Primary care practitioners’ perspectives of discharge communication and continuity of care for stroke survivors in Australia: A qualitative descriptive study

BackgroundStrategies have been developed for use in primary care to identify patients at risk of declining health and dying, yet little is known about the perceptions of doing so or the broader implications and impacts.AimTo explore the acceptability and implications of using a primary care-based electronic medical record algorithm to help providers identify patients in their practice at risk of declining health and dying.Design and settingQualitative descriptive study in Ontario and Nova Scotia, Canada.MethodSix focus groups were conducted, supplemented by one-on-one interviews, with 29 healthcare providers, managers, and policymakers in primary care, palliative care, and geriatric care. Participants were purposively sampled to achieve maximal variation. Data were analysed using a constant comparative approach.ResultsSix themes were prevalent across the dataset: early identification is aligned with the values, aims, and positioning of primary care; providers have concerns about what to do after identification; how we communicate about the end of life requires change; early identification and subsequent conversations require an integrated team approach; for patients, early identification will have implications beyond medical care; and a public health approach is needed to optimise early identification and its impact.ConclusionStakeholders were much more concerned with how primary care providers would navigate the post-identification period than with early identification itself. Implications of early identification include the need for a team-based approach to identification and to engage broader communities to ensure people live and die well post-identification.

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Disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study

BMC Family Practice ◽

10.1186/s12875-020-01143-8 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Ruta Valaitis ◽

Laura Cleghorn ◽

Jenny Ploeg ◽

Cathy Risdon ◽

Derelie Mangin ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Social Services ◽

Descriptive Study ◽

Community Based ◽

Health And Social Services ◽

Qualitative Descriptive

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Doctors’ Views on How to Improve Communication and Quality of Care for Patients Experiencing End-of-Life: A Qualitative Descriptive Study

Healthcare ◽

10.3390/healthcare9101294 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1294

Author(s):

Fiona McCormack ◽

Rachel Hopley ◽

Judith Kurth ◽

Zafar Iqbal

Keyword(s):

Primary Care ◽

Quality Of Care ◽

End Of Life ◽

Descriptive Study ◽

Patient Centred Care ◽

Individual Interviews ◽

Qualitative Descriptive ◽

Advance Care ◽

Communication And Coordination

(1) Background: There remains a lack of sufficient progress in enhancing quality of care for patients experiencing end-of-life. This study aimed to better understand the views of doctors on how to improve end-of-life healthcare, in light of existing challenges and processes. (2) Methods: This qualitative descriptive study used semi-structured individual interviews. Through purposive sampling, sixteen doctors from primary care (three general practices) or acute care (one National Health Service hospital trust) participated. Interviews were audio-recorded, transcribed and thematic analysis conducted. (3) Results: Two main themes were identified: First, planning for patient-centred care—conversations about end-of-life care should take place earlier to allow for care that is planned and personalised. The need for more training and improvements to documenting patient wishes were highlighted. Second, delivering on patients’ wishes: improvements to the healthcare system—the importance of a record of patient wishes that can be shared across the system was identified. Improved utilisation of available resources is also needed to better deliver quality patient-centred care. (4) Conclusion: More effective communication and coordination across acute and primary care settings is needed. The importance of patient wishes and advance care planning was emphasised. More guidance at a strategic level may help provide clarity about expectations, roles and responsibilities.

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Barriers and Benefits of the Scheduled Telephone Referral Model (DETELPROG): A Qualitative Approach

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105280 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5280

Author(s):

Luis Miguel Azogil-López ◽

Valle Coronado-Vázquez ◽

Juan José Pérez-Lázaro ◽

Juan Gómez-Salgado ◽

Esther María Medrano-Sánchez

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Descriptive Study ◽

Mobile Telephone ◽

Structured Interviews ◽

Face To Face ◽

Healthcare Burden ◽

Qualitative Descriptive ◽

Attending Physicians ◽

The Relationship

The recently developed scheduled mobile-telephone referral model (DETELPROG) has achieved especially important results in reducing waiting days for patients, but it has been decided to explore what barriers and positive aspects were detected by both primary care physicians (PCPs) and hospital attending physicians (HAPs) regarding its use. For this, a qualitative descriptive study was carried out through six semi-structured interviews and two focus groups in a sample of eleven PCPs and five HAPs. Interviews were carried out from September 2019 to February 2020. Data were analysed by creating the initial categories, recording the sessions, transcribing the information, by doing a comprehensive reading of the texts obtained, and analysing the contents. The results show that DETELPROG gives the PCP greater prominence as a patient’s health coordinator by improving their relationship and patient safety; it also improves the relationship between PCP and HAP, avoiding unnecessary face-to-face referrals and providing safety to the PCP when making decisions. The barriers for DETELPROG to be used by PCP were defensive medicine, patients’ skepticism in DETELPROG, healthcare burden, and inability to focus on the patient or interpret a sign, symptom, or diagnostic test. For HAP, the barriers were lack of confidence in the PCP and complexity of the patient. As a conclusion, DETELPROG referral model provides a lot of advantages and does not pose any new barrier to face-to-face referral or other non-face-to-face referral models, so it should be implemented in primary care.

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