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Article
Publication date: 10 March 2020

Salman Bin Naeem, Rubina Bhatti and Khurshid Ahmad

This study is a part of the doctoral dissertation that proposes concrete measures to improve health-care information outreach program for rural health-care professionals…

Abstract

Purpose

This study is a part of the doctoral dissertation that proposes concrete measures to improve health-care information outreach program for rural health-care professionals in primary and secondary health care in Punjab, Pakistan. This study aims to report on the barriers to accessing and using online health-care information from rural settings of the Punjab province of Pakistan.

Design/methodology/approach

A cross-sectional survey was conducted in primary and secondary health-care settings in the Punjab province of Pakistan. The study’s population consisted of the rural primary care physicians (PCPs), who were geographically dispersed across 2,873 different remote health-care settings across Punjab. These practice settings included 2,455 basic health units, 293 rural health centers, 89 tehsil headquarter hospitals and 36 district headquarter hospitals.

Findings

Limited internet access, non-availability of required equipment and lack of training facilities were identified as the main barriers. PCPs’ gender, previous enrollment in post-graduation programs and type of health-care facility were significant factors in the perceived barriers related to both “non-availability of required equipment” and “inadequate training facilities on the use of information resources”.

Practical implications

The findings of the study hold some important practical implications for different stakeholders. This study identifies and addresses the barriers to accessing and using health-care information for PCPs in rural settings. The success of the health-care information outreach program in Punjab, Pakistan, should rely on the eradication of these barriers.

Originality/value

To the best of the authors’ knowledge, this is the first large-scale study in Pakistan that assesses the barriers and proposes ways to overcome these barriers to effectively access and use health-care information.

Details

Information Discovery and Delivery, vol. 48 no. 4
Type: Research Article
ISSN: 2398-6247

Keywords

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Article
Publication date: 3 October 2008

Michael Aherne and José L. Pereira

The purpose of this paper is to use a descriptive case study to establish how collaboration, innovation and knowledge‐management strategies have scaled‐up learning and…

Abstract

Purpose

The purpose of this paper is to use a descriptive case study to establish how collaboration, innovation and knowledge‐management strategies have scaled‐up learning and development in rural, remote and other resource‐constrained Canadian delivery settings.

Design/methodology/approach

Intervention design was realized through a one‐time, collaborative, national capacity‐building project. A project portfolio of 72 sub‐projects, initiatives and strategic activities was used to improve access, enhance quality and create capacity for palliative and end‐of‐life care services. Evaluation was multifaceted, including participatory action research, variance analysis and impact analysis. This has been supplemented by post‐intervention critical reflection and integration of relevant literature.

Findings

The purposeful use of collaboration, innovation and knowledge‐management strategies have been successfully used to support a rapid scaling‐up of learning and development interventions. This has enabled enhanced and new pan‐Canadian health delivery capacity implemented at the local service delivery catchment‐level.

Research limitations/implications

The intervention is bounded by a Canada‐specific socio‐cultural/political context. Design variables and antecedent conditions may not be present and/or readily replicated in other nation‐state contexts. The findings suggest opportunities for future integrative and applied health services and policy research, including collaborative inquiry that weaves together concepts from adult learning, social science and industrial engineering.

Practical implications

Scaling‐up for new capacity is ideally approached as a holistic, multi‐faceted process which considers the total assets within delivery systems, service catchments and communities as potentially being engaged and deployed.

Originality/value

The Pallium Integrated Capacity‐building Initiative offers model elements useful to others seeking theory‐informed practices to rapidly and effectively scale‐up learning and development efforts.

Details

Leadership in Health Services, vol. 21 no. 4
Type: Research Article
ISSN: 1751-1879

Keywords

Content available
Article
Publication date: 4 December 2017

Bita A. Kash, Paul Ogden, Elizabeth Popp, Melissa Shaffer and Jane Bolin

The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address…

Abstract

Purpose

The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the burden of chronic disease in a population-based approach.

