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 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 ◽  
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.

Telementoring for improving primary care provider knowledge and competence in managing chronic pain: A randomised controlled trial

2018 ◽  
Vol 26 (1-2) ◽  
pp. 21-27 ◽  
Author(s):  
Linda H Eaton ◽  
Daniel S Godfrey ◽  
Dale J Langford ◽  
Tessa Rue ◽  
David J Tauben ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Primary Care Providers ◽  
Perceived Competence ◽  
Control Group ◽  
Care Providers ◽  
Knowledge And Attitudes ◽  
Randomised Controlled

Introduction Primary care providers are frequently unprepared to manage chronic pain adequately due in part to insufficient professional training. This study evaluated the effect of a telementoring intervention on knowledge and perceived competence related to chronic pain management. Methods The study design was a cluster randomised controlled trial. Primary care clinics that were part of the University of Washington Medicine Telehealth network were the unit of randomization. Primary care providers comprised the intervention group ( n = 23) and the control group ( n = 18). Providers in the intervention group attended telementoring sessions through the TelePain programme and presented patient cases at the beginning and end of their enrolled patients’ 12-week study period. TelePain sessions included a didactic presentation and telementoring for specific patient cases by a panel of pain specialists from the disciplines of pain medicine, internal medicine, anaesthesiology, rehabilitation medicine, psychiatry, addiction medicine, nursing and complementary and integrative pain management. Providers’ baseline and end-of-study knowledge and perceived competence in managing chronic pain were assessed by three questionnaires: Knowledge and Attitudes Survey Regarding Pain, the KnowPain-12 and the Perceived Competence Scale. Results Knowledge (Z = –0.34, p = 0.97 (Knowledge and Attitudes Survey Regarding Pain) and Z = 0.49, p = 0.62 (KnowPain-12)) and perceived competence (Z = –0.74, p = 0.46) did not increase for providers in the intervention group compared with providers in the control group. These providers attended on average 12.5 sessions (range 0–31) while participating in the study. Discussion Further research is recommended to establish the effectiveness of this telementoring intervention.

scholarly journals Patient Discomfort and Resident Confidence After Knee Intra-articular Injection Simulation Training: A Randomized Control Trial Study

2018 ◽  
Vol 11 ◽  
pp. 117954411878290 ◽  
Author(s):  
Adae O Amoako ◽  
George GA Pujalte ◽  
Neha Kaushik ◽  
Timothy Riley
Keyword(s):  
Primary Care ◽  
Simulation Training ◽  
Intervention Group ◽  
Primary Care Providers ◽  
Comfort Level ◽  
Control Group ◽  
P Value ◽  
Care Providers ◽  
Patient Discomfort ◽  
The Mean

Teaching primary care providers how to perform musculoskeletal procedures has become increasingly important as more and more patients with orthopedic conditions present in primary care clinics. This study aims to evaluate whether targeted simulation model training in residency can increase residents’ comfort level in performing intra-articular knee injections and decrease the pain of the procedure, as reported by patients injected. Residents were randomized into intervention and control groups. The comfort level of the residents as well as the pain levels from the procedures, as reported by patients, was recorded. The mean comfort level for the intervention group was 1.2, compared with that in the control group, which was 2.13; P value was .047. The mean pain level in the intervention group was 1.8, whereas in the control group was 3.63; P value was .156. Simulation training may boost residents’ comfort level, but not necessarily decrease patient discomfort during intra-articular knee injections.

