Family practice
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Early diagnosis of pediatrics urinary tract infections in the outpatient settings is challenging but essential to prevent hospitalization and kidney damage. ⋯ All 4 point-of-care tests were suboptimal for use in the broad range of children presenting with acute illnesses to general practice. General practitioners need novel methods for obtaining reliable urine samples during the time of the consultation, especially for children not yet toilet-trained.
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Health coaching (HC) and mindfulness (MFN) are proven interventions for mobilizing patients' inner resources and are slowly being integrated into public primary care. Since 2015 the medical community in Gibsons BC has integrated physician-led HC and MFN-based programs into team-based care. This exploratory study aimed to understand the mechanisms by which these rural programs helped both patients and clinicians, and to elicit priorities for future study in these fields. ⋯ These themes highlight critical qualities of HC and MFN programs when implemented in a Medicare system. Key features include reducing stigma around mental health through making programs physician-led and a natural part of primary care, enriching accessibility through public funding, and enhancing patient agency through cultivating embodied awareness, self-compassion, and interpersonal skills. These themes inform the next steps to support upscaling these programs to other communities.
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New Zealand (NZ) has high rates of colorectal cancer (CRC) but low rates of early detection. The majority of CRC is diagnosed through general practice, where lengthy diagnostic intervals are common. We investigated factors contributing to diagnostic delay in a cohort of patients newly diagnosed with CRC. ⋯ NZ patients with CRC can experience long diagnostic intervals, attributed to patient and health system factors. Young patients, Māori, females, and patients experiencing change of bowel habit may be at particular risk. We need to increase symptom awareness of CRC for patients and GPs. Concentrated efforts are needed to ensure equity for Māori in access to screening, diagnostics, and treatment.
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The canton of Vaud's public health authorities, in Switzerland, invited general practitioners (GPs) to participate in managing suspected COVID-19 patients and continue caring for their non-COVID-19 patients. However, this course of action was not mandatory. The present study's objective was to describe and understand how involved GPs were in dealing with the COVID-19 pandemic's first wave. ⋯ This study illustrated the complexity and limitations of a primary care system based completely on private healthcare providers.
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Healthcare complaints are underutilized for quality improvement in general practice. Systematic analysis of complaints has identified hot spots (areas across the care pathway where issues occur frequently) and blind spots (areas across the care pathway that cannot be observed by staff) in secondary care. The Healthcare Complaints Analysis Tool (HCAT) has been adapted to the HCAT(GP). ⋯ Complaints are valuable data for improving general practice. This study demonstrated that the HCAT(GP) can support the systematic analysis of general practice complaints, and identify hot spots and blind spots in care.