scholarly journals PATIENT PARTICIPATION IN SERVICE IMPROVEMENT OF PRIMARY CARE SERVICES

RAHIS ◽  
2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Mayara Ramos ◽  
Marcelo Gitirana Gomes Ferreira ◽  
Fernando Antônio Forcellini
Keyword(s):  
Primary Care ◽  
Community Participation ◽  
Community Involvement ◽  
Planning Process ◽  
Healthcare Services ◽  
Public Healthcare ◽  
Service Improvement ◽  
Structured Interviews ◽  
Care Services ◽  
Annual Planning

Healthcare services from western economies use patient and public participation to promote quality improvement. In Brazil, community participation is a guideline for the public healthcare system. However, community participation is little developed and few efforts are made to improve it. Through a case study, we described and analyze the service improvement process used in SUS primary care units of Florianopolis and the community involvement in this process. Semi-structured interviews with healthcare professionals, and community representatives were conducted. Results show that improvements are made in local improvements or in an annual planning process, and the community participation in them is low. The annual planning process have deficiencies in its methodology and conduction. The adoption of co-creative methods can improve community participation on SUS and strengthen its participation policy. These methods can also help better structure improvement processes.

scholarly journals ICT Framework to Support a Patient-Centric approach in Public Healthcare

2020 ◽  
Vol 16 ◽  
pp. 45-76
Author(s):  
Richard Pankomera ◽  
Darelle Van Greunen
Keyword(s):  
Public Health ◽  
Information And Communication Technologies ◽  
Health Sector ◽  
Cost Effective ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Poor Countries ◽  
Patient Centric

Although Information and Communication Technologies (ICTs) in the healthcare sector are extensively deployed globally, they are not used effectively in developing countries. Many resource poor countries face numerous challenges in implementing the ICT interventions. For instance, many health applications that have been deployed are not user-centric. As a result, such ICT interventions do not benefit many health consumers. The lack of an ICT framework to support patient-centric healthcare services in Malawi renders the e-health and mhealth interventions less sustainable and less cost effective. The aim of the study was therefore to develop an ICT Framework that could support patient-centric healthcare services in the public health sector in Malawi. The comprehensive literature review and semi-structured interviews highlighted many challenges underlying ICT development in Malawi. An ICT framework for patient-centric healthcare services is therefore proposed to ensure that eHealth and mobile health interventions are more sustainable and cost effective. The framework was validated by five experts selected from different areas of expertise including mhealth application developers, ICT policy makers and public health practitioners. Results show that the framework is relevant, useful and applicable within the setting of Malawi. The framework can also be implemented in various countries with similar settings.

scholarly journals Atrial fibrillation screening: feasible approaches and implementation challenges across Europe

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
D Engler ◽  
C Hanson ◽  
L Desteghe ◽  
G Boriani ◽  
S Z Diederichsen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Healthcare Services ◽  
Sufficient Evidence ◽  
Opportunistic Screening ◽  
Structured Interviews ◽  
Implementation Challenges ◽  
Access To Primary Care ◽  
Public Grant ◽  
Personal Devices

Abstract Background Atrial fibrillation (AF) screening has the potential to increase early detection and possibly reduce complications of AF. Guidelines recommend screening, but the most appropriate approaches are unknown. Purpose We aimed to explore the views of stakeholders across Europe about the opportunities and challenges of implementing four different AF screening scenarios. Method This qualitative study included 21 semi-structured interviews with healthcare professionals and regulators potentially involved in AF screening implementation in nine European countries. Data were analysed using thematic analysis. Results Three themes evolved. 1) Current approaches to screening: there are no national AF screening programmes, with most AF detected in symptomatic patients. Patient-led screening exists via personal devices, creating screening inequity by the reach of screening programmes being limited to those who access healthcare services. 2) Feasibility of screening approaches: single time point opportunistic screening in primary care using single lead ECG devices was considered the most feasible approach and AF screening may be possible in previously unexplored settings such as dentists and podiatrists. Software algorithms may aid identification of patients suitable for screening and telehealth services have the potential to support diagnosis. However, there is a need for advocacy to encourage the use of telehealth to aid AF diagnosis, and training for screening familiarisation and troubleshooting. 3) Implementation requirements: sufficient evidence of benefit is required. National rather than pan-European screening processes must be developed due to different payment mechanisms and health service regulations. There is concern that the rapid spread of wearable devices for heart rate monitoring may increase workload due to false positives in low risk populations for AF. Data security and inclusivity for those without access to primary care or personal devices must be addressed. Conclusions There is an overall awareness of AF screening. Opportunistic screening appears to be most feasible across Europe. Challenges that need to be addressed concern health inequalities, identification of best target groups for screening, streamlined processes, the need for evidence of benefit, and a tailored approach adapted to national realities. Funding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): H2020 Screening Scenarios  Graphical abstract

scholarly journals Perception of Childbirth Experiences of Japanese Women in Bali, Indonesia: A Qualitative Study

