scholarly journals Remaking Practices in the Redesign of a Primary Healthcare Program

2017 ◽  
Vol 12 (1) ◽  
pp. 36-41
Author(s):  
John Rule ◽  
Roger Dunston ◽  
Nicky Solomon
Keyword(s):  
General Practice ◽  
Professional Learning ◽  
Primary Healthcare ◽  
Data Gathering ◽  
Practice Change ◽  
Design Data ◽  
Community Healthcare ◽  
New Ways Of Working ◽  
Healthcare Program ◽  
Liaison Nurse

Objective: To develop a detailed account of changed practices in everyday work in the redesign of a primary healthcare program. Design: The research aimed to produce layered and rich descriptions of the complex and multidimensional remaking of health practices. Empirical data was gathered through ethnographic methods including; interviewing, self-reporting, observation and shadowing. The subjects of the research were involved as active participants in the research design, data gathering and analysis. Setting: HealthOne was a New South Wales government attempt to provide a local and responsive model to improve chronic disease management in primary and community healthcare settings. We report specifically on the HealthOne program implemented in a suburb of Western Sydney. Main outcome measures: The research did not aim to evaluate the program but to uncover instances of professional learning though identifying changes in professional practice. These were noted and observed by the researchers and research participants or through reflexive conversations with the program planners, healthcare workers and the research team. Results: Drawing on the work of a number of learning and practice-based theory writers, particularly those using a socio-material approach, we describe how practice change has occurred and how work practiceshave been remade at this site - especially in the role of the General Practice Liaison Nurse (GPLN). Conclusions: The research demonstrated the potential for new categories and practices of health work to emerge; this was especially seen in the work of the GPLN but also extended to new ways of working through General Practitioners and community health networks. Abbreviations: GP – General Practitioner; GPLN – General Practice Liaison Nurse. 

scholarly journals Exploration of sedentary behaviour among general practitioners: protocol for a mixed methods study

2021 ◽  
Vol 8 (1) ◽  
pp. 51
Author(s):  
Richard S. Mayne ◽  
Nigel D. Hart ◽  
Neil Heron
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
Sedentary Behaviour ◽  
General Practitioners ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
New Ways Of Working ◽  
Adverse Health Outcomes ◽  
Sequential Mixed Methods ◽  
Working Day

<p class="abstract"><strong>Background:</strong> Many general practitioners (GPs) are sedentary for most of their working day. Levels of sedentary behaviour may have been exacerbated by increased use of telemedicine in light of the COVID-19 pandemic, as this is traditionally performed while sitting down. Excessive sedentary behaviour is associated with many adverse health outcomes and increased all-cause mortality. This study will gain quantitative data on levels of sedentary behaviour among GPs and general practice specialty trainees (GPSTs), to identify to what extent general practice is a sedentary occupation, as well as qualitative data regarding the barriers and facilitators to reducing sedentary behaviour in the general practice setting.</p><p class="abstract"><strong>Methods:</strong> The study follows a sequential, mixed-methods model. The first stage will involve the dissemination of a questionnaire survey, where participants self-estimate their sedentary behaviour on a working day and on a non-working day. The second stage will use thigh-worn accelerometers and a sleep/work log to obtain objective data regarding sedentary behaviour among a purposive subset of participants who responded to the questionnaire. The third stage will involve semi-structured interviews with a purposive subset of accelerometer study participants, analysed with the application of a theoretical framework regarding the acceptability of healthcare interventions.</p><p class="abstract"><strong>Conclusions: </strong>This paper outlines a protocol for a sequential, mixed-methods study exploring sedentary behaviour among GPs and GPSTs. Findings of this study will shed light on the new ways of working as a result of the COVID-19 pandemic, which will be relevant to clinicians working in similar primary care settings throughout the world.</p><p class="abstract"><strong>Trial Registration:</strong> ClinicalTrials.gov Identifier: NCT04556695. Date of registration: 21<sup>st</sup> September 2020.</p><p class="abstract"> </p>

scholarly journals Remaking Practices in the Redesign of a Primary Healthcare Program

