scholarly journals Development of a self-reported reflective tool on advanced access to support primary healthcare providers: study protocol of a mixed-method research design using an e-Delphi survey

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e046411
Author(s):  
Mylaine Breton ◽  
Isabelle Gaboury ◽  
Maxime Sasseville ◽  
Christine Beaulieu ◽  
Sabina Abou Malham ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Healthcare Providers ◽  
Mixed Method Research ◽  
Research Committee ◽  
Face To Face ◽  
Conference Presentations ◽  
Timely Access ◽  
Services Sociaux ◽  
Advanced Access ◽  
Primary Healthcare Providers

IntroductionTimely access is one of the cornerstones of strong primary healthcare (PHC). New models to increase timely access have emerged across the world, including advanced access (AA). Recently in Quebec, Canada, the AA model has spread widely across the province. The model has largely been implemented by PHC professionals with important variations; however, a tool to assess their practice improvement within AA is lacking. The general objective of this study is to develop a self-reported online reflective tool that will guide PHC professionals’ reflection on their individual AA practice and formulation of recommendations for improvement. Specific objectives are: (1) operationalisation of the pillars and subpillars of AA; (2) development of a self-reported questionnaire; and (3) evaluation of the psychometrics.Methods and analysisThe pillars composing Murray’s model of AA will first be reviewed in collaboration with PHC professional and stakeholders, patients and researchers in a face-to-face meeting, with the goal to establish consensus on the pillars and subpillars of AA. Leading from these definitions, items will be identified for evaluation through an e-Delphi consultation. Three rounds are planned in 2020–2021 with a group of 20–25 experts. A repository of recommendations on how to improve one’s AA practice will be populated based on the literature and enriched by our experts throughout the consultation. Median and measures of dispersions will be used to evaluate agreement. The resulting tool will then be evaluated by PHC professionals for psychometrics in 2021–2022.Ethics and disseminationThe Centre Intégré de Santé et de Services Sociaux de la Montérégie-Centre Scientific Research Committee approved the protocol, and the Research Ethics Board provided ethics approval (2020-441, CP 980475). Dissemination plan is a mix of community diffusion through and for our partners and to the scientific community including peer-reviewed publications and conference presentations.

Promoting competition in Swedish primary care

2015 ◽  
Vol 29 (1) ◽  
pp. 25-38 ◽  
Author(s):  
Lars Norén ◽  
Agneta Ranerup
Keyword(s):  
Primary Healthcare ◽  
Healthcare Providers ◽  
Invisible Hand ◽  
Mixed Method Research ◽  
Content Type ◽  
Quality Differentiation ◽  
Selection Processes ◽  
Provider Quality ◽  
Primary Healthcare Providers

Purpose – The purpose of this paper is to examine the role of accreditation documents (ADs) in the competition based on provider quality in a quasi-market for primary healthcare. Design/methodology/approach – The paper uses a mixed-method research methodology to analyse two primary healthcare ADs in two Swedish regions. In total, 19 interviews were conducted with actors involved in the creation and use of such documents. Findings – This paper points to the crucial role of ADs in the identification of quality differences that influence the competition in primary healthcare. This finding contrasts with the commonly held laissez-faire idea that competition causes providers to develop their own service concepts and where the invisible hand creates quality differences. The paper adds to the discussion with its detailed description of how ADs create competition among primary healthcare providers through selection processes, quality differentiation, and ranking. Research limitations/implications – The paper does not explore quality differences in the medical treatment of patients in primary healthcare centres. Practical implications – The paper provides insights for politicians on how to use ADs to control competition and regulate choice. Originality/value – The paper takes an innovative approach to the examination of how ADs increase the competition in primary healthcare choice.

