scholarly journals Experiences of older primary care patients with multimorbidity and their caregivers in navigating the healthcare system: A qualitative study protocol

2020 ◽  
Vol 10 ◽  
pp. 2235042X2098406
Author(s):  
Eng Sing Lee ◽  
Gayathri Muthulingam ◽  
Evelyn Ai Ling Chew ◽  
Poay Sian Sabrina Lee ◽  
Hui Li Koh ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthcare System ◽  
Older Patients ◽  
Current System ◽  
Healthcare Providers ◽  
Improve Patient Care ◽  
Healthcare Setting ◽  
Positive Health ◽  
Burden Of Treatment ◽  
Study Team

Background: Patients with multimorbidity must bear not just the burden of their illness, but also the burden of treatment which is, in part, induced by their interactions with the healthcare system. The need to shuttle between different healthcare institutions and multiple healthcare providers can make navigating the healthcare system challenging, and this may be even more so for older patients with limited resources and support. Objectives: Few qualitative studies have explored the experiences of patients with multimorbidity in navigating the healthcare system. This study will explore the experiences of older patients with multimorbidity and their caregivers as they navigate through the healthcare system. We aim to arrive at a better understanding of patient experiences of possible gaps in the continuity of care and how the current system can be modified and adapted to better address the needs of older patients with multimorbidity. Method: Semi-structured, in-depth interviews will be conducted with purposively sampled older patients with multimorbidity, aged 60 and above seen in primary care, together with their caregivers. Interviews will be transcribed verbatim and analysed by the study team using inductive thematic analysis. Conclusions: Our study seeks to explore the navigational experiences within the healthcare system for older patients with multimorbidity in an Asian, multi-ethnic society. The findings will be shared with decision-makers in the healthcare setting in order to improve patient care for this population and ultimately maximise their positive health outcomes, and will add to better understanding how the burden of treatment arising from navigational challenges within the healthcare system may be reduced for older patients with multimorbidity.

scholarly journals Informal caregivers’ views on the quality of healthcare services provided to older patients aged 80 or more in the hospital and 30 days after discharge

2020 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland
Keyword(s):  
Health Services ◽  
Social Services ◽  
Healthcare System ◽  
Older Patients ◽  
Informal Caregivers ◽  
Healthcare Providers ◽  
The European Union ◽  
Professional Care ◽  
The Impact

Abstract Background: In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients.Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method: We conducted semi-structured individual interviews with 12 participants to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. The interviews were then transcribed and analysed thematically.Results: The analysis yielded the overarching theme ‘Informal caregivers – a health service alliance – quality contributor’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically.Conclusion: Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.

scholarly journals Perspectives of LGBTQ Youth and Pediatricians in the Primary Care Setting: A Systematic Review

2021 ◽  
Vol 12 ◽  
pp. 215013272110443
Author(s):  
Molly Stern
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Sexual Minority ◽  
English Language ◽  
Care Setting ◽  
Primary Care Setting ◽  
Healthcare Providers ◽  
Healthcare Setting ◽  
Pediatric Primary Care ◽  
Lgbtq Youth

Objectives: Conduct a systematic review designed to determine needs and experiences of LGBTQ adolescents in the pediatric primary care setting and to the ability of primary care practitioners to provide the most inclusive care to LGBTQ adolescents. Methods: PubMed, CINAHL, and Embase searches using the following keywords: LGBTQ, Adolescents, Pediatrics, Sexual-Minority, Gender-Identity, and primary care, to identify peer-reviewed publications from 1998 to 2017 that focused on stigma in the healthcare setting related to LGBTQ youth and the knowledge of healthcare providers on enhancing care for their sexual and gender minority patients. Article inclusion criteria include: primary research studies conducted in a pediatric primary care describing LGBTQ patients, pediatric patients as described by the American Academy of Pediatrics (AAP), and written in the English language. Articles were excluded if they used inaccurate definitions for LGBTQ identity, inappropriate patient ages outside of those defined by the AAP, and studies not in a pediatric primary care setting. Results: Four articles were identified for the review. Of the included articles, the majority of LGBTQ adolescents experience stigma in the healthcare setting. A limited number of physicians providing care to LGBTQ adolescents felt equipped to care for their sexual-minority patients due to lack of education and resources. Conclusions: The education of physicians should include a more detailed approach to providing care to the LGBTQ population, particularly to those training to become pediatricians. A standard guide to treating LGBTQ adolescents could eliminate stigma in the healthcare setting.

