scholarly journals The Methodological Development of an Interprofessional Educational Program to Provide Proactive Integrated Care for Elders

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Linda Smit ◽  
Jeroen Dikken ◽  
Inge Pool ◽  
Marjolein Van Wijk ◽  
Marieke Schuurmans ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Professionals ◽  
Interprofessional Collaboration ◽  
Role Identity ◽  
Shared Vision ◽  
Methodological Development ◽  
Structured Interviews ◽  
Time Investment ◽  
Implementation Context

Background: Interprofessional collaboration in practice (IPCP) between professionals from the medical and social domain within primary care is desirable; however, it is also challenging due to fragmented healthcare. Little is known about the development of IPCP in primary care to fit the implementation context. This article describes the methodological development and the final content of an IPCP program.Methods and findings: The development process started with the identification of IPCP competencies in a literature review and a qualitative needs analysis with semi-structured interviews among eight elders and four health care professionals. The results were discussed during a first consultation with an expert team, which consisted of ten health care professionals. Consensus was reached on the themes role identity, communication, and shared vision development to form the basis of the program. A second consultation with the experts discussed the first version of the program. Then, consensus was reached on the final version of the program, which included a blended learning approach consisting of two face-to-face meetings, online learning, and on-the-job learning with a sixteen-hour time investment over a six-week period.Conclusions: The IPCP program was developed based on educational strategies and evidence, and with the support and knowledge of practice experts to fit the implementation context. 

Multidisciplinary collaboration in primary care: through the eyes of patients

2013 ◽  
Vol 19 (3) ◽  
pp. 190 ◽  
Author(s):  
Lynn H. Cheong ◽  
Carol L. Armour ◽  
Sinthia Z. Bosnic-Anticevich
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Chronic Illness ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Primary Health Care System ◽  
Structured Interviews ◽  
Multidisciplinary Collaboration ◽  
Primary Health

Managing chronic illness is highly complex and the pathways to access health care for the patient are unpredictable and often unknown. While multidisciplinary care (MDC) arrangements are promoted in the Australian primary health care system, there is a paucity of research on multidisciplinary collaboration from patients’ perspectives. This exploratory study is the first to gain an understanding of the experiences, perceptions, attitudes and potential role of people with chronic illness (asthma) on the delivery of MDC in the Australian primary health care setting. In-depth semi-structured interviews were conducted with asthma patients from Sydney, Australia. Qualitative analysis of data indicates that patients are significant players in MDC and their perceptions of their chronic condition, perceived roles of health care professionals, and expectations of health care delivery, influence their participation and attitudes towards multidisciplinary services. Our research shows the challenges presented by patients in the delivery and establishment of multidisciplinary health care teams, and highlights the need to consider patients’ perspectives in the development of MDC models in primary care.

scholarly journals To Do or Not to Do… Primary Health Care Professionals Experiences With Mothers With Children Born of Sexual Violence

2021 ◽  
Vol 12 ◽  
Author(s):  
Eline Meuleman ◽  
Elisa van Ee
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Sexual Violence ◽  
Health Care Professionals ◽  
Youth Services ◽  
Structured Interviews ◽  
Knowledge And Skills ◽  
Clinical Nurse Specialists ◽  
Adequate Care ◽  
Challenges And Opportunities

Mothers and their children born of sexual violence are at heightened risk for developing an insecure attachment relationship. These mothers and their children often enter care late or not at all, as they are not identified by health care professionals. In this qualitative study, semi structured interviews were conducted with sixteen professionals in primary care for pregnant women and/or young mothers with the aim to identify the status quo in knowledge and skills, challenges, and opportunities. Participants included among others professionals working at Youth Services, psychologists, and clinical nurse specialists. Through a thematic analysis, five themes were identified: the knowledge of the professional, discussing the sexual violence, suitable interventions, points of attention during care, and recommendations. Analysis revealed that three groups of professionals can be distinguished, based on their level of awareness of this target group and their available knowledge and skills. To improve primary care for mothers with children born of sexual violence an increase in awareness, knowledge, and skills is a necessary prerequisite. Scientifically based best practices are therefore necessary for health care professionals to provide adequate care for mothers with children born of sexual violence.

scholarly journals Implementation of the e-SUS Primary Care system: Impact on the routine of Primary Health Care professionals