Design/methodology/approach

A systematic literature review was conducted and identified 1,880 published records through PubMed using 26 search terms. After abstract and full-text review, 70 articles remained as potential models.

Findings

Although there is already a severe shortage of physicians in Texas, emerging practice patterns and choices among physicians are likely to erode access to primary care services in the state. Health-care leaders are encouraged to consider models such as complex adaptive systems for team-based care, pharmacist hypertension care management program and combined nurse-led care management with group visit structure.

Research limitations/implications

As with any study, this research has its limitations; for example, models that might work in one state, or under a unique state-funded academic medical center, might not be “do-able” in another state within the nuances of a different funding mechanism.

Practical implications

Results of this research provide a model for implementing IPCM for the state of Texas first and will guide IPCM planning and implementation in other states.

Originality/value

This study is “land grant-centric” and focused on carrying out the mission of a major, top-tier research university with an emerging college of medicine at an academic medical center.

Details

International Journal of Innovation Science, vol. 9 no. 4
Type: Research Article
ISSN: 1757-2223

Keywords

Content available
Article
Publication date: 5 November 2019

Robyn Ramsden, Richard Colbran, Tricia Linehan, Michael Edwards, Hilal Varinli, Carolyn Ripper, Angela Kerr, Andrew Harvey, Phil Naden, Scott McLachlan and Stephen Rodwell

While one-third of Australians live outside major cities, there are ongoing challenges in providing accessible, sustainable, and appropriate primary health care services…

Abstract

Purpose

While one-third of Australians live outside major cities, there are ongoing challenges in providing accessible, sustainable, and appropriate primary health care services in rural and remote communities. The purpose of this paper is to explore a partnership approach to understanding and addressing complex primary health workforce issues in the western region of New South Wales (NSW), Australia.

Design/methodology/approach

The authors describe how a collaboration of five organisations worked together to engage a broader group of stakeholders and secure commitment and resources for a regional approach to address workforce challenges in Western NSW. A literature review and formal interviews with stakeholders gathered knowledge, identified issues and informed the overarching approach, including the development of the Western NSW Partnership Model and Primary Health Workforce Planning Framework. A stakeholder forum tested the proposed approach and gained endorsement for a collaborative priority action plan.

Findings

The Western NSW Partnership Model successfully engaged regional stakeholders and guided the development of a collaborative approach to building a sustainable primary health workforce for the future.

Originality/value

Given the scarcity of literature about effective partnerships approaches to address rural health workforce challenges, this paper contributes to an understanding of how to build sustainable partnerships to positively impact on the rural health workforce. This approach is replicable and potentially valuable elsewhere in NSW, other parts of Australia and internationally.

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Article
Publication date: 5 June 2017

Eric R. Kushins, Henry Heard and J. Michael Weber

This article proposes a new disruptive innovation in healthcare through the development of a physician assistant business model, which can be most readily applied in…

Abstract

Purpose

This article proposes a new disruptive innovation in healthcare through the development of a physician assistant business model, which can be most readily applied in vulnerable rural health care settings.

Design/methodology/approach

This study reviews the current state of the health care system in terms of physician assistant utilization and primary care shortages in rural communities. The study proposes that the physician assistant-owned and -operated primary care business represents a disruptive innovation, via the application of the five principles of Clayton Christensen’s (1997) thesis on disruptive innovation.

Findings

Considering the current state of the health care industry, the study logically defends the proposed model as a disruptive innovation in that it: focuses on an underserved market, has lower costs, has few competitors, offers high quality and provides a sustainable competitive advantage.

Practical implications

The physician assistant business model is a viable solution for providing primary care for rural communities with educational, financial, transportation and other resource limitations.

