scholarly journals Implementation of the e-SUS Primary Care system: Impact on the routine of Primary Health Care professionals

2021 ◽  
Vol 29 ◽  
Author(s):  
Tatiele Estefâni Schönholzer ◽  
Ione Carvalho Pinto ◽  
Fabiana Costa Machado Zacharias ◽  
Rodrigo André Cuevas Gaete ◽  
Maria Del Pilar Serrano-Gallardo
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Daily Life ◽  
Primary Care System ◽  
Structured Interviews ◽  
Learning Mechanisms ◽  
Primary Health ◽  
Care System

Objective: to understand how the implementation of the e-SUS Primary Care system has been processed and its impact on the daily life of the health teams. Method: a qualitative research study, conducted in a municipality in the inland of the state of São Paulo with professionals who work in Primary Health Care and use the e-SUS Primary Care system as a work tool. Semi-structured interviews and thematic data analysis were used with Kotter’s three-phase approach. Results: a total of 17 professionals, nurses, physicians, dentists and community agents were interviewed. The implementation of e-SUS Primary Care and its impact on the daily life of health teams were understood in terms of mandatory implementation; weaknesses for implementation, such as absence of material resources and implicit imposition for the use of the system; fragile training for deployment and learning from experience. Conclusion: a harmful incentive process was observed, conducted from the perspective of institutional pressure, use of the system to justify the work performed and, on the other hand, there was the creation of collaborative learning mechanisms between the teams.

Multidisciplinary collaboration in primary care: through the eyes of patients

2013 ◽  
Vol 19 (3) ◽  
pp. 190 ◽  
Author(s):  
Lynn H. Cheong ◽  
Carol L. Armour ◽  
Sinthia Z. Bosnic-Anticevich
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Chronic Illness ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Primary Health Care System ◽  
Structured Interviews ◽  
Multidisciplinary Collaboration ◽  
Primary Health

Managing chronic illness is highly complex and the pathways to access health care for the patient are unpredictable and often unknown. While multidisciplinary care (MDC) arrangements are promoted in the Australian primary health care system, there is a paucity of research on multidisciplinary collaboration from patients’ perspectives. This exploratory study is the first to gain an understanding of the experiences, perceptions, attitudes and potential role of people with chronic illness (asthma) on the delivery of MDC in the Australian primary health care setting. In-depth semi-structured interviews were conducted with asthma patients from Sydney, Australia. Qualitative analysis of data indicates that patients are significant players in MDC and their perceptions of their chronic condition, perceived roles of health care professionals, and expectations of health care delivery, influence their participation and attitudes towards multidisciplinary services. Our research shows the challenges presented by patients in the delivery and establishment of multidisciplinary health care teams, and highlights the need to consider patients’ perspectives in the development of MDC models in primary care.

scholarly journals Integrative and complementary practices in Primary Care: unveiling health promotion

2020 ◽  
Vol 28 ◽  
Author(s):  
Indiara Sartori Dalmolin ◽  
Ivonete Teresinha Schülter Buss Heidemann
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Health Care Professionals ◽  
Daily Life ◽  
Disease Process ◽  
Primary Health ◽  
Three Stages

Objective: to understand the use of integrative and complementary practices as a health promotion action. Method: qualitative study, action-participant type, with the application of Paulo Freire’s Research Itinerary, in which 30 Primary Health Care professionals participated. Thematic research was developed with two Primary Care Units, one that used integrative and complementary practices in daily life and another that focused more on allopathic concepts of assistance. To carry out the three stages of the method used, seven Culture Yarning Circles took place. The critical unveiling took place concurrently with the participation of those surveyed. Results: integrative and complementary practices constitute a form of health care, with the purpose of understanding the human being in the health-disease process, making it possible to work with the different aspects that involve them. In this way, they reduce damages resulting from the excessive use of medications, stimulate comprehensiveness and promote health. Conclusion: integrative and complementary practices are resources for health promotion, through comprehensive care and reducing the use of medications.

scholarly journals Modeling of Food and Nutrition Surveillance in Primary Health Care

