical effectiveness, (4) cost, (5) logistical and operational considerations. Due to the changing nature of technology over time, there were differing technical issues across the studies. Generally, teleconsultations were acceptable to patients, but this was less consistent among health care professionals. However, among both groups, face-to-face consultations were still seen as the gold standard. A wide range of clinical scenarios found teleconsultations to be clinically useful but potentially limited to more straightforward clinical interactions. Due to the wide array of study types and changes in technology over time, it is difficult to draw definitive conclusions on the cost involved. However, cost savings for health care providers have been demonstrated by the goal-directed implementation of teleconsultations. The integration of technology into routine practice represents a complex problem with barriers identified in funding and hospital reimbursement, information technologies infrastructure, and integration into clinicians’ workflow. CONCLUSIONS Teleconsultations appear to be safe and effective in the correct clinical situations. Where offered, it is likely that patients will be keen to engage, although teleconsultations should only be offered as an option to support traditional care models rather than replace them outright. Health care staff should be encouraged and supported in using teleconsultations to diversify their practice. Health care organizations need to consider developing a digital technology strategy and implementation groups to assist health care staff to integrate digitally enabled care into routine practice. The introduction of new technologies should be assessed after a set period with service evaluations, including feedback from key stakeholders.


Author(s):  
E. Rydwik ◽  
L. Anmyr ◽  
M. Regardt ◽  
A. McAllister ◽  
R. Zarenoe ◽  
...  

Abstract Background The knowledge of the long-term consequences of covid-19 is limited. In patients, symptoms such as fatigue, decreased physical, psychological, and cognitive function, and nutritional problems have been reported. How the disease has affected next of kin, as well as staff involved in the care of patients with covid-19, is also largely unknown. The overall aim of this study is therefore three-fold: (1) to describe and evaluate predictors of patient recovery, the type of rehabilitation received and patients’ experiences of specialized rehabilitation following COVID-19 infection; (2) to study how next of kin experienced the hospital care of their relative and their experiences of the psychosocial support they received as well as their psychological wellbeing; (3) to describe experiences of caring for patients with COVID-19 and evaluate psychological wellbeing, coping mechanisms and predictors for development of psychological distress over time in health care staff. Methods This observational longitudinal study consists of three cohorts; patients, next of kin, and health care staff. The assessments for the patients consist of physical tests (lung function, muscle strength, physical capacity) and questionnaires (communication and swallowing, nutritional status, hearing, activities of daily living, physical activity, fatigue, cognition) longitudinally at 3, 6 and 12 months. Patient records auditing (care, rehabilitation) will be done retrospectively at 12 months. Patients (3, 6 and 12 months), next of kin (6 months) and health care staff (baseline, 3, 6, 9 and 12 months) will receive questionnaires regarding, health-related quality of life, depression, anxiety, sleeping disorders, and post-traumatic stress. Staff will also answer questionnaires about burnout and coping strategies. Interviews will be conducted in all three cohorts. Discussion This study will be able to answer different research questions from a quantitative and qualitative perspective, by describing and evaluating long-term consequences and their associations with recovery, as well as exploring patients’, next of kins’ and staffs’ views and experiences of the disease and its consequences. This will form a base for a deeper and better understanding of the consequences of the disease from different perspectives as well as helping the society to better prepare for a future pandemic.


2021 ◽  
pp. 152483992110035
Author(s):  
Jennifer Utter ◽  
Sally McCray

Family meals provide a unique opportunity for families to eat well and engage positively with each other. In response to the challenges presented by the COVID-19 (coronavirus disease 2019) pandemic, a new initiative to support health care staff to share healthy meals with their families was developed. At a hospital in Queensland, Australia, dietetic staff collaborated with the on-site food service retailer to develop and offer a range of hot meals that staff could take home for their families at the end of their day. The meals were nutritious, reasonably priced, and designed to feed a family of four. The dietetic staff worked with the hospital marketing department and staff health and wellness program to promote the initiative. Over the 3 months that it has been running, nearly 300 meals have been purchased. Anecdotal comments from the food service retailer highlighted that the initiative was a good thing to do for staff to maintain a positive reputation of the business. The staff evening meal initiative is a healthy, affordable, educational, and socially engaging alternative to takeaway meals and food delivery by app, and it is mutually beneficial for health care staff and the on-site food retailer. The initiative also offers a unique opportunity for promoting nutrition and social engagement during stressful times.


Sign in / Sign up

Export Citation Format

Share Document