2020 ◽  
Author(s):  
Kazuko Tanaka ◽  
Ni Made Dian Kurniasari ◽  
Desak Nyoman Widyanthini ◽  
Ni Luh Putu Suariyani ◽  
Rina Listyowati ◽  
...  
Keyword(s):  
Postnatal Care ◽  
Qualitative Content Analysis ◽  
Perinatal Care ◽  
Healthcare Services ◽  
Japanese Women ◽  
Structured Interviews ◽  
Related Information ◽  
Care Services ◽  
Japanese Residents ◽  
Childbirth Experiences

Abstract Background:Maternal healthcare services in Indonesia have seen dramatic improvements over the past 25 years and yet there is still room for improvement. The perception,by the women,of the perinatalcare provided,is a vital input to further improving theseservices. This study examineshow the perinatal care provided is experienced by Japanese women in Bali, using an interview survey.Methods:We conducted semi-structured interviews, from August to October 2017, with 14 Japanese women living in Badung Regency and Denpasar City in Bali Province, Indonesia to reporttheir perception of the perinatal care they experienced during their pregnancies. The interview guide included among others, the reasons for choosing specific (perinatal care) health facilities and their satisfaction with their experience of using the antenatal, delivery, and postnatal care services. The data were analysed using the qualitative content analysis method.Results:From the interview data, 12 categories across five themes were extracted. Participants reported experiencing various concerns during their pregnancies such as difficulty in obtaining perinatal care related information. Participants,from the beginning of their pregnancies gradually establishedtrusting relationships with midwives, but in many situations, they were disappointed with their childbirth experiences, as they felt that the care provided was not woman-centred.Through their own efforts and with the support of family members and other Japanese residents, many women were able to eventually consider their childbirth experiences as positive. Nonetheless, some women could not overcome their negative impressions even years after childbirth.Conclusions:Participants desired close attention and encouragement from nurses and midwives. Our results suggest that Japanese women in Bali expected a woman-centred perinatal care and active support from nursing/midwifery staff during their pregnancies and postnatal care.

scholarly journals How do older adults understand and manage distress? A qualitative study

2019 ◽  
Author(s):  
Alice Moult ◽  
Tom Kingstone ◽  
Carolyn Chew-Graham
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Older People ◽  
Help Seeking ◽  
Management Strategies ◽  
Healthcare Services ◽  
Ethical Review ◽  
Structured Interviews ◽  
Management Options ◽  
Community Groups

Abstract Background Anxiety and depression are prevalent in older adults, however, older people may be reluctant to seek medical help and may manage their own mood problems. Due to stigma, older adults are more likely to perceive and/ or recognise their mood problems as distress. Whilst previous literature has focused on how younger adults self-manage mood problems, little research has explored how older people self-manage distress. The study reported here seeks to address this gap through qualitative methods. Methods This study was approved by Keele University’s ethical review panel. Older adults who self-identified as distressed, depressed or anxious within the previous 12 months were recruited from community groups in North Staffordshire, England. Data were generated through semi-structured interviews and analysed thematically using constant comparison methods. A public and patient involvement and engagement group contributed to development of the research questions and methods, and offered their perspectives on the findings. Results Data saturation was achieved after 18 interviews. Key themes were: experiences of distress, actions taken, help-seeking from healthcare services and perceptions of treatments offered in primary care. Various forms of loss contributed to participants’ distress. Participants initiated their own self-management strategies which included: pursuing independent activities, seeking social support and attending community groups and church. Five participants reported having consulted a GP when distressed but described a lack of acceptable treatments offered. Conclusions To support older adults who are distressed, primary care healthcare professionals need to explore patients’ existing ways of managing mood problems, provide information about a range of management options and consider the use of sign-posting older adults to community resources.

scholarly journals The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California and Texas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Angelo Ercia
Keyword(s):  
Access To Care ◽  
Affordable Care Act ◽  
Health Care Services ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Care Services ◽  
Healthcare Needs ◽  
The Affordable Care Act ◽  
Insured Patients ◽  
The Impact

