scholarly journals Promoting rational antibiotics prescribing for non-complicated infections: Understanding social influence in primary care networks in Germany

2019 ◽  
Author(s):  
Regina Poss-Doering ◽  
Martina Kamradt ◽  
Katharina Glassen ◽  
Edith Andres ◽  
Petra Kaufmann-Kolle ◽  
...  
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Social Influence ◽  
Health Professionals ◽  
Best Practice ◽  
Care Providers ◽  
Self Reflection ◽  
Physician Health ◽  
Depth Analysis ◽  
Improvement Programs

Abstract Primary care networks in Germany are formalized regional collaborations of physicians and other healthcare providers. Common goals are optimized healthcare processes and services for patients, enhanced communication, agency for professional concerns and strengthened economic power. In the ARena study (Sustainable reduction of antibiotic-induced antimicrobial resistance), 14 primary care networks in two federal German states aimed to promote appropriate antibiotics use for acute non-complicated infections by fostering awareness and understanding. Factors related to the role of primary care networks were to be identified. Methods For this study, audio-recorded telephone interviews were conducted with physicians, non-physician health professionals and stakeholder representatives. Pseudonymized verbatim transcripts were coded using thematic analysis. In-depth analysis was based on the inductive categories ‘social support’, ‘social learning’, ‘social normative pressures’ and ‘social contagion’ to reflect social influence processes. To foster understanding of the networks’ potential impact on antibiotics prescribing, data generated through surveys with physicians and non-physician health professionals were analyzed descriptively. Results : Social influence processes proved to be relevant regarding knowledge transfer, manifestation of best-practice care and self-reflection. Peer communication was seen as great asset, main reason for membership and affirmative for own perspectives. All interviewed physicians (n=27) considered their network to be a strong support factor for daily routines, introduction of new routines, and continuity of care. They utilized network-offered training programs focusing on best practice guideline-oriented use of antibiotics and considered their networks supportive in dealing with patient expectations. A shared attitude combined with ARena intervention components facilitated reflected management of antibiotics prescribing. Non-physician health professionals (n=11) also valued network peer exchange. They assumed their employers joined networks to offer improved and continuous care. Stakeholders (n=7) expected networks and their members to be drivers for care optimization. Conclusion: Primary care networks play a crucial role in providing a platform for professional peer exchange, social support and reassurance. With regards to their impact on antibiotics prescribing for acute non-complicated infections, networks seem to facilitate and amplify quality improvement programs by providing a platform for refreshing awareness, knowledge and self-reflection among care providers. They are well suited to promote a rational use of antibiotics. .

scholarly journals Promoting rational antibiotic prescribing for non-complicated infections: Understanding social influence in primary care networks in Germany

2020 ◽  
Author(s):  
Regina Poss-Doering ◽  
Martina Kamradt ◽  
Katharina Glassen ◽  
Edith Andres ◽  
Petra Kaufmann-Kolle ◽  
...  
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Social Influence ◽  
Health Professionals ◽  
Best Practice ◽  
Antibiotic Prescribing ◽  
Care Providers ◽  
Self Reflection ◽  
Physician Health ◽  
Improvement Programs

Abstract Background Primary care networks in Germany are formalized regional collaborations of physicians and other healthcare providers. Common goals are optimized healthcare processes and services for patients, enhanced communication, agency for professional concerns and strengthened economic power. In the ARena study (Sustainable reduction of antibiotic-induced antimicrobial resistance), 14 primary care networks in two federal German states aimed to promote appropriate antibiotics use for acute non-complicated infections by fostering awareness and understanding. Factors related to the role of primary care networks were to be identified. Methods For this study, audio-recorded telephone interviews were conducted with physicians, non-physician health professionals and stakeholder representatives. Pseudonymized verbatim transcripts were coded using thematic analysis. In-depth analysis was based on the inductive categories ‘social support’, ‘social learning’, ‘social normative pressures’ and ‘social contagion’ to reflect social influence processes. Data generated through a survey with physicians and non-physician health professionals were analyzed descriptively to foster understanding of the networks’ potential impact on antibiotic prescribing. Results Social influence processes proved to be relevant regarding knowledge transfer, manifestation of best-practice care and self-reflection. Peer communication was seen as great asset, main reason for membership and affirmative for own perspectives. All interviewed physicians (n=27) considered their network to be a strong support factor for daily routines, introduction of new routines, and continuity of care. They utilized network-offered training programs focusing on best practice guideline-oriented use of antibiotics and considered their networks supportive in dealing with patient expectations. A shared attitude combined with ARena intervention components facilitated reflected management of antibiotic prescribing. Non-physician health professionals (n=11) also valued network peer exchange. They assumed their employers joined networks to offer improved and continuous care. Stakeholders (n=7) expected networks and their members to be drivers for care optimization. Conclusion Primary care networks play a crucial role in providing a platform for professional peer exchange, social support and reassurance. With regards to their impact on antibiotic prescribing for acute non-complicated infections, networks seem to facilitate and amplify quality improvement programs by providing a platform for refreshing awareness, knowledge and self-reflection among care providers. They are well suited to promote a rational use of antibiotics.

