scholarly journals A qualitative study on professionals’ attitudes and views towards the introduction of patient reported measures into public maternity care pathway

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
An Chen ◽  
Kirsi Väyrynen ◽  
Riikka-Leena Leskelä ◽  
Seppo Heinonen ◽  
Paul Lillrank ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Maternity Care ◽  
Care Pathway ◽  
Care Service ◽  
Health Care Service ◽  
Routine Practice ◽  
Successful Implementation ◽  
Maternity Service ◽  
Patient Reported ◽  
Patient Reported Measures

Abstract Background The importance and potential benefits of introducing patient reported measures (PRMs) into health care service have been widely acknowledged, yet the experience regarding their implementation into practice is limited. There is a considerable paucity of research in adopting PRMs in maternity care routine. This study, which utilizes the PRMs included in Pregnancy and Childbirth (PCB) outcome set developed by International Consortium for Health Outcomes Measurement (ICHOM) as sample measures, aims to elicit Finnish professionals’ views on PRMs and to explore the applicability of PRMs in Finnish public maternity care. Methods This qualitative study, applying semi-structured interviews, described the local professionals’ views towards the application of PRMs in Finnish public maternity care. Professionals were asked to assess the PRMs defined in ICHOM PCB set and provide their expectations and concerns on the implementation of PRMs in Finnish public maternity service. Results Twenty professionals participated in the interviews. Participants agreed on the importance and relevance of the PRMs questions included in ICHOM PCB set for delivering and developing maternity care in Finland. However, they criticized the number and length of questions as well as the recommended time points of data collection. In addition, for a successful implementation, various steps like developing suitable questions, redesigning service pathway and protocols, and motivating women to respond to PRMs questions were considered to be important. Also, some potential obstacles, difficulties and risks associated with the implementation were underlined. Conclusion This study indicates that the implementation of PRMs into Finnish public maternity service is possible, highly relevant and important. However, the adoption of PRMs into routine practice may be challenging and will require a series of efforts. This study shows viewpoints from Finnish professionals who have not participated in developing the ICHOM PCB standard set and provides important insights on the development and implementation of PRMs.

scholarly journals Introducing Patient Reported Measures (PRMs) Into Finnish Public Maternity Service: A Study on Professionals’ Views

2021 ◽  
Author(s):  
An Chen ◽  
Kirsi Väyrynen ◽  
Riikka-Leena Leskelä ◽  
Seppo Heinonen ◽  
Paul Lillrank ◽  
...  
Keyword(s):  
Maternity Care ◽  
Care Service ◽  
Health Care Service ◽  
Routine Practice ◽  
Successful Implementation ◽  
Maternity Service ◽  
Structured Interviews ◽  
Pregnancy And Childbirth ◽  
Patient Reported ◽  
Patient Reported Measures

Abstract Background: The importance and potential benefits of introducing patient reported measures (PRMs) into health care service have been widely acknowledged, yet the experience regarding their implementation into practice is limited. There is a considerable paucity of research in adopting PRMs in maternity care. This study, which utilizes the PRMs included in Pregnancy and Childbirth (PCB) outcome set developed by International Consortium for Health Outcomes Measurement (ICHOM) as sample measures, aims to elicit Finnish professionals’ views on PRMs and to explore the applicability of PRMs in Finnish public maternity care. Methods: This qualitative study, applying semi-structured interviews, is designed to describe the local professionals’ views towards the application of PRMs in Finnish public maternity care. Professionals were asked to assess the PRMs defined in ICHOM PCB set and provide their expectations and concerns on the implementation of PRMs in Finnish public maternity service. Results: Twenty professionals participated in the interviews. Participants agreed on the importance and relevance of the PRMs questions included in ICHOM PCB set for delivering and developing maternity care in Finland. However, they criticized the number and length of questions as well as the recommended time points of data collection. In addition, for a successful implementation, various steps like developing suitable questions, redesigning service pathway and protocols, and motivating patients were considered to be important. Also, some potential obstacles, difficulties and risks associated with the implementation were underlined. Conclusion: This study indicates that the implementation of PRMs into Finnish public maternity service is possible, highly relevant and important. However, the adoption of PRMs into routine practice may be challenging and will require a series of efforts. This study shows viewpoints from Finnish professionals who have not participated in developing the ICHOM PCB standard set and provides important insights on the development and implementation of PRMs.

scholarly journals Practices used by a home care team: implications for caregivers

