Delivery of Preconception Counselling Services: The Snags of Health Care Service Providers.

Purpose: This study investigates the difficulties the health care service providers encounter in the quest of rendering preconception counselling services in Ghana. Methodology: The study employed descriptive survey design with the use of both qualitative and quantitative research approaches using questionnaire as the main tool. The study employed simple random sampling to sampled 135 out of 675 health care service providers from 23 health facilities in the Bole District of the Savanna Region in Ghana. The quantitative data obtained for the study was analysed using Statistical Package for Social Solution (SPSS) whilst the qualitative data were subjected to descriptive and narrative discussion. Findings: The study revealed that, health care practitioners need continuous training programme. It also became clear that, there no any clear national guideline or policy on preconception counselling in Ghana. It came to light that, the healthcare service providers face a lot of difficulties to capture women of child bearing age to offer them the services. Inadequate knowledge and expertise to effectively offer the preconception counselling services was also identified as a challenge. Recommendations: The study therefore recommend that the Ministry of Health and Ghana Health Service should come out with a clear policy guideline on preconception counselling and also provide an intensive training for the health care professionals. The health care providers should also be provided with the needed resources to embark on sensitisation and advocacy campaigns to create the awareness for women of childbearing age to appreciate the need for preconception and genetic carrier risk counselling.

Implementation of Active Management of the Third Period of Childbirth (AMTPC/ GATPA) For The Prevention of Immediate Post-Partum Bleeding in Four Regional Maternity Hospitals of Guinea (Conakry)

Objectives: To determine the frequency, skills level of health care service providers; to identify complications and difficulties related to the implementation of AMTPC/GATPA. Methodology: It was about prospective study, descriptive of 6 months (March 1st to August 31st, 2014) carried out in the maternity hospitals of Faranah, Kindia, Mamou and Nzérékoré. It concerned the parturient women who had recently given birth and the personnel that carried out AMTPC /GATPA in these hospitals. Results: During the study period of 1,254 out of 1,305 births had benefited of AMTPC/ GATPA, a frequency of 96.1%. The midwives were the most represented personnel in the implementation of GATPA (44.1%). In 46.4% of the cases, the health care service providers acquired this competence from the initial training. The release was obtained in the first trial in 64.9% cases. The duration of implementation of GATPA was less than 5 minutes in 72.6% cases. The different stages were respected in 91.5% cases. Complications were dominated by retention of placental fragments (10.2%). Lack of oxytocin was the main difficulty (36.6%). Conclusion: The sustainability of this achievement would depend on the systematic and correct implementation of AMTPC /GATPA at all childbirth attendants and the effective management of oxytocin.

The Impact of COVID-19 on the Performance of Primary Health Care Service Providers in a Capitation Payment System: A Case Study from Poland

In Poland, as in many other countries, the use of capitation payment schemes in primary health care is popular. Despite this popularity, the subject literature discusses its role in decreasing the quality of primary medical services. This problem is particularly important during COVID-19, when medical entities provide telehealth services to patients. The objective of the study is to examine the effects of COVID-19 pandemic on the performance of the primary health care providers in Poland under a capitation payment scheme. In this study the authors use data from interviews with personnel of medical entities and financial and administrative reports of primary health care providers in order to identify how this crisis situation impacts the performance of primary health care entities, under capitation payment system. The performance indicators include both the financial and quality measures. Selected to the case study primary health care service providers significantly improved their profitability due to considerable costs savings and reduction of services provided to patients in a time of COVID-19 pandemic. Capitation payment system proved to be inefficient, in the studied pandemic period, in terms of the services provided by primary health care service providers to patients and the funds paid to them, in exchange, by the government entities.

The professional contribution of chiropractors to Danish elite football clubs: a qualitative exploration of role and perceived value in an interprofessional service provision context