Originality/value

This is a unique application of the theory of disruptive innovation, which illustrates how a new business model can solve a chronic shortage in primary care, especially in underserved populations.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 11 no. 2
Type: Research Article
ISSN: 1750-6123

Keywords

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Article
Publication date: 18 May 2012

Faridahwati Mohd‐Shamsudin and Nirachon Chuttipattana

The purpose of this paper is first, to identify the critical managerial competencies of primary care managers; and second, to determine the relationship between…

Abstract

Purpose

The purpose of this paper is first, to identify the critical managerial competencies of primary care managers; and second, to determine the relationship between personality and motivation, and managerial competency.

Design/methodology/approach

A survey was conducted involving distribution of questionnaires to 358 rural primary care managers in Southern Thailand.

Findings

The survey found six critical managerial competencies: visionary leadership; assessment, planning, and evaluation; promotion of health and prevention of disease; information management; partnership and collaboration; and communication. Both personality and motivation are found to significantly influence primary care managers' managerial competency. In particular, conscientiousness (i.e. perseveres until the task is finished, does a thorough job, full of energy, does things efficiently, and a lot of enthusiasm) is related to all managerial competencies. It is clear that extrinsic and intrinsic factors (i.e. quality of supervision and leadership, organizational policy and administration, interpersonal relationship, working conditions, work itself, amount of responsibility, and job recognition) are influential in primary care manager motivation that can significantly improve morale.

Research limitations/implications

The short version of the personality instrument may limit the generalization of some of the findings. Future research is needed to assess the relationship between managerial competency and performance. Further research could be done in other countries to see if this conclusion is in fact correct. It would also be useful to research if the findings apply to other health and social areas.

Practical implications

Personality and motivation are able to co‐predict managerial competency whereby motivation tends to have a stronger influence than personality. These findings will be useful to policy makers and to those responsible for the human development in the preparation of management training and development programs. Moreover, top management should not overlook the motivational system as a way to encourage managers to be competent in their job.

Originality/value

The paper contributes to our understanding of managerial competency within the context of rural primary care sectors. The success of any organized health program depends upon effective management, but health systems worldwide face a lack of competent management at all levels. Management development for health systems, particularly at the first line of supervision, must be given much higher priority for investment.

Details

Journal of Health Organization and Management, vol. 26 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

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Article
Publication date: 1 March 1998

Michael E. Samuels, Leiyu Shi and Norma J. Campbell

This article is a descriptive revenue profile of Community and Migrant Health Centers providing preventive and primary health care services to underserved rural and urban…

Abstract

This article is a descriptive revenue profile of Community and Migrant Health Centers providing preventive and primary health care services to underserved rural and urban populations throughout the United States. The study is a secondary data analysis of the 1994 Bureau Common Reporting Requirements (BCRR) reports of the 626 Community and Migrant Health Centers to the Bureau of Primary Health Care. The purpose of the analysis is to examine the sources of revenue of the centers and consider the implications for public policy. In 1994, the 626 centers generated more than $2 billion from all payment sources to care for more than 7 million users. The findings should guide and assist policy makers at the state and federal levels in first deciding the role of C/MHCs in developing managed health care strategies for underserved rural and urban populations and developing the appropriate funding policies to support these decisions.

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. 10 no. 4
Type: Research Article
ISSN: 1096-3367

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Article
Publication date: 14 June 2021

Salman Bin Naeem, Rubina Bhatti, Khurshid Ahmad and Muhammad Rafi

The purpose of this paper is to appraise the possible response outcomes (no response, fear control or danger control) of a fear-based message on falling behind current…

Abstract

Purpose

The purpose of this paper is to appraise the possible response outcomes (no response, fear control or danger control) of a fear-based message on falling behind current medical knowledge among health-care professionals (HCPs).

Design/methodology/approach

This study was conducted using a quantitative research design. A cross-sectional survey was carried out in 2,873 health-care facilities across 36 districts of Punjab. The Extended Parallel Process Model (EPPM) provided a theoretical framework for this study. The important components to EPPM such as threat, efficacy and outcomes were used to collect the data. The collected data was analyzed using Statistical Package for Social Sciences (SPSS) version 22.