2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Yara Cardoso Silva ◽  
Kênia Lara Silva ◽  
Isabela Silva Câncio Velloso
Keyword(s):  
Health Care ◽  
Discourse Analysis ◽  
Qualitative Study ◽  
Home Care ◽  
Home Health Care ◽  
Care Service ◽  
Health Care Service ◽  
Home Health ◽  
Care Team ◽  
Power Relationship

ABSTRACT Objectives: to analyze the practices of a home care team and their implications for caregivers’ performance. Methods: qualitative study with data obtained from observation of 21 users, 30 caregivers and 6 professionals from the home health care service in a municipality in Minas Gerais, from February to June 2018. The material was analyzed from the perspective of discourse analysis according to Michel Foucault. Results: team interference upon caregivers is exercised by disciplinary practices and prescriptive, authoritative and surveilling behaviors. The team’s knowledge-power relationship determines caregivers’ acceptance through convincing or through difficulty of understanding assigned orientations. Educational practices would enable caregivers to be constituted as active, participative, empowered and reflective subjects. Final Considerations: team practices interfere with caregivers’ ways of acting and being and they have implications in objectification and subjectification processes.

scholarly journals Physicians’ experiences of SBIRT training and implementation for SUD management in primary care in the UAE: a qualitative study

2017 ◽  
Vol 19 (04) ◽  
pp. 344-354
Author(s):  
Christiane Pflanz-Sinclair ◽  
Catriona Matheson ◽  
Christine M. Bond ◽  
Amna Almarzouqi ◽  
Amanda J. Lee ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Qualitative Study ◽  
Primary Care Physicians ◽  
Substance Misuse ◽  
Care Pathway ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Successful Implementation ◽  
Cultural Issues

AimThe objective of this paper is to present a qualitative study of introducing substance misuse screening using the Screening Brief Intervention and Referral to Treatment (SBIRT) model, in primary care in Abu Dhabi.BackgroundSubstance misuse in the UAE is an increasing problem. However religious beliefs and fear of legal consequences have prevented this topic from being openly discussed, risk levels identified through screening and treatment options offered.MethodsA controlled trial was undertaken which included a qualitative process study which is reported here. Qualitative interviews with primary care physicians from two intervention clinics were undertaken to explore their views, experiences and attitudes towards substance misuse management in their clinic. Physicians were trained on SBIRT and on the research project process and documentation. At completion of the project, 10 months after the training, physicians (n=17) were invited to participate in an interview to explore their experiences of training and implementation of SBIRT. Interviews were recorded and transcribed. Inductive thematic coding was applied.FindingsIn total, 11 physicians were interviewed and three main themes emerged: (1) The SBIRT screening project, (2) cultural issues and (3) patient follow-up. Findings revealed a general willingness toward the concept of screening and delivering brief interventions in primary care although increased workload and uncertainties about remuneration for the service may be a barrier to future implementation. There was a perceived problem of substance misuse that was not currently being met and a strong perception that patients were not willing to reveal substance use due cultural barriers and fear of police involvement. In conclusion this qualitative process evaluation provided essential insight into implementing SBIRT in the Middle East. In conclusion, despite physician willingness and a clinical need for a substance misuse care pathway, the reluctance among patients to admit to substance use in this culture needs to be addressed to enable successful implementation.

scholarly journals Assistance for people with diabetes mellitus during the COVID-19 pandemic. The experience of the TO3 Local Health Care Service in Piedmont

2020 ◽  
Vol 23 (4) ◽  
pp. 263
Author(s):  
Ozzello, A.
Keyword(s):  
Diabetes Care ◽  
Care Pathway ◽  
Care Service ◽  
Health Care Service ◽  
Standard Of Care ◽  
System Stability ◽  
Medical Services ◽  
Local Health ◽  
Chronic Patients ◽  
The Right