2017 ◽  
Vol 30 (1) ◽  
pp. 109-126 ◽  
Author(s):  
Santuzza Arreguy Silva VITORINO ◽  
Marly Marques da CRUZ ◽  
Denise Cavalcante de BARROS
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care System ◽  
Document Analysis ◽  
Logic Model ◽  
Structured Interviews ◽  
Primary Health ◽  
Food And Nutrition ◽  
Definition Of ◽  
Care System

ABSTRACT Objective: To describe the modeling stages of food and nutrition surveillance in the Primary Health Care of the Unified Health Care System, considering its activities, objectives, and goals Methods: Document analysis and semi-structured interviews were used for identifying the components, describe the intervention, and identify potential assessment users. Results: The results include identification of the objectives and goals of the intervention, the required inputs, activities, and expected effects. The intervention was then modeled based on these data. The use of the theoretical logic model optimizes times, resources, definition of the indicators that require monitoring, and the aspects that require assessment, identifying more clearly the contribution of the intervention to the results Conclusion: Modeling enabled the description of food and nutrition surveillance based on its components and may guide the development of viable plans to monitor food and nutrition surveillance actions so that modeling can be established as a local intersectoral planning instrument.

scholarly journals Reporting of noise-induced hearing loss: perceptions of primary health care professionals

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Gonçalves ◽  
H Pedroso ◽  
J Areosa
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Hearing Loss ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Health Concern ◽  
Noise Induced Hearing Loss ◽  
Care Network ◽  
Primary Health ◽  
Health Care Network

Abstract Background Worldwide, workers' health is still a Public Health concern, given the high number of hazardous occupational activities, as well as workers affected by work-related diseases. Among these diseases, occupational Noise-Induced Hearing Loss-NIHL is considered the second commonest occupational disease, and in Brazil, its reporting is compulsory. However, occupational diseases are usually underreported, hindering the knowledge of their actual magnitude, and the elaboration of prevention-oriented public policies. Objective To analyze the perception and knowledge of Primary Health Care professionals in Curitiba-Parana State, Brazil, on the compulsory NIHL reporting. Methods quantitative and qualitative approach conducted in three steps: analysis of a series of NIHL case histories reported in the official database between 2007 and 2018; application of a questionnaire to Primary Health Care Network professionals; collective interview with Primary Health Care Network nurses, speech therapists and doctors. Results NIHL reporting evidenced 82 cases, 67 (81.7%) among males, age ranging 50-64 years, 10 (12.2%) had complete high school level, 27 (32.9%) were formally employed, and 12 (14.6%) worked in the processing industry. Regarding the result of the applied questionnaire among the Primary Health Care professionals, 48 (68.7%) stated that they were prepared to identify workers' health problems, to 33 (68.7%) professionals, guidance to reassure users' comprehensive care is more important than the compulsory reporting, 21 (43.7%) claimed that they were qualified to identify NIHL cases, and 25 (52.1%) did not report the cases. Difficulties in reporting NIHL cases are: not understanding their flow, being afraid of the legal implications, which may generate difficulties in requesting audiometric testing, not having the management support, etc. Conclusions Most health care professionals are knowledgeable on NIHL, but they do not report the suspected cases due to lack of guidance. Key messages Primary care health professionals does not consider occupational health as part of the service to be provided. Primary care services are not prepared to establish the relationship between the injury and the job.

scholarly journals CARE OF CHILDREN WITH A CHRONIC CONDITION IN PRIMARY CARE: CHALLENGES TO THE HEALTHCARE MODEL

2015 ◽  
Vol 24 (4) ◽  
pp. 1009-1017 ◽  
Author(s):  
Elysângela Dittz Duarte ◽  
Kênia Lara Silva ◽  
Tatiana Silva Tavares ◽  
Corina Lemos Jamal Nishimoto ◽  
Paloma Morais Silva ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Chronic Conditions ◽  
Structured Interviews ◽  
Primary Health ◽  
Healthcare Model ◽  
Belo Horizonte ◽  
The City ◽  
Children With Chronic Conditions

ABSTRACT This is a qualitative study aiming to analyze the healthcare model for children with chronic conditions in Primary Health Care. The study subjects were nurses, nurse technicians and auxiliary nurses working in 16 basic health units in the city of Belo Horizonte, Minas Gerais. Data were collected through semi-structured interviews and later analyzed from the critical perspective, seeking to identify the common themes in the empirical material. Data revealed how primary health care professionals identified and reached children with chronic conditions, as well as how they presented the care actions performed. However, the development of a model of care for children with chronic conditions in primary health that considers their specific health needs constitutes a challenge.

