Relevant bibliographies by topics / Primary care (Medicine) Victoria Administration

Academic literature on the topic 'Primary care (Medicine) Victoria Administration'

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Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Primary care (Medicine) Victoria Administration"

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Lord, Bill, Emily Andrew, Amanda Henderson, David J. Anderson, Karen Smith, and Stephen Bernard. "Palliative care in paramedic practice: A retrospective cohort study." Palliative Medicine 33, no. 4 (February 5, 2019): 445–51. http://dx.doi.org/10.1177/0269216319828278.

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Background: Paramedics may be involved in the care of patients experiencing a health crisis associated with palliative care. However, little is known about the paramedic’s role in the care of these patients. Aim: To describe the incidence and nature of cases attended by paramedics and the care provided where the reason for attendance was associated with a history of palliative care. Design: This is a retrospective cohort study. Setting/participants: Adult patients (aged >17 years) attended by paramedics in the Australian state of Victoria between 1 July 2015 and 30 June 2016 where terms associated with palliative care or end of life were recorded in the patient care record. Secondary transfers including inter-hospital transport cases were excluded. Results: A total of 4348 cases met inclusion criteria. Median age was 74 years (interquartile range 64–83). The most common paramedic assessments were ‘respiratory’ (20.1%), ‘pain’ (15.8%) and ‘deceased’ (7.9%); 74.4% ( n = 3237) were transported, with the most common destination being a hospital (99.5%, n = 3221). Of those with pain as the primary impression, 359 (53.9%) received an analgesic, morphine, fentanyl or methoxyflurane, and 356 (99.2%) were transported following analgesic administration. Resuscitation was attempted in 98 (29.1%) of the 337 cases coded as cardiac arrest. Among non-transported cases, there were 105 (9.6%) cases where paramedics re-attended the patient within 24 h of the previous attendance. Conclusion: Paramedics have a significant role in caring for patients receiving palliative care. These results should inform the design of integrated systems of care that involve ambulance services in the planning and delivery of community-based palliative care.
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Mitra, Biswadev, Stephen Bernard, Dashiell Gantner, Brian Burns, Michael C. Reade, Lynnette Murray, Tony Trapani, et al. "Protocol for a multicentre prehospital randomised controlled trial investigating tranexamic acid in severe trauma: the PATCH-Trauma trial." BMJ Open 11, no. 3 (March 2021): e046522. http://dx.doi.org/10.1136/bmjopen-2020-046522.

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IntroductionHaemorrhage causes most preventable prehospital trauma deaths and about a third of in-hospital trauma deaths. Tranexamic acid (TXA), administered soon after hospital arrival in certain trauma systems, is an effective therapy in preventing or managing acute traumatic coagulopathy. However, delayed administration of TXA appears to be ineffective or harmful. The effectiveness of prehospital TXA, incidence of thrombotic complications, benefit versus risk in advanced trauma systems and the mechanism of benefit remain uncertain.Methods and analysisThe Pre-hospital Anti-fibrinolytics for Traumatic Coagulopathy and Haemorrhage (The PATCH-Trauma study) is comparing TXA, initiated prehospital and continued in hospital over 8 hours, with placebo in patients with severe trauma at risk of acute traumatic coagulopathy. We present the trial protocol and an overview of the statistical analysis plan. There will be 1316 patients recruited by prehospital clinicians in Australia, New Zealand and Germany. The primary outcome will be the eight-level Glasgow Outcome Scale Extended (GOSE) at 6 months after injury, dichotomised to favourable (GOSE 5–8) and unfavourable (GOSE 1–4) outcomes, analysed using an intention-to-treat (ITT) approach. Secondary outcomes will include mortality at hospital discharge and at 6 months, blood product usage, quality of life and the incidence of predefined adverse events.Ethics and disseminationThe study was approved by The Alfred Hospital Research and Ethics Committee in Victoria and also approved in New South Wales, Queensland, South Australia, Tasmania and the Northern Territory. In New Zealand, Northern A Health and Disability Ethics Committee provided approval. In Germany, Witten/Herdecke University has provided ethics approval. The PATCH-Trauma study aims to provide definitive evidence of the effectiveness of prehospital TXA, when used in conjunction with current advanced trauma care, in improving outcomes after severe injury.Trial registration numberNCT02187120.
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Armstrong, Brent, Odette Levesque, Jonathan B. Perlin, Cathy Rick, and Gordon Schectman. "Reinventing Veterans Health Administration: Focus on Primary Care." Journal of Healthcare Management 50, no. 6 (November 2005): 399–409. http://dx.doi.org/10.1097/00115514-200511000-00009.

