scholarly journals Protocol for a non-randomised feasibility study evaluating a codesigned patient safety guide in primary care

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039752
Author(s):  
Rebecca L Morris ◽  
Kay Gallacher ◽  
Mark Hann ◽  
Carly Rolfe ◽  
Nicola Small ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Health Service ◽  
Healthcare Professionals ◽  
Patient Empowerment ◽  
Service Utilisation ◽  
Two Phase ◽  
Ethical Approval ◽  
General Practices ◽  
The Uk

IntroductionPatients and carers should be active partners in patient safety with healthcare professionals and be empowered to use personalised approaches to identify safety concerns and work together to prevent them. This protocol paper details a study to examine the feasibility of a multicomponent intervention to involve patients and/or carers in patient safety in primary care in the UK.Methods and analysisThis is a two-phase, non-randomised feasibility mixed methods pragmatic study of a patient safety guide for primary care (PSG-PC). 8 general practices will recruit 120 patient and/or carer participants. All patient and/or carer participants will receive the PSG-PC. It will examine the feasibility and acceptability of the PSG-PC in primary care settings in patients aged 18 years or older who attend appointments at general practice with health professionals four or more times per year as either patients or carers. It will identify secondary outcomes for improving patient safety, health status and patient empowerment, and reducing health service utilisation over 6 months between baseline and 6-month follow-ups. The findings will inform whether a main effectiveness trial is feasible and, if so, how it should be designed, and how many patients and practices will be needed. The study will be undertaken between January 2020 and September 2021.Ethics and disseminationEthical approval was obtained from the National Health Service London-West London and Gene Therapy Advisory Committee Research Ethics Committee (reference: 19/LO/1289). Research findings will be disseminated with participating general practices and shared in a range of different ways to engage different audiences, including presenting at international and national conferences, publishing in open-access, peer-reviewed journals and facilitating dissemination workshops within local communities with patients, carers and healthcare professionals.Trial registration numberISRCTN90222092.

How can healthcare professionals address poor health service utilisation among refugees after resettlement in Australia? A narrative systematic review of recent evidence

2019 ◽  
Vol 25 (3) ◽  
pp. 205
Author(s):  
Jamuna Parajuli ◽  
Dell Horey
Keyword(s):  
Health Service ◽  
Health Services ◽  
Cultural Competency ◽  
Communication Skills ◽  
Healthcare Professionals ◽  
Qualitative Studies ◽  
Service Utilisation ◽  
Knowledge And Skills ◽  
Service Barriers ◽  
Synthesis Approach

This systematic narrative review of qualitative studies examined health service barriers and facilitators in Australia for refugees after resettlement. Twelve qualitative studies published between 2006 and 2017 involving more than 500 participants were included in the review. Approximately half of all participants were healthcare professionals. A meta-synthesis approach was used to compare and combine findings from across studies. Few facilitators were identified. Barriers to accessing health services were commonly attributed to refugees, but several barriers were associated with healthcare professionals and health services. Barriers attributed to healthcare professionals included gaps in knowledge and skills; poor cultural competency; poor communication skills; and time constraints. Understanding such barriers is the first step in developing strategies to overcome them. The skills and knowledge of healthcare professionals are important to facilitating access to healthcare among this vulnerable population.

scholarly journals Improving patient safety through education: how visual recognition skills may reduce medication errors on surgical wards

2011 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Christopher R. Davis ◽  
Edward C. Toll ◽  
Paul M. Bevis ◽  
Helena P. Burden
Keyword(s):  
Patient Safety ◽  
Medication Errors ◽  
Undergraduate Education ◽  
Visual Recognition ◽  
Healthcare Professionals ◽  
Postgraduate Training ◽  
Response Rate ◽  
Recognition Rate ◽  
Compromise Patient Safety ◽  
The Uk

