scholarly journals Bridging the Gap 2021- Summary Report

2021 ◽  
pp. 1-52
Author(s):  
Indranil Chakravorty ◽  
Sunil Daga ◽  
Shivani Sharma ◽  
Martin Fischer ◽  
Subarna Chakravorty ◽  
...  
Keyword(s):  
Online Survey ◽  
Healthcare Services ◽  
Structural Barriers ◽  
Summary Report ◽  
Full Spectrum ◽  
Big Society ◽  
Thematic Synthesis ◽  
Differential Outcomes ◽  
Career Cycle ◽  
Structural Inequalities

Differential Attainment Healthcare professionals are among the most respected, valued members in any society- and also the most regulated. It attracts some of the most talented, innovative and resilient individuals who are keen to do good. Respect, job satisfaction and autonomy are fundamental to the experience of any professional, and often valued above financial or material reward. Doctors are no different. Education and training of the healthcare workforce is a lengthy and resource intense process. No nation-state can be truly self-sufficient. Hence workforce migration is a reality where various pull and push factors lead to professionals moving across countries and continents, in the service of populations. Society is divided along many lines and steeped with structural inequalities. Many of these are the result of thousands of years of history, legacy and societal wrongs. Healthcare services and professionals reflect similar patterns of the 'big society'. The phenomenon of differential attainment (DA), which is the subject of this report is simply a manifestation of such structural inequalities. DA or differential outcomes for doctors due to their age, race, gender, sexual orientation, ethnicity, disability, socio-economic deprivation or influenced by migrant status - rather than motivation, ability, effort or enterprise. DA is fundamentally unfair. Those affected by DA are either unaware or unable to counteract the influence on their careers. DA leads to demoralisation, disengagement and poor outcomes for professionals and their patients. It takes its toll not only on careers but on lives and livelihoods. DA leads to a huge under-utlisation of human resources- a true waste of talent and enterprise. This report- BTG21 focuses on DA in the medical profession exploring the career cycle through the themes of recruitment, assessments, career progression, research & academia, leadership roles, awards and professionalism. BTG21 is people-centred and in tackling inequalities offers solutions on career fulfillment and wellbeing- by an ideological shift of hearts and minds. Thematic Synthesis BTG21 summary report is the culmination of a thematic synthesis of evidence covering the full spectrum of medical careers. It presents lived experiences (collected through mixed method approaches) capturing patterns in peoples experiences through an online survey, and in-depth qualitative interviews with a purposive sample of professionals from across the career cycle, range of ethnic heritage, medical specialism and country of origin. Followed by consensus developed through workshops by a triumvirate of experts, stakeholders and grassroots professionals. There are 5 primary causes of DA- bias, social class & deprivation, immigration status, geographical and individual factors and impacts every stage of medical professional careers. The thematic synthesis reviews are published in the Sushruta Journal of Health Policy. Recommendations The Workshop discussions, recommendations (the 10-point plan) include policy enablers, immediate actions and research questions in the following areas; Tackling bias Embracing diversity & inclusion Celebrating the contribution of migrants Leveling the playing field Inclusive leadership & accountability Removing structural barriers Review-Reform-Rethink assessments Redefining professionalism Disaggregation-intersectionality-benchmarking of data Support-flexibility & Wellbeing

scholarly journals Older and Wiser? The Need to Reexamine the Impact of Health Professionals Age and Experience on Competency-Based Practices

2021 ◽  
Vol 7 ◽  
pp. 237796082110290
Author(s):  
Jing Xu ◽  
Kristen Hicks-Roof ◽  
Chloe E. Bailey ◽  
Hanadi Y. Hamadi
Keyword(s):  
Health Professionals ◽  
Online Survey ◽  
Evidence Based Practice ◽  
Core Competencies ◽  
Healthcare Services ◽  
Interdisciplinary Teams ◽  
Evidence Based ◽  
Health Providers ◽  
Cross Sectional ◽  
The Impact

