scholarly journals Learner Perceptions of a Video Recording Activity for Patient Consultation Training in a Pharmacist-Led Primary Care Clinic Located in an Academic Institution

2021 ◽  
Vol 12 (3) ◽  
pp. 3
Author(s):  
Hayley Bessette ◽  
Anita I. Kapanen ◽  
Nic Medgyesi ◽  
Jamie Yuen
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Video Recording ◽  
Educational Activity ◽  
Learning Activity ◽  
Care Practice ◽  
Care Clinic ◽  
Learner Perceptions ◽  
Consultation Skills ◽  
Patient Consultation

Description of the problem: Development of evidence-based educational activities is needed to provide educators with the tools to aid learners in strengthening patient consultation skills in the primary care practice setting, an emerging area of practice in Canada. Objective: The objective was to develop an educational activity to bring self-awareness to fourth year pharmacy student and pharmacy resident consultation skills and to determine learner perceptions of this educational activity, including identifying the key areas of skill development that learners found were positively impacted. Description of the innovation: An innovative learning activity utilizing audio-video technology to enable recording and reviewing of learner-led patient consultations was developed and implemented within the University of British Columbia Pharmacists Clinic. Learners had the opportunity to lead 60-minute patient consultations. With patient and learner consent, patient consultations were recorded for learner viewing and self-assessment. Pharmacist preceptors supervised and assessed learner performance. Learners completed an online anonymous survey after the learning activity to evaluate its value. Critical analysis: Between September 2018 and July 2019, eight pharmacy learners, consisting of student pharmacists (5) and post-graduate pharmacy residents (3) completed the learning activity and provided their feedback. The majority of learners (87.5%) felt the learning activity was beneficial to the development of patient consultation skills. Learners gained awareness of areas requiring improvement which included appropriate questioning, clear and concise language, time management and non-verbal habits. Next steps: Adapting and modifying this learning activity to align with specific practice settings and learning objectives is feasible for other primary care practice sites offering experiential practicums.

Abstract 16093: Cardiology Clinic Integration Into a Primary Care Practice: Improving Access and Time to Testing

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Lindsey E Scierka ◽  
Kim G Smolderen ◽  
Carlos Mena-hurtado
Keyword(s):  
Primary Care ◽  
Health System ◽  
Diagnostic Test ◽  
Primary Care Practice ◽  
Diagnostic Testing ◽  
Primary Care Clinic ◽  
Care Practice ◽  
P Value ◽  
Care Clinic ◽  
Cardiology Clinic

Introduction: The demand for cardiovascular care has been increasing but there are numerous barriers to accessing care. No-show rates are higher for specialist visits and place an economic burden on the health care system. Integrating specialists into primary care practices can improve access and cardiovascular outcomes. We sought to describe a real-world experience of integrating a cardiology clinic into a primary care practice at a large health system and its association with access and process metrics. Methods: We compared two cohorts of patients requiring referral to a cardiologist from a primary care clinic at a large academic medical center over two years. The standard-referral cohort was referred to a cardiologist within the health system but outside of the clinic. The integrated-referral cohort was seen by a cardiologist integrated physically and clinically into the primary care clinic during a bi-weekly 4-hour clinic session. Information from both groups included demographics, medical history, referral information, and diagnostic testing. We documented patient access to a sub-specialist (as measured by time from cardiology referral to appointment), no-show rates, and time from referral to diagnostic testing. Results: The cohorts contained 27 and 39 patients, respectively. Overall, patients were 52.5% male, 68.9% non-Hispanic, 68.8% had Medicare or Medicaid as their primary insurance, and 47.6% had a prior cardiology referral. There were no statistically significant demographic differences between groups. Time to cardiologist for the standard-referral group was a mean of 49.3 + 11.1 days versus 12.4 + 1.6 days in the integrated referral group (p-value .004). Time to first diagnostic test was a mean of 60.6 + 35 days versus 20.0 + 15.9 days respectively (p-value .003). The no show rate for the standard-referral group was 33.3% and integrated-referral group was 12.8%, X 2 (1, N=66) = 4.017, p= .045. Conclusion: Integration of a cardiovascular sub-specialist into a primary care practice in a 4-hour bi-weekly session decreased time from referral to appointment, time to first diagnostic test, and no-show rate among patients in a university primary care practice. Further studies regarding the cost benefit analysis of integration would be beneficial.