People with diabetes with coronavirus infection have a high likelihood of progression to severe COVID-19. The pandemic has upset our health model; the booking suspension limited access to emergencies, made it difficult to guarantee medical services, with different access priorities, to assist chronic patients, such as diabetics, for whom discontinuity of care could become a risk for and in case of infection. In ASLTO3 we have developed an emergency procedure, in compliance with the lockdown provisions to limit the presence in the clinic, for the provision of services, in presence or at a distance, to people with diabetes blocked at home, or in isolation, hospitalized or quarantined, or to be hospitalized. We have developed a strategy based on the diabetes care pathway PDTA, standard of care in Piedmont, to stratify the risk of loss of access to services and to prepare organizational measures to select, case by case, the relative and deferred urgent requests, direct on the right location for the right answer giving priority to those who still did not know or already knew they had diabetes, even positive for COVID-19, and needed treatment, and uses dedicated telephone lines and e-mails, for a virtual clinic. During the first peak of the pandemic, we assisted over 4000 people with diabetes by providing 7598 services, 244 for endocrinology, 7199 for diabetes, 155 consultations, 431 face-to-face and over 5,000 remotes. Studies produced during the COVID-19 emergency have confirmed that the active resilience of the diabetes care service can help improve patient outcomes and system stability. Experience in the implementation of technologies, such as diabetes PDTA, adapted to the emergency, can help to triage both persons, activities, prevention and assistance, and telemedicine projects to minimize the risk in future events. KEY WORDS pandemic COVID-19; diabetes care pathway; medical services; triage patient; telemedicine.

scholarly journals Barriers to implementing guideline recommendations to improve childbirth care: a rapid review of evidence

2021 ◽  
Vol 45 ◽  
pp. 1
Author(s):  
Cintia de Freitas Oliveira ◽  
Aline Ângela Victoria Ribeiro ◽  
Cézar D. Luquine Jr. ◽  
Maritsa Carla de Bortoli ◽  
Tereza Setsuko Toma ◽  
...  
Keyword(s):  
Health Care ◽  
Service Management ◽  
Care Service ◽  
Health Care Service ◽  
Rapid Review ◽  
Gender Inequalities ◽  
Successful Implementation ◽  
Socioeconomic Conditions ◽  
Care Model ◽  
Childbirth Care

Objectives. To identify potential barriers to the implementation of the National Childbirth Guidelines in Brazil based on the best available global evidence. Methods. A rapid review of evidence was performed in six databases in March/April 2019. Secondary studies published in English, Spanish, or Portuguese with a focus on barriers of any nature relating to the implementation of the Guidelines were retrieved. Results. Twenty-three documents (21 reviews and two practice guides) were included in the review. The barriers identified were grouped into 52 meaning categories and then reorganized into nine thematic clusters: delivery and childbirth care model, human resource management, knowledge and beliefs, gender relations, health care service management, attitudes and behaviors, communication, socioeconomic conditions, and political interests. Conclusions. The results show that combined approaches may be required to address different barriers to the implementation of the Guidelines. For successful implementation, it is essential to engage health care leaders, professionals, and users in the effort to change the delivery and childbirth care model. Also necessary is the development of intersectoral initiatives to improve the socioeconomic conditions of women and families and to curtail gender inequalities.

scholarly journals A Shared Information Technology-Business-Health Model: Lessons for Healthcare Leaders on Integrating Technology from Investment

2021 ◽  
Vol 7 (1) ◽  
pp. 1-18
Author(s):  
Donald M. Hilty ◽  
◽  
John Luo ◽  
Evangelina Giron ◽  
Dong-Gil Ko ◽  
...  
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Service Delivery ◽  
Behavioral Health ◽  
Full Text ◽  
Care Service ◽  
Health Care Service ◽  
Successful Implementation ◽  
Manual Search ◽  
Full Text Review