Medication errors compromise patient safety and cost £500m per annum in the UK. Patients who forget the name of their medication may describe the appearance to the doctor. Nurses use recognition skills to assist in safe administration of medications. This study quantifies healthcare professionals’ accuracy in visually identifying medications. Members of the multidisciplinary team were asked to identify five commonly prescribed medications. Mean recognition rate (MRR) was defined as the percentage of correct responses. Dunn’s multiple comparison tests quantified inter-professional variation. Fifty-six participants completed the study (93% response rate). MRRs were: pharmacists 61%; nurses 35%; doctors 19%; physiotherapists 11%. Pharmacists’ MRR were significantly higher than both doctors and physiotherapists (P<0.001). Nurses’ MRR was statistically comparable to pharmacists (P>0.05). The majority of healthcare professionals cannot accurately identify commonly prescribed medications on direct visualization. By increasing access to medication identification resources and improving undergraduate education and postgraduate training for all healthcare professionals, errors may be reduced and patient safety improved.

scholarly journals Help-seeking and receipt of treatment among UK service personnel

2010 ◽  
Vol 197 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Amy C. Iversen ◽  
Lauren van Staden ◽  
Jamie Hacker Hughes ◽  
Tess Browne ◽  
Neil Greenberg ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Help Seeking ◽  
Service Use ◽  
Common Mental Disorders ◽  
Armed Forces ◽  
Service Utilisation ◽  
Professional Help ◽  
Military Health ◽  
The Uk

BackgroundFor armed forces personnel, data on help-seeking behaviour and receipt of treatment for mental disorders are important for both research and policy.AimsTo examine mental healthcare service use and receipt of treatment in a sample of the UK military.MethodParticipants were drawn from an existing UK military health cohort. The sample was stratified by reserve status and by participation in the main war-fighting period of the Iraq War. Participants completed a telephone-based structured diagnostic interview comprising the Patient Health Questionnaire and Primary Care Post-Traumatic Stress Disorder Screen (PC–PTSD), and a series of questions about service utilisation and treatment receipt.ResultsOnly 23% of those with common mental disorders and still serving in the military were receiving any form of medical professional help. Non-medical sources of help such as chaplains were more widely used. Among regular personnel in receipt of professional help, most were seen in primary care (79%) and the most common treatment was medication or counselling/psychotherapy. Few regular personnel were receiving cognitive–behavioural therapy (CBT). These findings are comparable with those reported for the general population.ConclusionsIn the UK armed forces, the majority of those with mental disorders are not currently seeking medical help for their symptoms. Further work to understand barriers to care is important and timely given that this is a group at risk of occupational psychiatric injury.

scholarly journals GP views on strategies to cope with increasing workload: a qualitative interview study

2017 ◽  
Vol 67 (655) ◽  
pp. e148-e156 ◽  
Author(s):  
Rebecca FR Fisher ◽  
Caroline HD Croxson ◽  
Helen F Ashdown ◽  
FD Richard Hobbs
Keyword(s):  
Primary Care ◽  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Self Management ◽  
Telephone Triage ◽  
Workload Management ◽  
Qualitative Interview Study ◽  
Data Saturation ◽  
The Uk ◽  
Maximum Variation Sample

BackgroundThe existence of a crisis in primary care in the UK is in little doubt. GP morale and job satisfaction are low, and workload is increasing. In this challenging context, finding ways for GPs to manage that workload is imperative.AimTo explore what existing or potential strategies are described by GPs for dealing with their workload, and their views on the relative merits of each.Design and settingSemi-structured, qualitative interviews with GPs working within NHS England.MethodAll GPs working within NHS England were eligible. Of those who responded to advertisements, a maximum-variation sample was selected and interviewed until data saturation was reached. Data were analysed thematically.ResultsResponses were received from 171 GPs, and, from these, 34 were included in the study. Four main themes emerged for workload management: patient-level, GP-level, practice-level, and systems-level strategies. A need for patients to take greater responsibility for self-management was clear, but many felt that GPs should not be responsible for this education. Increased delegation of tasks was felt to be key to managing workload, with innovative use of allied healthcare professionals and extended roles for non-clinical staff suggested. Telephone triage was a commonly used tool for managing workload, although not all participants found this helpful.ConclusionThis in-depth qualitative study demonstrates an encouraging resilience among GPs. They are proactively trying to manage workload, often using innovative local strategies. GPs do not feel that they can do this alone, however, and called repeatedly for increased recruitment and more investment in primary care.

scholarly journals Healthcare professionals’ perspectives on lung cancer screening in the UK: a qualitative study