2006 ◽  
Vol 12 (1) ◽  
pp. 36-41
Author(s):  
John Rule ◽  
◽  
Roger Dunston ◽  
Nicky Solomon
Keyword(s):  
Primary Healthcare ◽  
Healthcare Program

scholarly journals Evaluation and prospect of scientific research capacity ranking for community healthcare centres in China

2020 ◽  
Vol 8 (1) ◽  
pp. e000298
Author(s):  
Qian Liu ◽  
Jianwei Shi ◽  
Dehua Yu ◽  
Hua Jin ◽  
Xuhua Ge ◽  
...  
Keyword(s):  
General Practice ◽  
Health Reform ◽  
Evaluation System ◽  
Research Team ◽  
Scientific Research ◽  
Research Capacity ◽  
Planning Commission ◽  
Community Healthcare ◽  
Republic Of China ◽  
First Time

The National Health and Family Planning Commission of the People's Republic of China has proposed to improve the medical capacity of general practitioners and the establishment of general practice in recent health reform. For the first time, the ability to conduct scientific research was included in this reform, which demands community healthcare centres (CHCs) to strengthen their research capacity. The evaluation of community scientific research capacity has become an important endeavour to promote the implementation of research in CHCs. Since 2016, our research team has been working on an evaluation system and has published the scientific research capacity ranking for the top 100 CHCs in China. The latest released ranking of scientific research capacities of China CHCs has aroused great attention in the country.

scholarly journals Financial viability, benefits and challenges of employing a nurse practitioner in general practice

2015 ◽  
Vol 39 (2) ◽  
pp. 205 ◽  
Author(s):  
Christopher Helms ◽  
Jo Crookes ◽  
David Bailey
Keyword(s):  
General Practice ◽  
Nurse Practitioner ◽  
Primary Healthcare ◽  
Case Reports ◽  
Models Of Care ◽  
Careful Consideration ◽  
Scope Of Practice ◽  
Financial Viability ◽  
Practice Nurses

This case study examines the financial viability, benefits and challenges of employing a primary healthcare (PHC) nurse practitioner (NP) in a bulk-billing healthcare cooperative in the Australian Capital Territory. There are few empirical case reports in the Australian literature that demonstrate financial sustainability of this type of healthcare professional in primary healthcare. This case study demonstrates that the costs of employing a PHC-NP in general practice are offset by direct and indirect Medicare billings generated by the PHC-NP, resulting in a cost-neutral healthcare practitioner. The success of this model relies on bidirectional collaborative working relationships amongst general practitioners and NPs. PHC-NPs should have a generalist scope of practice and specialist expertise in order to maximise their utility within the general practice environment. What is known about the topic? NPs represent a growing workforce of highly trained and educated advanced practice nurses that aims to improve access to timely and affordable healthcare for underserviced populations. Recent legislation has allowed for greater exploration of innovative models of care using NPs in Australian primary healthcare. What does this paper add? This case study provides practical information on the financial and logistical implications of employing an NP in a bulk-billing general practice. It demonstrates the broad capability of this workforce in Australian primary healthcare, and gives an overview of the facilitators and barriers to their use in private practice. What are the implications for practitioners? Employment of a PHC NP in general practice requires careful consideration of the direct and indirect benefits associated with the complimentary care they offer. NP access to the Medicare Benefits Schedule is severely restricted, which impairs their ability to achieve a full scope of practice and may contribute to increased health system costs and inefficiencies. There are opportunities for integration and facilitation of this emerging role in general practice with existing nursing workforce. Further research into this evolving area would be of benefit.

scholarly journals Low Back Pain in Primary Care: A Description of 1250 Patients with Low Back Pain in Danish General and Chiropractic Practice

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Lise Hestbaek ◽  
Anders Munck ◽  
Lisbeth Hartvigsen ◽  
Dorte Ejg Jarbøl ◽  
Jens Søndergaard ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Low Back Pain ◽  
Back Pain ◽  
Sick Leave ◽  
Primary Healthcare ◽  
Healthcare Sector ◽  
Detailed Knowledge ◽  
Low Back ◽  
Chiropractic Practice

