scholarly journals The effects of Enhanced Primary Healthcare interventions on primary care providers job satisfaction

2020 ◽  
Author(s):  
Wen Jun Wong ◽  
Aisyah Mohd Norzi ◽  
Swee Hung Ang ◽  
Chee Lee Chan ◽  
Faeiz Syezri Adzmin Jaafar ◽  
...  
Keyword(s):  
Primary Care ◽  
Job Satisfaction ◽  
Primary Healthcare ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Intervention Group ◽  
Well Being ◽  
Primary Care Providers ◽  
Care Providers ◽  
Post Intervention

Abstract Background:In response to address the rising burden of cardiovascular risk factors, Malaysian government has implemented Enhanced Primary Healthcare (EnPHC) interventions in July 2017 at public clinics level. Healthcare providers (HCPs) play crucial roles in healthcare service delivery and health system reform can influence HCPs’ job satisfaction. However, studies evaluating HCPs’ job satisfaction following primary care transformation remain scarce in low- and middle-income countries. This study aims to evaluate the effects of EnPHC interventions on HCPs. Methods:This is a quasi-experimental study conducted in 20 intervention and 20 matched control clinics. We surveyed all healthcare providers who were directly involved in patient management. A self-administered questionnaire which included six questions on job satisfaction were distributed at baseline (April and May 2017) and post-intervention (March and April 2019). Difference-in-differences analysis was used in the multivariable linear regression model in which we adjusted for providers and clinics characteristics to detect the changes in job satisfaction following EnPHC interventions. Results:A total of 1042 and 1215 HCPs responded at baseline and post-intervention respectively. At post-intervention, the intervention group reported higher level of stress and change in score between two groups was -0.14 (β= -0.139; 95% CI -0.266,-0.012; p=0.032). In subgroup analysis, nurses from intervention group experienced increase in work stress following EnPHC interventions (β= -0.223; 95% CI -0.419,-0.026; p=0.026). Additionally, the same group also responded that they were less likely to perceive their profession as well-respected at post-intervention (β= -0.175; 95% CI -0.331,-0.019; p=0.027). Conversely, allied health professionals from intervention group were more likely to report a good balance between work and effort (β= 0.386; 95% CI 0.033,0.738; p=0.032) after implementing EnPHC interventions. Conclusions:Our findings suggest that EnPHC interventions had resulted in some untoward effect on HCPs’ job satisfaction. Job dissatisfaction can have detrimental effects on the organisation and healthcare system. Therefore, provider experience and well-being should be considered before introducing healthcare delivery reforms to avoid overburdening of HCPs.

scholarly journals The effects of Enhanced Primary Healthcare interventions on primary care providers job satisfaction

2019 ◽  
Author(s):  
Wen Jun Wong ◽  
Aisyah Mohd Norzi ◽  
Swee Hung Ang ◽  
Chee Lee Chan ◽  
Faeiz Syezri Adzmin Jaafar ◽  
...  
Keyword(s):  
Primary Care ◽  
Job Satisfaction ◽  
Primary Healthcare ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Intervention Group ◽  
Well Being ◽  
Primary Care Providers ◽  
Care Providers ◽  
Post Intervention

Abstract Background In response to address the rising burden of cardiovascular risk factors, Malaysian government has implemented Enhanced Primary Healthcare (EnPHC) interventions in July 2017 at public clinics level. Healthcare providers (HCPs) play crucial roles in healthcare service delivery and health system reform can influence HCPs’ job satisfaction. However, studies evaluating HCPs’ job satisfaction following primary care transformation remain scarce in low- and middle-income countries. This study aims to evaluate the effects of EnPHC interventions on HCPs. Methods This is a quasi-experimental study conducted in 20 intervention and 20 matched control clinics. We surveyed all healthcare providers who were directly involved in patient management. A self-administered questionnaire which included six questions on job satisfaction were distributed at baseline (April and May 2017) and post-intervention (March and April 2019). Difference-in-differences analysis was used in the multivariable linear regression model in which we adjusted for providers and clinics characteristics to detect the changes in job satisfaction following EnPHC interventions. Results A total of 1042 and 1215 HCPs responded at baseline and post-intervention respectively. At post-intervention, the intervention group reported higher level of stress and change in score between two groups was -0.14 (β= -0.139; 95% CI -0.266,-0.012; p =0.032). In subgroup analysis, nurses from intervention group experienced increase in work stress following EnPHC interventions (β= -0.223; 95% CI -0.419,-0.026; p =0.026). Additionally, the same group also responded that they were less likely to perceive their profession as well-respected at post-intervention (β= -0.175; 95% CI -0.331,-0.019; p =0.027). Conversely, allied health professionals from intervention group were more likely to report a good balance between work and effort (β= 0.386; 95% CI 0.033,0.738; p =0.032) after implementing EnPHC interventions. Conclusions Our findings suggest that EnPHC interventions had resulted in some untoward effect on HCPs’ job satisfaction. Job dissatisfaction can have detrimental effects on the organisation and healthcare system. Therefore, provider experience and well-being should be considered before introducing healthcare delivery reforms to avoid overburdening of HCPs.