scholarly journals Promoting rational antibiotic prescribing for non-complicated infections: Understanding social influence in primary care networks in Germany

2020 ◽  
Author(s):  
Regina Poss-Doering ◽  
Martina Kamradt ◽  
Katharina Glassen ◽  
Edith Andres ◽  
Petra Kaufmann-Kolle ◽  
...  
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Social Influence ◽  
Health Professionals ◽  
Best Practice ◽  
Antibiotic Prescribing ◽  
Care Providers ◽  
Self Reflection ◽  
Physician Health ◽  
Improvement Programs

Abstract Background Primary care networks in Germany are formalized regional collaborations of physicians and other healthcare providers. Common goals are optimized healthcare processes and services for patients, enhanced communication, agency for professional concerns and strengthened economic power. In the ARena study (Sustainable reduction of antibiotic-induced antimicrobial resistance), 14 primary care networks in two federal German states aimed to promote appropriate antibiotics use for acute non-complicated infections by fostering awareness and understanding. Factors related to the role of primary care networks were to be identified. Methods For this study, audio-recorded telephone interviews were conducted with physicians, non-physician health professionals and stakeholder representatives. Pseudonymized verbatim transcripts were coded using thematic analysis. In-depth analysis was based on the inductive categories ‘social support’, ‘social learning’, ‘social normative pressures’ and ‘social contagion’ to reflect social influence processes. Data generated through a survey with physicians and non-physician health professionals were analyzed descriptively to foster understanding of the networks’ potential impact on antibiotic prescribing. Results Social influence processes proved to be relevant regarding knowledge transfer, manifestation of best-practice care and self-reflection. Peer communication was seen as great asset, main reason for membership and affirmative for own perspectives. All interviewed physicians (n=27) considered their network to be a strong support factor for daily routines, introduction of new routines, and continuity of care. They utilized network-offered training programs focusing on best practice guideline-oriented use of antibiotics and considered their networks supportive in dealing with patient expectations. A shared attitude combined with ARena intervention components facilitated reflected management of antibiotic prescribing. Non-physician health professionals (n=11) also valued network peer exchange. They assumed their employers joined networks to offer improved and continuous care. Stakeholders (n=7) expected networks and their members to be drivers for care optimization. Conclusion Primary care networks play a crucial role in providing a platform for professional peer exchange, social support and reassurance. With regards to their impact on antibiotic prescribing for acute non-complicated infections, networks seem to facilitate and amplify quality improvement programs by providing a platform for refreshing awareness, knowledge and self-reflection among care providers. They are well suited to promote a rational use of antibiotics.

scholarly journals Promoting rational antibiotic prescribing for non-complicated infections: Understanding social influence in primary care networks in Germany

2020 ◽  
Author(s):  
Regina Poss-Doering ◽  
Martina Kamradt ◽  
Katharina Glassen ◽  
Edith Andres ◽  
Petra Kaufmann-Kolle ◽  
...  
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Social Influence ◽  
Health Professionals ◽  
Best Practice ◽  
Antibiotic Prescribing ◽  
Care Providers ◽  
Self Reflection ◽  
Physician Health ◽  
Improvement Programs

