A pandemic of abuse against general practice staff

2021 ◽  
Vol 31 (7) ◽  
pp. 16-19
Author(s):  
Kathy Oxtoby
Keyword(s):  
General Practice ◽  
Practice Staff

With a survey revealing as many as three quarters of practice staff receive abuse from patients daily, more needs to be done to prevent and deal with this rising tide of insults, threats and violence, reports Kathy Oxtoby

Pharmacists in general practice: a qualitative process evaluation of the General Practice Pharmacist (GPP) study

2020 ◽  
Vol 37 (5) ◽  
pp. 711-718
Author(s):  
Oscar James ◽  
Karen Cardwell ◽  
Frank Moriarty ◽  
Susan M Smith ◽  
Barbara Clyne
Keyword(s):  
General Practice ◽  
Process Evaluation ◽  
Controlled Trial ◽  
Qualitative Approach ◽  
Structured Interviews ◽  
Practice Staff ◽  
Practice Nurses ◽  
Practice Team ◽  
Prescribing Quality ◽  
Descriptive Qualitative

Abstract Background There is some evidence to suggest that pharmacists integrated into primary care improves patient outcomes and prescribing quality. Despite this growing evidence, there is a lack of detail about the context of the role. Objective To explore the implementation of The General Practice Pharmacist (GPP) intervention (pharmacists integrating into general practice within a non-randomized pilot study in Ireland), the experiences of study participants and lessons for future implementation. Design and setting Process evaluation with a descriptive qualitative approach conducted in four purposively selected GP practices. Methods A process evaluation with a descriptive qualitative approach was conducted in four purposively selected GP practices. Semi-structured interviews were conducted, transcribed verbatim and analysed using a thematic analysis. Results Twenty-three participants (three pharmacists, four GPs, four patients, four practice nurses, four practice managers and four practice administrators) were interviewed. Themes reported include day-to-day practicalities (incorporating location and space, systems and procedures and pharmacists’ tasks), relationships and communication (incorporating GP/pharmacist mode of communication, mutual trust and respect, relationship with other practice staff and with patients) and role perception (incorporating shared goals, professional rewards, scope of practice and logistics). Conclusions Pharmacists working within the general practice team have potential to improve prescribing quality. This process evaluation found that a pharmacist joining the general practice team was well accepted by the GP and practice staff and effective interprofessional relationships were described. Patients were less clear of the overall benefits. Important barriers (such as funding, infrastructure and workload) and facilitators (such as teamwork and integration) to the intervention were identified which will be incorporated into a pilot cluster randomized controlled trial.

scholarly journals Deprescribing intervention activities mapped to guiding principles for use in general practice: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e052547
Author(s):  
Amy Coe ◽  
Catherine Kaylor-Hughes ◽  
Susan Fletcher ◽  
Elizabeth Murray ◽  
Jane Gunn
Keyword(s):  
General Practice ◽  
Family Practice ◽  
Data Extraction ◽  
Controlled Trial ◽  
Future Research ◽  
Original Research ◽  
Practice Staff ◽  
Quasi Experimental ◽  
Guiding Principles ◽  
Randomised Controlled

ObjectiveTo identify and characterise activities for deprescribing used in general practice and to map the identified activities to pioneering principles of deprescribing.SettingPrimary care.Data sourcesMedline, EMBASE (Ovid), CINAHL, Australian New Zealand Clinical Trials Registry (ANZCTR), Clinicaltrials.gov, ISRCTN registry, OpenGrey, Annals of Family Medicine, BMC Family Practice, Family Practice and British Journal of General Practice (BJGP) from inception to the end of June 2021.Study selectionIncluded studies were original research (randomised controlled trial, quasi-experimental, cohort study, qualitative and case studies), protocol papers and protocol registrations.Data extractionScreening and data extraction was completed by one reviewer; 10% of the studies were independently reviewed by a second reviewer. Coding of full-text articles in NVivo was conducted and mapped to five deprescribing principles.ResultsFifty studies were included. The most frequently used activities were identification of appropriate patients for deprescribing (76%), patient education (50%), general practitioners (GP) education (48%), and development and use of a tapering schedule (38%). Six activities did not align with the five deprescribing principles. As such, two principles (engage practice staff in education and appropriate identification of patients, and provide feedback to staff about deprescribing occurrences within the practice) were added.ConclusionActivities and guiding principles for deprescribing should be paired together to provide an accessible and comprehensive guide to deprescribing by GPs. The addition of two principles suggests that practice staff and practice management teams may play an instrumental role in sustaining deprescribing processes within clinical practice. Future research is required to determine the most of effective activities to use within each principle and by whom.