Abstract Background The Affordable Care Act (ACA) enabled millions of people to gain coverage that was expected to improve access to healthcare services. However, it is unclear the extent of the policy’s impact on Federally Qualified Health Centers (FQHC) and the patients they served. This study sought to understand FQHC administrators’ views on the ACA’s impact on their patient population and organization. It specifically explores FQHC administrators’ perspective on 1) patients’ experience with gaining coverage 2) their ability to meet patients’ healthcare needs. Methods Twenty-two semi-structured interviews were conducted with administrators from FQHCs in urban counties in 2 Medicaid-expanded states (Arizona and California) and 1 non-expanded state (Texas). An inductive thematic analysis approach was used to analyze the interview data. Results All FQHC administrators reported uninsured patients were more likely to gain coverage from Medicaid than from private health insurance. Insured patients generally experienced an improvement in accessing healthcare services but depended on their plan’s covered services, FQHCs’ capacity to meet demand, and specialist providers’ willingness to accept their coverage type. Conclusion Gaining coverage helped improved newly insured patients’ access to care, but limitations remained. Additional policies are required to better address the gaps in the depth of covered services in Medicaid and the most affordable PHI plans and capacity of providers to meet demand to ensure beneficiaries can fully access the health care services they need.

Improving access to primary care services for those on low income: voluntary advocacy

2020 ◽  
Vol 25 (4) ◽  
pp. 162-166
Author(s):  
Thomas George ◽  
Helen Aveyard
Keyword(s):  
Primary Care ◽  
Social Isolation ◽  
Low Income ◽  
Service Users ◽  
Structured Interviews ◽  
Instrumental Case Study ◽  
Care Services ◽  
Primary Care Services ◽  
Access To Primary Care ◽  
And Control

Nurses in primary care are often the first point of access for those seeking health care, and it is well known that accessing health services can be difficult for some, especially those on a low income. A charity initiative has been developed in a low-income area in England to help such individuals, wherein volunteers help local residents to access local services and support. This study explores the experiences of service users in order to understand their perceptions and feelings about the service, using an instrumental case study method with semi-structured interviews. Qualitative data were collected from six service users and transcribed by the researcher for subsequent thematic analysis. The participants' experiences were characterised by reduced social isolation, reduced emotional distress, improved mobility and transport options, improved confidence and control over life, and effective management of memory issues. Various aspects of advocacy and empowerment were also observed. Further, the coping strategies used by the participants while facing the challenges of social isolation and ageing were highlighted. The findings provide important insight into the support needs of populations on low income, the ways in which they access healthcare and how the volunteer service can best support them.

Community participation framework for post-disaster resettlement and its practical application in Pakistan

2018 ◽  
Vol 27 (5) ◽  
pp. 604-622 ◽  
Author(s):  
Ali Jamshed ◽  
Irfan Ahmad Rana ◽  
Masood Ali Khan ◽  
Nikhil Agarwal ◽  
Ahsan Ali ◽  
...  
Keyword(s):  
Community Participation ◽  
Community Involvement ◽  
Planning Process ◽  
Provincial Government ◽  
Primary Data ◽  
Group Discussions ◽  
Content Type ◽  
Effective Community ◽  
Local Ngo ◽  
Post Disaster

Purpose The purpose of this paper is to propose a practical framework for community participation in post-disaster resettlement. Design/methodology/approach The proposed framework has been tested in two model villages (MVs) of Punjab, Pakistan. Primary data were collected through household surveys, focus group discussions and expert interviews. A survey with 67 households was conducted for obtaining qualitative data regarding community participation in post-disaster resettlement. Findings The first MV (Ittehad MV) was resettled by the local NGO, and the second (Basti Meera Mullan) by the provincial government. Results indicate that community participation significantly varied in selected MVs. NGOs have achieved positive realizations due to effective community involvement in resettlement efforts, whereas the governmental approach lacked in proactive community participation. Practical implications This framework can be used for other disasters, by refining and incorporating disaster relevant components. This research will be highly useful for disaster managers, private developers and NGOs engaged in resettling disaster-affected population. Social implications The proposed framework can help disaster-affected communities to resettle according to their terms. This can only be attained if affected communities will proactively participate in resettlement planning process. Originality/value This original framework is exclusively designed to attain sustainability for post-disaster settlement through community participation.

Telephone consultation in primary care

2018 ◽  
Vol 32 (2) ◽  
pp. 321-337 ◽  
Author(s):  
Francisco Gonzalez ◽  
Blanca Cimadevila ◽  
Julio Garcia-Comesaña ◽  
Susana Cerqueiro ◽  
Eladio Andion ◽  
...  
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Public Healthcare ◽  
Telephone Consultation ◽  
Content Type ◽  
Face To Face ◽  
Care Services ◽  
Primary Care Services ◽  
Gender And Age ◽  
Telephone Calls