BJGP Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. bjgpopen20X101035
Author(s):  
Charikleia Margariti ◽  
Maria Kordowicz ◽  
Gillian Selman ◽  
Arjun Nair ◽  
Yvonne Akande ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Care ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Healthcare Professionals ◽  
Lung Cancer Screening ◽  
Case Finding ◽  
Smoking Cessation Services ◽  
Potential Impact ◽  
The Uk

BackgroundLung cancer screening with low-dose computed tomography (LDCT) has been shown to decrease mortality. Low lung cancer survival rates in the UK, driven primarily by late-stage presentation, provide the impetus for implementing screening. Nascent guidance on screening in the UK recommends primary care case-finding. However, the potential impact and acceptability on primary care, and the opportunistic utilisation of other case-finding routes, such as pharmacies, smoking cessation services, and respiratory clinics, have not been fully explored.AimTo explore healthcare professionals’ views and perspectives about lung cancer screening and their preparedness and willingness to be involved in its implementation.Design & settingA qualitative study was carried out with semi-structured interviews conducted with GPs, pharmacists, staff from smoking cessation services within Southwark and Lambeth in London, and staff from respiratory clinics in Guys’ and St Thomas’ NHS Foundation Trust in London between April 2018 and December 2018.MethodSixteen participants were interviewed and the interview transcripts were analysed thematically.ResultsParticipants described lung cancer screening as an important diagnostic tool for capturing lung cancer at an earlier stage and in increasing survivorship. However, the majority expressed a lack of awareness and understanding, uncertainty and concerns about the validity of screening, and the potential impact on their patients and workload.ConclusionStudy participants had mixed opinions about lung cancer screening and expressed their concerns about its implementation. Addressing these concerns by providing resources and effective and detailed guidelines for their use may lead to greater engagement and willingness to be involved in lung cancer screening.

scholarly journals 517Challenges in data linkage – experiences from an upper gastrointestinal cancer data linkage study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Nadia Khan ◽  
Liane Ioannou ◽  
Charles Pilgrim ◽  
Arul Earnest ◽  
Ashika Maharaj ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Service ◽  
Data Linkage ◽  
Population Level ◽  
Data Access ◽  
Health Service Utilisation ◽  
Service Utilisation ◽  
Financial Barriers ◽  
Level Data ◽  
Upper Gastrointestinal

Abstract Background Linked, population-level data is valuable for mapping patterns of care and evaluating health service utilisation, particularly in difficult-to-reach populations. Upper gastrointestinal (UGI) cancers have a dismal prognosis, creating difficulties engaging patients in research. The utility of a linked dataset in this population is of high value. Methods Key objectives included identifying the operational and feasibility issues associated with linking Australian state-based administrative and registry data for understanding health service utilisation in UGI cancers. Datasets pertained to hospital admissions, radiotherapy, community health, primary care, palliative care, Medicare and Pharmaceutical Benefits Schedule’s and UGI cancers. Results From a logistical perspective, data access request approval processes varied, with some requiring consent to be sought from individual services contributing data. The availability of unique person-level identifying information varied widely. Additionally, the time period of data capture differed between and within datasets, limiting the quality of the linked data. Significant costs were associated with linking with primary care and Medicare and Pharmaceutical Benefits Schedule’s. Federal dataset linkage required at least a one-year waiting period. Conclusions Whilst in theory data linkage is a powerful mechanism for obtaining population-level data, in reality, there are many logistical and financial barriers to linking multiple datasets. Consequently, critical data, which has the potential to inform policy and improve patient outcomes, cannot be procured. Key messages Logistical and financial challenges are associated with linking administrative and registry datasets for research, limiting the potential of data linkage.

scholarly journals Identifying naturally occurring communities of primary care providers in the English National Health Service in London

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036504
Author(s):  
Jonathan Clarke ◽  
Thomas Beaney ◽  
Azeem Majeed ◽  
Ara Darzi ◽  
Mauricio Barahona
Keyword(s):  
Primary Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Management ◽  
Lower Layer ◽  
Primary Care Providers ◽  
Care Providers ◽  
General Practices ◽  
Natural Communities