scholarly journals Patient Safety in Primary Health Care in a Brazilian municipality

2021 ◽  
Vol 31 (4) ◽  
Author(s):  
Marcelo Pereira da Rocha ◽  
Ingrid Soares Viana ◽  
Iago Freitas Vieira
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Patient Safety ◽  
Content Analysis ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Family Health ◽  
Qualitative Approach ◽  
Exploratory Research ◽  
Primary Health

Abstract The adoption of safe practices by health services drives out health harms and preventable deaths at all levels of health care. This study aimed to understand how patient safety actions are organized in the conception of primary health care professionals in a municipality in the state of Bahia. exploratory research, with a qualitative approach, was performed through in person and online interviews with two Nurses and three Dental Surgeons, with broad knowledge of the researched matter and working in traditional primary care and Family Health teams. Data were analyzed through content analysis. It was perceived that knowledge of the researched topic was insufficient and that there was a need for the matter to become part of the teams’ discussion agenda. The reports point out that, in the interviewees’ view, actions related to patient safety are not yet implemented in the researched location. It was identified the need for structuring actions aimed at preventing adverse events and institutionalizing safety in health care.

scholarly journals Atuação dos profissionais de educação física na atenção primária à saúde

2017 ◽  
Vol 15 (2) ◽  
pp. 105-113
Author(s):  
Joel Carlos Valcanaia Ferreira ◽  
Joel Saraiva Ferreira
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Physical Education ◽  
Health Care Professionals ◽  
Private Higher Education ◽  
Education Professionals ◽  
Department Of Health ◽  
Primary Health ◽  
Intervention Context

O objetivo do estudo foi analisar as características sociodemográficas e econômicas dos profissionais de Educação Física atuantes na Atenção Primária à Saúde no município de Campo Grande - MS. A distribuição dos profissionais na rede municipal de saúde foi fornecida pela Secretaria Municipal de Saúde. Para obter as informações junto aos profissionais, utilizou-se de questionário autoaplicável elaborado especificamente para o presente estudo. Os resultados indicaram que 61% dos profissionais de Educação Física com vínculo funcional com a Secretaria Municipal de Saúde Pública de Campo Grande - MS atuavam na Atenção Primária. Os profissionais são maioria do sexo masculino (54%), predominância de casados (82%), faixa etária de 30 a 39 anos (73%), renda mensal de até três salários mínimos (73%), formação em Educação Física (Licenciatura Plena) (54%), concluída há mais de 10 anos (82%), majoritariamente em instituições privadas de ensino superior (73%), concursados no serviço público (91%), com jornada de serviço semanal de 40 horas (91%), atuantes há mais de três anos da Atenção Primária à Saúde (82%). Concluiu-se que as características sociodemográficas e econômicas revelaram que os PEF detém estabilidade funcional, com experiência na área de atuação e formação condizente com o contexto de intervenção.ABSTRACT. The work of physical education professionals on primary health care. The goal of this study was to analyze the sociodemographic and economical characteristics of the physical education professionals working with Primary Health Care in the municipality of Campo Grande - MS. The data were initially collected with the management of municipal department of health, in order to identify the distribution of professionals in the municipal health network and, later, with the Primary Health Care professionals themselves. In order to obtain the information from the professionals, it was used a self-applicable questionnaire devised specifically for this study. The results showed that 61% of the physical education professionals functionally linked to the municipal department of public health of Campo Grande-MS worked with primary care, which represented a coverage of approximately 30% of supply of physical activities on that level of health care. The evaluated professionals presented a sociodemographic profile with a majority of males (54%), prevalently married (82%), in the age group between 30 and 39 years old (73%), with a monthly income of up to three minimum wages (73%), with a full licentiateship in Physical Education (54%), concluded over 10 years ago (82%), mostly in private higher education institutions (73%), with public service tender (91%), with a 40-hour workweek (91%), working with primary care for over three years (82%). It was concluded that the sociodemographic and economical characteristics showed that the Physical Education professionals have functional tenure, with experience in the area of work and training in line with the intervention context.

scholarly journals Why do they do it? A grounded theory study of the use of low-value care among primary health care physicians