Purpose The purpose of this paper is to describe and analyze a teleconsultation modality based on a simple telephone call, using either landline or mobile phone, made available to more than two million people. Telecommunication systems are an increasingly common feature in modern healthcare. However, making teleconsultations available to the entire population covered by a public health system is a challenging goal. Design/methodology/approach This retrospective longitudinal observational study analyzed how this modality was used at the primary care level in Galicia, a region in the Northwest of Spain, in 2014 and 2015, focusing on demand, gender and age preferences, rural vs urban population and efficiency. Findings Of 28,472,852 consultations requested in this period, 9.0 percent were telephone consultations. Women requested more telephone consultations (9.9 percent of total consultations) than men (7.7 percent of total consultations). The highest demand occurred for the over 85 age group for both men and women. In both years, 2014 and 2015, the number of telephone consultations per inhabitant was higher in urban (0.53 and 0.69) than in rural areas (0.34 and 0.47). In 10.9 percent of cases, the telephone consultations required further face-to-face consultation. Originality/value Conventional voice telephone calls can efficiently replace conventional face-to-face consultations in primary healthcare in roughly 10 percent of cases. Women are more likely than men to use primary care services in both face-to-face and telephone consultation modalities. Public healthcare systems should consider implementing telephone consultations to deliver their services.

scholarly journals ‘The world is not only for hearing people – It’s for all people’: The experiences of women who are deaf or hard of hearing in accessing healthcare services in Johannesburg, South Africa

2021 ◽  
Vol 10 ◽  
Author(s):  
Khetsiwe P. Masuku ◽  
Nomfundo Moroe ◽  
Danielle Van der Merwe
Keyword(s):  
South Africa ◽  
Hard Of Hearing ◽  
Healthcare Professionals ◽  
Healthcare Services ◽  
Communication Barriers ◽  
African Women ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Healthcare Facilities ◽  
Experiences Of Women

Background: Despite legal and adopted frameworks purporting access to healthcare and rehabilitation services, which are both a human right and key to developmental issues, women who are deaf and/or hard of hearing (HoH) are still excluded and experience barriers when accessing healthcare services. Largely, this is attributed to communication barriers between healthcare professionals and women who are deaf and/or HoH. There have been limited research studies carried out on women with invisible disabilities, such as deafness, especially amongst African women.Objectives: This study sought to gain insights into the communication experiences of women who are deaf or HoH when accessing public healthcare services in hospitals in Johannesburg.Methods: A qualitative research study employing semi-structured interviews with 10 African women who are deaf and/or HoH residing in Johannesburg, South Africa and attending government healthcare facilities was conducted. Participants were purposively selected. Data were analysed using thematic analysis.Results: Data revealed the following themes: communication barriers resulting in compromised quality of care and infringement on participants’ right to confidentiality; accommodation that is not accommodative and negative attitudes of healthcare professionals.Conclusion: The findings of this study confirm the alienating, exclusion, marginalisation, discrimination, invisibility, lack of independence and autonomy of women who are deaf and/or HoH when accessing healthcare services. Therefore, this study argues for a need for the conscientisation of healthcare professionals on communication needs of persons who are deaf and/or HoH. This has implications for the implementation of training programmes that will address communication, reasonable accommodation and attitudes of healthcare professionals.

scholarly journals Strategies For Strengthening High Risk Pregnancy Care In Primary Healthcare Services

2019 ◽  
Author(s):  
Nathan Aratani ◽  
Oswaldo Yoshimi Tanaka
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
High Risk Pregnancy ◽  
Pregnancy Care ◽  
Basic Health ◽  
Care Services ◽  
Primary Care Services ◽  
Risk Pregnancy

Abstract Background: In the Brazilian Public healthcare system (The Unified Healthcare System - Sistema Único de Saúde), Primary Healthcare has expanded from implementing healthcare networks, an organization form of services with centrality to primary care services. Due to the extension and heterogeneity of Brazilian municipalities, several organization forms of primary care services existed. In the city of São Paulo they were organized by three modalities of Basic Health Units. Thus, this study aimed to evaluate the care continuity in high-risk pregnancy care in different models of the basic health units. Methods:Data analysis defined performing prenatal care in primary care even after referral to the high-risk pregnancy service as the dependent variable. The independent variables were the sociodemographic and organizational aspects of health services. Logistic regression was used as the statistical technique. Results:Care is provided in a similar way in all basic health unit models, without prioritizing pregnant women with greater vulnerabilities (under 15 years and over 35 years, with education less than 7 years). Regarding women of black or brown color, it was observed that they were more likely (OR 1.997) to have care continuity in family health units. Home visiting and knowing the community health agent proved to be tools for organizing health services which are capable of producing better care. Conclusion: Primary healthcare services in Brazil for high-risk pregnancy care are organized without considering individual vulnerabilities. The home visits and the presence of the community health agent need to be strengthened in organizing the services, as they are able to modify the process of producing healthcare.

Sign in / Sign up

Export Citation Format

Share Document