Improving quality in general practice using the Primary Care Practice Improvement Tool (PC-PIT) with Primary Health Network support

2020 ◽  
Vol 26 (6) ◽  
pp. 484
Author(s):  
Samantha J. Borg ◽  
Maria Donald ◽  
Koula Totsidis ◽  
Narelle Quinn ◽  
Claire L. Jackson
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Care Home ◽  
Care Practice ◽  
Organisational Performance ◽  
Health Network ◽  
Practice Improvement ◽  
Primary Health ◽  
Primary Care Sector

Optimal primary care sector performance is vital for ensuring the delivery of quality health services and effective clinical management of populations. The Primary Care Practice Improvement Tool (PC-PIT) incorporates subjective staff input and objective indicators to measure 13 elements of organisational performance. This study aimed to measure change in organisational performance for general practices using the PC-PIT with Primary Health Network (PHN) support. A pre-post design was used for changes in PC-PIT subjective and objective scores. Practices used results with PHN support to complete two Plan Do Study Act initiatives and were reassessed 9-months later. PC-PIT scales were dichotomised into lower and higher scores, with odds ratios used to determine effect size. Staff survey response rates were 55.4% at baseline and 50.1% at follow up. There were modest increases in the likelihood of staff rating several elements higher at follow up. When implemented with PHN support staff, the PC-PIT has the potential for effective, focussed and sustained quality improvement, with capacity to support Health Care Home model transition and implementation.

The Primary Care Practice Improvement Tool (PC-PIT) process for organisational improvement in primary care: application by Australian Primary Health Networks

2019 ◽  
Vol 25 (2) ◽  
pp. 185 ◽  
Author(s):  
Samantha J. Borg ◽  
Lisa Crossland ◽  
Jo Risk ◽  
Julie Porritt ◽  
Claire L. Jackson
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Care Home ◽  
Care Practice ◽  
Theory Approach ◽  
Health Networks ◽  
Practice Improvement ◽  
Primary Health ◽  
General Practices ◽  
Improvement Programs

The Primary Care Practice Improvement Tool (PC-PIT) is an organisational performance improvement tool recently implemented by two Primary Health Networks (PHNs). This study explored barriers and facilitators to implementing the PC-PIT process at scale, from the initial introduction of the tool to completion of Plan-Do-Study-Act cycles with general practices. Using a qualitative design, in-depth, semi-structured interviews were conducted with 10 PHN staff to seek feedback on the delivery of the PC-PIT to general practices. Interview results were analysed using a grounded theory approach. The identification of barriers such as difficulty engaging practices and lack of report sharing with the PHNs will help streamline future implementation. The PC-PIT was highly compatible with existing quality improvement programs and offers enhanced opportunity to support capacity building and implementation of the Health Care Home model.

Follow-up of 100 dogs with acute diarrhoea in a primary care practice

2014 ◽  
Vol 199 (1) ◽  
pp. 188-190 ◽  
Author(s):  
C.M. Berset-Istratescu ◽  
O.J. Glardon ◽  
I. Magouras ◽  
C.F. Frey ◽  
S. Gobeli ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Acute Diarrhoea ◽  
Care Practice

scholarly journals Development and pilot study of the Primary Care Practice Improvement Tool (PC‐PIT): an innovative approach

2014 ◽  
Vol 201 (S3) ◽  
Author(s):  
Lisa Crossland ◽  
Tina Janamian ◽  
Mary Sheehan ◽  
Victor Siskind ◽  
Julie Hepworth ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Primary Care Practice ◽  
Innovative Approach ◽  
Care Practice ◽  
Practice Improvement

scholarly journals Call your doctor: prospective description study of telemedicine during the first COVID-19 outbreak in a Swiss primary care practice

2020 ◽  
Author(s):  
Joëlle Suillot ◽  
Sophie Zuercher ◽  
Lydie Zufferey ◽  
Julien Sagez
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Primary Care Practice ◽  
Emergency Services ◽  
Phone Call ◽  
Categorical Variables ◽  
Care Practice ◽  
Or Groups ◽  
Swiss Primary Care

Abstract Background: Telemedicine is a healthcare assistance method which has been promoted during the COVID-19 pandemic for the management of patients. The aim of this study is to quantify the type of request that primary care physicians are experiencing, as well as the healthcare assistance modalities and ultimately, how many physical consultations are necessary.Methods: We conducted a prospective, descriptive study in a primary care practice in Switzerland on telephone consultations related to COVID-19. The data collected included the reasons for the call, symptoms, healthcare assistance modalities and follow-up. The categorical variables are expressed as percentages of the total cases or groups.Results: We included 200 calls corresponding to 113 patients. The majority of patients (76.1%) were taken care of solely through telemedicine. The physical consultations were due to the need: for a swab test (12.4%), for a somatic assessment at the practice (9.7%) and for an emergency services consultation (1.8%). In 64.6% of cases, patient assistance required only one phone call. Calls lasted 7.85 minutes on average and were more frequent on Mondays (24%) and Fridays (18.5%). Calls led to the prescription of medication in 12.5% of cases, of a bronchodilator in 3% of cases and of an antibiotic in 0.5% of cases.Conclusion: A rigorous telephone follow-up strategy carried out by primary care physicians requires few physical consultations in patients showing symptoms of COVID-19.