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Post, Edward P., and William W. Van Stone. "Veterans Health Administration Primary Care-Mental Health Integration Initiative." North Carolina Medical Journal 69, no. 1 (January 2008): 49–52. http://dx.doi.org/10.18043/ncm.69.1.49.

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Vedsted, Peter, David Weller, Alina Zalounina Falborg, Henry Jensen, Jatinderpal Kalsi, David Brewster, Yulan Lin, et al. "Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data." BMJ Open 12, no. 12 (December 2022): e059669. http://dx.doi.org/10.1136/bmjopen-2021-059669.

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ObjectivesA growing body of evidence suggests longer time between symptom onset and start of treatment affects breast cancer prognosis. To explore this association, the International Cancer Benchmarking Partnership Module 4 examined differences in breast cancer diagnostic pathways in 10 jurisdictions across Australia, Canada, Denmark, Norway, Sweden and the UK.SettingPrimary care in 10 jurisdictions.ParticipantData were collated from 3471 women aged >40 diagnosed for the first time with breast cancer and surveyed between 2013 and 2015. Data were supplemented by feedback from their primary care physicians (PCPs), cancer treatment specialists and available registry data.Primary and secondary outcome measuresPatient, primary care, diagnostic and treatment intervals.ResultsOverall, 56% of women reported symptoms to primary care, with 66% first noticing lumps or breast changes. PCPs reported 77% presented with symptoms, of whom 81% were urgently referred with suspicion of cancer (ranging from 62% to 92%; Norway and Victoria). Ranges for median patient, primary care and diagnostic intervals (days) for symptomatic patients were 3–29 (Denmark and Sweden), 0–20 (seven jurisdictions and Ontario) and 8–29 (Denmark and Wales). Ranges for median treatment and total intervals (days) for all patients were 15–39 (Norway, Victoria and Manitoba) and 4–78 days (Sweden, Victoria and Ontario). The 10% longest waits ranged between 101 and 209 days (Sweden and Ontario).ConclusionsLarge international differences in breast cancer diagnostic pathways exist, suggesting some jurisdictions develop more effective strategies to optimise pathways and reduce time intervals. Targeted awareness interventions could also facilitate more timely diagnosis of breast cancer.
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SUTHERLAND, Georgina, Jane YELLAND, Jan WIEBE, Jennifer KELLY, Penny MARLOWE, and Stephanie BROWN. "Role of general practitioners in primary maternity care in South Australia and Victoria." Australian and New Zealand Journal of Obstetrics and Gynaecology 49, no. 6 (December 2009): 637–41. http://dx.doi.org/10.1111/j.1479-828x.2009.01078.x.

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Reid, Robert J., and Edward H. Wagner. "The Veterans Health Administration Patient Aligned Care Teams: Lessons in Primary Care Transformation." Journal of General Internal Medicine 29, S2 (April 9, 2014): 552–54. http://dx.doi.org/10.1007/s11606-014-2827-8.

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Laing, Angus, Gordon Marnoch, Lorna McKee, Rita Joshi, and John Reid. "Administration to innovation: the evolving management challenge in primary care." Journal of Management in Medicine 11, no. 2 (April 1997): 71–87. http://dx.doi.org/10.1108/02689239710177701.

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Newman, D. "Maritime Pre-Hospital Emergency Care Primary Retrieval Team – Operational Considerations." Journal of The Royal Naval Medical Service 98, no. 1 (March 2012): 16–18. http://dx.doi.org/10.1136/jrnms-98-16.

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AbstractThis article examines the non clinical skills and training required for effective maritime pre-hospital emergency care provision within a Role Two Afloat facility, allowing for a Primary Retrieval Team to be deployed in support of boarding operations. The provision of pre-hospital emergency care and sending a retrieval team forward has been trialled in various forms. In 2010 and 2011 a R2A team was deployed aboard RFA FORT VICTORIA. This included a Primary Retrieval Team consisting of an Emergency Nurse Specialist, a Medical Assistant which can be enhanced when required by an Emergency Care or Anaesthetic Consultant. This differs from the land operations support provided by the airborne Medical Emergency Response Team (MERT) as the maritime environment requires a bespoke solution for casualty retrieval as the method of deployment and the type of casualties and their locations may be more varied, requiring greater flexibility of approach.
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Zalucki, Paula M. "PRACTITIONER APPLICATION: Reinventing Veterans Health Administration: Focus on Primary Care." Journal of Healthcare Management 50, no. 6 (November 2005): 409. http://dx.doi.org/10.1097/00115514-200511000-00010.