Study Design. Baseline description of a multicenter cohort study. Objective. To describe patients with low back pain (LBP) in both chiropractic and general practice in Denmark. Background. To optimize standards of care in the primary healthcare sector, detailed knowledge of the patient populations in different settings is needed. In Denmark, most LBP-patients access primary healthcare through chiropractic or general practice. Methods. Chiropractors and general practitioners recruited adult patients seeking care for LBP. Extensive baseline questionnaires were obtained and descriptive analyses presented separately for general and chiropractic practice patients, Mann-Whitney rank sum test and Pearson’s chi-square test, were used to test for differences between the two populations. Results. Questionnaires were returned from 934 patients in chiropractic practice and 319 patients from general practice. Four out of five patients had had previous episodes, one-fourth were on sick leave, and the LBP considerably limited daily activities. The general practice patients were slightly older and less educated, more often females, and generally worse on all disease-related parameters than chiropractic patients. All differences were statistically significant. Conclusions. LBP in primary care was recurrent, causing sick leave and activity limitations. There were clear differences between the chiropractic and general practice populations in this study.

Benefits of simulated General Practice clinics in the preparation of medical students for primary healthcare

2019 ◽  
Vol 30 (5) ◽  
pp. 275-281 ◽  
Author(s):  
Karryn Lytton ◽  
Torres Woolley ◽  
Roy Rasalam ◽  
Susan Gorton ◽  
Paula Heggarty
Keyword(s):  
General Practice ◽  
Medical Students ◽  
Primary Healthcare

Working with General Practitioners

1988 ◽  
Vol 153 (4) ◽  
pp. 513-520 ◽  
Author(s):  
John Horder
Keyword(s):  
General Practice ◽  
Clinical Practice ◽  
General Practitioners ◽  
Central Theme ◽  
Or Education ◽  
New Ways Of Working ◽  
Working Together

Psychiatrists and general practitioners have found new ways of working together in the last ten years, but there have also been separate activities which could develop into rivalry. These opportunities and dangers are the central theme of this paper. Ways are considered in which the psychiatry of general practice differs from the experience of psychiatrists. Forms of help are suggested which general practitioners need from psychiatrists, whether in clinical practice or education.

scholarly journals Effectiveness of E-SBIRT intervention in community healthcare institution in China: study proposal for a randomised controlled trial

2021 ◽  
Vol 34 (5) ◽  
pp. e100486
Author(s):  
Rao Fu ◽  
Chenxin Yuan ◽  
Wei Sun ◽  
Wenzheng Wang ◽  
Lei Zhang ◽  
...  
Keyword(s):  
Substance Use ◽  
Randomised Controlled Trial ◽  
Primary Healthcare ◽  
Negative Emotion ◽  
Controlled Trial ◽  
Intervention Group ◽  
Addiction Severity Index ◽  
Control Group ◽  
Community Healthcare ◽  
Randomised Controlled

BackgroundMany studies have demonstrated the effectiveness of Screening, Brief Intervention and Referral to Treatment (SBIRT) in addressing substance use problem. However, owing to the shortage of counsellors, it has not been widely used in China. With the development of smart medicine, we developed a web-based electronic SBIRT (E-SBIRT) program and explored the effectiveness of E-SBIRT in reducing substance use in China.MethodsA randomised controlled trial will be conducted in primary healthcare institutions. Four primary healthcare institutions will be selected and randomly divided into an intervention group and a control group (each institution will recruit 60 participants, and in total, 240 participants will be recruited). The control group will get a pamphlet of drug abuse prevention, and the intervention group will get the E-SBIRT intervention and the pamphlet. Both groups will receive baseline and follow-up assessment at 1 and 3 months after the intervention. The primary outcome is the change in scores on the Alcohol, Smoking and Substance Use Involvement Screening Test, and the secondary outcomes include changes in motivation, depression, anxiety, positive/negative emotion, self-esteem, addiction knowledge and addiction severity index.ConclusionsIf the ‘E-SBIRT’ program is found to be effective, it will be an accessible, affordable and widely implementable intervention to help participants at moderate risk of substance use to reduce their consumption. The potential benefit is to provide early intervention to high-risk patients in time and reduce the harmful consequences to individuals and society.Trial registration numberNCT03452241.

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