scholarly journals The effects of Enhanced Primary Healthcare interventions on primary care providers’ job satisfaction

2020 ◽  
Author(s):  
Wen Jun Wong ◽  
Aisyah Mohd Norzi ◽  
Swee Hung Ang ◽  
Chee Lee Chan ◽  
Faeiz Syezri Adzmin Jaafar ◽  
...  
Keyword(s):  
Primary Care ◽  
Job Satisfaction ◽  
Primary Healthcare ◽  
Healthcare Delivery ◽  
Intervention Group ◽  
Well Being ◽  
Primary Care Providers ◽  
Control Group ◽  
Care Providers ◽  
Post Intervention

Abstract Background: In response to the rising burden of cardiovascular risk factors, the Malaysian government has implemented Enhanced Primary Healthcare (EnPHC) interventions in July 2017 at public clinic level to improve management and clinical outcomes of type 2 diabetes and hypertensive patients. Healthcare providers (HCPs) play crucial roles in healthcare service delivery and health system reform can influence HCPs’ job satisfaction. However, studies evaluating HCPs’ job satisfaction following primary care transformation remain scarce in low- and middle-income countries. This study aims to evaluate the effects of EnPHC interventions on HCPs’ job satisfaction. Methods: This is a quasi-experimental study conducted in 20 intervention and 20 matched control clinics. We surveyed all HCPs who were directly involved in patient management. A self-administered questionnaire which included six questions on job satisfaction were assessed on a scale of 1-4 at baseline (April and May 2017) and post-intervention phase (March and April 2019). Unadjusted intervention effect was calculated based on absolute differences in mean scores between intervention and control groups after implementation. Difference-in-differences analysis was used in the multivariable linear regression model and adjusted for providers and clinics characteristics to detect changes in job satisfaction following EnPHC interventions. A negative estimate indicates relative decrease in job satisfaction in the intervention group compared with control group. Results: A total of 1042 and 1215 HCPs responded at baseline and post-intervention respectively. At post-intervention, the intervention group reported higher level of stress with adjusted differences of -0.139 (95% CI -0.266,-0.012; p=0.032). Nurses, being the largest workforce in public clinics were the only group experiencing dissatisfaction at post-intervention. In subgroup analysis, nurses from intervention group experienced increase in work stress following EnPHC interventions with adjusted differences of -0.223 (95% CI -0.419,-0.026; p=0.026). Additionally, the same group were less likely to perceive their profession as well-respected at post-intervention (β= -0.175; 95% CI -0.331,-0.019; p=0.027]). Conclusions: Our findings suggest that EnPHC interventions had resulted in some untoward effect on HCPs’ job satisfaction. Job dissatisfaction can have detrimental effects on the organisation and healthcare system. Therefore, provider experience and well-being should be considered before introducing healthcare delivery reforms to avoid overburdening of HCPs.

scholarly journals Influencers on deprescribing practice of primary healthcare providers in Nova Scotia: An examination using behavior change frameworks

2020 ◽  
Vol 4 ◽  
pp. 239920262092250
Author(s):  
Natalie Kennie-Kaulbach ◽  
Rachel Cormier ◽  
Olga Kits ◽  
Emily Reeve ◽  
Anne Marie Whelan ◽  
...  
Keyword(s):  
Primary Care ◽  
Nova Scotia ◽  
Behavior Change ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
System Level ◽  
Care Providers ◽  
Behavior Change Wheel ◽  
Primary Healthcare Providers

Background: Deprescribing is a complex process requiring consideration of behavior change theory to improve implementation and uptake. Aim: The aim of this study was to describe the knowledge, attitudes, beliefs, and behaviors that influence deprescribing for primary healthcare providers (family physicians, nurse practitioners (NPs), and pharmacists) within Nova Scotia using the Theoretical Domains Framework version 2 (TDF(v2)) and the Behavior Change Wheel. Methods: Interviews and focus groups were completed with primary care providers (physicians, NPs, and pharmacists) in Nova Scotia, Canada. Coding was completed using the TDF(v2) to identify the key influencers. Subdomain themes were also identified for the main TDF(v2) domains and results were then linked to the Behavior Change Wheel—Capability, Opportunity, and Motivation components. Results: Participants identified key influencers for deprescribing including areas related to Opportunity, within TDF(v2) domain Social Influences, such as patients and other healthcare providers, as well as Physical barriers (TDF(v2) domain Environmental Context and Resources), such as lack of time and reimbursement. Conclusion: Our results suggest that a systematic approach to deprescribing in primary care should be supported by opportunities for patient and healthcare provider collaborations, as well as practice and system level enhancements to support sustainability of deprescribing practices.

