Staff perceptions of primary healthcare service change: influences on staff satisfaction

2014 ◽  
Vol 38 (5) ◽  
pp. 580 ◽  
Author(s):  
Rachel Tham ◽  
Penny Buykx ◽  
Leigh Kinsman ◽  
Bernadette Ward ◽  
John S. Humphreys ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Service Delivery ◽  
Health Outcomes ◽  
Population Health ◽  
Primary Healthcare ◽  
Visionary Leadership ◽  
Staff Satisfaction ◽  
Primary Health ◽  
Service Change

Strong primary healthcare (PHC) services are efficient, cost-effective and associated with better population health outcomes. However, little is known about the role and perspectives of PHC staff in creating a sustainable service. Staff from a single-point-of-entry primary health care service in Elmore, a small rural community in north-west Victoria, were surveyed. Qualitative methods were used to collect data to show how the key factors associated with the evolution of a once-struggling medical service into a successful and sustainable PHC service have influenced staff satisfaction. The success of the service was linked to visionary leadership, teamwork and community involvement while service sustainability was described in terms of inter-professional linkages and the role of the service in contributing to the broader community. These factors were reported to have a positive impact on staff satisfaction. The contribution of service delivery change and ongoing service sustainability to staff satisfaction in this rural setting has implications for planning service change in other primary health care settings. What is known about this topic? Integrated PHC services have an important role to play in achieving equitable population health outcomes. Many rural communities struggle to maintain viable PHC services. Innovative PHC models are needed to ensure equitable access to care and reduce the health differential between rural and metropolitan people. What does this paper add? Multidisciplinary teams, visionary leadership, strong community engagement combined with service partnerships are important factors in the building of a rural PHC service that substantially contributes to enhanced staff satisfaction and service sustainability. What are the implications for practitioners? Understanding and engaging local community members is a key driver in the success of service delivery changes in rural PHC services.

scholarly journals Primary care organizational model mix and avoidable hospitalization: an ecological study in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Pinto ◽  
J V Santos ◽  
M Lobo ◽  
J Viana ◽  
J Souza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Pay For Performance ◽  
Care Quality ◽  
Organizational Model ◽  
Avoidable Hospitalizations ◽  
Primary Health ◽  
Age And Sex

Abstract Background In Portugal, there are different organizational models in primary health care (PHC), mainly regarding the payment scheme. USF-B is the only type with financial incentives to the professional (pay-for-performance). Our goal was to assess the relationship between groups of primary healthcare centres (ACES) with higher proportion of patients within USF-B model and the rate of avoidable hospitalizations, as proxy of primary care quality. Methods We conducted a cross-sectional study considering the 55 ACES from mainland Portugal, in 2017. We used data from public hospitalizations to calculate the prevention quality indicator (avoidable hospitalizations) adjusted for age and sex, using direct standardization. The main independent variable was the proportion of patients in one ACES registered in the USF-B model. Unemployment rate, proportion of patients with family doctor and presence of Local Health Unit (different organization model) within ACES were also considered. The association was assessed by means of a linear regression model. Results Age-sex adjusted PQI value varied between 490 and 1715 hospitalizations per 100,000 inhabitants across ACES. We observed a significant effect of the proportion of patients within USF-B in the crude PQI rate (p = 0.001). However, using the age-sex adjusted PQI, there was not a statistical significant association (p = 0.504). This last model was also adjusted for confounding variables and the association remains non-significant (p = 0.865). Conclusions Our findings suggest that, when adjusting for age and sex, there is no evidence that ACES with more patients enrolled in a pay-for-performance model is associated with higher quality of PHC (using avoidable hospitalizations as proxy). Further studies addressing individual data should be performed. This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”. Key messages Adjusting PQI to sex and age seems to influence its value more than the type of organizational model of primary health care. Groups of primary healthcare centres with more units under the pay-for-performance scheme was not associated with different rate of avoidable hospitalizations.

Impact of community participation in primary health care: what is the evidence?

2015 ◽  
Vol 21 (1) ◽  
pp. 2 ◽  
Author(s):  
Jessamy Bath ◽  
John Wakerman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Outcomes ◽  
Community Participation ◽  
Service Providers ◽  
Developmental Process ◽  
Service Access ◽  
Primary Health ◽  
Intermediate Outcomes ◽  
The Impact

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.

scholarly journals Using population health surveys to provide information on access to and use of quality primary health care

2006 ◽  
Vol 30 (4) ◽  
pp. 485 ◽  
Author(s):  
Elizabeth J Comino ◽  
Oshana Hermiz ◽  
Jeff Flack ◽  
Elizabeth Harris ◽  
Gawaine Powell Davies ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Population Health ◽  
Health Survey ◽  
Health Surveys ◽  
Diabetes Management ◽  
Relevant Information ◽  
Population Based ◽  
Primary Health ◽  
Data Collections

Objective: Currently, primary health care (PHC) is under-represented in health statistics due to the lack of a comprehensive PHC data collection. This research explores the utility of population health surveys to address questions relating to access to and use of PHC, using diabetes as an example. Methods: Drawing on published material relating to diabetes management, we developed a conceptual framework of access to and use of quality PHC. Using this framework we examined three recent population-based health surveys ? the 2001 National Health Survey, 2002?03 NSW Health Survey, and AusDiab ? to identify relevant information collection. Results: We identified seven domains comprising aspects of quality PHC for people with diabetes. For each domain we proposed associated indicators. In critiquing the three population health surveys in relation to these indicators, we identified strengths and weaknesses of the data collections. Conclusion: This approach could inform the development of questions and extension of population health surveys to provide a better understanding of access to and use of quality PHC in Australia. The additional information would complement other data collections with a communitybased perspective and contribute to the develop- ment of PHC policy.