Primary healthcare providers' attitudes and beliefs about the menopause-related care needs of women who have migrated from low- and middle-income countries to Australia

2020 ◽  
Vol 26 (1) ◽  
pp. 88
Author(s):  
Karin A. Stanzel ◽  
Karin Hammarberg ◽  
Jane Fisher
Keyword(s):  
Primary Healthcare ◽  
Online Survey ◽  
Healthcare Providers ◽  
Migrant Women ◽  
Care Needs ◽  
Middle Income ◽  
Structural Support ◽  
Middle Income Countries ◽  
Primary Healthcare Providers ◽  
Low And Middle Income

Health behaviour during midlife is linked to health outcomes in older age. Primary healthcare providers (PHCPs) are ideally placed to provide health-promoting information opportunistically to women in midlife. The aim of this study was to explore PHCPs views about the menopause-related care needs of migrant women from low- and middle-income countries and what they perceive as barriers and enablers for providing this. Of the 139 PHCPs who responded to an anonymous online survey, less than one-third (29.9%) routinely offered menopause-related information during consultations with migrant women. Most agreed that short appointments times (70.8%), lack of culturally and linguistically appropriate menopause information (82.5%) and lack of confidence in providing menopause-related care (32.5%) are barriers for providing comprehensive menopause-related care to migrant women. To overcome these, a menopause-specific Medicare item number and a one-stop website with health information in community languages were suggested. These findings suggest that menopause-related care is not routinely offered by PHCPs to migrant women from low- and middle- income countries and that their capacity to do this may be improved with adequate educational and structural support.

scholarly journals The relationship between primary healthcare providers and their external supervisors in Rwanda

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Michael Schriver ◽  
Vincent K. Cubaka ◽  
Laetitia Nyirazinyoye ◽  
Sylvere Itangishaka ◽  
Per Kallestrup
Keyword(s):  
Primary Healthcare ◽  
Healthcare Providers ◽  
Relationship Building ◽  
Performance Evaluations ◽  
Supervisory Relationship ◽  
Group Discussions ◽  
Healthcare Facilities ◽  
Performance Based Financing ◽  
The Relationship ◽  
Primary Healthcare Providers

Background: External supervision of Rwandan primary healthcare facilities unfolds as an interaction between supervisors and healthcare providers. Their relationship has not been thoroughly studied in Rwanda, and rarely in Africa.Aim: To explore perceived characteristics and effects of the relationship between providers in public primary healthcare facilities and their external supervisors in Rwanda.Setting: We conducted three focus group discussions with primary healthcare providers (n = 16), three with external supervisors (n = 15) and one mixed (n = 5).Methods: Focus groups were facilitated under low-moderator involvement. Findings were extracted thematically and discussed with participating and non-participating providers and supervisors.Results: While external supervision is intended as a source of motivation and professional development in addition to its managerial purpose, it appeared linked to excessive evaluation anxiety among Rwandan primary healthcare providers. Supervisors related this mainly to inescapable evaluations within performance-based financing, whereas providers additionally related it to communication problems.Conclusion: External supervision appeared driven by systematic performance evaluations, which may prompt a strongly asymmetric supervisory power relation and challenge intentions to explore providers’ experienced work problems. There is a risk that this may harm provider motivation, calling for careful attention to factors that influence the supervisory relationship. It is a dilemma that providers most in need of supervision to improve performance may be most unlikely to benefit from it. This study reveals a need for provider-oriented supportive supervision including constructive attention on providers who have performance difficulties, effective relationship building and communication, objective and diligent evaluation and two-way feedback channels.

scholarly journals Childhood Cancer Early Detection Training Program for Primary Healthcare Providers

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 135s-135s ◽  
Author(s):  
B. Ntacyabukura
Keyword(s):  
Early Detection ◽  
Health Care Providers ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Signs And Symptoms ◽  
Health Centers ◽  
Childhood Cancers ◽  
Care Providers ◽  
Train The Trainer ◽  
Primary Healthcare Providers

