scholarly journals Short-term training of family medicine teams on cardiovascular risk assessment and management: Effects on practice and outcomes

2021 ◽  
Vol 52 (3) ◽  
pp. 165-173
Author(s):  
Savka Štrbac ◽  
Nataša Pilipović-Broćeta ◽  
Nevena Todorović ◽  
Vesna Vujić-Aleksić ◽  
Siniša Stević ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cardiovascular Risk ◽  
Family Medicine ◽  
Clinical Guidelines ◽  
Training Workshop ◽  
Primary Health ◽  
Target Values ◽  
Before And After ◽  
Risk Assessment And Management

Background/Aim: The prevention of cardiovascular risk factors and cardiovascular disease management contributes to the cardiovascular mortality reduction. The effects of these activities have been measured by quality indicators. The aim of this study was to determine the effects of family medicine team training workshop and implementation of clinical guidelines on the cardiovascular risk factors and diseases management in primary health care in the Republic of Srpska/Bosnia and Herzegovina. Methods: The "CardioVascular Risk Assessment and Management" study included a sample of 373 teams from 41 primary health care centres trained to provide adequate services and to compare the quality of cardiovascular risk management before and after the training workshop and implementation of clinical guidelines. The comparison was based on nine project defined performance indicators related to hypertension, type 2 diabetes mellitus, hyperlipidaemia, tobacco smoking and obesity. Results: Significant improvements were observed in six indicators after the training workshop and implementation of guidelines. Target values for blood pressure and HbA1c were achieved in over 80 % of patients (82.12 ± 15.81 vs 84.49 ± 12.71 and 84.49 ± 12.71 vs 85.49 ± 24.55; before and after the training workshop, respectively), while the target values for LDL cholesterol were achieved in 54.98 % ± 20.33 before and 57.64 % ± 16.66 after the training workshop. The number of teams that had less than 20 % of recorded data significantly decreased after the training workshop and guidelines implementation, and adequate recording of all indicators was improved. Conclusion: The training workshop of family medicine teams and implementation of clinical guidelines resulted in significant quality improvement of cardiovascular diseases management in primary health care.

scholarly journals Evaluation of Emergency Health-Care Initiatives to Reduce Overcrowding in a Referral Medical Complex, Jeddah, Saudi Arabia

2021 ◽  
pp. 1-6
Author(s):  
Khalid Alabbasi ◽  
Estie Kruger ◽  
Marc Tennant
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Public Hospital ◽  
Waiting Times ◽  
Care Centre ◽  
Health Care Centre ◽  
Transfer Policy ◽  
Primary Health ◽  
Before And After ◽  
Ed Visits

<b><i>Purpose:</i></b> Excessive delays and emergency department (ED) overcrowding have become an increasingly major problem for public health worldwide. This study was to assess the key strategies adopted by an ED, at a public hospital in Jeddah, to reduce delays and streamline patient flow. <b><i>Materials and Methods:</i></b> This study was a service evaluation for a Saudi patient population of all age-groups who attended the ED of a public hospital for the period between June 2016 and July 2019. The Saudi initiative to reduce the ED visits at the King Abdullah Medical Complex hospital has started on August 7, 2018. The initiative was to apply an urgency transfer policy which outlines the procedures to follow when patients arrive to the ED where they are reviewed based on the Canadian Triage and Acuity Scale (CTAS). Patients with less-urgent conditions (category 4 and 5) are referred to a primary health-care practice (where a family medicine consultant is available). Patients with urgent conditions (category 1–3) are referred to a specialized health-care centre if the service is not currently provided. To test the effectiveness of ED initiative on reducing the overcrowd, data were categorized into before and after the initiative. The bivariate analysis χ<sup>2</sup> tests and 2 sample <i>t</i>-tests were run to explore the relationship of gender and age with dependent variable emergency. <b><i>Results:</i></b> A total of 233,998 patients were included in this study, 61.8% of them were males and the average age of ED patients were 35.5 ± 18.6 years. The majority of cases were those classified as “less urgent” (CTAS 4), which accounted for 65.4%. Number of ED visits before and after the initiative was 67 and 33%, respectively. ED waiting times after the initiative have statistically significantly decreased across all acuity levels compared to ED waiting times before the initiative. <b><i>Conclusion and Implication:</i></b> The findings suggest that the majority of patients arrive to the ED with less-urgent conditions and arrived by walking-in. The number of cases attending the ED significantly decreased following the introduction of the urgency transfer policy. Referral for less-urgent patients to primary health-care centre may be an important front-end operational strategy to relieve congestion.

scholarly journals Portugal's primary health care human resources assessment

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Oliveira Miranda ◽  
P Santos Luis ◽  
M Sarmento
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Human Resources ◽  
Health Professional ◽  
Health Care Services ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
The Mean