scholarly journals Job Satisfaction and Self-Perceived Health Status among Primary Care Providers in China

2020 ◽  
Author(s):  
Jun Wang ◽  
Jingmin Zhu ◽  
Hailun Liang
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Job Satisfaction ◽  
Health Status ◽  
Healthcare Providers ◽  
Perceived Health ◽  
Primary Care Providers ◽  
Care Providers ◽  
Perceived Health Status ◽  
Job Type

Abstract Background: Healthcare providers’ health and safety can influence the quality of patient care. The attitude towards work, either satisfaction or dissatisfaction, could influence the way in which people perceive their health status. To check this hypothesis, some studies have shown an association between healthcare providers’ health status and job satisfaction. The present study examined the associations between self-perceived health status and job satisfaction among primary care providers in China, and the moderating effect of job type.Methods: Data were collected by using questionnaire survey among Chinese primary care providers, who work for general practice teams (GPTs). The GPT members’ self-perceived health, job satisfaction, and job type were evaluated, where job satisfaction comprised work, promotion and training, and work environment. Multivariate logistic regression analysis was performed.Findings: Of the 536 participants, 48.51% reported good physical health, and 55.78% reported good mental health. Participants reported being moderately satisfied with their job. Self-perceived physical and mental health were significantly and positively associated with job satisfaction in similar magnitudes. Promotion and training satisfaction were more strongly associated with physical health, whereas work environment had the strongest association with mental health. Job type moderated this association, wherein the association was significant only for non-general practitioners (non-GPs).Conclusion: Primary care providers’ job satisfaction is significantly associated with their self-perceived health. Actions are needed to increase their job satisfaction and therefore to improve their health. Meanwhile, further research into GPs’ health determinants is needed.

scholarly journals Lightweight Mobile Automated Assistant-to-physician for Global Lower-resource Areas

2021 ◽  
Author(s):  
Chao Zhang ◽  
Hanxin Zhang ◽  
Atif Khan ◽  
Ted Kim ◽  
Olasubomi Omoleye ◽  
...  
Keyword(s):  
Primary Care ◽  
Real Time ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Learning System ◽  
Care Providers ◽  
Wide Range ◽  
Multiple Data Sets ◽  
Primary Healthcare Providers

Importance: Lower-resource areas in Africa and Asia face a unique set of healthcare challenges: the dual high burden of communicable and non-communicable diseases; a paucity of highly trained primary healthcare providers in both rural and densely populated urban areas; and a lack of reliable, inexpensive internet connections. Objective: To address these challenges, we designed an artificial intelligence assistant to help primary healthcare providers in lower-resource areas document demographic and medical sign/symptom data and to record and share diagnostic data in real-time with a centralized database. Design: We trained our system using multiple data sets, including US-based electronic medical records (EMRs) and open-source medical literature and developed an adaptive, general medical assistant system based on machine learning algorithms. Main outcomes and Measure: The application collects basic information from patients and provides primary care providers with diagnoses and prescriptions suggestions. The application is unique from existing systems in that it covers a wide range of common diseases, signs, and medication typical in lower-resource countries; the application works with or without an active internet connection. Results: We have built and implemented an adaptive learning system that assists trained primary care professionals by means of an Android smartphone application, which interacts with a central database and collects real-time data. The application has been tested by dozens of primary care providers. Conclusions and Relevance: Our application would provide primary healthcare providers in lower-resource areas with a tool that enables faster and more accurate documentation of medical encounters. This application could be leveraged to automatically populate local or national EMR systems.

scholarly journals The effects of enhanced primary healthcare interventions on primary care providers’ job satisfaction

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wen Jun Wong ◽  
Aisyah Mohd Norzi ◽  
Swee Hung Ang ◽  
Chee Lee Chan ◽  
Faeiz Syezri Adzmin Jaafar ◽  
...  
Keyword(s):  
Primary Care ◽  
Job Satisfaction ◽  
Primary Healthcare ◽  
Primary Care Providers ◽  
Care Providers ◽  
Healthcare Interventions

Pearls and pitfalls for prescribing opioids in a climate of increased provider scrutiny

2017 ◽  
Vol 52 (2) ◽  
pp. 190-195
Author(s):  
Joanna Gedzior ◽  
Arlen Kwong
Keyword(s):  
Primary Care ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Opiate Addiction ◽  
Opioid Epidemic ◽  
Care Providers ◽  
Health Crisis ◽  
Surgeon General

In August 2016, U.S. Surgeon General Vivek Murthy, MD, MBA, issued a letter to healthcare providers requesting aid in addressing “an urgent health crisis facing America: the opioid epidemic.” In this article, we address some of the more poignant challenges that surface in treating patients with opiate addiction. We provide an outline of recommendations from the leading medical organizations to educate primary care providers on how to navigate patients to decreased or discontinued medication loads.