2021 ◽  
Vol 29 ◽  
Author(s):  
Tatiele Estefâni Schönholzer ◽  
Ione Carvalho Pinto ◽  
Fabiana Costa Machado Zacharias ◽  
Rodrigo André Cuevas Gaete ◽  
Maria Del Pilar Serrano-Gallardo
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Daily Life ◽  
Primary Care System ◽  
Structured Interviews ◽  
Learning Mechanisms ◽  
Primary Health ◽  
Care System

Objective: to understand how the implementation of the e-SUS Primary Care system has been processed and its impact on the daily life of the health teams. Method: a qualitative research study, conducted in a municipality in the inland of the state of São Paulo with professionals who work in Primary Health Care and use the e-SUS Primary Care system as a work tool. Semi-structured interviews and thematic data analysis were used with Kotter’s three-phase approach. Results: a total of 17 professionals, nurses, physicians, dentists and community agents were interviewed. The implementation of e-SUS Primary Care and its impact on the daily life of health teams were understood in terms of mandatory implementation; weaknesses for implementation, such as absence of material resources and implicit imposition for the use of the system; fragile training for deployment and learning from experience. Conclusion: a harmful incentive process was observed, conducted from the perspective of institutional pressure, use of the system to justify the work performed and, on the other hand, there was the creation of collaborative learning mechanisms between the teams.

scholarly journals Women, Exercise, and Eating Disorder Recovery: The Normal and the Pathological

2021 ◽  
pp. 104973232199204
Author(s):  
Hester Hockin-Boyers ◽  
Megan Warin
Keyword(s):  
Health Care ◽  
Eating Disorder ◽  
Affect Regulation ◽  
Health Care Professionals ◽  
Value Systems ◽  
Structured Interviews ◽  
Data Set ◽  
The United Kingdom ◽  
Theoretical Frame ◽  
Intensity Of Exercise

The appropriate form, regularity, and intensity of exercise for individuals recovering from eating disorders is not agreed upon among health care professionals or researchers. When exercise is permitted, it is that which is mindful, embodied, and non-competitive that is considered normative. Using Canguilhem’s concepts of “the normal and the pathological” as a theoretical frame, we examine the gendered assumptions that shape medical understandings of “healthy” and “dysfunctional” exercise in the context of recovery. The data set for this article comes from longitudinal semi-structured interviews with 19 women in the United Kingdom who engaged in weightlifting during their eating disorder recovery. We argue that women in recovery navigate multiple and conflicting value systems regarding exercise. Faced with aspects of exercise that are pathologized within the eating disorder literature (such as structure/routine, body transformations, and affect regulation), women re-inscribe positive value to these experiences, thus establishing exercise practices that serve them.

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

scholarly journals Nurses and Pharmaceutical Care: Interprofessional, Evidence-Based Working to Improve Patient Care and Outcomes

2021 ◽  
Vol 18 (11) ◽  
pp. 5973
Author(s):  
Tinne Dilles ◽  
Jana Heczkova ◽  
Styliani Tziaferi ◽  
Ann Karin Helgesen ◽  
Vigdis Abrahamsen Grøndahl ◽  
...  
Keyword(s):  
Health Care ◽  
Pharmaceutical Care ◽  
Health Care Professionals ◽  
Interprofessional Collaboration ◽  
Improve Patient Care ◽  
Modern Medicine ◽  
Care Quality ◽  
Practice Research ◽  
Evidence Based ◽  
Research Education

Pharmaceutical care necessitates significant efforts from patients, informal caregivers, the interprofessional team of health care professionals and health care system administrators. Collaboration, mutual respect and agreement amongst all stakeholders regarding responsibilities throughout the complex process of pharmaceutical care is needed before patients can take full advantage of modern medicine. Based on the literature and policy documents, in this position paper, we reflect on opportunities for integrated evidence-based pharmaceutical care to improve care quality and patient outcomes from a nursing perspective. Despite the consensus that interprofessional collaboration is essential, in clinical practice, research, education and policy-making challenges are often not addressed interprofessionally. This paper concludes with specific advises to move towards the implementation of more interprofessional, evidence-based pharmaceutical care.

