scholarly journals Review: nurse practitioner primary care improves patient satisfaction and quality of care with no difference in health outcomes

2002 ◽  
Vol 5 (4) ◽  
pp. 121-121 ◽  
Author(s):  
F. C Donald
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Outcomes ◽  
Nurse Practitioner

scholarly journals Impact of GP gatekeeping on quality of care, and health outcomes, use, and expenditure: a systematic review

2019 ◽  
Vol 69 (682) ◽  
pp. e294-e303 ◽  
Author(s):  
Poompong Sripa ◽  
Benedict Hayhoe ◽  
Priya Garg ◽  
Azeem Majeed ◽  
Geva Greenfield
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Outcomes ◽  
Direct Access ◽  
Cochrane Library ◽  
Patients With Cancer ◽  
The Impact

BackgroundGPs often act as gatekeepers, authorising patients’ access to specialty care. Gatekeeping is frequently perceived as lowering health service use and health expenditure. However, there is little evidence suggesting that gatekeeping is more beneficial than direct access in terms of patient- and health-related outcomes.AimTo establish the impact of GP gatekeeping on quality of care, health use and expenditure, and health outcomes and patient satisfaction.Design and settingA systematic review.MethodThe databases MEDLINE, PreMEDLINE, Embase, and the Cochrane Library were searched for relevant articles using a search strategy. Two authors independently screened search results and assessed the quality of studies.ResultsElectronic searches identified 4899 studies (after removing duplicates), of which 25 met the inclusion criteria. Gatekeeping was associated with better quality of care and appropriate referral for further hospital visits and investigation. However, one study reported unfavourable outcomes for patients with cancer under gatekeeping, and some concerns were raised about the accuracy of diagnoses made by gatekeepers. Gatekeeping resulted in fewer hospitalisations and use of specialist care, but inevitably was associated with more primary care visits. Patients were less satisfied with gatekeeping than direct-access systems.ConclusionGatekeeping was associated with lower healthcare use and expenditure, and better quality of care, but with lower patient satisfaction. Survival rate of patients with cancer in gatekeeping schemes was significantly lower than those in direct access, although primary care gatekeeping was not otherwise associated with delayed patient referral. The long-term outcomes of gatekeeping arrangements should be carefully studied before devising new gatekeeping policies.

Primary care nurse practitioner burnout and perceptions of quality of care

Nursing Forum ◽  
2021 ◽  
Author(s):  
Cilgy M. Abraham ◽  
Katherine Zheng ◽  
Allison A. Norful ◽  
Affan Ghaffari ◽  
Jianfang Liu ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Nurse Practitioner ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
Primary Care Nurse Practitioner

scholarly journals Study of the Strengths and Weaknesses of Nursing Work Environments in Primary Care in Spain

2021 ◽  
Vol 18 (2) ◽  
pp. 434
Author(s):  
Vicente Gea-Caballero ◽  
José Ramón Martínez-Riera ◽  
Pedro García-Martínez ◽  
Jorge Casaña-Mohedo ◽  
Isabel Antón-Solanas ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Health Outcomes ◽  
Work Environments ◽  
Head Nurse ◽  
Cross Sectional ◽  
Primary Health

Background: Nursing work environments are defined as the characteristics of the workplace that promote or hinder the provision of professional care by nurses. Positive work environments lead to better health outcomes. Our study aims to identify the strengths and weaknesses of primary health care settings in Spain. Methods: Cross-sectional study carried out from 2018 to 2019. We used the Practice Environment Scale of the Nursing Work Index and the TOP10 Questionnaire of Assessment of Environments in Primary Health Care for data collection. The associations between sociodemographic and professional variables were analyzed. Results: In total, 702 primary care nurses participated in the study. Responses were obtained from 14 out of the 17 Spanish Autonomous Communities. Nursing foundation for quality of care, management and leadership of head nurse and nurse–physician relationship were identified as strengths, whereas nurse participation in center affairs and adequate human resources to ensure quality of care were identified as weaknesses of the nursing work environment in primary health care. Older nurses and those educated to doctoral level were the most critical in the nursing work environments. Variables Age, Level of Education and Managerial Role showed a significant relation with global score in the questionnaire. Conclusion: Interventions by nurse managers in primary health care should focus on improving identified weaknesses to improve quality of care and health outcomes.

Effects of employing primary care doctors in hospital to improve the quality of care and health outcomes of rural patients: A systematic scoping review

2021 ◽  
Vol 29 (4) ◽  
pp. 492-501
Author(s):  
I Nyoman Sutarsa ◽  
Rosny Kasim ◽  
Claudia Slimings ◽  
Suzanne Bain‐Donohue ◽  
Amanda Barnard
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Health Outcomes ◽  
Scoping Review ◽  
Primary Care Doctors ◽  
Rural Patients

scholarly journals Nurse Practitioner–Physician Comanagement of Patients in Primary Care

2018 ◽  
Vol 19 (3-4) ◽  
pp. 82-90 ◽  
Author(s):  
Allison A. Norful ◽  
Siqin Ye ◽  
Mieke Van der-Biezen ◽  
Lusine Poghosyan
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Nurse Practitioner ◽  
Care Delivery ◽  
Qualitative Interviews ◽  
Recommended Care ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Care Delivery

Current demand for primary care services will soon exceed the primary care provider (PCP) workforce capacity. As patient panel sizes increase, it has become difficult for a single PCP to deliver all recommended care. As a result, provider comanagement of the same patient has emerged in practice. Provider comanagement is defined as two or more PCPs sharing care management responsibilities for the same patient. While physician–physician comanagement of patients has been widely investigated, there is little evidence about nurse practitioner (NP)–physician comanagement. Given the large number of NPs that are practicing in primary care, more evidence is warranted about the PCP perspectives of physicians and NPs comanaging patient care. The purpose of this study was to explore NP–physician comanagement in primary care from the perspectives of PCPs. We conducted in-person qualitative interviews of 26 PCPs, including NPs and physicians, that lasted 25 to 45 minutes, were audio recorded, and then professionally transcribed. Transcripts were deidentified and checked for accuracy prior to a deductive and inductive data analysis. Physicians and NPs reported that comanagement increases adherence to recommended care guidelines, improves quality of care, and increases patient access to care. Effective communication, mutual respect and trust, and a shared philosophy of care are essential attributes of NP–physician comanagement. Physicians and NPs are optimistic about comanagement care delivery and find it a promising approach to improve the quality of care and alleviate primary care delivery strain. Efforts to promote effective NP–physician comanagement should be supported in clinical practice.

scholarly journals Nurse Practitioner Practice Environments in Primary Care and Quality of Care for Chronic Diseases

Medical Care ◽  
2018 ◽  
pp. 1
Author(s):  
Lusine Poghosyan ◽  
Allison A. Norful ◽  
Jianfang Liu ◽  
Mark W. Friedberg
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Chronic Diseases ◽  
Nurse Practitioner
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