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Open Access
Article
Publication date: 3 August 2023

Fury Maulina, Mubasysyir Hasanbasri, Jamiu O. Busari and Fedde Scheele

This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors’ leadership skills in…

Abstract

Purpose

This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors’ leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle‐income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings.

Design/methodology/approach

This study applied an educational intervention consisting of a two-day workshop. The authors evaluated the impact of the workshop on participants’ knowledge and skill by combining quantitative pre- and post-intervention questionnaires (based on Levels 1 and 2 of Kirkpatrick’s model) with qualitative post-intervention in-depth interviews, using a phenomenological approach and thematic analysis.

Findings

The workshop yielded positive results, as evidenced by participants’ increased confidence to apply and use the information and skills acquired during the workshop. Critical success factors were as follows: participants were curiosity-driven; the use of multiple learning methodologies that attracted participants; and the use of authentic scenarios as a critical feature of the program.

Originality/value

The intervention may offer a preliminary model for improving physician leadership skills in rural and remote settings by incorporating multiple teaching approaches and considering local cultural norms.

Details

Leadership in Health Services, vol. 37 no. 5
Type: Research Article
ISSN: 1751-1879

Keywords

Open Access
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 the…

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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

Open Access
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 in rural

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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.

Open Access
Article
Publication date: 9 December 2021

Frances Barraclough and Sabrina Pit

The COVID-19 pandemic has led to “forced innovation” in the health education industry. High-quality training of the future rural health workforce is crucial to ensure a pipeline…

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Abstract

Purpose

The COVID-19 pandemic has led to “forced innovation” in the health education industry. High-quality training of the future rural health workforce is crucial to ensure a pipeline of rural health practitioners to meet the needs of rural communities. This paper describes the implementation of an online multidisciplinary teaching program focusing on integrated care and the needs of rural communities.

Design/methodology/approach

A multidisciplinary teaching program was adapted to allow students from various disciplines and universities to learn together during the COVID-19 pandemic. Contemporary issues such as the National Aged Care Advocacy Program for Residential Aged Care COVID-19 Project were explored during the program.

Findings

This case study describes how the program was adopted, how learning needs were met, practical examples (e.g. the Hand Hygiene Advocacy within a Rural School Setting Project), the challenges faced and solutions developed to address these challenges. Guidelines are proposed for remote multidisciplinary learning among health professional students, including those in medical, nursing, pharmacy, dentistry, and allied health disciplines.

Originality/value

The originality of this program centers around students from multiple universities and disciplines and various year levels learning together in a rural area over an extended period of time. Collaboration among universities assists educators in rural areas to achieve critical mass to teach students. In addition it provides experiences and guidance for the work integrated learning sector, rural health workforce practitioners, rural clinical schools, universities, policy makers, and educators who wish to expand rural online multidisciplinary learning.

Open Access
Article
Publication date: 1 December 2020

Richard Colbran, Robyn Ramsden, Michael Edwards, Emer O'Callaghan and Dave Karlson

While Australia has continued to invest in polices and strategies aimed at improving rural health service provision, many communities still confront a disproportionate share of…

1346

Abstract

Purpose

While Australia has continued to invest in polices and strategies aimed at improving rural health service provision, many communities still confront a disproportionate share of the rural workforce shortage. The NSW Rural Doctors Network (RDN) contributes its perspectives about the importance of a whole of life career and the meandering stream concept to support the retention of health professionals rurally. We unpack these concepts and examine how they bring to light a new and useful approach to addressing rural workforce challenges and potentially contribute to building a stronger integrated care approach.

Design/methodology/approach

The approach used involved tapping into RDN's 30-years of experience in recruitment and retention of remote and rural health professionals, combined with insights from relevant existing and emerging evidence.

Findings

We suggest that reframing retention to consider a life stage approach to career will guide more effective targeting of rural health policies, workforce planning, collaborative approaches and allocation of incentives. We posit that an understanding and acceptance of modern lifestyles and career pathways, and a celebration of career commitment to serving rural communities, is necessary for successful recruitment and retention of Australia's future rural health workforce beyond the training pipeline.

Originality/value

We outline and visually represent RDN's meandering stream approach to building and retaining a capable rural health workforce through addressing life cycle and workforce level needs. This perspective paper draws on RDN's direct experience in the field.

Details

Journal of Integrated Care, vol. 30 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 30 March 2021

Katarzyna Miszczynska and Piotr Marek Miszczyński

The main aim of the study was to measure and assess the efficiency of the healthcare system in Poland.

2739

Abstract

Purpose

The main aim of the study was to measure and assess the efficiency of the healthcare system in Poland.