Genetic Competencies Essential for Health Care Professionals in Primary Care

2005 ◽  
Vol 50 (3) ◽  
pp. 177-183 ◽  
Author(s):  
Janet L. Engstrom ◽  
Marlene G. S. Sefton ◽  
Jolie Kim Matheson ◽  
Kristine M. Healy
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Professionals

Advanced Care Planning for Persons With Dementia in Primary Care: Attitudes and Barriers Among Health-Care Professionals

2018 ◽  
Vol 34 (4) ◽  
pp. 248-254 ◽  
Author(s):  
Linda Lee ◽  
Loretta M. Hillier ◽  
Jason Locklin ◽  
Jennifer Lee ◽  
Karen Slonim
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Family Practice ◽  
Health Care Professionals ◽  
Comfort Level ◽  
Care Planning ◽  
Memory Clinic ◽  
Point Scale ◽  
Collaborative Memory ◽  
Regular Family

Background: Advance care planning (ACP) provides clarity on goals and preferences for future health-care decisions, the timeliness of which is critical for persons with dementia. Aim: This study assessed Primary Care Collaborative Memory Clinic (PCCMC) health-care practitioners’ desire for more education on ACP, capacity for and attitudes toward ACP, and current ACP practices in their regular family practice and in their PCCMC. Methods: Primary Care Collaborative Memory Clinic health-care professionals completed a questionnaire in which they rated their interest in learning various ACP-related topics (5-point scale: not at all to very much so), attitudes toward ACP, and the importance of and perceived degree of responsibility for ACP (5-point scale: not at all to extremely). Respondents estimated ACP completion in regular family practice and PCCMC. Results: Two hundred and sixty one surveys were completed. Mean knowledge ratings were moderate (M = 3.0) and mean ratings of interest in ACP topics were all high (median ≥ 4). Despite the perception that ACP is very important (M = 4.9) and the responsibility of PCCMCs (M = 3.7), the majority of respondents estimated that 40% or fewer patients have had ACP. Ratings of willingness to conduct ACP (M = 3.7) and comfort level (M = 3.4) were moderate but significantly exceeded ratings of ability (M = 2.9), comfort (M = 3.5), and confidence (M = 2.8). Conclusion: There was a striking disconnect between perceptions of the importance of completing ACP for persons with dementia and actual ACP completion rates. Primary Care Collaborative Memory Clinics may be in an ideal position to support ACP discussions; however, there is a need to improve health-care professionals’ knowledge and attitudes toward ACP.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

scholarly journals Issues Associated With the Management and Governance of Sensor Data and Information to Assist Aging in Place: Focus Group Study With Health Care Professionals (Preprint)

2020 ◽  
Author(s):  
Inga Hunter ◽  
Phoebe Elers ◽  
Caroline Lockhart ◽  
Hans Guesgen ◽  
Amardeep Singh ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Needs ◽  
Sensor Data ◽  
Care Providers ◽  
Community Based ◽  
Age In Place

BACKGROUND Smart home and telemonitoring technologies have often been suggested to assist health care workers in supporting older people to age in place. However, there is limited research examining diverse information needs of different groups of health care workers and their access to appropriate information technologies. OBJECTIVE The aim of this study was to investigate the issues associated with using technologies that connect older people to their health care providers to support aging in place and enhance older people’s health and well-being. METHODS Seven focus group discussions were conducted comprising 44 health care professionals who provided clinic-based or in-home services to community-dwelling older people. Participants were asked about their information needs and how technology could help them support older people to age in place. The recordings of the sessions were transcribed and thematically analyzed. RESULTS The perspectives varied between the respondents who worked in primary care clinics and those who worked in community-based services. Three overarching themes were identified. The first theme was “access to technology and systems,” which examined the different levels of technology in use and the problems that various groups of health care professionals had in accessing information about their patients. Primary care professionals had access to good internal information systems but they experienced poor integration with other health care providers. The community-based teams had poor access to technology. The second theme was “collecting and sharing of information,” which focused on how technology might be used to provide them with more information about their patients. Primary care teams were interested in telemonitoring for specific clinical indicators but they wanted the information to be preprocessed. Community-based teams were more concerned about gaining information on the patients’ social environment. The third theme was that all respondents identified similar “barriers to uptake”: cost and funding issues, usability of systems by older people, and information security and privacy concerns. CONCLUSIONS The participants perceived the potential benefits of technologies, but they were concerned that the information they received should be preprocessed and integrated with current information systems and tailored to the older people’s unique and changing situations. Several management and governance issues were identified, which needed to be resolved to enable the widespread integration of these technologies into the health care system. The disconnected nature of the current information architecture means that there is no clear way for sensor data from telemonitoring and smart home devices to be integrated with other patient information. Furthermore, cost, privacy, security, and usability barriers also need to be resolved. This study highlights the importance and the complexity of management and governance of systems to collect and disseminate such information. Further research into the requirements of all stakeholder groups and how the information can be processed and disseminated is required.

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