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Article
Publication date: 24 May 2021

John Adie, Wayne Graham, Kerron Bromfield, Bianca Maiden, Sam Klaer and Marianne Wallis

This case study describes a community-based urgent care clinic in a general practitioner (GP) super clinic in South East Queensland.

Abstract

Purpose

This case study describes a community-based urgent care clinic in a general practitioner (GP) super clinic in South East Queensland.

Design/methodology/approach

This retrospective chart audit describes patient demographic characteristics, types of presentations and management for Sundays in 2015.

Findings

The majority of patients (97%) did not require admission to hospital or office investigations (95%) and presented with one condition (94%). Of the presentations, 66.5% were represented by 30 conditions. Most patients received a prescription (57%), some were referred to the pathology laboratory (15%) and some were referred to radiology (12%). A majority (54%) of patients presented in the first three hours. Approximately half (51%) of patients presenting were aged under 25. More females (53%) presented than males. A majority (53%) lived in the same postcode as the clinic. The three most common office tests ordered were urinalysis, electrocardiogram (ECG) and urine pregnancy test. Some patients (19%) needed procedures, and only 3% were referred to hospital.

Research limitations/implications

The study offers analysis of the client group that can be served by an urgent care clinic in a GP super clinic on a Sunday. The study provides an option for emergency department avoidance.

Originality/value

Despite calls for more research into community-based urgent care clinics, little is known in Australia about what constitutes an urgent care clinic. The study proposes a classification system for walk-in presentations to an urgent care clinic, which is comparable to emergency department presentations.

Details

Journal of Health Organization and Management, vol. 35 no. 8
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 1 February 2021

Muhammad Khalilur Rahman, Md Shah Newaz, Mina Hemmati and S M Yusuf Mallick

The purpose of this study is to explore the private general practice (GP) clinics' service environment, patients' satisfaction and their impact on word of mouth (WoM) for others…

Abstract

Purpose

The purpose of this study is to explore the private general practice (GP) clinics' service environment, patients' satisfaction and their impact on word of mouth (WoM) for others for future treatment in GP clinics.

Design/methodology/approach

Data are collected from 367 respondents using a paper-based survey questionnaire. Partial least square (PLS) is used to evaluate the proposed model and hypotheses relationships.

Findings

The findings reveal that ambience and service delivery have a high significant influence on patients' emotional satisfaction (β = 0.27, t = 4.31, p = 0.00) and (β = 0.26, t = 4.81, p = 0.00), respectively, while interior décor has a positive and significant influence on satisfaction (β = 0.13, t = 1.98, p = 0.04). The results indicate that exterior design and cleanliness are not associated with satisfaction. Patients' emotional satisfaction is highly related to WoM (β = 0.55, t = 13.44, p = 0.00). The results also show that emotional satisfaction has a significant mediating effect on the relationship between clinic service environments (ambience, interior décor, service delivery) and WoM (β = 0.15, t = 3.94, p = 0.00), (β = 0.073, t = 3.94, p = 0.04), (β = 0. 0.143, t = 4.13, p = 0.00), respectively.

Originality/value

The study will provide insights regarding Malaysian health consumers' perceptions toward GP clinics' service environment, whether they remain utilitarian or have evolved to entail hedonic appreciations. The contribution to the service environment could be adopted by future health-care studies, particularly those intended to examine GP clinics and other clinic-based institutions.

Details

Health Education, vol. 121 no. 3
Type: Research Article
ISSN: 0965-4283

Keywords

Article
Publication date: 4 May 2010

Amanda Edgeworth and Edward C. Coles

This paper aims to compare anticoagulant management in secondary care for the year prior to the introduction of near‐patient testing in a general practice, and in the subsequent…

Abstract

Purpose

This paper aims to compare anticoagulant management in secondary care for the year prior to the introduction of near‐patient testing in a general practice, and in the subsequent year after it was introduced.

Design/methodology/approach

This paper is a retrospective, paired before‐after study. Details of test results in the two‐year‐long periods on the 46 patients who met the inclusion criteria were collected and analysed pairwise.

Findings

Despite an increase in the frequency of testing this set of patients were controlled as well in general practice as they had been with a secondary‐care service, and better that in a number of studies in the literature.

Research limitations/implications

This research reviews a recently introduced service at a single centre. Further research of patient satisfaction and adverse events in a multi‐centre longer‐term trial are desirable.

Practical implications

Technology now allows the increasing amount of individuals on anticoagualtion to be controlled with near‐patient testing in general practice. This study shows that satisfactory control can be maintained in patients who transfer from a secondary care‐based to a primary care‐based service.