Introduction Delivery of healthcare services makes up a complex system and it requires providers to be competent and to be able to integrate each of the institute of medicine’s (IOM) 5 core competencies into practice. However, healthcare providers are challenged with the task to be able to understand and apply the IOM core competencies into practice. Objective The purpose of the study was to examine the factors that influence health professional’s likelihood of accomplishing the IOM core competencies. Methods A cross-sectional study design was used to administer a validated online survey to health providers. This survey was distributed to physicians, nursing professionals, specialists, and allied healthcare professionals. The final sample included 3,940 participants who completed the survey. Results The study findings show that younger health professionals more consistently practice daily competencies than their older counterparts, especially in the use of evidence-based practice, informatics, and working in interdisciplinary teams. Less experienced health professionals more consistently applied quality improvement methods but less consistently used evidence-based practice compared to their more experienced counterparts. Conclusion There is a need to understand how health professionals’ age and experience impact their engagement with IOM’s core competencies. This study highlights the need for educational resources on the competencies to be tailored to health providers’ age and experience.

Older migrants’ access to healthcare: a thematic synthesis

2018 ◽  
Vol 14 (4) ◽  
pp. 425-438 ◽  
Author(s):  
Sanjana Arora ◽  
Astrid Bergland ◽  
Melanie Straiton ◽  
Bernd Rechel ◽  
Jonas Debesay
Keyword(s):  
Healthcare System ◽  
Home Country ◽  
Healthcare Services ◽  
Future Research ◽  
Content Type ◽  
Thematic Synthesis ◽  
Older Migrants ◽  
Body Of Knowledge ◽  
Geographical Scope ◽  
Migrant Groups

Purpose The purpose of this paper is to synthesise data from the existent literature on the experiences of non-western older migrants in Europe in accessing and using healthcare services. Design/methodology/approach In total, 1,606 records were reviewed and 12 studies were selected. A thematic synthesis using Thomas and Harden’s approach was conducted. Findings The findings resulted in the three overarching themes: traditional discourses under new circumstances; predisposed vulnerabilities of older migrants and the healthcare system; and the conceptualization of health and the roles of healthcare professionals. The authors found that older migrants’ experience of accessing healthcare is influenced by many factors, such as health literacy, differences in healthcare beliefs and language barriers, and is not limited to cultural and traditional discourses of care. Findings reveal that there is a limited body of knowledge on barriers experienced by older migrant women. Research limitations/implications The geographical scope of the study and subsequent type of healthcare systems should be taken into account while understanding barriers to care. Another limitation is that although we studied different migrant groups, the authors synthesised barriers experienced by all. Future research could study migrants as separate groups to better understand how previous experiences with healthcare in their home country and specific social, cultural and economic circumstances shape them. Originality/value This paper provides a synthesis of the experiences of migrants from non-western countries who moved to a host country with a very different language, culture and healthcare system.

scholarly journals Information and genetic counselling for psychiatric risks in children with rare genomic disorders

2019 ◽  
Author(s):  
Andrew Cuthbert ◽  
Aimee Challenger ◽  
Jeremy Hall ◽  
Marianne BM van den Bree
Keyword(s):  
Genetic Counselling ◽  
Online Survey ◽  
Genomic Medicine ◽  
Genetic Diagnosis ◽  
Single Nucleotide Variants ◽  
Full Spectrum ◽  
Face To Face ◽  
Professional Information ◽  
Genomic Disorders ◽  
Psychiatric Manifestations

