CAPACITY AND CONFIDENCE IN PERFORMING CLINICAL PROCEDURES AMONG PRIMARY CARE TEAMS IN THE CENTRAL REGION OF VIETNAM

2017 ◽  
pp. 77-83
Author(s):  
Duc Toan Vo ◽  
Minh Tam Nguyen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Care Team ◽  
Primary Care Team ◽  
Health Staff ◽  
Ministry Of Health ◽  
Clinical Procedures ◽  
The Government

Background and Aim: To develop primary care services is one of the top priorities of the health sector in Vietnam. In recent years, the Government and the Ministry of Health have made great efforts to strengthen and improve the quality of healthcare services at the grassroof level. However, several studies showed that the needs for healthcare remained unmet at primary care level. This study aimed to examine the gaps in competency and confidence of the primary care team in delivery of clinical procedures. Methods: A crosssectional descriptive study was conducted in 49 commune health centers (CHCs) of 3 provinces. The health care teams reported their ability and confidence to perform the list of clinical procedures based on the regulation on clinical procedures performed at the CHC issued by the Ministry of Health. Results: The average number of procedures performed by the CHCs was 46,4/109 procedures. There were 65.3% of CHCs performed less than 50% of assigned techniques, and only 28.6% CHCs performed 50-80% of assigned techniques. The confidence of CHC teams was high in performing procedures of Resuscitation, Internal Medicine, Pediatrics and OBGYN. Conclusion: There is a substantial gap in the capability to perform clinical procedures among CHC team. The confidence in performing essential procedural skills varied among procedures, depending on clinical experience and the types of procedure. Our results show a strong call to develop training programs that fit to the competency standards of primary care team in order to enhance the capacity and confidence of health staff in healthcare delivery at grassroots level. Key words: Health care, Thua Thien Hue, Quang Tri

Primary Care through a Public-Private Partnership

2011 ◽  
pp. 127-153
Author(s):  
Sofi Bergkvist ◽  
Hanna Pernefeldt
Keyword(s):  
Primary Care ◽  
State Government ◽  
Health Management ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Public Private Partnership ◽  
Private Partnership ◽  
Clinical Procedures ◽  
Contextual Framework

The primary care delivery model developed by the Health Management and Research Institute (HMRI) in India, integrates innovative technical solutions and process-oriented operations for the provision of healthcare services, while supporting the public health system. Through a public-private partnership with the state government of Andhra Pradesh, HMRI has a unique base to pilot large scale health interventions. The HMRI Model includes components such as a medical helpline, rural outreach health services, a disease surveillance program, a blood bank application, and telemedicine projects. Both clinical and non-clinical procedures are strengthened by technology that enables research, tailored and evidence-based interventions, as well as improves efficiency and quality of healthcare delivery. Health management and decision-making is assisted by the organization’s large database of electronic medical records. Challenges to implementation include implications of large government contracts, funding issues, as well as technical constraints and human resources issues. This chapter describes the Model’s various components and its contextual framework with enabling and constraining factors. HMRI has developed a unique system for preventive and primary care that can serve as a model for low, middle, and high income countries, though external evaluations are critically needed for further assessment of best practices.

Primary Care through a Public-Private Partnership

2011 ◽  
pp. 1438-1460
Author(s):  
Sofi Bergkvist ◽  
Hanna Pernefeldt
Keyword(s):  
Primary Care ◽  
State Government ◽  
Health Management ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Public Private Partnership ◽  
Private Partnership ◽  
Clinical Procedures ◽  
Contextual Framework

The primary care delivery model developed by the Health Management and Research Institute (HMRI) in India, integrates innovative technical solutions and process-oriented operations for the provision of healthcare services, while supporting the public health system. Through a public-private partnership with the state government of Andhra Pradesh, HMRI has a unique base to pilot large scale health interventions. The HMRI Model includes components such as a medical helpline, rural outreach health services, a disease surveillance program, a blood bank application, and telemedicine projects. Both clinical and non-clinical procedures are strengthened by technology that enables research, tailored and evidence-based interventions, as well as improves efficiency and quality of healthcare delivery. Health management and decision-making is assisted by the organization’s large database of electronic medical records. Challenges to implementation include implications of large government contracts, funding issues, as well as technical constraints and human resources issues. This chapter describes the Model’s various components and its contextual framework with enabling and constraining factors. HMRI has developed a unique system for preventive and primary care that can serve as a model for low, middle, and high income countries, though external evaluations are critically needed for further assessment of best practices.

scholarly journals A Primary Care Role in Building Local Capacity Following Volcanic Activity in Vanuatu