Design/methodology/approach

An output-oriented Data Envelopment Analysis model with a 2-years window analysis extension was used between 2013 and 2018. The analysis was completed with a determination of the sources of productivity changes (between the first and last year of the study period) and factors that influence efficiency.

Findings

Efficient regions have been identified and the spatial diversity in their efficiency was confirmed. The study identified individual efficiency trends together with “all-windows” best and worst performers. Using panel modeling, it was confirmed that the efficiency of health protection is influenced by, among others, accreditation certificates, the length of the waiting list or the number of medical personnel.

Research limitations/implications

Although the analysis was conducted at the voivodeship level (NUTS2), which was fully justified, it would be equally important to analyze data with a lower aggregation level. It would be extremely valuable from the perspective of difficulties faced by the healthcare system in Poland.

Practical implications

The identification of areas and problems affecting the efficiency of the healthcare system in Poland may also be a hint for other countries with similar system solutions that also struggle with the same problems.

Originality/value

The paper explains the efficiency of the country's healthcare system while also paying attention to changes in its level, factors influencing it, spatial diversity and impact on the sector functioning.

Details

International Journal of Productivity and Performance Management, vol. 71 no. 7
Type: Research Article
ISSN: 1741-0401

Keywords

Open Access
Article
Publication date: 30 November 2022

Attia Aman-Ullah, Azelin Aziz, Hadziroh Ibrahim, Waqas Mehmood and Attiqa Aman-Ullah

This research aimed to study the impact of compensation on employee retention and turnover intentions among healthcare employees. The study also tested the mediation role of job…

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Abstract

Purpose

This research aimed to study the impact of compensation on employee retention and turnover intentions among healthcare employees. The study also tested the mediation role of job satisfaction in the relationship.

Design/methodology/approach

In the present study, self-administrated questionnaires were distributed among 600 doctors working in public hospitals of Pakistan, following stratified sampling. The data analysis was conducted through SPSS and smart-PLS.

Findings

Results of the present study supported all the hypotheses (H1–H7), such as the significant relationship of compensation with employee retention and turnover intentions. Results further confirmed the mediation effect of job satisfaction between compensation and employee retention as well as compensation and turnover intentions.

Practical implications

This study is useful for policymakers and organizational managers since the study provides guidelines on employee retention and high turnover intentions and how these factors are influenced by improved compensation.

Originality/value

This study sheds light on the relationship of compensation together with employee retention and turnover intentions through the mediating role of job satisfaction in healthcare context, which was overlooked in the existing literature.

Details

Revista de Gestão, vol. 30 no. 2
Type: Research Article
ISSN: 1809-2276

Keywords

Open Access
Article
Publication date: 4 December 2023

Mariona Espaulella-Ferrer, Felix Jorge Morel-Corona, Mireia Zarco-Martinez, Alba Marty-Perez, Raquel Sola-Palacios, Maria Eugenia Campollo-Duquela, Maricelis Cruz-Grullon, Emma Puigoriol-Juvanteny, Marta Otero-Viñas and Joan Espaulella-Panicot

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of…

Abstract

Purpose

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

Design/methodology/approach

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

Findings

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

Originality/value

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

Open Access
Book part
Publication date: 6 May 2019

Mitch Blair and Denise Alexander

Equity is an issue that pervades all aspects of primary care provision for children and as such is a recurring theme in the Models of Child Health Appraised project. All European…

Abstract

Equity is an issue that pervades all aspects of primary care provision for children and as such is a recurring theme in the Models of Child Health Appraised project. All European Union member states agree to address inequalities in health outcomes and include policies to address the gradient of health across society and target particularly vulnerable population groups. The project sought to understand the contribution of primary care services to reducing inequity in health outcomes for children. We focused on some key features of inequity as they affect children, such as the importance of good health services in early childhood, and the effects of inequity on children, such as the higher health needs of underprivileged groups, but their generally lower access to health services. This indicates that health services have an important role in buffering the effects of social determinants of health by providing effective treatment that can improve the health and quality of life for children with chronic disorders. We identified common risk factors for inequity, such as gender, family situation, socio-economic status (SES), migrant or minority status and regional differences in healthcare provision, and attempted to measure inequity of service provision. We did this by analysing routine data of universal primary care procedures, such as vaccination, age at diagnosis of autism or emergency hospital admission for conditions that can be generally treated in primary care, against variables of inequity, such as indicators of SES, migrant/ethnicity or urban/rural residency. In addition, we focused on the experiences of child population groups particularly at risk of inequity of primary care provision: migrant children and children in the state care system.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

Keywords

Open Access
Book part
Publication date: 6 May 2019

Denise Alexander, Uttara Kurup, Arjun Menon, Michael Mahgerefteh, Austin Warters, Michael Rigby and Mitch Blair

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health…

Abstract

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

Keywords

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