scholarly journals Engagement with and delivery of the ‘parkrun practice initiative’ in general practice: a mixed methods study

2020 ◽  
Vol 70 (697) ◽  
pp. e573-e580
Author(s):  
Joanna Fleming ◽  
Carol Bryce ◽  
Joanne Parsons ◽  
Chrissie Wellington ◽  
Jeremy Dale
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
Focus Group ◽  
Online Survey ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Practice Staff ◽  
Health And Wellbeing ◽  
Positive Effects ◽  
Improve Patient

BackgroundThe parkrun practice initiative, a joint collaboration between parkrun and the Royal College of General Practitioners, was launched to encourage general practices to improve the health and wellbeing of patients and staff through participating in local 5 km parkrun events. Why and how practices engage with the initiative is unknown.AimTo investigate engagement with and delivery of the parkrun practice initiative in general practice.Design and settingMixed methods study conducted from April–July 2019 comprising an online survey of all registered parkrun practices, and interviews and a focus group with practice staff in the West Midlands.MethodThe designated contacts at 780 registered parkrun practices were invited to complete an online survey. A purposive sample of parkrun practice staff and non-registered practice staff took part either in semi-structured interviews or a focus group, with transcripts analysed thematically.ResultsOf the total number of parkrun practices, 306 (39.2%) completed the survey. Sixteen practice staff (from nine parkrun practices and four non-registered practices) took part in either semi-structured interviews (n = 12) or a focus group (n = 4). Key motivators for becoming a parkrun practice were: to improve patient and staff health and wellbeing, and to become more engaged with the community and enhance practice image. Practices most commonly encouraged patients, carers, and staff to take part in parkrun and displayed parkrun flyers and posters. Challenges in implementing activities included lack of time (both personal and during consultations) and getting staff involved. Where staff did engage there were positive effects on morale and participation. Non-registered practices were receptive to the initiative, but had apprehensions about the commitment involved.ConclusionPractices were keen to improve patient and staff health. Addressing time constraints and staff support needs to be considered when implementing the initiative.

scholarly journals Connecting Care in the Community: what works and what doesn't

2016 ◽  
Vol 22 (6) ◽  
pp. 539 ◽  
Author(s):  
Elizabeth Lucas ◽  
Elizabeth Halcomb ◽  
Sandra McCarthy
Keyword(s):  
General Practice ◽  
Complex Disease ◽  
Complex Care ◽  
Practice Staff ◽  
Local Resources ◽  
Care Integration ◽  
What Works ◽  
Semistructured Interviews ◽  
Role Confusion

As the burden of chronic and complex disease grows, there is an emphasis on programs that enhance the quality of care within primary care. The Connecting Care in the Community (CCC) program is an example of the implementation of care integration. This qualitative study sought to explore the experiences general practice staff face in managing clients with chronic and complex care issues, and their perceptions of the contribution of the CCC program to this care. Seventeen general practice staff from 11 practices throughout the Illawarra/Shoalhaven region participated in semistructured interviews. Five main themes emerged: (1) awareness of the CCC program; (2) varying program exposure and value placed on the program; (3) practice ‘busyness’ and role confusion; (4) communication and information sharing; and (5) the need for staff education and knowledge of local resources. If policymakers and healthcare organisations can gain a better understanding of the experiences of general practice staff, they will be able to design and implement programs that best meet the needs of the providers that they are attempting to integrate.