Abstract Background Primary care networks in Germany are formalized regional collaborations of physicians and other healthcare providers. Common goals are optimized healthcare processes and services for patients, enhanced communication, agency for professional concerns and strengthened economic power. In the ARena study (Sustainable reduction of antibiotic-induced antimicrobial resistance), 14 primary care networks in two federal German states aimed to promote appropriate antibiotics use for acute non-complicated infections by fostering awareness and understanding. Factors related to the role of primary care networks were to be identified. Methods For this study, audio-recorded telephone interviews were conducted with physicians, non-physician health professionals and stakeholder representatives. Pseudonymized verbatim transcripts were coded using thematic analysis. In-depth analysis was based on the inductive categories ‘social support’, ‘social learning’, ‘social normative pressures’ and ‘social contagion’ to reflect social influence processes. Data generated through a survey with physicians and non-physician health professionals were analyzed descriptively to foster understanding of the networks’ potential impact on antibiotic prescribing. Results Social influence processes proved to be relevant regarding knowledge transfer, manifestation of best-practice care and self-reflection. Peer communication was seen as great asset, main reason for membership and affirmative for own perspectives. All interviewed physicians (n=27) considered their network to be a strong support factor for daily routines, introduction of new routines, and continuity of care. They utilized network-offered training programs focusing on best practice guideline-oriented use of antibiotics and considered their networks supportive in dealing with patient expectations. A shared attitude combined with ARena intervention components facilitated reflected management of antibiotic prescribing. Non-physician health professionals (n=11) also valued network peer exchange. They assumed their employers joined networks to offer improved and continuous care. Stakeholders (n=7) expected networks and their members to be drivers for care optimization. Conclusion Primary care networks play a crucial role in providing a platform for professional peer exchange, social support and reassurance. With regards to their impact on antibiotic prescribing for acute non-complicated infections, networks seem to facilitate and amplify quality improvement programs by providing a platform for refreshing awareness, knowledge and self-reflection among care providers. They are well suited to promote a rational use of antibiotics.

scholarly journals Consensus guidelines on managing Rett syndrome across the lifespan

2020 ◽  
Vol 4 (1) ◽  
pp. e000717
Author(s):  
Cary Fu ◽  
Dallas Armstrong ◽  
Eric Marsh ◽  
David Lieberman ◽  
Kathleen Motil ◽  
...  
Keyword(s):  
Primary Care ◽  
Rett Syndrome ◽  
Health Professionals ◽  
Best Practice ◽  
Neurodevelopmental Disorder ◽  
Primary Care Providers ◽  
Care Providers ◽  
Medical Comorbidities ◽  
Modified Delphi ◽  
Delphi Approach

BackgroundRett syndrome (RTT) is a severe neurodevelopmental disorder with complex medical comorbidities extending beyond the nervous system requiring the attention of health professionals. There is no peer-reviewed, consensus-based therapeutic guidance to care in RTT. The objective was to provide consensus on guidance of best practice for addressing these concerns.MethodsInformed by the literature and using a modified Delphi approach, a consensus process was used to develop guidance for care in RTT by health professionals.ResultsTypical RTT presents early in childhood in a clinically recognisable fashion. Multisystem comorbidities evolve throughout the lifespan requiring coordination of care between primary care and often multiple subspecialty providers. To assist health professionals and families in seeking best practice, a checklist and detailed references for guidance were developed by consensus.ConclusionsThe overall multisystem issues of RTT require primary care providers and other health professionals to manage complex medical comorbidities within the context of the whole individual and family. Given the median life expectancy well into the sixth decade, guidance is provided to health professionals to achieve current best possible outcomes for these special-needs individuals.

scholarly journals VitalSign6: A Primary Care First (PCP-First) Model for Universal Screening and Measurement-Based Care for Depression

2019 ◽  
Vol 12 (2) ◽  
pp. 71 ◽  
Author(s):  
Madhukar Trivedi ◽  
Manish Jha ◽  
Farra Kahalnik ◽  
Ronny Pipes ◽  
Sara Levinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Universal Screening ◽  
Primary Care Providers ◽  
The United States ◽  
Care Providers ◽  
Similar Treatment ◽  
Measurement Based Care