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Dissertations / Theses on the topic "Primary care (Medicine) Victoria Administration"

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Clissold, Carolyn M. "How discourses stifle the Primary Health Care Strategy's intent to reduce health inequalities : a thesis submitted to the Victoria University of Wellington in partial fulfilment of the requirements for the degree of Master of Arts (Applied) in Nursing /." ResearchArchive@Victoria, 2006. http://hdl.handle.net/10063/185.

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Ashe, Karen M. "Factors Associated With Weight Management Counseling During Primary Care Clerkships." eScholarship@UMMS, 2019. https://escholarship.umassmed.edu/gsbs_diss/1007.

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Background: The United States Preventive Services Task Force guidelines support screening and provision of intensive multi-component behavioral counseling for adults who have obesity. One barrier to providing such counseling is lack of training in medical school. Not much is known about factors associated with medical students’ perceived weight management counseling (WMC) skills or whether preceptors model or teach WMC during primary care clerkships. Methods: A mixed methods approach addressed factors affecting WMC training during primary care clerkships. A secondary analysis of 3rd year medical students (n=730) described students’ perceived WMC skills, attitudes and frequency of engagement in 5As educational experiences. Linear mixed models were used to determine associations between educational experiences and perceived skills. Semi-structured interviews (n=12) and a survey were administered to primary care preceptors (n=77). Interviews described individual, inter-personal and institutional factors associated with preceptors’ WMC. The survey described preceptors’ frequency of modeling WMC behaviors, perceived WMC skills, and attitudes. Results: Students perceived themselves to be moderately skilled (M=2.6, SD=0.05, range 1-4). Direct patient experiences and specific instruction were associated with higher perceived skill. Preceptors support WMC curricula but do not perceive themselves to be experts in WMC. Preceptors perceive themselves to be moderately skilled (M=2.8, SD=0.06, range 1-4) but only sometimes model WMC (M=3.3, SD=0.05, range 1-5) to students during clerkships. Conclusion: Preceptor modeling WMC may not be feasible or necessary during primary care clerkships. Providing specific WMC instruction and working with patients may provide more benefit as they were more strongly associated with students’ perceived skills.
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McKinnon, Kevin Jeffrey. "Telemedicine: An Augmentation Strategy to Mitigate the Primary Care Shortage." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4535.

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According to the Association of American Medical Colleges, the primary care workforce shortage in 2025 will exceed 46,000 primary care physicians. Healthcare business leaders in Gwinnett County, Georgia have not evaluated the advantages and disadvantages of telemedicine (TM) to mitigate the workforce shortage. The purpose of this qualitative descriptive study was to determine factors primary care physician administrators consider when deciding to implement TM as a potential solution for the growing physician shortage. A purposive sample of 20 primary care physician administrators located in Gwinnett County, Georgia was drawn. The theory of disruptive technology was the conceptual framework. Data collected stemmed from semistructured interviews with each participant and review of organizational plans and workflow documents. Data were recorded, transcribed, and coded to develop themes. Three themes morphed from the study: TM awareness and education, TM cost and reimbursement, and TM implementation and utilization. Results indicated that awareness and education of leaders toward TM requires improvement, costs, and reimbursement were variables for deciding to implement or not implement TM, and TM implementation requires knowing the appropriate use of TM. The implications for positive social change include the potential for primary care physician administrators to positively influence the healthcare workforce shortage by adding flexibility to manage patient workflow with TM. Additionally, the potential for physician administrators to utilize TM for healthcare access, creating savings in transportation, energy consumption, and resource optimization, may provide better access to hard-to-reach populations.
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Click, Ivy A. "Practice Characteristics of Graduates of East Tennessee State University Quillen College of Medicine: Factors Related to Career Choices in Primary Care." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etd/1112.