ObjectivesPrimary Care Networks (PCNs) are a new organisational hierarchy with wide-ranging responsibilities introduced in the National Health Service (NHS) Long Term Plan. The vision is that PCNs should represent ‘natural’ communities of general practices (GP practices) collaborating at scale and covering a geography that fits well with practices, other healthcare providers and local communities. Our study aims to identify natural communities of GP practices based on patient registration patterns using Markov Multiscale Community Detection, an unsupervised network-based clustering technique to create catchments for these communities.DesignRetrospective observational study using Hospital Episode Statistics - patient-level administrative records of attendances to hospital.SettingGeneral practices in the 32 Clinical Commissioning Groups of Greater LondonParticipantsAll adult patients resident in and registered to a GP practice in Greater London that had one or more outpatient encounters at NHS hospitals between 1st April 2017 and 31st March 2018.Main outcome measuresThe allocation of GP practices in Greater London to PCNs based on the registrations of patients resident in each Lower Layer Super Output Area (LSOA) of Greater London. The population size and coverage of each proposed PCN.Results3 428 322 unique patients attended 1334 GPs in 4835 LSOAs in Greater London. Our model grouped 1291 GPs (96.8%) and 4721 LSOAs (97.6%) into 165 mutually exclusive PCNs. Median PCN list size was 53 490, with a lower quartile of 38 079 patients and an upper quartile of 72 982 patients. A median of 70.1% of patients attended a GP within their allocated PCN, ranging from 44.6% to 91.4%.ConclusionsWith PCNs expected to take a role in population health management and with community providers expected to reconfigure around them, it is vital to recognise how PCNs represent their communities. Our method may be used by policymakers to understand the populations and geography shared between networks.

Healthcare professionals’ perspectives on lung cancer screening in the UK: a qualitative study

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711449 ◽  
Author(s):  
Charikleia Margariti ◽  
Maria Kordowicz ◽  
Gillian Selman ◽  
Arjun Nair ◽  
Yvonne Akande ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Care ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Healthcare Professionals ◽  
Lung Cancer Screening ◽  
Case Finding ◽  
Smoking Cessation Services ◽  
Potential Impact ◽  
The Uk

BackgroundLung cancer screening with low-dose CT has been shown to decrease mortality. Low lung cancer survival rates in the UK, driven primarily by late-stage presentation, provide the impetus for implementing screening. Nascent guidance on screening in the UK recommends primary care case-finding. However, the potential impact and acceptability on primary care, and the opportunistic utilisation of other case-finding routes such as pharmacies, smoking cessation services and respiratory clinics, have not been fully explored.AimTo explore healthcare professionals’ views and perspectives about lung cancer screening and their preparedness and willingness to be involved in its implementation.MethodA qualitative study was carried out with semi-structured interviews conducted with GPs, pharmacists and staff from smoking cessation services within Southwark and Lambeth and from respiratory clinics in Guy’s and St. Thomas’ NHS Trust in London in 2018. Sixteen participants were interviewed, and the interview transcripts were analysed thematically.ResultsParticipants described lung cancer screening as an important diagnostic tool for capturing lung cancer at an earlier stage and in increasing survivorship. However, the majority expressed a lack of awareness and understanding, uncertainty and concerns about the validity of screening, its misuse and the potential impact on their patients and workload.ConclusionStudy participants had mixed opinions about lung cancer screening and expressed their concerns about its implementation. Addressing these concerns by providing resources and effective and detailed guidelines for their use may lead to greater engagement and willingness to be involved in lung cancer screening.

Personal and Public Involvement in Healthcare Provision

2020 ◽  
pp. 89-116
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
National Health Service ◽  
Health Service ◽  
Public Involvement ◽  
Healthcare Providers ◽  
Healthcare Provision ◽  
Governance Framework ◽  
Levels Of Care ◽  
National Healthcare

Personal and public involvement in healthcare provision has become an essential part of the governance framework of the National Health Service (NHS) today. Patient safety, quality, and responsiveness of care are the main priorities of national healthcare providers. Yet in practice, there are significant limitations to the introduction of a true patient- or person-centred approach, which will be described in this chapter. Two case studies have been included to illustrate the challenges to implementing a true person-centred approach in the NHS. The first relates to the Mid-Staffordshire Hospital Trust where hundreds of patients died as a result of sub-standard levels of care. The second focuses on a family's struggle to access a joined-up package of care for a Parkinson's disease sufferer in a primary care setting.

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