scholarly journals Undertaking general practice quality improvement to improve cancer screening - a thematic analysis of provider experiences

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Steven A. Trankle ◽  
Christine Metusela ◽  
Jennifer Reath
Keyword(s):  
General Practice ◽  
Quality Improvement ◽  
Cancer Screening ◽  
Thematic Analysis ◽  
Community Education ◽  
Practice Staff ◽  
Health Network ◽  
Primary Health ◽  
Incidence And Mortality ◽  
General Practices

Abstract Background Cancer is a major cause of illness and death, and its incidence and mortality can be reduced through effective screening. In order to improve below target screening rates in one region of Australia, the local Primary Health Network supported local general practices to implement a range of quality improvement initiatives. Methods We used a qualitative approach and interviewed 18 general practice staff and five Primary Health Network staff and contractors to understand their experiences with these quality improvement initiatives. Results In a thematic analysis, we identified four key themes related to program set-up and implementation; patient and community education and promotion; engaging patients and communities in screening; and general practice enhancement. Program roles were clear and understood, and the program received strong oversight and support. Practice staff felt supported and motivated. Information Technology was a challenge for many practices often requiring tailored assistance. Education provided by practices facilitated patient empowerment but practice staff noted difficulties engaging patients in screening. Practices were enhanced though strong leadership and teamwork and practice learning activities. Conclusions The tailored evidence-based quality improvement initiatives were considered effective in supporting general practices to increase their cancer screening. Key facilitators reported by participants included use of Plan-Do-Study-Act cycles, enhanced data entry and audit capacity, effective recall and reminder systems and maintaining staff motivation.

scholarly journals Development of the Prototype Concise Safe Systems Checklist Tool for General Practice

2020 ◽  
Author(s):  
Ian J Litchfield ◽  
Rachel Spencer ◽  
Brian Bell ◽  
Anthony Avery ◽  
Katherine Perryman ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Safety ◽  
Primary Care Patient ◽  
Safety Information ◽  
Care Patient ◽  
Ease Of Use ◽  
Structured Interviews ◽  
Practice Staff ◽  
Safety Issues

Abstract Background In the course of producing a patient safety toolkit for primary care, we identified the need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. This paper describes the development of a prototype checklist designed to be used in busy general practice environments to provide an overview of key patient safety related processes and prompt practice wide-discussion. Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the results, summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing, and use of IT systems from which a 13 item checklist was trialled in 16 practices resulting in a nine item prototype checklist, which was tested in eight practices. Qualitative data on the utility and usability of the prototype was collected through a series of semi-structured interviews.Results In testing the prototype four of nine items on the checklist were achieved by all eight practices. Three items were achieved by seven of eight practices and two items by six of eight practices. Participants welcomed the brevity and ease of use of the prototype, that it might be used within time scales at their discretion and its ability to engage a range of practice staff in relevant discussions on the safety of existing processes. The items relating to prescribing safety were considered particularly useful. Conclusions As a result of this work the concise patient safety checklist tool, specifically designed for general practice, has now been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Senior practice staff such as practice managers and GP partners should find it a useful tool to understand the safety of less explored yet important safety processes within the practice.

scholarly journals Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.