Results of a randomized controlled study of personalized care plans in breast cancer survivors from a single institution.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 109-109 ◽  
Author(s):  
Rashida Haq ◽  
Christine Brezden-Masley ◽  
Ronita Lee ◽  
Suzanne Richter ◽  
Ralph L. George ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Qualitative Analysis ◽  
Cancer Survivors ◽  
Intervention Group ◽  
Primary Care Providers ◽  
Controlled Study ◽  
Control Group ◽  
Care Providers ◽  
Post Intervention ◽  
Care Plans

109 Background: In 2006, Institute of Medicine recommended care plans for coordination of care of cancer survivors. Our pilot study of multifaceted care plans met information and communication needs of breast cancer (BC) survivors and their primary care providers (PCP). In this study, a Personalized Multifaceted Care Plan (PMCP) was developed, implemented and evaluated. Methods: This was a randomized study with mixed methods design. Upon REB approval, 78 women diagnosed with invasive BC for adjuvant treatments were recruited from the breast clinic from June 2013 to March 2015. After informed consent, participants were randomized to the control or the intervention group and stratified to chemotherapy (CT) vs. endocrine therapy (ET). The intervention group received a PMCP (paper based treatment and care plans (TP & CP) with information on breast pathology, treatment sequence, supportive care and follow-up guidelines with access to a website). CT arm patients received a TP at the start of therapy and a CP at completion. ET patients received the CP upfront. Quantitative outcomes were assessed by 3 standardized questionnaires at baseline and following treatment. Within-group baseline and post-intervention scores were compared using paired t-tests. The post-intervention control group and intervention group’s scores were compared using unpaired t-tests. In the intervention group, qualitative analysis was done through focus groups of BC survivors & PCP interviews. Results: Baseline scores in the mean intervention and control groups were similar. In the CT arm of the intervention group, post-intervention scores on Communication and Efficacy Scale showed statistically significant increase (p < 0.05, 95% CI). Results in the control group and in the intervention group of patients on ET were not significantly different. Focus group participants commented that the PMCP helped them feel ‘educated’ and engaged in their cancer treatment and their PCPs found the PMCP contained useful, concise medical summaries. Conclusions: Upfront PMCP improves self-efficacy scores in patients on CT. Qualitative analysis substantiates the benefits of PMCP. PMCP should be standard of care in BC survivors receiving CT.

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

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 Asylum Seekers and Swiss Nationals with Low-Acuity Complaints: Disparities in the Perceived level of Urgency, Health Literacy and Ability to Communicate—A Cross-Sectional Survey at a Tertiary Emergency Department

2020 ◽  
Vol 17 (8) ◽  
pp. 2769 ◽  
Author(s):  
Karsten Klingberg ◽  
Adrian Stoller ◽  
Martin Müller ◽  
Sabrina Jegerlehner ◽  
Adam D. Brown ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Literacy ◽  
Primary Care Providers ◽  
Control Group ◽  
Care Providers ◽  
Health Seeking ◽  
Health Seeking Behavior ◽  
Medical Needs ◽  
Seeking Behavior ◽  
Attending Physicians

Background: Emergency departments (EDs) are being increasingly used for low-acuity conditions and as primary care providers. Research indicates that patients with the status of asylum seeker (AS) may be seeking care in EDs at higher levels than nationals. The aim of this study was to identify disparities in the use of emergency care between AS and Swiss nationals (SN) with non-urgent complaints. Methods: Data were obtained from a survey in the period 01/12/2016–31/07/2017 of walk-in low-acuity patients attending the ED of the University Hospital Bern (Switzerland). AS and a gender, age-matched control group of SN of ≥16 years of age were included. Sociodemographic and survey data comprised information about health-seeking behavior in the home and reception country, knowledge of health care systems (HCSs), barriers to care and perceived acuity of the visit. Furthermore, attending physicians assessed the level of urgency of each case. Results: Among AS patients, 30.2% reported that they had no knowledge of the Swiss HCS. In total, 14.2% considered that their medical needs were non-urgent. On the other hand, 43.4% of the attending physicians in the ER considered that the medical needs were non-urgent. This contrast was less pronounced in SN patients. The majority of AS (63.2%) and SN (67.6%) patients sought care from the ED without first contacting a GP. In 53.8% of cases, an interpreter was needed during the ED consultation. Conclusions: Several factors associated with health-seeking behavior in the ED differed between AS and SN patients. Measures to increase health literacy, provision of easily accessible primary care services and intercultural-trained staff could improve quality of care and reduce the usage of EDs as primary care providers.

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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