AbstractPurposeGenomic medicine has transformed the diagnosis of neurodevelopmental disorders. Evidence of increased psychiatric comorbidity associated with genomic copy number and single nucleotide variants (CNV and SNV) may not be fully considered when providing genetic counselling. We explored parents’ experiences of genetics services and how they obtained information concerning psychiatric manifestations.MethodsParents of children diagnosed with genomic variants completed an online survey exploring, (i) how they experienced the genetic diagnosis, and (ii) how they acquired information about psychiatric, developmental and physical manifestations.ResultsTwo-hundred and 86 respondents completed the survey. Thirty percent were unsatisfied with receiving genetic diagnoses. Satisfaction was predicted if communication was by geneticists (p = 0.004); provided face-to-face (p = 0.003); clearly explained (p < 0.001); and accompanied by support (p = 0.017). Parents obtained psychiatric information from non-professional sources more often than developmental (ϕ 0.26, p < 0.001) and physical manifestations (ϕ 0.21, p = 0.003), which mostly came from health professionals. Information from support organisations was more helpful than from geneticists (odds ratio [OR] 21.0, 95% CI 5.1 – 86.8, p < 0.001); paediatricians (OR 11.0, 1.4 – 85.2, p = 0.004); and internet sites (OR 15.5, 3.7 – 64.8, p < 0.001).ConclusionA paucity of professional information about psychiatric risks after genetic diagnosis may impede early diagnosis and intervention for children with high genotypic risks. Planned integration of genomic testing into mainstream services should include genetic counselling training to address the full spectrum of developmental, physical and psychiatric manifestations and timely provision of high-quality information.

scholarly journals How men who have sex with men experience HIV health services in Kampala, Uganda

2020 ◽  
Vol 5 (4) ◽  
pp. e001901
Author(s):  
Rachel King ◽  
Zubayiri Sebyala ◽  
Moses Ogwal ◽  
George Aluzimbi ◽  
Rose Apondi ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Health Services ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Health Staff ◽  
Structural Factors ◽  
Structural Barriers ◽  
Sub Saharan ◽  
Sex With Men

In sub-Saharan Africa, men who have sex with men (MSM) are socially, largely hidden and face disproportionate risk for HIV infection. Attention to HIV epidemics among MSM in Uganda and elsewhere in sub-Saharan Africa has been obscured by repressive governmental policies, criminalisation, stigma and the lack of basic epidemiological data describing these epidemics. In this paper, we aim to explore healthcare access, experiences with HIV prevention services and structural barriers to using healthcare services in order to inform the acceptability of a combination HIV prevention package of services for men who have sex with men in Uganda. We held focus group discussions (FGDs) with both MSM and healthcare providers in Kampala, Uganda, to explore access to services and to inform prevention and care. Participants were recruited through theoretical sampling with criteria based on ability to answer the research questions. Descriptive thematic coding was used to analyse the FGD data. We described MSM experiences, both negative and positive, as they engaged with health services. Our findings showed that socio-structural factors, mediated by psychological and relational factors impacted MSM engagement in care. The socio-structural factors such as stigma, homophobia and policy issues emerged strongly as did the mediating factors such as relations with specific health staff and a social support structure. A combination intervention addressing structural, social and psychological barriers could have an impact even in the precarious policy environment where this study was conducted.

The Ontario oncology electronic medical record (EMR): The integration of end user and provincial needs.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 248-248
Author(s):  
Vishal Kukreti ◽  
Sara Lankshear ◽  
Arthur G. Manzon ◽  
Nancy Wolf ◽  
Shafiq Habib ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Quality Indicators ◽  
Online Survey ◽  
Clinical Care ◽  
Functional Requirements ◽  
End User ◽  
Oncology Patient ◽  
Full Spectrum ◽  
Patient Profile

248 Background: The use of ambulatory electronic medical record (EMR) systems within oncology provides an opportunity for aligning provincial, local and end-user patient-centred quality indicators in the design, delivery and evaluation of clinical care and resource utilization. The aim of this provincial initiative is to define the “meaningful use” for the Oncology EMR by identifying the essential data elements and functional requirements required to facilitate integrated care, information standards (both local and provincial), and system integration needs. This paper presents the results of a provincial field study designed to determine end-user needs for information and quality metrics. Methods: Data collection included two separate onsite focus groups at each of the 13 regional cancer programs, with a focus on Clinical and Operational requirements. A total of 141 participants, representing physicians, interprofessional clinical team members, administrators and health information specialists were involved. An additional online survey was used for optimal engagement, with a total of 194 respondents, primarily nurses and physicians. Inclusion and exclusion criteria were developed to assist in coding and distillation of concepts generated. Results: A total of 1,598 ideas were generated (Clinical = 997, Operational = 601). Multiple rounds of content analysis were used to eliminate duplicates, identify common themes and distill the wealth of information down to the “vital few” discrete information requirements that should be included in the oncology EMR. At this time, 63 clinical and 55 operational concepts have been identified to support clinical care as well as operational planning and system evaluation. The online survey has helped define the data required for a Provincial Oncology Patient Profile within the EMR. Conclusions: The study employed significant consultation to merge end user and existing provincial quality measurement needs in order to define the Ontario Oncology EMR. A full spectrum of quality indicators identified through these processes will inform the future provincial priorities for information standards and quality monitoring that will be facilitated by a standardized EMR.