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Sara Ingvarsson ◽  
Hanna Augustsson ◽  
Henna Hasson ◽  
Per Nilsen ◽  
Ulrica von Thiele Schwarz ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Grounded Theory ◽  
Primary Health Care ◽  
Health Care System ◽  
Theory Approach ◽  
Use Of Resources ◽  
Primary Health ◽  
Perceived Pressure ◽  
Care System

Abstract Background The use of low-value care (LVC) is widespread and has an impact on both the use of resources and the quality of care. However, few studies have thus far studied the factors influencing the use of LVC from the perspective of the practitioners themselves. The aim of this study is to understand why physicians within primary care use LVC. Methods Six primary health care centers in the Stockholm Region were purposively selected. Focus group discussions were conducted with physicians (n = 31) working in the centers. The discussions were coded inductively using a grounded theory approach. Results Three main reasons for performing LVC were identified. Uncertainty and disagreement about what not to do was related to being unaware of the LVC status of a practice, guidelines perceived as conflicting, guidelines perceived to be irrelevant for the target patient population, or a lack of trust in the guidelines. Perceived pressure from others concerned patient pressure, pressure from other physicians, or pressure from the health care system. A desire to do something for the patients was associated with the fact that the visit in itself prompts action, symptoms to relieve, or that patients' emotions need to be reassured. The three reasons are interdependent. Uncertainty and disagreement about what not to do have made it more difficult to handle the pressure from others and to refrain from doing something for the patients. The pressure from others and the desire to do something for the patients enhanced the uncertainty and disagreement about what not to do. Furthermore, the pressure from others influenced the desire to do something for the patients. Conclusions Three reasons work together to explain primary care physicians’ use of LVC: uncertainty and disagreement about what not to do, perceived pressure from others, and the desire to do something for the patients. The reasons may, in turn, be influenced by the health care system, but the decision nevertheless seemed to be up to the individual physician. The findings suggest that the de-implementation of LVC needs to address the three reasons from a systems perspective.

scholarly journals An implementation history of primary health care transformation: Alberta’s primary care networks and the people, time and culture of change

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Myles Leslie ◽  
Akram Khayatzadeh-Mahani ◽  
Judy Birdsell ◽  
P. G. Forest ◽  
Rita Henderson ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Fee For Service ◽  
Structured Interviews ◽  
Policy Documents ◽  
Incremental Change ◽  
Primary Health ◽  
History Of

Abstract Background Primary care, and its transformation into Primary Health Care (PHC), has become an area of intense policy interest around the world. As part of this trend Alberta, Canada, has implemented Primary Care Networks (PCNs). These are decentralized organizations, mandated with supporting the delivery of PHC, funded through capitation, and operating as partnerships between the province’s healthcare administration system and family physicians. This paper provides an implementation history of the PCNs, giving a detailed account of how people, time, and culture have interacted to implement bottom up, incremental change in a predominantly Fee-For-Service (FFS) environment. Methods Our implementation history is built out of an analysis of policy documents and qualitative interviews. We conducted an interpretive analysis of relevant policy documents (n = 20) published since the first PCN was established. We then grounded 12 semi-structured interviews in that initial policy analysis. These interviews explored 11 key stakeholders’ perceptions of PHC transformation in Alberta generally, and the formation and evolution of the PCNs specifically. The data from the policy review and the interviews were coded inductively, with participants checking our emerging analyses. Results Over time, the PCNs have shifted from an initial Frontier Era that emphasized local solutions to local problems and featured few rules, to a present Era of Accountability that features central demands for standardized measures, governance, and co-planning with other elements of the health system. Across both eras, the PCNs have been first and foremost instruments and supporters of family physician authority and autonomy. A core group of people emerged to create the PCNs and, over time, to develop a long-term Quality Improvement (QI) vision and governance plan for them as organizations. The continuing willingness of both these groups to work at understanding and aligning one another’s cultures to achieve the transformation towards PHC has been central to the PCNs’ survival and success. Conclusions Generalizable lessons from the implementation history of this emerging policy experiment include: The need for flexibility within a broad commitment to improving quality. The importance of time for individuals and organizations to learn about: quality improvement; one another’s cultures; and how best to support the transformation of a system while delivering care locally.

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