Originality/value

This paper demonstrates that a single general practice can provide a high quality anticoagulant service using near‐patient testing and computer‐based decision support. This adds to the already available evidence and will hopefully encourage other practices to adopt the same.

Details

International Journal of Health Care Quality Assurance, vol. 23 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Abstract

Details

Mental Health Review Journal, vol. 1 no. 3
Type: Research Article
ISSN: 1361-9322

Article
Publication date: 12 March 2014

Maha Younis, Abdul Kareem Al Obaidi and Ahmed Al-Nuaimi

The purpose of this paper is to demonstrate how a psychiatric clinic in a general hospital can function in conflict-ridden Iraq through the easing of patient access to services…

Abstract

Purpose

The purpose of this paper is to demonstrate how a psychiatric clinic in a general hospital can function in conflict-ridden Iraq through the easing of patient access to services.

Design/methodology/approach

The workload of psychiatrists was analyzed for one year (2010) at the psychiatry consultation clinic located in the campus of the Medical City Hospital in Central Baghdad which is also a training center.

Findings

A total of 2,997 consultations (both adults and children) occurred in 2010. In total, 96 percent were self or family referrals. Patient services were provided by five consulting psychiatrists for a variety of psychiatric disorders. The main therapeutic intervention was the prescription of psychotropics.

Research limitations/implications

Despite the turbulent circumstances and limited mental health resources in Iraq, this clinic was established as a model to attract patients for consultation and triage management to reduce appointment defaults and delayed care.

Practical implications

The data can contribute to the planning and development of mental health services in Iraq, contributing to the current body of literature and serving as a model for other conflict areas.

Originality/value

To best of the understanding this study is the first in the country.

Details

Journal of Public Mental Health, vol. 13 no. 1
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 31 January 2018

Ann Kirby, Aileen Murphy and Colin Bradley

Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an approach…

Abstract

Purpose

Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an approach is formally encouraged in the management of Atrial Fibrillation patients through the European Society of Cardiology guidelines. Since the emergence of new oral anticoagulants switching between oral anticoagulants (OACs) has become prevalent. This case study considers the role of multi-disciplinary decision making, given the complex nature of the agents. The purpose of this paper is to explore Irish General Practitioners’ (GPs) experience of switching between all OACs for Arial Fibrillation (AF) patients; prevalence of multi-disciplinary decision making in OAC switching decisions and seeks to determine the GP characteristics that appear to influence the likelihood of multi-disciplinary decision making.

Design/methodology/approach

A probit model is used to determine the factors influencing multi-disciplinary decision making and a multinomial logit is used to examine the factors influencing who is involved in the multi-disciplinary decisions.

Findings

Results reveal that while some multi-disciplinary decision-making is occurring (64 per cent), it is not standard practice despite international guidelines on integrated care. Moreover, there is a lack of patient participation in the decision-making process. Female GPs and GPs who have initiated prescriptions for OACs are more likely to engage in multi-disciplinary decision-making surrounding switching OACs amongst AF patients. GPs with training practices were less likely to engage with cardiac consultants and those in urban areas were more likely to engage with other (non-cardiac) consultants.

Originality/value

For optimal decision making under uncertainty multi-disciplinary decision-making is needed to make a more informed judgement and to improve treatment decisions and reduce the opportunity cost of making the wrong decision.

Details

Journal of Health Organization and Management, vol. 32 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 1 June 1997

Stephen Peckham

Examines the evidence on the extent to which young people’s sexual health services contribute to the prevention of teenage pregnancy. Reports the findings of a survey of health…

2098

Abstract

Examines the evidence on the extent to which young people’s sexual health services contribute to the prevention of teenage pregnancy. Reports the findings of a survey of health, education, youth and social services, and providers of services, which was undertaken for the Department of Health. Summarizes other recent reviews of evaluations of services and young people’s sexual health services. Provides guidance for health, education, youth and social services purchasers and providers on good practice for young people’s services and identifies gaps in our knowledge where further research is needed. Argues for closer working with young people in identifying their sexual health needs and in the development and monitoring of services.

Details

Health Education, vol. 97 no. 3
Type: Research Article
ISSN: 0965-4283

Keywords

Article
Publication date: 6 June 2016

David Forbes and Pornpit Wongthongtham

There is an increasing interest in using information and communication technologies to support health services. But the adoption and development of even basic ICT communications…

Abstract

Purpose

There is an increasing interest in using information and communication technologies to support health services. But the adoption and development of even basic ICT communications services in many health services is limited, leaving enormous gaps in the broad understanding of its role in health care delivery. The purpose of this paper is to address a specific (intercultural) area of healthcare communications consumer disadvantage; and it examines the potential for ICT exploitation through the lens of a conceptual framework. The opportunity to pursue a new solutions pathway has been amplified in recent times through the development of computer-based ontologies and the resultant knowledge from ontologist activity and consequential research publishing.

