Future-proofing the primary care workforce: A qualitative study of home visits by emergency care practitioners in the UK.

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Robert Oliver Barker, Rachel Stocker, Siân Russell, Barbara Hanratty
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引用次数: 4

Abstract

Background: Broadening the skill-mix in general practice is advocated to build resilience into the primary care workforce. However, there is little understanding of how extended-scope practitioners from different disciplines, such as paramedicine and nursing, embed into roles traditionally ascribed to general practitioners (GPs).

Objectives: This study sought to explore patients' and professionals' experiences of a primary care home visiting service delivered by emergency care practitioners (ECPs), in place of GPs; to determine positive impacts/unintended consequences and establish whether interdisciplinary working was achieved.

Methods: Three practices in England piloted an ECP (extended-scope practitioners with a paramedic or nursing background) home visiting service (November 2018-March 2019). Following the pilot, focus groups were conducted with each of the three primary healthcare teams (14 participants, including eight GPs), and one with ECPs (five participants) and nine individual patient interviews. Data were analysed using a modified framework approach.

Results: The impact of ECP home visiting on GP workload and patient care was perceived as positive by patients, GPs and ECPs. Initial preconceptions of GPs and patients about the ECP role and expertise, and reservations about the appropriacy of ECPs for home visiting, were perceived to have been overcome by the expertise and interpersonal skills of ECPs. Fostering a culture of collaboration between ECPs and GPs was instrumental to remodelling professional boundaries at the practice level.

Conclusion: Broadening the skill-mix to incorporate extended-scope practitioners such as ECPs, to deliver primary care home visiting, presents an opportunity to increase resilience in the general practice workforce.

Abstract Image

面向未来的初级保健工作人员:英国急诊护理从业人员家访的定性研究。
背景:提倡在全科实践中扩大技能组合,以建立初级保健劳动力的复原力。然而,对于来自不同学科(如辅助医学和护理)的扩展范围从业人员如何嵌入传统上归因于全科医生(gp)的角色,人们知之甚少。目的:本研究旨在探讨患者和专业人员对急诊护理从业人员(ECPs)代替全科医生提供的初级保健家访服务的体验;确定积极的影响/意外的后果,并确定是否实现了跨学科的工作。方法:2018年11月至2019年3月,英国三家医院试点了ECP(具有护理人员或护理背景的大范围从业人员)家访服务。在试点之后,分别对三个初级保健小组(14名参与者,包括8名全科医生)和一个初级保健小组(5名参与者)进行了焦点小组讨论,并对9名患者进行了个别访谈。使用改进的框架方法分析数据。结果:患者、全科医生和ECP认为ECP家访对全科医生工作量和病人护理的影响是积极的。全科医生和患者最初对ECP的作用和专业知识的先入之见,以及对ECP家访的适当性的保留,被认为已经被ECP的专业知识和人际交往能力所克服。培养初级医师和普通医师之间的合作文化有助于在实践层面重塑专业界限。结论:扩大技能组合,纳入扩展范围的从业人员,如ECPs,提供初级保健家访,提供了一个机会,以提高全科医生队伍的弹性。
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来源期刊
European Journal of General Practice
European Journal of General Practice PRIMARY HEALTH CARE-MEDICINE, GENERAL & INTERNAL
CiteScore
5.10
自引率
5.90%
发文量
31
审稿时长
>12 weeks
期刊介绍: The EJGP aims to: foster scientific research in primary care medicine (family medicine, general practice) in Europe stimulate education and debate, relevant for the development of primary care medicine in Europe. Scope The EJGP publishes original research papers, review articles and clinical case reports on all aspects of primary care medicine (family medicine, general practice), providing new knowledge on medical decision-making, healthcare delivery, medical education, and research methodology. Areas covered include primary care epidemiology, prevention, diagnosis, pharmacotherapy, non-drug interventions, multi- and comorbidity, palliative care, shared decision making, inter-professional collaboration, quality and safety, training and teaching, and quantitative and qualitative research methods.
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