scholarly journals P.039 Generating choosing wisely Canada recommendations for neurology

2019 ◽  
Vol 46 (s1) ◽  
pp. S24
Author(s):  
C Beyak ◽  
F Costello ◽  
P Couillard
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Online Survey ◽  
Care Delivery ◽  
Primary Care Providers ◽  
Choosing Wisely ◽  
Board Members ◽  
Care Providers ◽  
Short List ◽  
Survey Results

Background: Many guidelines in neurology encompass the principles of Choosing Wisely Canada (CWC): resource stewardship, patient safety, and high value care. There are currently 49 medical societies with CWC recommendations excluding the Canadian Neurologic Society (CNS). Methods: A descriptive process for list generation is outlined. A review of the American Choosing Wisely recommendations was undertaken to generate an adapted list of ten recommendations. CNS board members vetted this list and an online survey was sent to each CNS member. Results: A short list of recommendations endorsed by the CNS membership at large will be presented according to the survey results. CWC promotion of the list will take place to reach specialists, primary care providers, and trainees to ensure high value neurological care delivery is the standard across Canada. Conclusions: The process to delineate CWC recommendations for neurology is outlined. Participating in the CWC movement is an important leadership initiative for the CNS. It demonstrates the commitment of Canadian neurologists to the principles of high value patient care in neurology.

scholarly journals Complementary and Integrative Health Knowledge and Practice in Primary Care Settings: A Survey of Primary Care Providers in the Northwestern United States

2021 ◽  
Vol 10 ◽  
pp. 216495612110233
Author(s):  
Malaika R Schwartz ◽  
Allison M Cole ◽  
Gina A Keppel ◽  
Ryan Gilles ◽  
John Holmes ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Health Knowledge ◽  
Care Delivery ◽  
Primary Care Providers ◽  
The United States ◽  
Research Network ◽  
Care Providers ◽  
Integrative Health ◽  
And Training

Background The demand for complementary and integrative health (CIH) is increasing by patients who want to receive more CIH referrals, in-clinic services, and overall care delivery. To promote CIH within the context of primary care, it is critical that providers have sufficient knowledge of CIH, access to CIH-trained providers for referral purposes, and are comfortable either providing services or co-managing patients who favor a CIH approach to their healthcare. Objective The main objective was to gather primary care providers’ perspectives across the northwestern region of the United States on their CIH familiarity and knowledge, clinic barriers and opportunities, and education and training needs. Methods We conducted an online, quantitative survey through an email invitation to all primary care providers (n = 483) at 11 primary care organizations from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). The survey questions covered talking about CIH with patients, co-managing care with CIH providers, familiarity with and training in CIH modalities, clinic barriers to CIH integration, and interest in learning more about CIH modalities. Results 218 primary care providers completed the survey (45% response rate). Familiarity with individual CIH methods ranged from 73% (chiropracty) to 8% (curanderismo). Most respondents discussed CIH with their patients (88%), and many thought that their patients could benefit from CIH (41%). The majority (89%) were willing to co-manage a patient with a CIH provider. Approximately one-third of respondents had some expertise in at least one CIH modality. Over 78% were interested in learning more about the safety and efficacy of at least one CIH modality. Conclusion Primary care providers in the Northwestern United States are generally familiar with CIH modalities, are interested in referring and co-managing care with CIH providers, and would like to have more learning opportunities to increase knowledge of CIH.

scholarly journals Prescribing and testing by primary care providers to assess adherence to the Choosing Wisely Canada recommendations: a retrospective cohort study

CMAJ Open ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. E603-E610
Author(s):  
Alexander Singer ◽  
Leanne Kosowan ◽  
Alan Katz ◽  
Kheira Jolin-Dahel ◽  
Karen Appel ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Primary Care Providers ◽  
Choosing Wisely ◽  
Care Providers

Systematic review of barriers and enablers to the delivery of palliative care by primary care practitioners

2019 ◽  
Vol 33 (9) ◽  
pp. 1131-1145 ◽  
Author(s):  
Mariko L Carey ◽  
Alison C Zucca ◽  
Megan AG Freund ◽  
Jamie Bryant ◽  
Anne Herrmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Palliative Care ◽  
Care Delivery ◽  
Primary Care Providers ◽  
Healthcare Services ◽  
Care Providers ◽  
Eligibility Criteria ◽  
Barriers And Enablers ◽  
Primary Care Practitioners

Background: There is increasing demand for primary care practitioners to play a key role in palliative care delivery. Given this, it is important to understand their perceptions of the barriers and enablers to optimal palliative care, and how commonly these are experienced. Aim: To explore the type and prevalence of barriers and enablers to palliative care provision reported by primary care practitioners. Design: A systematic review of quantitative data-based articles was conducted. Data sources: Medline, Embase and PsychINFO databases were searched for articles published between January 2007 and March 2019. Data synthesis: Abstracts were assessed against the eligibility criteria by one reviewer and a random sample of 80 articles were blind coded by a second author. Data were extracted from eligible full-texts by one author and checked by a second. Given the heterogeneity in the included studies’ methods and outcomes, a narrative synthesis was undertaken. Results: Twenty-one studies met the inclusion criteria. The most common barriers related to bureaucratic procedures, communication between healthcare professionals, primary care practitioners’ personal commitments, and their skills or confidence. The most common enablers related to education, nurses and trained respite staff to assist with care delivery, better communication between professionals, and templates to facilitate referral to out-of-hours services. Conclusion: A holistic approach addressing the range of barriers reported in this review is needed to support primary care providers to deliver palliative care. This includes better training and addressing barriers related to the interface between healthcare services.