Development and implementation of a culturally tailored early childhood program in an integrated pediatric primary care practice.

2020 ◽  
Vol 8 (3) ◽  
pp. 288-297
Author(s):  
Tyanna C. Snider ◽  
Whitney J. Raglin Bignall ◽  
Cody A. Hostutler ◽  
Ariana C. Hoet ◽  
Bethany L. Walker ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Childhood ◽  
Primary Care Practice ◽  
Pediatric Primary Care ◽  
Care Practice ◽  
Early Childhood Program ◽  
Culturally Tailored ◽  
Childhood Program

scholarly journals An Effectiveness Trial of STEADI in an Outpatient, Primary Care Practice

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 774-774
Author(s):  
David Rein ◽  
Madeleine Hackney ◽  
Michele Dougherty ◽  
Camille Vaughan ◽  
Laurie Imhof ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Review ◽  
Primary Care Practice ◽  
Controlled Trial ◽  
Care Practice ◽  
Strength Assessment ◽  
Randomized Controlled ◽  
Study Team ◽  
One Year ◽  
The Impact

Abstract The STEADI Options trial uses a randomized, controlled-trial design to assess the effectiveness and cost-effectiveness of the STEADI Initiative . Beginning March, 2020, we will randomize 3,000 adults ≥ 65 years of age at risk for falls seen in an Emory Clinic primary care practice to: (1) full STEADI; (2) a STEADI-derived gait, balance, and strength assessment with physical therapy referrals; (3) a STEADI-derived medication review and management; or (4) usual care. This presentation will discuss decisions made by the study team to facilitate implementation of STEADI including electronically conducting screening prior to the date of encounter, the use of dedicated nursing staff to conduct assessments, implementation of strength, balance, orthostatic hypotension, and vision testing, methods to facilitate medication review, and communication of assessment information to providers. The results from this study will be used to estimate the impact of STEADI on falls, service utilization, and costs over one year.

scholarly journals Challenging the status quo: results of an acceptability and feasibility study of hypertensive disorders of pregnancy (HDP) management pathways in Indonesian primary care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fitriana Murriya Ekawati ◽  
Ova Emilia ◽  
Jane Gunn ◽  
Sharon Licqurish ◽  
Phyllis Lau
Keyword(s):  
Primary Care ◽  
Health Care Professionals ◽  
Primary Care Practice ◽  
Scale Up ◽  
Primary Care Providers ◽  
Care Practice ◽  
Local Health ◽  
Care Providers ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Abstract Background Hypertensive disorders of pregnancy (HDP) are the leading cause of maternal mortality in Indonesia. Focused HDP management pathways for Indonesian primary care practice have been developed from a consensus development process. However, the acceptability and feasibility of the pathways in practice have not been explored. This study reports on the implementation process of the pathways to determine their acceptability and feasibility in Indonesian practice. Methods The pathways were implemented in three public primary care clinics (Puskesmas) in Yogyakarta province for a month, guided by implementation science frameworks of Medical Research Council (MRC) and the Practical Robust Implementation and Sustainability Model (PRISM). The participating providers (general practitioners (GPs), midwives, and nurses) were asked to use recommendations in the pathways for a month. The pathway implementation evaluations were then conducted using clinical audits and a triangulation of observations, focus groups (FGs), and interviews with all of the participants. Clinical audit data were analysed descriptively, and qualitative data were analysed using a mix of the inductive-deductive approach of thematic analysis. Results A total of 50 primary care providers, four obstetricians, a maternal division officer in the local health office and 61 patients agreed to participate, and 48 of the recruited participants participated in evaluation FGs or interviews. All of the providers in the Puskesmas attempted to apply recommendations from the pathways to various degrees, mainly adopting preeclampsia risk factor screenings and HDP monitoring. The participants expressed that the recommendations empowered their practice when it came to HDP management. However, their practices were challenged by professional boundaries and hierarchical barriers among health care professionals, limited clinical resources, and regulations from the local health office. Suggestions for future scale-up studies were also mentioned, such as involving champion obstetricians and providing more patient education toolkits. Conclusion The HDP management pathways are acceptable and feasible in Indonesian primary care. A further scale-up study is desired and can be initiated with investigations to minimise the implementation challenges and enhance the pathways’ value in primary care practice.

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