scholarly journals A patient-oriented research approach to assessing patients’ and primary care physicians’ opinions on trauma-informed care

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254266
Author(s):  
Seint Kokokyi ◽  
Bridget Klest ◽  
Hannah Anstey
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Patient Engagement ◽  
Primary Care Physicians ◽  
Clinical Pathways ◽  
Physician Training ◽  
Research Approach ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
Impact Patient Care

Objective To gather patients’ and primary care physicians’ (PCP) opinions on trauma-informed Care (TIC) and to investigate the acceptability of recommendations developed by patient, family, and physician advisors. Design Cross-sectional research survey design and patient engagement. Setting Canada, 2017 to 2019. Participants English-speaking adults and licensed PCPs residing in Canada. Main outcome measures Participants were given a series of questionnaires including a list of physician actions and a list of recommendations consistent with TIC. Results Patients and PCPs viewed TIC as important. Both patients and PCPs rated the following recommendations as helpful and likely to positively impact patient care: physician training, online trauma resource centres, information pamphlets, the ability to extend appointment times, and clinical pathways for responding to trauma. PCPs’ responses were significantly more positive than patients’ responses. Conclusion TIC is important to patients and PCPs. Patients and PCPs believe changes to physician training, patient engagement, and systemic factors would be helpful and likely to positively impact patient care. Future research needs to be conducted to investigate whether these recommendations improve patient care.

Trauma-Informed Care Survey of Psychiatrists and Primary Care Physicians in the Middle East

2017 ◽  
Vol 19 (5) ◽  
Author(s):  
Ossama T. Osman ◽  
Laeth Nasir ◽  
Richard F. Mollica ◽  
Taoufik Zoubeidi ◽  
James Lavelle ◽  
...  
Keyword(s):  
Primary Care ◽  
Middle East ◽  
Primary Care Physicians ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
Care Survey

scholarly journals Patient-Care Questions that Physicians Are Unable to Answer

2007 ◽  
Vol 14 (4) ◽  
pp. 407-414 ◽  
Author(s):  
John W. Ely ◽  
Jerome A. Osheroff ◽  
Saverio M. Maviglia ◽  
Marcy E. Rosenbaum
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Primary Care Physicians ◽  
Clinical Information ◽  
Clinical Findings ◽  
Information Resources ◽  
Clinical Information Systems ◽  
Unanswered Question ◽  
Test Results ◽  
Clinical Questions

Abstract Objective: To describe the characteristics of unanswered clinical questions and propose interventions that could improve the chance of finding answers. Design: In a previous study, investigators observed primary care physicians in their offices and recorded questions that arose during patient care. Questions that were pursued by the physician, but remained unanswered, were grouped into generic types. In the present study, investigators attempted to answer these questions and developed recommendations aimed at improving the success rate of finding answers. Measurements: Frequency of unanswered question types and recommendations to increase the chance of finding answers. Results: In an earlier study, 48 physicians asked 1062 questions during 192 half-day office observations. Physicians could not find answers to 237 (41%) of the 585 questions they pursued. The present study grouped the unanswered questions into 19 generic types. Three types accounted for 128 (54%) of the unanswered questions: (1) “Undiagnosed finding” questions asked about the management of abnormal clinical findings, such as symptoms, signs, and test results (What is the approach to finding X?); (2) “Conditional” questions contained qualifying conditions that were appended to otherwise simple questions (What is the management of X, given Y? where “given Y” is the qualifying condition that makes the question difficult.); and (3) “Compound” questions asked about the association between two highly specific elements (Can X cause Y?). The study identified strategies to improve clinical information retrieval, listed below. Conclusion: To improve the chance of finding answers, physicians should change their search strategies by rephrasing their questions and searching more clinically oriented resources. Authors of clinical information resources should anticipate questions that may arise in practice, and clinical information systems should provide clearer and more explicit answers.

scholarly journals Patient care complexity as perceived by primary care physicians.