Major depressive disorder affects one in five adults in the United States. While practice guidelines recommend universal screening for depression in primary care settings, clinical outcomes suffer in the absence of optimal models to manage those who screen positive for depression. The current practice of employing additional mental health professionals perpetuates the assumption that primary care providers (PCP) cannot effectively manage depression, which is not feasible, due to the added costs and shortage of mental health professionals. We have extended our previous work, which demonstrated similar treatment outcomes for depression in primary care and psychiatric settings, using measurement-based care (MBC) by developing a model, called Primary Care First (PCP-First), that empowers PCPs to effectively manage depression in their patients. This model incorporates health information technology tools, through an electronic health records (EHR) integrated web-application and facilitates the following five components: (1) Screening (2) diagnosis (3) treatment selection (4) treatment implementation and (5) treatment revision. We have implemented this model as part of a quality improvement project, called VitalSign6, and will measure its success using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. In this report, we provide the background and rationale of the PCP-First model and the operationalization of VitalSign6 project.

scholarly journals Mediation role of perceived social support and burnout on financial satisfaction and turnover intention in primary care providers: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huosheng Yan ◽  
Lingzhi Sang ◽  
Hongzhang Liu ◽  
Cancan Li ◽  
Zijing Wang ◽  
...  
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Turnover Intention ◽  
Structural Equation ◽  
Perceived Social Support ◽  
Maslach Burnout Inventory ◽  
Primary Care Providers ◽  
Equation Modeling ◽  
Financial Satisfaction ◽  
Care Providers

Abstract Background Turnover intention is a major cause of reduced team morale and low work efficiency. It hinders work performance and reduces the quality of medical services. This study aimed to investigate the relationship between financial satisfaction and turnover intention and its mediators among primary care providers. Methods Multi-stage random cluster sampling was used to select 1241 participants from four counties and three districts in Anhui province, China. Data were collected using a self-administered questionnaire. Turnover intention was assessed with a turnover intention assessment scale. Perceived social support and burnout were measured with the 12-item Perceived Social Support Scale and the Chinese version of the Maslach Burnout Inventory, respectively. Structural equation modeling was used for data analysis. Results The findings showed high turnover intention among primary care providers (mean score 14.16 ± 4.337), and most providers reported low financial satisfaction (mean score 2.49 ± 0.990). The mean perceived social support score was 64.93 ± 13.229, and only 6.1% of primary care providers reported no burnout. Compared with participants with high financial satisfaction, those with low financial satisfaction were more likely to report higher turnover intention (β = − 0.216, p < 0.001), less perceived social support (β = 0.181, p < 0.001), and more severe burnout (β = − 0.123, p < 0.05). Turnover intention may be related to perceived social support (β = − 0.147, p < 0.001) and burnout (β = 0.239, p < 0.001). Furthermore, the effect of financial satisfaction on turnover intention was significantly mediated by perceived social support (β = − 0.027, p < 0.001) and burnout (β = − 0.029, p < 0.05). Conclusions Turnover intention is associated with financial satisfaction, with this association mediated by perceived social support and burnout. A reasonable mechanism needs to be established to improve financial satisfaction and perceived social support and reduce burnout among primary care providers.

scholarly journals Providing gender-affirming hormone therapy through primary care: Service users' and health professionals' experiences of a pilot clinic

2020 ◽  
Author(s):  
A Ker ◽  
Gloria Fraser ◽  
Antonia Lyons ◽  
C Stephenson ◽  
T Fleming
Keyword(s):  
Primary Care ◽  
Health Care ◽  
New Zealand ◽  
Hormone Therapy ◽  
Health Care Providers ◽  
Health Professionals ◽  
Care Service ◽  
Gender Diversity ◽  
Service Users ◽  
Care Providers

© 2020 CSIRO Publishing Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a. INTRODUCTION: Primary health care providers are playing an increasingly important role in providing gender-affirming health care for gender diverse people. This article explores the experiences of a primary care-based pilot clinic providing gender-affirming hormone therapy in Wellington, New Zealand. AIM: To evaluate service users' and health professionals' experiences of a pilot clinic at Mauri Ora (Victoria University of Wellington's Student Health and Counselling Service) that provided gender-affirming hormones through primary care. METHODS: In-depth interviews were conducted with four (out of six) service users and four health professionals about their perspectives on the clinic. Interviews were transcribed verbatim and analysed using thematic analysis. RESULTS: Three themes were identified in service users' interviews, who discussed receiving affirming care due to the clinic's accessibility, relationship-centred care and timeliness. Three themes were identified in the health professionals' interviews, who described how the clinic involves partnership, affirms users' gender and agency, and is adaptable to other primary care settings. Both service users and health professionals discussed concerns about the lack of adequate funding for primary care services and the tensions between addressing mental health needs and accessing timely care. DISCUSSION: The experiences of service users and health professionals confirm the value of providing gender-affirming hormone therapy in primary care. Models based in primary care are likely to increase accessibility, depathologise gender diversity and reduce wait times.