Background and context: Over 250,000 new pediatric cancer cases are diagnosed yearly worldwide. Health care providers (mainly nurses) at health centers (HC) level are the children´s first opportunity for correctly recognizing and responding to early signs and symptoms of childhood cancers by appropriately referring them to district hospitals but studies show that 83% of nurses did not receive training on pediatric cancers. Insufficient knowledge about the warning signs and symptoms of pediatric cancer usually leads to improper diagnosis or delay to diagnosis and hence loss of many lives of these children. After realizing that majority in our community lack information on childhood cancers, our efforts since 2017 has been concentrated on training primary healthcare providers to recognize early signs and symptoms of childhood cancers. Aim: Improve survival of children with cancer by early detection of symptoms and signs and prompt referral by nurses at health centers. Strategy/Tactics: The program is consisted of trainings in selected regions of Rwanda. The first step is a “train the trainer workshop” where volunteering medical students and doctors are trained to train the nurses and community health workers. A two days workshop is organized subsequently in each province bringing together at least with one nurse from each selected health center. These trained nurses go back with materials to train their colleagues. They are followed up every three months with a survey to assess how much they retain the learned knowledge and the impact made. Prior to trainings, RCCR and pediatric oncologists develop training materials that include training curriculum for both the trainers and for the trainees (nurses), educational and awareness material (posters, fliers, brochures). Trained nurses are kept in RCCR database for their follow-up and track any case of a childhood cancer at their health facilities. Program/Policy process: The program is run in 4 phases, Phase 1: Develop training materials materials Phase 2: Recruitment and train the trainer phase Phase 3: Selection of health center and recruitment of healthcare providers Phase 4: The execution phase. Trainings are carried out in selected health centers. Phase 5: Post training follow-up. Outcomes: In 2017, the program was conducted in 4 health centers and around 90 health care providers were trained with more than 800 posters, 950 brochures and 300 flyers distributed. According to reports, after the training, the number of referrals from health centers increased and the posttraining showed how accurate nurses were in stating their differential diagnoses. What was learned: Childhood cancers are curable when detected and treated early, there is a need to build strong partnerships with private and public sectors to address the challenge of early detection and late presentation at the hospital because the program of training primary healthcare providers showed a good impact.

“We Had to Keep Pushing”: Caregivers' Perspectives on Autism Screening and Referral Practices of Black Children in Primary Care

2018 ◽  
Vol 56 (5) ◽  
pp. 321-336 ◽  
Author(s):  
Sarah Dababnah ◽  
Wendy E. Shaia ◽  
Karen Campion ◽  
Helen M. Nichols
Keyword(s):  
Primary Care ◽  
Primary Healthcare ◽  
Racial Bias ◽  
Healthcare Providers ◽  
Black Children ◽  
Autism Spectrum ◽  
Theory Approach ◽  
Early Intervention Services ◽  
Primary Healthcare Providers

Abstract Black children with autism spectrum disorder (ASD) are diagnosed later than their White peers, are more likely to be misdiagnosed, and are less likely to receive early intervention services or a developmental evaluation by three years old. Using a grounded theory approach, we solicited the perspectives of parents and other primary caregivers of Black children with ASD on barriers and facilitators to ASD screening and referrals in primary care. A socioeconomically diverse sample of 22 female caregivers participated. Four themes emerged. First, while some caregivers noted their child's primary healthcare providers facilitated a timely ASD diagnosis, other participants reported these providers ignored early concerns about child developmental delays. Second, many participants felt racial bias negatively impacted caregiver-primary healthcare provider interactions. Third, legal/custodial issues slowed caregivers' abilities to follow up on referrals from their primary healthcare providers. Finally, caregivers described denial, shame, and stigma relating to ASD in the Black community as possible factors for delayed follow up to referrals. Differences based on socioeconomic status are discussed. Efforts to improve family-centered, culturally relevant care for all Black caregivers raising children with or at-risk for ASD are needed, particularly for those families experiencing the multiple effects of poverty.

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