scholarly journals Informal caregivers’ views on the quality of health care services provided to older patients aged 80 or more in the hospital and 30 days after discharge

2020 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland
Keyword(s):  
Health Services ◽  
Social Services ◽  
Healthcare System ◽  
Older Patients ◽  
Informal Caregivers ◽  
Healthcare Providers ◽  
The European Union ◽  
Professional Care ◽  
The Impact

Abstract Background In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients. Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method We conducted semi-structured individual interviews with 12 participants to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. The interviews were then transcribed and analysed thematically. Results The analysis yielded the overarching theme ‘Informal caregivers – a health service alliance – quality contributor’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically. Conclusion Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.

scholarly journals Informal caregivers’ views on the quality of health care services provided to older patients aged 80 or more in the hospital and 30 days after discharge

2020 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland
Keyword(s):  
Health Services ◽  
Social Services ◽  
Healthcare System ◽  
Older Patients ◽  
Informal Caregivers ◽  
Healthcare Providers ◽  
The European Union ◽  
Professional Care ◽  
The Impact

Abstract Background In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients. Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method We conducted semi-structured individual interviews with 12 participants to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. The interviews were then transcribed and analysed thematically. Results The analysis yielded the overarching theme ‘Informal caregivers – a health service alliance – quality contributor’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically. Conclusion Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.

scholarly journals Promoting Safer and More Efficient Medication Administration within the Accident and Emergency Department at Georgetown Public Hospital Corporation

2019 ◽  
pp. 1-2
Author(s):  
Jessica Van Meter ◽  
Sally Dye ◽  
Amanda Clarke ◽  
Marcia Heylinger ◽  
Arlene Thomas
Keyword(s):  
Emergency Department ◽  
Care Delivery ◽  
Current System ◽  
Storage System ◽  
Healthcare Providers ◽  
Improve Patient Care ◽  
Medication Administration ◽  
Brand Names ◽  
Medication Storage ◽  
Nurses Perceptions

Objective: The Emergency Department is a complex environment in which healthcare providers are confronted with uncontrolled and unpredictable critical patient workload. This necessitates multitasking, organization, critical thinking and clear communication. Safe practices during dispensing and administration of medications vastly reduces the potential for patient harm and decreases medication errors (Institute for Healthcare Improvement, 2008).   Design/Methods: An eight-question survey was developed to determine nurses’ perceptions of the current medication storage system. Participants were asked to identify ways in which this system could be improved and medications organized in a safer, more systematic way. Following initial data collection, all medications were rearranged to improve medication organization and retrieval. The participants were then surveyed following the intervention to ascertain feedback. Results: 68% of participants noted that they perceived the current system to be chaotic. When asked if organizational changes might improve patient care delivery and safety, 96% responded in the affirmative. Labeling medication with both generic/ brand names and organizing them by class and alphabetically thereafter were all identified as potential options for reorganization. Following the intervention, a post-survey demonstrated that 100% of respondents remained enthusiastic about the new system approximately 9 months after implementation. Conclusions: The previous medication storage system was fractured and chaotic. Systematic organization of medications by name/class improved nurses’ perceptions of medication safety and delivery while inadvertently reducing the waste of expired medications. Greater measures are needed to truly minimize the risk for a medication administration errors including targeted continuing education and implementation of an electronic medication administration system.

scholarly journals Informal caregivers’ views on the quality of health care services provided to older patients aged 80 or more in the hospital and 30 days after discharge

2019 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland
Keyword(s):  
Health Services ◽  
Social Services ◽  
Healthcare System ◽  
Older Patients ◽  
Informal Caregivers ◽  
Healthcare Providers ◽  
The European Union ◽  
Professional Care ◽  
The Impact

Abstract Background In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients. Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method We used a phenomenological perspective to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. We conducted semi-structured individual interviews with 12 participants. The interviews were then transcribed and analysed thematically. Results The analysis yielded the overarching theme ‘Relatives – a health service alliance – quality creator’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically. Conclusion Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.