2019 ◽  
Vol 34 (s1) ◽  
pp. s52-s52
Author(s):  
Alison Lyon
Keyword(s):  
Primary Care ◽  
Volcanic Activity ◽  
Care Team ◽  
Primary Care Team ◽  
Urgent Care ◽  
Care Needs ◽  
Healthcare Needs ◽  
Local Capacity ◽  
The Government ◽  
Tract Infections

Introduction:Vanuatu is situated in the Pacific Ring of Fire. In July 2018, there was increased volcanic activity on Ambae, an island with a population of 11,000 people. Due to the destruction of food sources, contamination of water supply, and respiratory issues caused by ash fall, an immediate compulsory evacuation was ordered by the government.Aim:To describe the role of the primary care team response to urgent and ongoing healthcare needs of evacuees following volcanic activity.Methods:A non-governmental organization (NGO) primary care team of a general practitioner, nurse practitioner, and two healthcare assistants undertook the initial assessment of a group of newly arrived evacuees. This allowed the identification and management of urgent care needs. Over the subsequent weeks, the primary care clinic provided care to the evacuees. A prospective database of anonymized case files was undertaken to monitor evolving primary healthcare needs of the evacuees.Results:Twenty-five patients were assessed initially. Two patients required urgent transfer to a hospital for acute management. Six diabetic patients required medication supplies. There were eight hypertensive patients. Two patients required urgent BP reduction and four required medication supplies. Over the following two weeks, 104 patients were reviewed at the clinic. During this time, 45 patients were treated for respiratory tract infections. Medication supplies were replenished for antihypertensives and diabetic medications for seven patients. Opportunistic cardiovascular and diabetes risk reviews were performed and follow up arranged for nine patients.Discussion:The primary care team role was part of a local services collaborative approach initiated by the government. Involving local primary care clinicians in disaster management builds local capacity. Patients are able to receive continuity of care for acute and ongoing medical problems. Clinicians are able to evaluate evolving care needs and gain an improved understanding of the impact of displacement on the community.

scholarly journals Critical Findings Reporting in Cranial CT Scans of Patients in a Tertiary Government Hospital Setting:A Pilot Study

Acta Medica ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 8-16
Author(s):  
Andro Reginald Luy Licaros ◽  
Johanna Patricia Adevoso Cañal
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Effective Communication ◽  
Care Team ◽  
Primary Care Team ◽  
Care Providers ◽  
Safe Practice ◽  
Cranial Ct ◽  
Practice Recommendations

BACKGROUND AND PURPOSE: Effective communication among health care providers within an institution is vital for ensuring patient safety.  A radiologist’s competence in identifying critical findings is just as important as being able to relay this information to the primary provider in a timely manner so that appropriate interventions can be initiated in life-threatening emergencies. This study aims to obtain baseline data regarding effective communication of critical findings between radiology and the primary health care providers.   MATERIALS AND METHODS: Based on the Massachusetts’s Coalition for Prevention of Medical Errors safe practice recommendations, a communication protocol was developed. Certain selected cranial critical findings (new hemorrhage, new herniation, acute brain edema, acute stroke and findings suggestive of meningitis or abscess) were used in the critical findings protocol. Total communication time (TCT) in the relay of critical findings included time from CT scan order to scan (OS time), time from scan to interpretation (SI) and time from interpretation to relay (IR).  All these times were recorded and compared to the standard 60 minutes using percent compliance, mean time, median time and standard deviation.   RESULTS: Seventy-nine (79) critical findings were recorded and relayed in a 30-day period. There was 100% (79/79) compliance with the relay of critical findings to the primary care team and 97.5% (77/79) success rate in direct communication of critical findings within 60 minutes of identification. The mean OS time was 155.09 (±134.43) minutes, mean SI time was 46.54 (±44.01) minutes, and mean IR time was 9.13 (±12.04) minutes. The average time elapsed from CT study acquisition to direct notification was 57.0 (± 45.80) minutes.   CONCLUSION: Effective communication of critical findings using a protocol adopted from set standards of safe practice recommendations is achievable in our institution. The proposed protocol exhibited compliance to and performed well against established benchmarks. The timely identification and delivery of critical findings to the primary care team is central to patient management and should be practiced in our setting.   Keywords: critical finding, effective communication, cranial CT, standards

Funding models and expenditures with primary healthcare in Salvador, Bahia, Brazil metropolitan area

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Vivas ◽  
M Duarte ◽  
A Pitta ◽  
B Christovam
Keyword(s):  
Public Health ◽  
Metropolitan Area ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Ministry Of Health ◽  
Healthcare Budget ◽  
Health Budget ◽  
The Public ◽  
Before And After ◽  
The Government