Objective: Technology is rapidly shifting our day-to-day existence, education, social relationships, health care and business. Psychiatric leaders have slowly explored telepsychiatric services – but few have an approach to technology in general–due to competing clinical, educational and research demands. Technology has typically been added on, rather than integrated, to institutional functions. Method: This narrative review used a literature search of Medline, PsycNET, PsycINFO, Embase, Cochrane, SpringerLink, Scopus, ABI/Inform, Business Source Complete, and Web of Science, using subject headings and keywords along with a manual search of reference lists of articles published by November 2020. The keywords explored four areas: 1) business; 2) service delivery; 3) system change; and 4) technology. Articles were reviewed by title/abstract, full text review and review of references. They were included if they discussed integration of technology into health care and compared literature from medicine/health, psychiatry/behavioral health, business, technology, leadership and health care administration. The goal was to explore how medicine/psychiatry has integrated technology compared to business, and apply business approaches to health care and training. Results: From a total of 2,710 potential references, two authors found 327 eligible for full text review and found 69 papers directly relevant to the concepts. Business and medicine/psychiatry have similarities/differences from both historical and contemporary views. Many health care systems and companies lack a strategic plan for technology and focus only on short-term due to administrative demands. Clinical informatics is a rapidly expanding area and would be central to this process. It has started to facilitate patient-centered care as defined by quality, affordable, and timely health care. While in principle information systems use integrative approaches, electronic health records, electronic means of communications with patients and staff, behavioral health indicators and related digital advances are often added to existing systems rather than integrated. Effective businesses use integrative approaches to share domain knowledge and streamline practices to link information technology (IT) with research and development, production, financing and marketing management. A case example highlights the IT strategy and business leaders’ comments in shifting to straight through processing (STP) from the banking industry for investments. It also exemplifies a model of shared IT-business understanding, which improves performance via efficiency, quality of data/information processing/integration and managerial teamwork. Conclusion: When it is integrated into health care service delivery workflow, evaluated and quality improved, IT facilitates the translation of strategic planning into organizational change. Incremental versus strategically innovative approaches to technological integration for care, education and administration are considered. Successful implementation requires a needs and impact assessment for patients, staff, clinicians and leaders across all levels of the organization. Benefits to the mission, limited disruptions of core operational workflow and reasonable costs reduce the likelihood of failure.

scholarly journals Socio-cultural factors favoring home delivery in Afar pastoral community, northeast Ethiopia: A Qualitative Study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Mohammed Ahmed ◽  
Meaza Demissie ◽  
Alemayehu Worku ◽  
Araya Abrha ◽  
Yamane Berhane
Keyword(s):  
Qualitative Study ◽  
Care Service ◽  
Health Care Service ◽  
Home Delivery ◽  
Cultural Factors ◽  
Health Facilities ◽  
Traditional Birth Attendants ◽  
Cultural Barriers ◽  
District Health ◽  
Birth Attendants

Abstract Background Despite expanding the number of health facilities, Ethiopia has still the highest home delivery services utilization. Health care service utilization varies between regions within the country. This study explored the socio-cultural factors influencing health facility delivery in a pastoralist region of Afar, Ethiopia. Methods An explorative qualitative study was conducted in October–December 2015. A total of 18 focus group discussions were conducted separately with mothers, male tribal leaders and religious leaders. In addition, 24 key informant interviews were conducted with Women’s Affairs Bureau and district health office experts and traditional birth attendants and all were selected purposively. Data were coded and categorized using open code software and analyzed based on a thematic approach. Results The social factors that affect the choice of delivery place include workload, lack of independence and decision-making power of women, and lack of substitute for childcare and household chores during pregnancy and childbirth. The cultural and spiritual factors include assuming delivery as natural process ought to happen at home, trust in traditional birth attendants, traditional practices during and after delivery and faithful to religion practice, besides, denial by health facilities to benign traditional and spiritual practices such as prayers and traditional food preparations to be performed over there. Conclusion Socio-cultural factors are far more than access to health centers as barriers to the utilization of health facilities for child birth. The provision of a maternity waiting home around the health facilities can alleviate some of these socio-cultural barriers.

scholarly journals Parents’ and medical staff’s experience of adolescents with suicide-related behaviors admitted to a general hospital in China: qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xi Fu ◽  
Jiaxin Yang ◽  
Xiaoli Liao ◽  
Yidong Shen ◽  
Jianjun Ou ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Qualitative Study ◽  
General Hospital ◽  
Care Service ◽  
Health Care Service ◽  
Health Resources ◽  
Professional Self ◽  
Professional Treatment ◽  
Psychiatric Department

Abstract Background Currently, there is increasing awareness of suicide-related behaviors. Mental health services are a key location for assisting people with suicide-related behaviors. However, few studies focused on the evaluation and experience of the mental health care system from families and the medical staff’s perspective in China. The study aims to explore parents’ and the front-line medical staff’s experience of an adolescent with suicide-related behaviors admitted to the psychiatry department of a general hospital in China. Design Qualitative study was employed in the study. Participants were recruited from a general hospital in China characterized by high levels in the Chinese mental health system. Methods Semi-structured in-depth interviews were conducted exploring their experience and perceptions when an adolescent was admitted to the hospital. The theme analysis method is used for data analysis. Results Participants expressed dissatisfaction in the psychiatric department. Other barriers in their work were identified, such as the shortage of staff and difficulties in caring or communicating with patients. Besides, the imperfect treatment system also contributes to the low satisfaction of patients and their families. Two themes and six subthemes were identified: 1) staff perceive patients with SRBs as difficult to engage (feelings of helplessness, the need for compassion, challenges of professional self-efficacy, the recommendations to the health care service); 2) parents not satisfied with the existing hospital services (doubt the hospitalization treatment and the advice to the health care service). Conclusion This study found that insufficient staffing and lacking of systematic professional treatment models are the major challenges. We suggest increasing the input of mental health resources to expand and train the mental health service team and establish a complete set of a treatment model for SRBs.