Background Interprofessional team-based care has been widely adopted in elite level athletic health and performance practice. Chiropractors can claim some penetration as health care service providers in high level sport. However, their position as valued members of interprofessional health care teams, especially those built around traditional medical organisational structures, is unclear. This investigation sought to explore the perceived role and value of chiropractors as service providers in elite Danish football clubs. Methods A comparative qualitative case study was conducted. Six Danish premiere league (Superliga) clubs were purposively sampled to compare and contrast instances where chiropractors were both present and absent from the health care team. Triangulated responses were solicited from healthcare coordinators, chiropractors and athletes within each club’s organization through semi-structured individual interviews. The audio-recorded responses were transcribed verbatim and thematically analyzed using a framework approach. Results Data were collected September and November 2019. A coding framework of 14 codes and 4 code families emerged, centering around the role of chiropractors, benefits of utilizing chiropractic care and facilitators and barriers to interprofessional practice. From this framework, three themes were abstracted, these being: “Broadening horizons”, “In-house preferred to take-away” and “Already covered, or even necessary?” Conclusion In this practice context, chiropractors fill the role of musculoskeletal health care service providers. Their perceived value stems from additional expert disciplinary knowledge, improved diagnostic triage and increased treatment flexibility. However, where not utilized, the role of a spinal health expert is questioned and when acknowledged, is limited to that of a technician/therapist. It is unclear from this investigation whether chiropractors can claim core provider status. Further exploration of this interesting context of interprofessional practice is warranted.

Transforming technology-mediated health-care services through strategic sense-giving

Purpose Service research has previously documented service providers’ role in addressing the barriers of technology mediation, mostly at the service delivery level. The purpose of this study is to enhance our understanding about the role of service providers who hold strategic and operational roles, as well as investigate the impact of coordinated, organization-wide initiatives in dealing with the demands and associated emotional ambivalence of technology-mediated services. Design/methodology/approach This qualitative study draws from a series of in-depth interviews with health-care service providers who hold strategic and operational roles in health-care organizations along with participant observation to develop an understanding of the broader organizational context of telehealth services. Findings This paper outlines the strategic sense-giving process and highlights how health-care service providers who hold strategic and operational roles enact the sense-giver role. This study illustrates that strategic sense-giving involves the recognition of sense-making gaps; identification of sense-giving opportunities; and provision of templates of action. Originality/value This study illustrates that sense-giving can be performed by a number of organizational members in a more formalized way which extends informal sense-giving efforts at the peer-to-peer level. The importance of strategic sense-giving in providing templates of action for service providers and consumers is highlighted. This study also shows how strategic sense-giving safeguards against confusion and errors by communicating appropriate ways of using technology. Finally, the role of strategic sense-giving in helping service providers and consumers cope with the emotional ambivalence of technology-mediated service interactions are demonstarted.

Implementation of active management of the third period of childbirth for the prevention of immediate post-partum bleeding in four regional maternity hospitals of Conakry, Guinea

Background: The objective of this study was to determine the frequency, skills level of health care service providers; to identify complications and difficulties related to the implementation of AMTPC/GATPA.Methods: It was about prospective study, descriptive of 6 months (1st March to 31st August 2014) carried out in the maternity hospitals of Faranah, Kindia, Mamou and Nzérékoré. It concerned the parturient women who had recently given birth and the personnel that carried out AMTPC/GATPA in these hospitals.Results: During the study period of 1,254 out of 1,305 births had benefited of AMTPC/GATPA, a frequency of 96.1%. The midwives were the most represented personnel in the implementation of GATPA (44.1%). In 46.4% of the cases, the health care service providers acquired this competence from the initial training. The release was obtained in the first trial in 64.9% cases. The duration of implementation of GATPA was less than 5 minutes in 72.6% cases. The different stages were respected in 91.5% cases. Complications were dominated by retention of placental fragments (10.2%). Lack of oxytocin was the main difficulty (36.6%).Conclusions: The sustainability of this achievement would depend on the systematic and correct implementation of AMTPC/GATPA at all childbirth attendants and the effective management of oxytocin.

The Professional Contribution of Chiropractors to Danish elite football clubs: A qualitative exploration of role and perceived value in an interprofessional service provision context.