Design/methodology/approach

A specific intercultural area of patient disadvantage arises from variations in meaning and understanding of patient and clinician words, phrases and non-verbal expression. Collection and localization of data concepts, their attributes and individual instances were gathered from an Aboriginal trainee nurse focus group and from a qualitative gap analysis (QGA) of 130 criteria-selected sources of literature. These concepts, their relationships and semantic interpretations populate the computer ontology. The ontology mapping involves two domains, namely, Aboriginal English (AE) and Type II diabetes care guidelines. This is preparatory to development of the Patient Practitioner Assistive Communications (PPAC) system for Aboriginal rural and remote patient primary care.

Findings

The combined QGA and focus group output reported has served to illustrate the call for three important drivers of change. First, there is no evidence to contradict the hypothesis that patient-practitioner interview encounters for many Australian Aboriginal patients and wellbeing outcomes are unsatisfactory at best. Second, there is a potent need for cultural competence knowledge and practice uptake on the part of health care providers; and third, the key contributory component to determine success or failures within healthcare for ethnic minorities is communication. Communication, however, can only be of value in health care if in practice it supports shared cognition; and mutual cognition is rarely achievable when biopsychosocial and other cultural worldview differences go unchallenged.

Research limitations/implications

There has been no direct engagement with remote Aboriginal communities in this work to date. The authors have initially been able to rely upon a cohort of both Indigenous and non-Indigenous people with relevant cultural expertise and extended family relationships. Among these advisers are health care practitioners, academics, trainers, Aboriginal education researchers and workshop attendees. It must therefore be acknowledged that as is the case with the QGA, the majority of the concept data is from third parties. The authors have also discovered that urban influences and cultural sensitivities tend to reduce the extent of, and opportunity to, witness AE usage, thereby limiting the ability to capture more examples of code-switching. Although the PPAC system concept is qualitatively well developed, pending future work planned for rural and remote community engagement the authors presently regard the work as mostly allied to a hypothesis on ontology-driven communications. The concept data population of the AE home talk/health talk ontology has not yet reached a quantitative critical mass to justify application design model engineering and real-world testing.

Originality/value

Computer ontologies avail us of the opportunity to use assistive communications technology applications as a dynamic support system to elevate the pragmatic experience of health care consultations for both patients and practitioners. The human-machine interactive development and use of such applications is required just to keep pace with increasing demand for healthcare and the growing health knowledge transfer environment. In an age when the worldwide web, communications devices and social media avail us of opportunities to confront the barriers described the authors have begun the first construction of a merged schema for two domains that already have a seemingly intractable negative connection. Through the ontology discipline of building syntactically and semantically robust and accessible concepts; explicit conceptual relationships; and annotative context-oriented guidance; the authors are working towards addressing health literacy and wellbeing outcome deficiencies of benefit to the broader communities of disadvantage patients.

Details

Information Technology & People, vol. 29 no. 2
Type: Research Article
ISSN: 0959-3845

Keywords

Abstract

Details

Mental Health Review Journal, vol. 9 no. 4
Type: Research Article
ISSN: 1361-9322

Article
Publication date: 4 June 2018

Richard Q. Lewis and Nav Chana

The purpose of this paper is to consider how the evolving concept of the “primary care home” (PCH) that is developing in England might be an effective vehicle for the delivery of…

Abstract

Purpose

The purpose of this paper is to consider how the evolving concept of the “primary care home” (PCH) that is developing in England might be an effective vehicle for the delivery of the goals of “population health”. The authors examine evidence from earlier initiatives to achieve similar objectives of primary care-led health system planning and care integration to understand relevant lessons for the PCH.

Design/methodology/approach

This paper is based on a descriptive review of the PCH using documentary sources and a non-systematic review of literature relating to primary care commissioning initiatives and recent initiatives to deliver general practice services on a larger scale.

Findings

The PCH is likely to bring forth relatively high engagement from general practitioners due to its neighbourhood scale, voluntary nature and its focus on professional partnership, personalisation of care and outcomes. It is important that participants have sufficient autonomy to act and that financial incentives are aligned with the goals of population health. It is also important that, unlike some earlier primary care initiatives, the PCH is given time to develop to maturity.

Originality/value

The PCH is a recent phenomenon that is developing in England and elsewhere. This paper locates the PCH within a historical context and draws conclusions from a relevant evidence base.

Details

Journal of Integrated Care, vol. 26 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

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