A Comparison of Perceptions of Reassurance in Patients with Nontraumatic Neck Pain and Whiplash-Associated Disorders in Consultations with Primary Care Practitioners—An Online Survey

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3377-3386
Author(s):  
Alma Viviana Silva Guerrero ◽  
Jenny Setchell ◽  
Annick Maujean ◽  
Michele Sterling
Keyword(s):  
Primary Care ◽  
Neck Pain ◽  
Structural Damage ◽  
Online Survey ◽  
Detailed Comparison ◽  
Primary Care Providers ◽  
Care Providers ◽  
Convenience Sample ◽  
Primary Care Practitioners ◽  
Pain Symptoms

Abstract Objectives Neck pain remains highly prevalent and costly worldwide. Although reassurance has been recommended as a first line of treatment, specific advice on the best ways to provide reassurance has not been provided due to lack of evidence. Pain symptoms and experiences differ between patients with whiplash-associated disorder (WAD) and those with nontraumatic neck pain (NTNP). The aims of this study were to 1) identify and compare the concerns, fears, and worries of patients with WAD and NTNP; and 2) determine if patients believe their concerns are addressed by primary care providers. Methods These questions were investigated through an online survey, with a convenience sample of 30 participants with NTNP and 20 with WAD. Results A thematic analysis of survey responses resulted in the following seven themes related to common concerns, and two regarding how well concerns were addressed. Common concerns expressed by both groups shared four themes: 1) further structural damage, 2) psychological distress, 3) concerns about the future, and 4) hardships that eventuate. Theme 5), pain/disability is long term, was specific to WAD. Themes 6), pain is current or reoccurring, and 7), interference with daily life, were specific to NTNP. Regarding how well patient concerns were addressed, two overarching themes were common to both conditions: 1) concerns were addressed, with both groups sharing the subthemes “successful treatment,” “reassurance,” and “trust”; and 2) concerns were not addressed, where all subthemes were shared with the exception of two unique to NTNP. Conclusions This detailed comparison provides information about neck pain patients’ concerns and fears, while providing health practitioners support for selecting strategies to promote reassurance appropriately for individual patient needs. Our findings from patients’ perspectives enhance the understanding for providing reassurance for neck pain as proposed by our analysis.

The Implementation of a Clinical Toolkit and Adolescent Depression Screening Program in Primary Care

2014 ◽  
Vol 53 (14) ◽  
pp. 1336-1344
Author(s):  
Jonathan M. Libby ◽  
Eileen Stuart-Shor ◽  
Almas Patankar
Keyword(s):  
Primary Care ◽  
Adolescent Depression ◽  
Care Setting ◽  
Primary Care Setting ◽  
Screening Program ◽  
Primary Care Providers ◽  
Depression Screening ◽  
Care Providers ◽  
Comfort Levels ◽  
Survey Results

Problem/Background. Adolescent depression is a growing problem for today’s society with only 30% receiving services. Aim and Methods. The aim of this project was to increase identification and treatment of depressed adolescents, and comfort levels of primary care providers with the implementation of a depression-screening program and use of a clinical depression toolkit within a primary care setting. Setting. The setting was a private pediatric practice in central Maine. Results. Over an 8-week period, 266 adolescents were screened. Twelve adolescents (4.5%) received a diagnosis of depression and 11 received treatment within 8 days. Survey results showed a significant increase in providers’ feelings of comfort and accountability. Conclusion. This project demonstrates that it is feasible to implement a depression screening and treatment program in primary care. It demonstrates that primary care providers can increase their comfort and feelings accountability in treating depression in primary care, thus increasing access for this monumental and potential catastrophic problem.

scholarly journals Cognitive and Initial Psychometric Testing of the Errors of Care Omission Survey: A New Patient Safety Tool for Primary Care

2019 ◽  
Vol 27 (1) ◽  
pp. 16-32 ◽  
Author(s):  
Lusine Poghosyan ◽  
Allison A. Norful ◽  
Jianfang Liu ◽  
Jonathan Shaffer
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Item Analysis ◽  
Psychometric Testing ◽  
Internal Consistency Reliability ◽  
Primary Care Providers ◽  
Care Providers ◽  
Safety Studies ◽  
High Internal Consistency ◽  
High Internal Consistency Reliability

Background and PurposeMost patient safety studies focus on errors of commission rather than on errors of omission. No tools measure errors of omission in primary care. We developed the Errors of Care Omission Survey (ECOS) and present its cognitive and psychometric testing.MethodsTwenty-six primary care providers (PCPs) participated in cognitive interviews, which were audiotaped, transcribed, and analyzed. ECOS was also pilot tested with 37 PCPs. Item analysis and reliability testing w conducted.ResultsInterviewees agreed that ECOS measures errors of omission and items were clear. The response categories were revised. All items were correlated and subscales had high internal consistency reliability.ConclusionsECOS can measure errors of omission in primary care.