Behavioural Interventions in Primary Care: An Implementation Trial

2008 ◽  
Vol 27 (2) ◽  
pp. 179-189 ◽  
Author(s):  
Dan Bilsker ◽  
John Anderson ◽  
Joti Samra ◽  
Elliot Goldner ◽  
David Streiner
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Best Practice ◽  
Management Approach ◽  
Care Providers ◽  
Intervention Delivery ◽  
Effective Strategies ◽  
Best Practice Guidelines ◽  
Risky Alcohol ◽  
Depression Intervention

Developing effective strategies to keep health care providers' practice current with best practice guidelines has proven to be challenging. This trial was conducted to determine the potential for using brief educational sessions to generate significant change in physician delivery of mental health and substance use interventions in primary care. A 1-hour educational session outlining interventions for depression and risky alcohol use was delivered to a sample of 85 family physicians. The interventions used a supported self-management approach and included free patient access to appropriate selfmanagement resources. The study initially evaluated physicians' implementation of these interventions over a 2-month period. Physician uptake of the depression intervention was significantly greater than uptake of the risky-drinking intervention (32% versus 10%). A follow-up at 6-months posttraining (depression intervention only) demonstrated fairly good maintenance of intervention delivery. Implications of these findings are discussed.

First Link: Strengthening Primary Care Partnerships for Dementia Support

2008 ◽  
Vol 27 (2) ◽  
pp. 117-127 ◽  
Author(s):  
Carrie A. Mcainey ◽  
David Harvey ◽  
Mary E. Schulz
Keyword(s):  
Primary Care ◽  
Health Professionals ◽  
Support Services ◽  
Primary Care Providers ◽  
Disease Course ◽  
Collaborative Partnerships ◽  
Older Individuals ◽  
Care Providers ◽  
Innovative Program ◽  
Potential Benefits

While primary care faces many challenges, including an increasing prevalence of older individuals, emerging knowledge about the potential benefits of collaborative partnerships has encouraged the development of new means of providing and supporting primary care. First Link™ is an innovative program involving collaborations among primary care providers, Alzheimer Societies, and other health professionals. The program aims to support persons with Alzheimer's and related diseases after the diagnosis is made and to link them with support services earlier in the disease course. This paper describes the First Link program, provides an overview of a study currently underway to evaluate it, and identifies some of the benefits and challenges associated with this partnership.

Interdisciplinary perspectives on the management of the unsettled baby: key strategies for improved outcomes

2012 ◽  
Vol 18 (4) ◽  
pp. 332 ◽  
Author(s):  
Pamela S. Douglas ◽  
Renata E. Mares ◽  
Peter S. Hill
Keyword(s):  
Primary Care ◽  
Health Professionals ◽  
Best Practice ◽  
Professional Communication ◽  
Selection Strategy ◽  
Clinical Expertise ◽  
Extensive Experience ◽  
Best Practice Guidelines ◽  
Early Primary ◽  
Primary Care Practitioners

The objectives of this study were to analyse the perspectives of key informants with clinical expertise in the care of unsettled babies in the first few months of life and their families, concerning changes required to improve outcomes. The research used a purposive selection strategy and thematic analysis of key informant interviews of 24 health professionals from 11 disciplines. Informants were selected for extensive experience in the management of unsettled babies and their families.Participants corroborated existing evidence that post-birth care in Australia is fragmented. All held the view that, first, early primary care intervention for unsettled infants and their families, and second, improved cross-professional communication, are vital if the burden of this problem to the infant, family and health system are to be minimised. There was consensus, third, that significant gaps exist in health professionals’ knowledge base and management behaviours.The development of education resources, best practice guidelines, shared assessment frameworks for primary care practitioners and strategies for improved cross-professional communication are necessary to improve the health outcomes and decrease the burden of this common yet complex post-birth problem.

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