scholarly journals The Role of Nurses in Primary Care Reform: “The Wheel and Hub of Health Care System”

2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Nina Mamishi
Keyword(s):  
Primary Care ◽  
Registered Nurses ◽  
Healthcare System ◽  
Primary Healthcare ◽  
National Level ◽  
Healthcare Providers ◽  
Effect Change ◽  
Primary Care Settings ◽  
Primary Care Reform ◽  
The Right

The current focus in Canadian healthcare system is on improving efficiencies and quality of care. Therefore, primary healthcare is receiving further attention. It is the right moment to highlight the value that registered nurses can bring to collaborative practice in primary care settings. Since nurses are the largest group of healthcare providers in Canada being present throughout the system, thy are ideally positioned to effect change at the national level. The purpose of this paper is to highlight the value that nurses bring to primary healthcare system to discuss how integrating registered nurses into family practice will optimize primary healthcare.  

Autism and healthcare

2017 ◽  
Vol 3 (3) ◽  
pp. 115-124 ◽  
Author(s):  
Christine Preißmann
Keyword(s):  
Medical Care ◽  
Healthcare System ◽  
Healthcare Providers ◽  
Healthcare Setting ◽  
Healthcare Services ◽  
Medical Doctor ◽  
Medical Setting ◽  
Content Type ◽  
Autistic People ◽  
Special Value

Purpose Many autistic people do not have any access to healthcare services or they experience significant barriers to navigating the healthcare system. The purpose of this paper is to represent a significant concern in almost every healthcare setting, including specialized doctors and psychotherapists, outpatient medical care, access to preventive treatments (e.g. information on health and hygiene, vaccinations and early diagnostic screenings) and treatments in hospitals for emergency medical care. Therefore, it is necessary to provide professionals with guidelines and knowledge and to establish concepts for the participation of autistic people also with respect to adequate healthcare. Design/methodology/approach As a doctor and autistic person, the author’s training and personal experiences have provided the author with a unique perspective on this topic. It has also given the author an important opportunity to provide recommendations on ways to improve access to appropriate medical services for autistic individuals, improve communication between healthcare providers and autistic individuals and improve overall experiences within the healthcare and medical setting. Findings The paper provides information about the shortcoming of the healthcare system for autistic people, problems and barriers to access the healthcare system and for assessment and treatment and offers various suggestions to overcome these restrictions. Originality/value This paper is of special value as it is written by a medical doctor who has the diagnosis of ASD herself since she is 27. This combination of professional background on one side and person with ASD on the other side is of special value to permeate the topic.

scholarly journals Emergency cricothyrotomy during the COVID-19 pandemic: how to suppress aerosolization

2020 ◽  
Vol 5 (1) ◽  
pp. e000542
Author(s):  
Nabil Issa ◽  
Whitney E Liddy ◽  
Sandeep Samant ◽  
David B Conley ◽  
Robert C Kern ◽  
...  
Keyword(s):  
Potential Risk ◽  
Healthcare Providers ◽  
Healthcare Setting ◽  
Healthcare Systems ◽  
Financial Resources ◽  
Risk Of Infection ◽  
X Ray ◽  
General Surgeons ◽  
Fluorescein Dye ◽  
Nose And Throat

BackgroundCricothyrotomy is associated with significant aerosolization that increases the potential risk of infection among healthcare providers. It is important to identify simple yet effective methods to suppress aerosolization and improve the safety of healthcare providers.Methods5 ear, nose and throat and general surgeons used a locally developed hybrid cricothyrotomy simulator with a porcine trachea to test three draping methods to suppress aerosolization during the procedure: an X-ray cassette drape, dry operating room (OR) towels and wet OR towels. The three methods were judged based on three categories: effectiveness of suppression, availability in all healthcare systems and ease of handling.ResultsAll five surgeons performed the procedure independently using each of the three suppression methods. The wet OR towel drape was found to be an effective method to suppress aerosolization, and it did not hinder the surgeons from performing the procedure accurately. This finding was confirmed by using an atomized fluorescein dye injection into the porcine trachea, representing aerosolized material while performing the procedure.ConclusionsWe present a novel intervention using wet towels to suppress aerosolization during cricothyrotomy. Wet towels are cheap and readily available within any healthcare setting regardless of the financial resources available.

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