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The nation is facing a physician shortage, specifically in relation to primary care and in rural underserved areas. The most basic function of a medical school is to educate physicians to care for the national population. The purpose of this study was to examine the physician practicing characteristics of the graduates of East Tennessee State University Quillen College of Medicine including factors that influence graduates’ specialty choices and practice locations, especially those related to primary care. Secondary data for this study were collected from the college’s student database system and the American Medical Association Physician Masterfile. The study population included all living graduates with Doctor of Medicine (MD) degrees who graduated from 1998 through 2009 (n=678). Statistical procedures included Pearson Chi-square, logistic regression, independent t tests, ANOVA, and multiple linear regression. Data analyses revealed that the majority of graduates were between 24 and 29 years of age, male, white, non-Hispanic, and from metropolitan hometowns. Most had completed the generalist track and initially entered a primary care residency training program. The majority passed USMLE Step 1 and Step 2 on the first attempt. The USMLE Step 2-CK average was 212.50. The average cumulative GPA was 3.44. Graduates were nearly evenly divided between primary care and nonprimary care practice, with the majority practicing in metropolitan areas. Graduates who initially entered primary care residency training were more likely to practice primary care medicine than those who entered nonprimary care programs; however, fewer graduates were practicing primary care than had entered primary care residency training. Graduates who attended internal medicine residency training were less likely to be practicing primary care medicine than those who attended family medicine, pediatrics, or OB/GYN programs. Women and Rural Primary Care Track graduates were significantly more likely to practice primary care than were men and generalist track graduates, respectively. Nonprimary care physicians had significantly higher USMLE Step 2-CK scores than did primary care physicians (PCPs). PCPs practiced in more rural locales than non-PCPs. Family physician graduates tended to practice in more rural locales than OB/GYNs or pediatricians. Hometown location predicted practice location over and above medical school track.
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Okoro, Chris U. "Perspectives of Primary Care Physicians on Adopting Electronic Medical Records in the Atlanta, Georgia Area." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5923.

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Slow adoption of electronic medical records (EMR) by primary care physicians in medical office practices has not facilitated the EMR adoption process. The problem is the slow pace of EMR adoption by primary care physicians in the Atlanta, Georgia area has become a public health concern. Research regarding the lived experiences of these physicians with EMR implementation and utilization may identify reasons for the slow adoption. The purpose of this phenomenological study was to explore the lived experiences of primary care physicians, who practice in the Atlanta area, regarding their perception, successes, barriers, and urgency of adoption of EMR in their healthcare practice. Lewin's change management model of health services served as the framework for the study. Data was collected during face-to-face interviews with 19 primary care physicians at Grady's Ponce de Leon Clinic and Grady's East Point Clinic in Atlanta, Georgia. Participants were physicians or residents and not those in authority to make decisions about the EMR at the two clinics. NVivo 10 and automatic coding was used for data analysis to develop themes from the interviews. The findings revealed that the adoption of EMR has enabled primary care physicians to spend more time with their patients, but the barriers such as a lack of interoperability and lack of training, has fostered a feeling of disinterestedness towards EMR adoption. This study supports positive social change that EMR adoption aids in improving patient safety and outcome.
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Natale, Susan. "The Role of Primary Care Nurses in Addressing Unmet Social Needs." eScholarship@UMMS, 2018. https://escholarship.umassmed.edu/gsn_diss/55.

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PURPOSE The purpose of this study was to explore how primary care registered nurses address unmet social needs in patients. SPECIFIC AIMS Explore how RNs in a safety-net, primary care setting develop an awareness of and address patient's unmet social needs. Describe how information about unmet social needs are integrated into nursing assessment and intervention activities, and are shared with other members of the health care team. Describe the challenges primary care RNs face when addressing unmet social needs. FRAMEWORK Critical caring theory provided the framework for this study. DESIGN This study used a descriptive, qualitative design. Semi-structured interviews were conducted with seventeen nurses working in 11 different safety-net primary care clinics within a hospital-based system. RESULTS Three major themes emerged. Key findings included the importance of the nurse-patient relationship, the establishment of trust, and a caring, nonjudgmental approach to patients with unmet social needs. Nurses used knowledge of unmet needs to coordinate patient care, provide social support, and work collaboratively with care team members to refer patients to resources within the health care system and in the community. CONCLUSION Unmet social needs contribute to adverse health outcomes, and addressing social and medical needs is critical to eliminating health inequities and reducing health care costs. In this study, primary care nurses described relationships with patients that allowed for the sharing of sensitive information, leading the nurse to identify and address unmet social needs that could impact patient health.
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Cordery, Carolyn Joy. "Dimensions of accountability : voices from New Zealand primary health organisations : a thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Doctor of Philosophy in Accounting /." ResearchArchive@Victoria e-Thesis, 2008. http://hdl.handle.net/10063/583.

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Lines, Lisa M. "Outpatient Emergency Department Utilization: Measurement and Prediction: A Dissertation." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsbs_diss/710.