scholarly journals Experiential Learning Curriculum Delivery Approach for Quality Improvement in Resource Limited Settings: Mobile Learning for Point-of-Care Technologies

2019 ◽  
Vol 11 (13) ◽  
pp. 158
Author(s):  
Nkosinothando Chamane ◽  
Tivani Phosa Mashamba-Thompson
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Experiential Learning ◽  
Service Delivery ◽  
Point Of Care ◽  
Service Improvement ◽  
Quality Service ◽  
Resource Limited Settings ◽  
Primary Health ◽  
Resource Limited

BACKGROUND: Despite impressive progress that has been made in the provision of health care services to all, the issue of quality service delivery still remains a challenge particularly for point-of-care (POC) diagnostics in resource-limited-settings. Poor competency of primary health care workers in these settings has been shown to be amongst the main contributors to poor quality service delivery. FINDINGS: Participatory-based continuous professional development (CPD) strategies to support technology advancements in health care are recommended. Experiential learning approaches have been shown to be efficient in supplementing traditional teaching methods for both health care students and professionals. These approaches have been shown to further contribute towards continuous skills development and lifelong learning. CONCLUSION: This review therefore provided an overview of literature on experiential learning as one of CPD approaches in relation to health care service improvement in resource-limited setting. In addition, this review has recommended a mobile-based experiential learning approach to help deliver a quality POC technology curriculum to Primary health care-based workers in resource-limited settings.

scholarly journals Psychological trauma and access to primary healthcare for people from refugee and asylum-seeker backgrounds: a mixed methods systematic review

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Clemence Due ◽  
Erin Green ◽  
Anna Ziersch
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
General Population ◽  
Primary Healthcare ◽  
Asylum Seeker ◽  
Psychological Trauma ◽  
Service Access ◽  
Primary Health ◽  
The Relationship

Abstract Background Several reviews have found that psychological trauma affects access to health care services, including mental health care, in the general population. People from refugee and asylum seeker backgrounds are more likely to have a mental illness than the general population, and experience a broad range of barriers and facilitators to service access. However, to date there has been no comprehensive consideration of the potential effect of psychological trauma on access to primary health care within this population. Methods This paper provides a mixed-methods systematic review of literature which included any consideration of the relationship between psychological trauma and access to primary health care. A systematic search of Medline, PsychInfo, Scopus, Web of Science, Embase, CINAHL and Cochrane Library was conducted. Study eligibility criteria were empirical, peer-reviewed studies that considered the relationship between psychological trauma and access to, or use of, primary healthcare in resettlement countries for refugees (including asylum seekers). Papers were required to be written in English and published between 1998 and August 2019. Quality was assessed using the Multi-Methods Appraisal Tool. The search identified a total of 14 eligible studies (11 quantitative and 3 qualitative) which had explored this relationship in refugee and asylum seeker populations. Results Overall, synthesis of findings indicated variable results with respect to the impact of psychological trauma on service access. Specifically, the review found that while rates of psychological trauma were high. Key themes were that while general health care access was comparable or greater than the general population, rates of mental healthcare specifically were low. In addition, included papers identified a range of barriers to service access—particularly somatisation, stigma and healthcare provide knowledge about psychological trauma. Conclusions While there is a critical need for more research in this area, the study points to several key recommendations including training of general practitioners in relation to psychological trauma, ensuring culturally responsive services, and the use of interpreters. Finally, due to the levels of somatisation found in some studies, ensuring general practitioners understand the somatic element of psychological trauma—particularly within some groups of people from refugee backgrounds—is important.

Towards Integrated Service Delivery for Primary Health Care: Can Programs Meet People's Lives?

2000 ◽  
Vol 6 (4) ◽  
pp. 43
Author(s):  
Vivian Lin
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Service Delivery ◽  
Health Care Policy ◽  
Unit Cost ◽  
Policy Research ◽  
Evidence Base ◽  
Integrated Service Delivery ◽  
Primary Health ◽  
Integrated Service

The primary health care sector faces a number of challenges. Some of these are in the form of persistent problems which include, inter alia, health disparities in resources and outcomes, a fragmented health system, issues of power with respect to priority setting and resource allocation, and a poor information and evidence base with which to allocate resources and evaluate outcomes. These problems are perennially accompanied by a gap between the rhetoric of policy and the reality of implementation. Neo-liberal reforms present a series of challenges to primary health, with the introduction of unit-cost funding, competitive tendering and increased user pays. Changing epidemiological patterns, the rise of evidence-based medicine, and new information and communication technology all question accepted methods of practice. Eroding community confidence in government and professionals, and the growing polarisation of society are also cause for concern. Three areas for development in primary health care policy and practice may provide the keys for dealing with these challenges. These are, first, the development of integrated service delivery models, which move away from narrowly defined single purpose programs delivered by one provider. Second, the development of innovative policy and managerial tools that support the objectives of primary health care while addressing the concerns of policy makers. Finally, the development of a strategic research and development agenda that effectively links policy, research and practice.

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