scholarly journals Virtual Geriatric Education Preferences of Rural Social Workers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 328-328
Author(s):  
Joan Ilardo ◽  
Raza Haque ◽  
Angela Zell
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Social Workers ◽  
Online Survey ◽  
Transitional Care ◽  
Healthcare Services ◽  
Multiple Chronic Conditions ◽  
Care Plans ◽  
Health Practitioners ◽  
Geriatric Service

Abstract Older adults in rural communities need access to comprehensive healthcare services provided by practitioners equipped with geriatric knowledge and skills. The Geriatric Rural Extension of Expertise through Telegeriatric Service (GREETS) project goal is to use telemedicine and telehealth to expand geriatric service options to underserved Michigan regions. GREETS educational programs train health practitioners to provide geriatric care for vulnerable older adults. To determine gaps in geriatric competencies, the team conducted an online survey of health professionals including behavioral health practitioners. Respondents identified educational topics and preferred virtual delivery methods. Demographic information included respondent’s professional position, practice setting, and county. The respondents were asked to indicate level of educational need using a scale ranging from a low, medium, or high need. Fifty (47%) of 106 total responses were from social workers. We compared the percent of social workers to other practitioners’ responses in our analysis. Four topics emerged for both groups as medium or high educational needs: 1) transitional care when changing residential settings or post-hospitalization; 2) assisting family caregivers cope with caregiving responsibilities; 3) incorporating community-based services into care plans; and 4) and managing frail older adults. Social workers noted higher need than the other respondents for: 1) managing chronic pain; 2) managing care of patients with multiple chronic conditions; 3) having serious illness conversations; 4) diagnosing dementia; and 5) discussing advance care planning. Both social worker and other respondents indicated interactive case-based webinars; published tools, toolkits, tip sheets; and didactic webinars as their top three learning formats.

scholarly journals Psychological impact of COVID-19 on doctors and medical undergraduate students in a government medical college in Uttar Pradesh, India

2020 ◽  
Vol 7 (12) ◽  
pp. 4781
Author(s):  
Kunwar Vaibhav ◽  
Adity Priya ◽  
Pratibha Gupta
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Large Scale ◽  
Online Survey ◽  
Psychological Impact ◽  
Well Being ◽  
Healthcare Services ◽  
Health Impact ◽  
Physical And Mental Health ◽  
Medical Undergraduate

Background: COVID-19 wrath has influenced the socio economic, physical and mental health well-being of all the citizens. Doctors being at the frontline has been affected substantially by it. The paucity of literature on mental health impact of medical health professionals directed the present study to explore the Psychological Impact of COVID-19 on doctors and medical undergraduates.Methods: A cross section online survey was used for data collection. Socio demographic, COVID 19 related preventive practice, Oslo social support scale-3 (OSSS-3) for social support and impact of events scale-revised (IES-R) scale for assessment of psychological Impact was used. Data was analyzed using SPSS 23.Results: Overall 56 (36.36%) of the participants reported having psychological Impact of whom 25 (43.86%) doctors and 31 (31.96%) students were affected. The predictor variables as derived by the regression model were presence of comorbidity, poor social support and postings in isolation wards.Conclusions: Large scale longitudinal multicentric studies can provide a better picture of the actual magnitude of the mental health impact. The predictive factors should be taken into account for policy making decisions. Coping skills and mental health preparedness for the frontline warriors can be lifesaving and will uplift their morale for better delivery of healthcare services in a resource constrained setting.

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