Findings

HCPs perceived high susceptibility and threat of falling behind current medical knowledge. A majority of the HCPs were at the danger control process and engaged in a behavior that is recommended for adaptive behavioral changes. Clinical experience and enrollment in post-graduation programs (e.g. FCPS, MCPS) were significant factors as to HCPs’ perceived response efficacy.

Research limitations/implications

The responses were obtained using a structured questionnaire, which is always subject to respondents’ personal biases and ability to understand the question’s statement.

Practical implications

This study has important implications in terms of introducing promotional, educational and logistical interventions that could help in HCPs overcoming the fear of falling behind current medical knowledge and develop productive and adoptive information behavior thus improving patient care and outcome.

Originality/value

This is the first large-scale empirical study in Pakistan that measured the level of threat and efficacy among HCPs using the EPPM. It proposes a framework for developing long-lasting adaptive information behavioral changes that may result in informed patient care and better decision-making.

Details

Information Discovery and Delivery, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2398-6247

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Article
Publication date: 30 December 2020

Deborah J. Moon and Adrian J. Ballard

This study aimed to develop a comprehensive framework that encompasses contextual determinants of integrated care implementation. The initial framework was developed based…

Abstract

Purpose

This study aimed to develop a comprehensive framework that encompasses contextual determinants of integrated care implementation. The initial framework was developed based on literature and was refined based on contexts and mechanisms that facilitated or interfered with integrating a pilot parenting intervention, Behavior Checker (BC), into the routine service delivery in a rural primary care clinic in the USA.

Design/methodology/approach

This study was a single organizational case study informed by the realist evaluation methodology. Data collection methods included key informant interviews, healthcare staff surveys, a focus group and direct observation of meetings. Data analysis focused on identifying the context-mechanism-outcome (CMO) frameworks, a heuristic used in a realist evaluation to map pathways of the interactions between program inputs and contextual conditions leading to intended and/or unintended outcomes.

Findings

The identified CMOs and antecedent contexts identified informed the process of revising the initial Comprehensive Framework for Integrated Healthcare Development and Implementation (CF-IHDI). The revised CF-IHDI contained six parent domains of outer setting, basic structures, people and value, intervention characteristics, organizational capabilities for change and key processes.

Research limitations/implications

The CMOs and core characteristics of contextual conditions that activated facilitating mechanisms can inform future studies examining healthcare integration efforts.

Practical implications

The CF-IHDI can guide primary care clinics in identifying factors and strategies to consider when integrating parenting or other psychosocial interventions into primary care routine service delivery.

Originality/value

The CF-IHDI developed in this study contributes to the knowledge of contexts and mechanisms that facilitate and interfere with integrated care implementation.

Details

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

Keywords

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Article
Publication date: 15 August 2016

Kathy L Rush, Nelly D Oelke, R. Colin Reid, Carol Laberge, Frank Halperin and Mary Kjorven

Older adults with atrial fibrillation (AF) have put growing demands on a poorly integrated healthcare system. This is of particular concern in rural communities with rapid…

Abstract

Purpose

Older adults with atrial fibrillation (AF) have put growing demands on a poorly integrated healthcare system. This is of particular concern in rural communities with rapid population aging and few healthcare resources elevating risk of stroke and mortality. The purpose of this paper is to explore healthcare delivery risks for rural older adults with AF.

Design/methodology/approach

This qualitative study collected data from AF patients, healthcare providers and decision makers. Ten patients participated in six-month care journeys involving interviews, logs, photos, and chart reviews. In total, 13 different patients and ten healthcare providers participated in focus groups and two decision makers participated in interviews.

Findings

Three key health service risks emerged: lack of patient-focussed access and self-management; unplanned care coordination and follow-up across the continuum of care; and ineffective teamwork with variable perspectives among patients, providers, and decision makers.

Originality/value

This study extends the understanding of risks to the health system level. Results provide important information for further research aimed at interventions to improve health service delivery and policy change to mitigate risks for this population.

Details

Journal of Integrated Care, vol. 24 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

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