Aust Fam Physician
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Skin infections are a cause of significant morbidity in Aboriginal and Torres Strait Islander populations. ⋯ Management should consist of treatment of the patient through medication and also general measures for the patient, their family and the community as a whole. There are significant health and socioeconomic burdens placed on communities as a result of the high rate of skin disease in some settings.
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Timeliness and quality of hospital discharge summaries are crucial for patient safety and efficient health service provision after discharge. ⋯ Completion rates were good but utility was compromised by delays, content omissions and formatting. Digital searching enables extraction of information from rich existing datasets contained in GP records for accurate measurement of discharge summary receipt rate and timing.
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Patients with multimorbidity are increasingly common in general practice. Multimorbidity is a challenge for both patients and practitioners because of the complexity of care and its impact on patients' lives. Single-disease-based guidelines are of limited use to providers managing patients with multimorbidity. ⋯ Providing effective care for multimorbidity requires shared decision-making about goals with patients and more effective communication and coordination between providers. For this group of patients, our current single-disease-based models of care need to be replaced with more integrated ones in which the impact of all the patient's conditions on their quality of life are considered.
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The increasing use of routinely collected data in electronic health record (EHR) systems for business analytics, quality improvement and research requires an extraction process fit for purpose. Little is known about the quality of EHR data extracts. We examined the accuracy of three data extraction tools (DETs) with two EHR systems in Australia. ⋯ Current DETs are not reliable and potentially unsafe. Proprietary EHRs and DETs must support transparency and independent testing with standardised queries. Quality control within an appropriate policy and legislative environment is essential.
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The review of a doctor's fitness to practice is being increasingly discussed internationally. The Medical Board of Australia has recently announced a desire to explore this issue. The United Kingdom (UK) introduced revalidation for doctors last year. The UK revalidation system is an enhancement of the National Health Service appraisal system that requires doctors to participate in annual appraisals conducted by trained peers. The appraisal process involves four stages: submission of a range of information; a confidential appraisal discussion; a personal development plan; and a post-appraisal sign-off. The criteria that doctors are assessed against are detailed in the General Medical Council's guidelines of Good Medical Practice. Satisfactory participation in the appraisal process over a 5-year cycle is likely to result in a recommendation for successful revalidation. ⋯ The revalidation process has been beneficial from a personal perspective, but the range of consequences and subsequent support mechanisms need to be considered and addressed.