scholarly journals I cannot touch you, but is that always essential?: A qualitative study about health care professionals’ experiences with the use of video consultations. (Preprint)

2021 ◽  
Author(s):  
Nina Primholdt Christensen ◽  
Karen Emilie Skou ◽  
Dorthe Boe Danbjørg
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Professionals ◽  
Care Service ◽  
Health Care Service ◽  
Study Data ◽  
Body Language ◽  
Medical Doctors ◽  
Video Consultation ◽  
Group Interviews

BACKGROUND The number of remote video consultations between doctors and patients have increased during the last years and especially during the COVID-19 pandemic. The health care service is faced by rising rates of chronic illness, but also many patients who are more confident in self-management of their illness. Add to this the improved long-term outlook for serious conditions such as cancer, that might require flexibility in the everyday life. OBJECTIVE This study aimed to investigate how medical doctors in the out-patient clinic experience the use of video consultations with the hematological patients with focus on relational and organizational aspects. METHODS The study was designed as an explorative and qualitative study. Data were collected via participant observations and focus group interviews with medical doctors RESULTS The study identified possibilities and barriers in relation to adapting to the different way of meeting the patient in the clinical setting. Some of the main findings in this study are that the medical doctors were afraid that they missed important observations as they were not able to perform a physical examination, if needed. They also emphasized that the handshake and eye-contact were important in order to ascertain the overall impression of the patient’s situation. It also came clear that the medical doctors were using their body language a lot more during a video consultation compared with a consultation in normal frames. The medical doctors found the contact with the patients via the screen good and the fact that the technology was working well made them feel secure with the video consultation. CONCLUSIONS In this study was found that the doctors we able to maintain good contact with the patients despite the screen and were able to sense the patient in a satisfying manner. Though there were still uncertainties among some doctors about the fact that they could not examine the patients physically. New knowledge about how to use gestures and non-verbal body language during a video consultation was also discovered.

scholarly journals Parents' and medical staff's experience of adolescents with suicide-related behaviors admitted to a general hospital in China: qualitative study

2020 ◽  
Author(s):  
Xi Fu ◽  
Jiaxin Yang ◽  
Xiaoli Liao ◽  
Yidong Shen ◽  
Jianjun Ou ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Qualitative Study ◽  
General Hospital ◽  
Care Service ◽  
Health Care Service ◽  
Health Resources ◽  
Professional Self ◽  
Professional Treatment ◽  
Psychiatric Department

Abstract Background: Currently, there is increasing awareness of suicide-related behaviors. Mental health services are a key location for assisting people with suicide-related behaviors. However, few studies focused on the evaluation and experience of the mental health care system from families and the medical staff’s perspective in China. The study aims to explore parents' and the front-line medical staff's experience of an adolescent with suicide-related behaviors admitted to the psychiatry department of a general hospital in China. Design: Qualitative study was employed in the study. Participants were recruited from a general hospital in China characterized by high levels in the Chinese mental health system. Methods: Semi-structured in-depth interviews were conducted exploring their experience and perceptions when an adolescent was admitted to the hospital. The theme analysis method is used for data analysis. Results: Participants expressed dissatisfaction in the psychiatric department. Other barriers in their work were identified, such as the shortage of staff and difficulties in caring or communicating with patients. Besides, the imperfect treatment system also contributes to the low satisfaction of patients and their families. Two themes and six subthemes were identified: 1) staff perceive patients with SRBs as difficult to engage (feelings of helplessness, the need for compassion, challenges of professional self-efficacy, the recommendations to the health care service); 2) parents not satisfied with the existing hospital services (doubt the hospitalization treatment and the advice to the health care service). Conclusion: This study found that insufficient staffing and lacking of systematic professional treatment models are the major challenges. We suggest increasing the input of mental health resources to expand and train the mental health service team and establish a complete set of a treatment model for SRBs.

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