Whose role is it? Primary care and the provision of emotional support for women experiencing miscarriage: a pilot qualitative Australian study

2020 ◽  
Vol 26 (5) ◽  
pp. 388
Author(s):  
Vellyna Sumarno ◽  
Meredith J. Temple-Smith ◽  
Jade E. Bilardi
Keyword(s):  
Primary Care ◽  
Emotional Support ◽  
Primary Care Practice ◽  
Care Practice ◽  
Health Issues ◽  
Structured Interviews ◽  
Self Blame ◽  
Physical Care

Miscarriage can cause significant psychological morbidity. Women frequently report dissatisfaction with healthcare professionals’ support following miscarriage. This pilot study aimed to explore the views and practices of GPs in providing emotional support to women experiencing miscarriage. Eight GPs participated in semi-structured interviews. GPs considered women’s physical care their top priority at the time of miscarriage; however, acknowledged miscarriage could result in significant emotional sequelae. Most GPs felt it was their role to provide emotional support, including expressing empathy, listening and normalising miscarriage to mitigate guilt and self-blame. GPs preferred an individualised approach to emotional support and mostly offered follow-up appointments if a patient requested it or was considered ‘high risk’ for mental health issues. Some GPs believed miscarriage support was within the scope of primary care practice; however, others felt it was the role of social networks and pregnancy loss support organisations. GPs identified several structural and external barriers that precluded enhanced emotional support. Further tools and resources to enhance support care may be of benefit to some GPs. The feasibility of GPs providing follow-up support remains uncertain. Further research is required to determine whether support is best placed within primary care or better served through external organisations.

Identifying Dementia in the Primary Care Practice

2000 ◽  
Vol 12 (4) ◽  
pp. 483-493 ◽  
Author(s):  
Paul R. Solomon ◽  
Michael Brush ◽  
Vivian Calvo ◽  
Felicity Adams ◽  
Richard D. DeVeaux ◽  
...  
Keyword(s):  
Primary Care ◽  
Negative Predictive Value ◽  
Random Sample ◽  
Predictive Value ◽  
Primary Care Practice ◽  
Diagnostic Evaluation ◽  
Care Practice ◽  
Test Retest Reliability ◽  
Cognitive Problems

Background: The purpose of this study was to evaluate the utility (i.e., positive and negative predictive value) of the 7 Minute Screen in identifying patients with probable Alzheimer's disease (AD) in a primary care practice. A second objective was to estimate the number of undiagnosed AD patients in a typical primary care practice. Methods: One hundred thirty-seven successive admissions (96%) of patients over the age of 60 to a primary care practice over a 53-day period who completed informed consent documents were administered the 7 Minute Screen. All patients who screened positive (n = 13) and a random sample of those who screened negative (n = 26) returned for full diagnostic evaluation. Positive predictive value (PPV) and negative predictive value (NPV) of the 7 Minute Screen were determined using the criterion standard of clinical diagnosis established by examination, history, and laboratory studies. Test-retest reliability and time for administration were also determined. Results: Of the 137 patients evaluated, 13 screened positive and 124 screened negative. Eleven of the 13 patients who screened positive were willing to return to the primary care practice for follow-up evaluation. A random sample of 26 patients who screened negative all agreed to return for follow-up evaluation. Of the 11 patients who screened positive who returned for evaluation, 10 were subsequently diagnosed with probable AD. The remaining patient was diagnosed with mixed dementia. The caregivers of the two patients who refused to return were contacted and both indicated that the patients were having significant cognitive problems as verified by an activities of daily living scale. Of the 26 patients who screened negative, 25 were judged to be cognitively normal and the 26th was judged to have mild cognitive impairment. Discussion: In successive admissions of patients over the age of 60 in a primary care practice, the 7 Minute Screen showed a PPV of 91% and an NPV of 96% in identifying patients who were subsequently identified with AD or other dementing disorder. These data suggest that this may be a useful instrument in identifying patients who should undergo diagnostic evaluation for AD and other dementing disorders. Additionally, extrapolation from the data in this practice suggests that there may be between 75 and 100 AD patients in the typical primary care practice, many of whom may not be diagnosed.

scholarly journals Incorporating the Patient Voice Into Practice Improvement:

2019 ◽  
Vol 51 (4) ◽  
pp. 348-352 ◽  
Author(s):  
Kristie Y. Hsu ◽  
Victor M. Contreras ◽  
Kathan Vollrath ◽  
Nancy Cuan ◽  
Steven Lin
Keyword(s):  
Primary Care ◽  
Medical Student ◽  
Rank Order ◽  
Patient Perspectives ◽  
Care Practice ◽  
Staff Perceptions ◽  
Practice Improvement ◽  
Patient Voice ◽  
Patient Concerns

Background and Objectives: Many primary care clinics rely on providers and staff to generate quality improvement (QI) ideas without explicitly including patients. However, without understanding patient perspectives, clinics may miss areas for improvement. We identified practice improvement opportunities using a medical student-driven pilot of QI design that incorporates the patient voice and explored provider/staff perceptions of patient perspectives. Methods: One medical student interviewed eight patients for their perspectives on QI opportunities at a university-based primary care practice. Two trainees independently coded interview transcripts using directed content analysis (final codebook: 11 themes) and determined frequency of mentions for each theme. We surveyed 11 providers/staff by asking them to select 5 of the 11 themes and place them in rank order based on their perceptions of patient concerns; their surveys were aggregated into one ranked list. Results: Patients most frequently identified the following themes as QI opportunities: relationship (ie, feeling of personal connection with providers/staff), specialty care, convenience, sustainability, and goal follow-up. While patients frequently identified relationship (rank=1) and goal follow-up (rank=3) as QI opportunities, the provider/staff top five list did not include relationship (rank=10) or goal follow-up (rank=7). Conclusions: Our study demonstrates two things: (1) there are areas of discordance between provider/staff perceptions and patient perspectives regarding practice improvement opportunities; and (2) medical students can participate meaningfully in the QI process. By harnessing patient perspectives with the help of medical trainees, clinics may better understand patient concerns and avoid potential QI blind spots.

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