Background: Interprofessional team-based care has been widely adopted in elite level athletic health and performance practice. Although chiropractors can claim some penetration as health care service providers in high level sport, their position as valued members of interprofessional health care teams, especially those built around traditional medical organisational structures, is unclear. As a first step to map the professional practice landscape of Danish sports chiropractors, this investigation sought to explore the perceived role and value of chiropractors as service providers in elite Danish football clubs. Methods: A comparative qualitative case study using semi-structured individual interviews was conducted. Six Danish Superliga clubs were purposively sampled to compare and contrast instances where chiropractors were absent from the health care team, contracted as in-house health care team members or engaged as external service providers. Triangulated responses were solicited from healthcare co-ordinators, chiropractors and athletes within each club’s organisation through short semi-structured individual interviews. The audio-recorded responses were transcribed verbatim and thematically analysed using a framework approach. Results: Inductive and deductive coding revealed 14 unique codes, which were further organised into 4 code families relating to the role of chiropractors, benefits of utilizing chiropractic care and facilitators and barriers to interprofessional practice. From this framework 3 themes were abstracted, these being: “Broadening horizons”, “In-house preferred to take-away” and “Already covered, or even necessary?”. Conclusion: In this practice context, chiropractors fill the role of musculoskeletal health care service providers. Their perceived value stems from additional expert disciplinary knowledge, improved diagnostic triage and increased treatment flexibility. However, where not utilized, the role of the spinal health expert is questioned and when acknowledged, limited to that of a technician/therapist. It is unclear whether chiropractors can claim core team member status. Further exploration of this interesting context of interprofessional practice is warranted.

The Professional Contribution of Chiropractors to Danish elite football clubs: A qualitative exploration of role and perceived value in an interprofessional service provision context.

Background: Interprofessional team-based care has been widely adopted in elite level athletic health and performance practice. And although chiropractors can claim some penetration as health care service providers in high level sport, their position as valued members of interprofessional health care teams, especially those built around traditional medical organisational structures, is unclear. In Denmark, the mainstream provider status of chiropractors is more favourable than in most parts of the world. Moreover, chiropractors have been identified as service providers in the Danish premiere football league (Super Liga). However, little is currently known about the professional contribution made by chiropractors in this powerful sporting context.As a first step to map the professional practice landscape of Danish sports chiropractors, this investigation sought to explore the perceived role and perceived value of chiropractors as service providers in elite Danish football clubs. Methods: A comparative qualitative case study using semi-structured individual interviews was conducted. Six Danish Superliga clubs were purposively sampled to compare and contrast instances where chiropractors were absent from the health care team, contracted as in-house health care team members or engaged as external service providers. Triangulated responses were solicited from healthcare co-ordinators, chiropractors and athletes within each club’s organisation through short semi-structured individual interviews. The audio-recorded responses were transcribed verbatim and thematically analysed using a framework approach.Results: Inductive and deductive coding revealed 14 unique codes, which were further organised into 4 code families relating to the role of chiropractors, benefits of utilizing chiropractic care and facilitators and barriers to interprofessional practice. From this framework 3 themes were abstracted, these being: “Broadening horizons”, “In-house preferred to take-away” and “Already covered, or even necessary?”. Conclusion: In this practice context, chiropractors fill the role of musculoskeletal health care service providers. Their perceived value stems from additional expert disciplinary knowledge, improved diagnostic triage and increased treatment flexibility. However, where not utilized, the role of the spinal health expert is questioned and when acknowledged, limited to that of a technician/therapist. It is unclear whether chiropractors can claim core team member status. Further exploration of this interesting context of IPP practice is warranted.

The Effectiveness of Educational Intervention in Improving Primary Health-Care Service Providers’ Knowledge, Identification, and Management of Elder Abuse and Neglect: A Systematic Review

Elder abuse and neglect (EAN) occurrence is expected to increase in many countries due to rapidly aging populations, yet it is still unrecognized and underreported. Gaps were identified in the knowledge and skills to intervene EAN among health-care service providers. It is still unclear whether educating health-care service providers on EAN improve the identification and management of EAN cases. A systematic review was conducted on the effectiveness of educational intervention designed to improve primary health-care service providers’ (PHSPs) knowledge, attitude, and practice in managing EAN cases. We performed a comprehensive and systematic search for original studies in the following major electronic databases (ScienceDirect, PubMed, EMBASE, and CINAHL) and specialist registers (Cochrane Central Controlled Trials Register) with a set of search terms. Studies included were randomized controlled trials (RCTs) and observational studies on EAN education intervention that aimed to improve knowledge, attitude, and management skills of the PHSPs. There were no publication period restrictions until June 2018 and written in English. Overall, three RCTs and 10 observational studies were selected. These studies were grouped based on the type of the study, methodological quality (six moderate risk of bias and seven serious risk of bias), and the type of educational intervention (seven face-to-face educational intervention, two educational videos, two simulation-based training, and two online educational training). The education programs in the selected studies range from brief didactic to experiential learning. EAN educational intervention among primary care service providers potentially result in increasing awareness and knowledge on EAN. However, there is a lack of evidence on the changes of attitude and practice.