scholarly journals 323. Fragility Fracture Risk in HIV: Awareness Among Primary Care Providers

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S171-S171
Author(s):  
Anne Abbate ◽  
Lisa Chirch ◽  
Michael Christopher. Thompson ◽  
Dorothy Wakefield ◽  
Faryal Mirza ◽  
...  
Keyword(s):  
Primary Care ◽  
Logistic Regression ◽  
Fracture Risk ◽  
Fragility Fracture ◽  
Chart Review ◽  
Assessment Tool ◽  
Primary Care Providers ◽  
Care Providers ◽  
Post Intervention ◽  
Hiv Patients

Abstract Background Recommendations on screening HIV-infected (+) patients for bone disease exist. We sought to characterize awareness of and adherence to HIV-specific recommendations and assess risk factors for fracture in this population. Methods Primary care provider (PCP) and ID specialist awareness of screening recommendations was assessed using an anonymous electronic survey. We conducted interviews of 45 HIV+ patients and chart review. We calculated risk using the fracture risk assessment tool (FRAX). Email notifications were sent if an indication dual-energy x-ray absorptiometry (DXA) scans was identified. Chart review was repeated 12 months later to assess response. Statistical methods included chi-square and Fisher’s exact test for categorical data, and t-tests or Wilcoxon rank-sum tests for continuous data. A multivariate logistic regression examined the relationship between adult fragility fractures and covariates. Results No immunologic or virologic factors or exposure to specific antiretroviral therapies (ART) were associated with FFX (Table 1). FRAX score (hip, major osteoporotic fracture) successfully predicted FFX history (P = 0.002, P = 0.001, respectively). Overall, 35 (78%) patients qualified for DXA; 23 (66%) were men, only 8 (23%) had a previous DXA. Following provider notification, an additional 5 patients had DXA ordered. DXA was recommended for all patients with FFX, compared with 68% without a fracture (P = 0.02). In logistic regression modeling, increasing age, male sex, and months of ART therapy were associated with FFX (Table 2). Twenty-seven providers responded to the pre-intervention survey, of whom only 35% were aware of screening recommendations for HIV+ patients. Of the 18 providers who responded post-intervention, 63% were aware of these recommendations (Table 3). Conclusion A brief educational intervention resulted in increased awareness of HIV-specific screening recommendations, but this translated into adherence to a lesser extent. HIV+ men were more likely to have a history of fragility fracture compared with females. No specific ART or immunologic marker predicted fracture risk or history. Fostering a greater understanding of unique characteristics and risks in this population is crucial to ensure appropriate preventive care. Disclosures All authors: No reported disclosures.

scholarly journals What matters most to patients about primary healthcare: mixed-methods patient priority setting exercises within the PREFeR (PRioritiEs For Research) project

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025954 ◽  
Author(s):  
Louisa Edwards ◽  
Melody Monro ◽  
Yaron Butterfield ◽  
Ravin Johl ◽  
Kent Cadogan Loftsgard ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mixed Methods ◽  
Priority Setting ◽  
Primary Healthcare ◽  
Health Resources ◽  
Primary Care Providers ◽  
Care Providers ◽  
Online Surveys ◽  
Care Research

ObjectivesTo identify patient-generated priority topics for future primary care research in British Columbia (BC), Canada within a diverse patient population.DesignMixed-methods priority setting exercises framed by the dialogue model, using the nominal group technique (rank-ordered scoring) and province-wide online surveys capturing importance ratings of the top 10 primary healthcare topics from patients and primary care providers.SettingBC, Canada.ParticipantsTopic identification was completed by 10 patient partners (7 female, 3 male) from the BC Primary Health Care Research Network Patient Advisory; online surveys were completed by 464 patients and 173 primary care providers.ResultsThe 10 members recruited to the patient advisory provided over 80 experiences of what stood out for them in BC primary care, which were grouped thematically into 18 topics, 10 of which were retained in province-wide surveys. Top-rated survey topics for both patients (n=464) and providers (n=173) included being unable to find a regular family doctor/other primary healthcare provider, support for living with chronic conditions, mental health resources and information sharing, including electronic medical records. However, all 10 topics were rated important, on average, by both groups.ConclusionsThe current project activities demonstrate the feasibility of including patients in priority setting exercises for primary healthcare in general, rather than focusing on a condition-specific population or disease area. There was considerable overlap between patient-generated topics and topics previously identified by other stakeholders, but patients identified two additional topics (mental health resources, improve and strengthen patient–provider communication). More similarities than differences in topic importance between patients and providers emerged in the online surveys. The project activities that follow (rapid literature reviews, multistakeholder dialogue) will highlight under-researched topics and inform the development of specific research questions.

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