2019 ◽  
Author(s):  
Belinda Parker ◽  
Melinda Rose Achilles ◽  
Mirjana Subotic-Kerry ◽  
Bridianne O'Dea
Keyword(s):  
Mental Illness ◽  
General Practice ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Depression And Anxiety ◽  
Practice Staff ◽  
Factors Affecting ◽  
Patient Health ◽  
Seeking Help ◽  
General Practices

Abstract Background: General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients. This service also provided evidence-based treatment recommendations and fortnightly monitoring of symptoms. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices. Methods: A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14-17 years who visited a participating GP during the screening period with their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who reported symptoms but were not currently seeking help from their GP, nor had sought help in the past. Feasibility and acceptability among GPs and practice staff were assessed using a battery of questionnaires. Results: Five GPs and 6 practice staff took part. A total of 46 youth patients were approached, 28 consented and 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service, and that they would use it again. Conclusions: The Youth StepCare service appears to be a useful tool for identifying youth with unidentified symptoms of mental illness that can be easily embedded into general practice. Further research would benefit from exploring the factors affecting initial GP uptake and a larger trial is required to determine the efficacy of the service on young people’s symptom reduction.

scholarly journals Undertaking General Practice Quality Improvement to Improve Cancer Screening - A Thematic Analysis of Provider Experiences

2021 ◽  
Author(s):  
STEVEN A TRANKLE ◽  
CHRISTINE METUSELA ◽  
JENNIFER REATH
Keyword(s):  
General Practice ◽  
Quality Improvement ◽  
Cancer Screening ◽  
Thematic Analysis ◽  
Community Education ◽  
Practice Staff ◽  
Health Network ◽  
Primary Health ◽  
Incidence And Mortality ◽  
General Practices

Abstract Background: Cancer is a major cause of illness and death, and its incidence and mortality can be reduced through effective screening. In order to improve below target screening rates in one region of Australia, the local Primary Health Network supported local general practices to implement a range of quality improvement initiatives.Methods: We used a qualitative approach and interviewed 16 general practice staff and five Primary Health Network staff and contractors to understand their experiences with these quality improvement initiatives.Results: In a thematic analysis, we identified four key themes related to program set-up and implementation; patient and community education and promotion; engaging patients and communities in screening; and general practice enhancement. Program roles were clear and understood, and the program received strong oversight and support. Practice staff felt supported and motivated. Information Technology was a challenge for many practices often requiring tailored assistance. Education provided by practices facilitated patient empowerment but practice staff noted difficulties engaging patients in screening. Practices were enhanced though strong leadership and teamwork and practice learning activities.Conclusions: The tailored evidence-based quality improvement initiatives were considered effective in supporting general practices to increase their cancer screening. Key facilitators reported by participants included use of Plan-Do-Study-Act cycles, enhanced data entry and audit capacity, effective recall and reminder systems and maintaining staff motivation.

scholarly journals Mobile memory clinic: implementing a nurse practitioner-led, collaborative dementia model of care within general practice

2021 ◽  
Vol 27 (1) ◽  
pp. 6
Author(s):  
Dimity Pond ◽  
Isabel Higgins ◽  
Karen Mate ◽  
Helga Merl ◽  
Dianne Mills ◽  
...  
Keyword(s):  
General Practice ◽  
Health Services ◽  
Nurse Practitioner ◽  
Limited Capacity ◽  
Memory Clinic ◽  
Model Of Care ◽  
Practice Staff ◽  
Australian Health ◽  
Poor Access ◽  
Service Framework

The limited capacity of secondary health services to address the increasing prevalence of dementia within the community draws attention to the need for an enhanced role for nurses working collaboratively with GPs in diagnosing and coordinating post-diagnostic care for patients with dementia. This study investigated the feasibility and acceptability of a nurse practitioner-led mobile memory clinic that was embedded within general practice and targeted to caring for patients and their carers in areas of socioeconomic disadvantage with poor access to specialist health services. Over the period from mid-2013 to mid-2014, 40 GPs referred 102 patients, with the nurse practitioner conducting assessments with 77 of these patients in their homes. Overall, there was a strong interest in this model of care by general practice staff, with the assessment and care provided by the nurse practitioner evaluated as highly acceptable by both patients and their carers. Nonetheless, there are financial and structural impediments to this model of care being implemented within the current Australian health service framework, necessitating further research investigating its cost-effectiveness and efficacy.

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