Abstract Background The government investments in quality primary healthcare are the basis to strengthening the health systems and monitoring the public expenditure in this area is a way to assess the effectiveness and efficiency of the public health policies. The Brazil Ministry of Health changed, in 2017, the method of onlending federal resources to states and cities seeking to make the public funds management more flexible. This change, however, suppressed mandatory investments in primary healthcare. This research aims to determine the difference of expenditures on primary healthcare in Salvador, Bahia, Brazil metropolitan area before and after this funding reform, seeking to verify how it can impact the quality of primary healthcare services and programs. Methods This is an ecological time-series study that used data obtained in the Brazil Ministry of Health budget reports. The median and interquartile range of expenditures on primary healthcare (set as the percentage of total public health budget applied in primary care services and programs) of the 13 cities in the Salvador metropolitan area were compared two years before and after the reform. Results The median of expenditures on primary healthcare in Salvador metropolitan area was 25.5% (13,9% - 32,2%) of total public health budget before and 24.8% (20.8% - 30.0%) of total public health budget after the reform (-0.7% difference). Seven cities decreased the expenditures on primary healthcare after the reform, ranging from 1.2% to 10.8% reduction in the primary healthcare budget in five years. Conclusions Expenditures on primary healthcare in Salvador metropolitan area decreased after the 2017 funding reform. Seven of 13 cities reduced the government investments on primary healthcare services and programs in this scenario. Although the overall difference was -0.7%, the budget cuts ranged from 1.2% to 10.8% in the analyzed period and sample. More studies should assess these events in wide areas and with long time ranges. Key messages Public health funding models can impact the primary healthcare settings regardless of the health policy. Reforms in the funding models should consider the possible benefits before implementation. Funding models and methods that require mandatory investments in primary healthcare may be considered over more flexible ones.

scholarly journals Family Physician’s and Primary Care Team’s Perspectives on Supporting Family Caregivers in Primary Care Networks

2021 ◽  
Vol 18 (6) ◽  
pp. 3293
Author(s):  
Jasneet Parmar ◽  
Sharon Anderson ◽  
Marjan Abbasi ◽  
Saeed Ahmadinejad ◽  
Karenn Chan ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Caregivers ◽  
Healthcare Providers ◽  
Family Physicians ◽  
Care Team ◽  
Primary Care Team ◽  
Caregiver Support ◽  
Team Members ◽  
Primary Care Teams ◽  
Support Family

Background. Research, practice, and policy have focused on educating family caregivers to sustain care but failed to equip healthcare providers to effectively support family caregivers. Family physicians are well-positioned to care for family caregivers. Methods. We adopted an interpretive description design to explore family physicians and primary care team members’ perceptions of their current and recommended practices for supporting family caregivers. We conducted focus groups with family physicians and their primary care team members. Results. Ten physicians and 42 team members participated. We identified three major themes. “Family physicians and primary care teams can be a valuable source of support for family caregivers” highlighted these primary care team members’ broad recognition of the need to support family caregiver’s health. “What stands in the way” spoke to the barriers in current practices that precluded supporting family caregivers. Primary care teams recommended, “A structured approach may be a way forward.” Conclusion. A plethora of research and policy documents recommend proactive, consistent support for family caregivers, yet comprehensive caregiver support policy remains elusive. The continuity of care makes primary care an ideal setting to support family caregivers. Now policy-makers must develop consistent protocols to assess, and care for family caregivers in primary care.

Primary Care Team of the Year: Primary care that makes a difference

BMJ ◽  
2011 ◽  
Vol 342 (apr12 1) ◽  
pp. d2118-d2118
Author(s):  
H. Macdonald ◽  
D. MacAuley
Keyword(s):  
Primary Care ◽  
Care Team ◽  
Primary Care Team

scholarly journals A Psychiatric Clinic in General Practice

1987 ◽  
Vol 11 (4) ◽  
pp. 114-117 ◽  
Author(s):  
Sally M. Browning ◽  
Michael F. Ford ◽  
Cait A. Goddard ◽  
Alexander C. Brown
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
General Practice ◽  
Psychiatric Disorder ◽  
Personality Disorders ◽  
Psychiatric Service ◽  
Significant Degree ◽  
Care Team ◽  
Primary Care Team ◽  
Psychiatric Clinic

Only a minority suffering from mental illness are treated by the specialist psychiatric service. The majority of psychiatrically ill patients seen in general practice suffer from minor neuroses, personality disorders and situational reactions and can be appropriately treated by the primary care team. However, a significant degree of morbidity, some of it severe, fails to be identified in general practice and the identification and treatment of psychiatric disorder varies according to the GP's interest and attitudes.

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