Barriers to caring for survivors of childhood cancer: Primary care providers’ and oncologists’ perspectives.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19194-e19194
Author(s):  
Aminat Adewumi ◽  
Cynthia Gerhardt ◽  
Randal S. Olshefski ◽  
Micah Skeens
Keyword(s):  
Primary Care ◽  
Childhood Cancer ◽  
Late Effects ◽  
Primary Care Physicians ◽  
Care Delivery ◽  
Paper Copy ◽  
Primary Care Providers ◽  
Comfort Level ◽  
Care Providers ◽  
Survivors Of Childhood Cancer

e19194 Background: Advances in treatment have resulted in a growing population of childhood cancer survivors. As most survivors will develop at least one late effect from treatment, it is important to continue to monitor their health. The incidence of late effects increases with age and often are not clinically apparent until decades after cancer treatment. The Institute of Medicine has recommended models of care delivery that include collaboration between oncologists and primary care physicians (PCP). Thus, we explored PCP and pediatric oncologists’ perceptions and experiences with survivors of childhood cancer in primary care. Methods: Recruitment of primary care physicians occurred utilizing the state Board of Medicine listings. A link and a paper copy of the survey were supplied via mail to approximately 3,000 pediatricians. Pediatric oncologists from a large Midwestern hospital completed the survey via email. Results: A total of 197 participants (19 oncologists/ 178 PCPs) completed the survey. The response rate was 95% for oncologists and 6% for PCPs. Although most PCPs (76%, n=134) had cared for a childhood cancer survivor, some respondents (16%, n=8) reported an unwillingness to care for a survivor. Using a ten-point scale, PCPs mean comfort level in caring for survivors of pediatric cancer was 5.78 ( SD= 2.37). PCPs identified the following barriers: limited knowledge of late effects (64%; n=114), lack of communication with oncologist (47%; n=83), and comfort level (38%; n=67). Nearly all oncologists (86%, n=19) reported referring patients to PCPs. Oncologists typically (83%, n=15) referred patients within the first year after treatment. Overall, oncologists were comfortable referring survivors to a PCP ( M=7.5; SD=1.97) and over half were satisfied with the PCP’s care of survivors (57%, n=12). Years in practice and sex of the oncologist were unrelated to comfort level referring to PCP. Conclusions: Barriers faced by PCPs in caring for survivors illustrate a need for increased education and communication between PCPs and oncologists. Attention to these concerns may improve follow-up care and comfort in the referral process.

scholarly journals Strategies in Primary Care to Face the SARS-CoV-2 / COVID-19 Pandemic: An Online Survey

2021 ◽  
Vol 8 ◽  
Author(s):  
Marion Eisele ◽  
Nadine Janis Pohontsch ◽  
Martin Scherer
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Health Care Providers ◽  
Online Survey ◽  
Qualitative Content Analysis ◽  
Primary Care Providers ◽  
Care Providers ◽  
Sources Of Information ◽  
Pandemic Preparedness ◽  
Team Meetings

Background: Primary care plays a key role in pandemics like the SARS-CoV-2 pandemic in 2020. We aimed to investigate the challenges faced and the solutions implemented in primary care.Methods: One hundred and twenty-one general practitioners in Germany completed the online survey. We used open questions to examine challenges experienced and solutions implemented during the early pandemic and chose qualitative content analysis to extract and describe the meaning of the answers. We derived deductive categories from the research questions and formed inductive categories during the material reviews.Results: Main challenges were: insufficient information, lack of protective equipment, need to restructure practice procedures and insufficient individual and structural pandemic preparedness, resulting in secondary challenges: fear of infection, impaired patient care, aggravated steering of patients, difficult cooperation with external entities and a not viable hygiene concept advised by authorities. Strategies to address these challenges included establishing regular team-meetings to develop new solutions, focusing on few reliable sources of information, working in alternating shifts, increasing telemedicine, establishing window and open-air practices and building networks with other health care providers. Respondents criticized the lack of consideration of their experiences in planning pandemic measures within primary care.Conclusions: General practitioners successfully applied pragmatic and creative strategies in their practices during the early phase of the pandemic. Among these, communication within and between practices emerged as a key strategy. These strategies should be provided with pandemic preparedness plans. The lacking consideration of the primary care providers' experiences in planning and implementing pandemic measures needs to be addressed by stakeholders.

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