2015 ◽  
Vol 33 (2) ◽  
pp. 137-145 ◽  
Author(s):  
Jill K. Mount ◽  
R. Michael Massanari ◽  
Jay Teachman
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Primary Care Physicians

scholarly journals Acute General Practice – the 7 year itch

2015 ◽  
Vol 14 (3) ◽  
pp. 132-135
Author(s):  
Ben Jameson
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Care ◽  
Secondary Care ◽  
Primary Care Physicians ◽  
Service Design ◽  
Improve Patient Care ◽  
Medical Assessment ◽  
Improve Patient

The Acute GP Service has operated in Plymouth for the last 7 years. We have a mandate to improve patient care through supporting community GPs and their patients at the point of need for urgent medical assessment. I outline our service design and delivery and make the argument for the use of primary care physicians to help manage the interface between primary and secondary care.

scholarly journals Improving After-Clinic Work Workflow in a Family Medicine Residency

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Nguyen V ◽  
◽  
Jaqua E ◽  
Oh A ◽  
Altamirano M ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Patient Care ◽  
Primary Care Physicians ◽  
Training Session ◽  
P Value ◽  
Post Intervention ◽  
Family Medicine Residency ◽  
Resident Physicians ◽  
Family Medicine Residents

Introduction: The broad range of patients and diagnoses addressed by primary care physicians lends to a larger after-work clinic load. The resulting after-clinic work, including various in-basket tasks, can be a substantial burden to physicians, and potentially leading to burnout. The goal of this study is to generate a standardized workflow to improve physician after-clinic work efficiency and patient care. Methods: A nine-question pre- and post-intervention survey about afterclinic work management was administered to family medicine residents at a multi-specialty FQHC in California. The intervention was done in June 2020 and included a twenty-minute training session explaining how to implement a standardized in-basket management flowchart in a family medicine residency clinic. Results: Pre- and post-intervention data were analyzed using nonindependent paired sample t-tests. The survey was sent to all 40 family medicine residents. Pre- and post-intervention survey response rate was 77.5% and 97.5% respectively. The result of the nine questions post intervention were statistically significant (p value of <0.001). The standardized flowchart addressed adequate supervision of resident physicians’ patient care. Conclusion: The post-intervention results showed that having a clear and standardized flowchart enhanced the overall knowledge and understanding by the resident physicians in how to management the in-basket workflow. With increased patient access via telehealth and enhanced electronic medical records, it is essential to have effective teaching and supervision of resident physician after-clinic work. Successful teaching of after-clinic work will improve work-life balance and the overall success of the new primary care physician.

Training Pediatric Primary Care Residents in Trauma-Informed Care: A Feasibility Trial

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1239-1249
Author(s):  
Aubrey R. Dueweke ◽  
Rochelle F. Hanson ◽  
Elizabeth Wallis ◽  
Emily Fanguy ◽  
Carla Newman
Keyword(s):  
Primary Care ◽  
Perceived Competence ◽  
Perceived Barriers ◽  
Feasibility Trial ◽  
Pediatric Residents ◽  
Paired Samples ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
Care Practices ◽  
Residents Attitudes

This study examined the feasibility and outcomes of a training designed to enhance pediatric residents’ trauma-informed practices in primary care. Paired samples t tests examined changes in 33 residents’ attitudes, perceived competence, and perceived barriers toward trauma-informed care after a 2-hour training. Fisher’s exact tests measured changes in residents’ screening and referral behaviors. A subsample (n = 9) of residents were interviewed about the training. Residents reported increases in favorable attitudes ( P = .065) and perceived competence ( P < .001) and decreases in perceived barriers ( P = .001 to .521) to implementing trauma-informed care practices. Chart reviews revealed a significant increase in completed trauma screens (0% to 8.0%, P < .001) but no difference in referrals for psychology/psychiatry services (1.9% to 4.2%, P = .200). Residents reported finding the training helpful. Although residents were willing and understood the utility of assessing for trauma, they faced substantial barriers.

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