Abstract Background Primary health care services are the cornerstone of all health systems. Having clear data on allocated human resources is essential for planning. This work intended to map and compare the primary health care human resources of the five administrative regions (ARS) of the Portuguese public health system, so that better human resources management can be implemented. Methods The chosen design was a descriptive cross sectional study. Each of the five ARS were divided into primary health care clusters, which included several primary health care units. All of these units periodically sign a “commitment letter”, where they stand their service commitments to the covered population. This includes allocated health professionals (doctors, nurses), and the information is publicly accessible at www.bicsp.min-saude.pt. Data was collected for 2017, the year for which more commitment letters were available. Several ratios were calculated: patients/health professional; patients/doctor (family medicine specialists and residents); patients/nurse and patients/family medicine specialist. Mean, standard deviation, minimum and maximum values were calculated. Results National patients/health professional ratio was 702 with the mean of the 5 ARS calculated at 674+-7.15% (min 619, max 734) whilst the national patients/doctor ratio was 1247 with the mean of the 5 ARS calculated at 1217+-7.17% (min 1074, max 1290). National patients/nurse ratio was 1607 with the mean of the 5 ARS calculated at 1529+-13.08% (min 1199, max 1701). Finally, national patients/family medicine specialist ratio was 1711 with the mean of the 5 ARS calculated at 1650+-6,36% (min 1551, max 1795). Conclusions Human resources were differently spread across Portugal, with variations between the five ARS in all ratios. The largest differences occur between nursing staff, and may translate into inequities of access, with impact on health results. A more homogeneous human resources allocation should be implemented. Key messages Human resources in the Portuguese primary health care services are not homogeneously allocated. A better and more homogeneous allocation of human resources should be implemented to reduce access health inequities.

Do primary health care nurses address cardiovascular risk in diabetes patients?

2014 ◽  
Vol 106 (2) ◽  
pp. 212-220 ◽  
Author(s):  
Barbara Daly ◽  
Timothy Kenealy ◽  
Bruce Arroll ◽  
Nicolette Sheridan ◽  
Robert Scragg
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cardiovascular Risk ◽  
Primary Health ◽  
Primary Health Care Nurses ◽  
Diabetes Patients

scholarly journals Why are there gaps in our management of those with high cardiovascular risk?

2012 ◽  
Vol 4 (1) ◽  
pp. 21 ◽  
Author(s):  
Fiona Doolan-Noble ◽  
Jocelyn Tracey ◽  
Stewart Mann
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Cardiovascular Risk ◽  
New Zealand ◽  
Barriers And Facilitators ◽  
Care Providers ◽  
High Cardiovascular Risk ◽  
Text Data ◽  
Primary Health

INTRODUCTION: Multiple New Zealand and other international studies have identified gaps in the management of those identified at high risk of a future cardiovascular (CV) event. This study sought to explore the views of health professionals about the barriers and facilitators present within the current primary health care system to the optimal management of those at high CV risk. METHODS: This qualitative study utilised a focus group methodology to examine the barriers and facilitators within primary health care (PHC), and employed a general inductive approach to analyse the text data. FINDINGS: The analysis of text data resulted in the emergence of interrelated themes, underpinned by subthemes. The patient, their circumstances and their characteristics and perceptions provided the first key theme and subthemes. The next key theme was primary health care providers, with subthemes of communication and values and beliefs. The general practice was the third theme and included multiple subthemes: implementation planning and pathway development, time and workload and roles and responsibilities. The final main theme was the health system with the subthemes linking to funding and leadership. CONCLUSION: This study determined the factors that act as barriers and facilitators to the effective management of those at high CV risk within the New Zealand PHC sector. General practice has a pivotal role in preventive health care, but to succeed there needs to be a refocusing of the PHC sector, requiring support from policy makers, District Health Boards and Primary Health Organisations, as well as those working in the sector. KEYWORDS: Primary health care; high cardiovascular risk management; general practitioners; practice nurses; barriers; facilitators

scholarly journals Establishment of an Accelerated Doctor of Family Medicine Program at Unaizah College of Medicine, Qassim University, Kingdom of Saudi Arabia

2019 ◽  
Vol 6 ◽  
pp. 238212051881884
Author(s):  
Ahmad Al-Shafei ◽  
Saleh Al-Damegh ◽  
Fahad Al-Matham ◽  
Abdulrahman Al-Mohaimeed ◽  
Abdullah Al-Nafeesah ◽  
...  
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Primary Health Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Total Duration ◽  
Performance Outcomes ◽  
Primary Health Care System ◽  
Kingdom Of Saudi Arabia ◽  
Primary Health

Primary health care is well known to be the cornerstone for the health of the society. Furthermore, efficient health care at the secondary and tertiary levels is entirely dependent on effective primary health care. The Kingdom of Saudi Arabia (KSA) is currently building up a rigorous primary health care system with a large number of well-equipped primary health care centers. However, there is an acute shortage of Saudi family physicians throughout the country; both in urban and rural areas. There is no evidence in the literature supporting the relatively long 7 years’ traditional duration of medical programs in the KSA. Rather, several US and Canadian medical schools have established accelerated programs in Internal Medicine and Family Medicine with graduates comparable with those of the traditional curricula in terms of standardized tests, initial resident characteristics, and performance outcomes. In response to the challenges the KSA is facing in primary health care, Unaizah College of Medicine at Qassim University is proposing to establish an accelerated Doctor of Family Medicine Program that would run for total duration of 6 years. Herein, we describe a concise outline of this program.

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