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Approximately half of all emergency department (ED) visits are primary-care sensitive (PCS) – meaning that they could potentially be avoided with timely, effective primary care. Reducing undesirable types of healthcare utilization (including PCS ED use) requires the ability to define, measure, and predict such use in a population. In this retrospective, observational study, we quantified ED use in 2 privately insured populations and developed ED risk prediction models. One dataset, obtained from a Massachusetts managed-care network (MCN), included data from 2009-11. The second was the MarketScan database, with data from 2007-08. The MCN study included 64,623 individuals enrolled for at least 1 base-year month and 1 prediction-year month in Massachusetts whose primary care provider (PCP) participated in the MCN. The MarketScan study included 15,136,261 individuals enrolled for at least 1 base-year month and 1 prediction-year month in the 50 US states plus DC, Puerto Rico, and the US Virgin Islands. We used medical claims to identify principal diagnosis codes for ED visits, and scored each according to the New York University Emergency Department algorithm. We defined primary-care sensitive (PCS) ED visits as those in 3 subcategories: nonemergent, emergent but primary-care treatable, and emergent but preventable/avoidable. We then: 1) defined and described the distributions of 3 ED outcomes: any ED use; number of ED visits; and a new outcome, based on the NYU algorithm, that we call PCS ED use; 2) built and validated predictive models for these outcomes using administrative claims data; 3) compared the performance of models predicting any ED use, number of ED visits, and PCS ED use; 4) enhanced these models by adding enrollee characteristics from electronic medical records, neighborhood characteristics, and payor/provider characteristics, and explored differences in performance between the original and enhanced models. In the MarketScan sample, 10.6% of enrollees had at least 1 ED visit, with about half of utilization scored as PCS. For the top risk group (those in the 99.5th percentile), the model’s sensitivity was 3.1%, specificity was 99.7%, and positive predictive value (PPV) was 49.7%. The model predicting PCS visits yielded sensitivity of 3.8%, specificity of 99.7%, and PPV of 40.5% for the top risk group. In the MCN sample, 14.6% (±0.1%) had at least 1 ED visit during the prediction period, with an overall rate of 18.8 (±0.2) visits per 100 persons and 7.6 (±0.1) PCS ED visits per 100 persons. Measuring PCS ED use with a threshold-based approach resulted in many fewer visits counted as PCS, discarding information unnecessarily. Out of 45 practices, 5 to 11 (11-24%) had observed values that were statistically significantly different from their expected values. Models predicting ED utilization using age, sex, race, morbidity, and prior use only (claims-based models) had lower R2 (ranging from 2.9% to 3.7%) and poorer predictive ability than the enhanced models that also included payor, PCP type and quality, problem list conditions, and covariates from the EMR, Census tract, and MCN provider data (enhanced model R2 ranged from 4.17% to 5.14%). In adjusted analyses, age, claims-based morbidity score, any ED visit in the base year, asthma, congestive heart failure, depression, tobacco use, and neighborhood poverty were strongly associated with increased risk for all 3 measures (all P<.001).
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Lines, Lisa M. "Outpatient Emergency Department Utilization: Measurement and Prediction: A Dissertation." eScholarship@UMMS, 2004. http://escholarship.umassmed.edu/gsbs_diss/710.

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Approximately half of all emergency department (ED) visits are primary-care sensitive (PCS) – meaning that they could potentially be avoided with timely, effective primary care. Reducing undesirable types of healthcare utilization (including PCS ED use) requires the ability to define, measure, and predict such use in a population. In this retrospective, observational study, we quantified ED use in 2 privately insured populations and developed ED risk prediction models. One dataset, obtained from a Massachusetts managed-care network (MCN), included data from 2009-11. The second was the MarketScan database, with data from 2007-08. The MCN study included 64,623 individuals enrolled for at least 1 base-year month and 1 prediction-year month in Massachusetts whose primary care provider (PCP) participated in the MCN. The MarketScan study included 15,136,261 individuals enrolled for at least 1 base-year month and 1 prediction-year month in the 50 US states plus DC, Puerto Rico, and the US Virgin Islands. We used medical claims to identify principal diagnosis codes for ED visits, and scored each according to the New York University Emergency Department algorithm. We defined primary-care sensitive (PCS) ED visits as those in 3 subcategories: nonemergent, emergent but primary-care treatable, and emergent but preventable/avoidable. We then: 1) defined and described the distributions of 3 ED outcomes: any ED use; number of ED visits; and a new outcome, based on the NYU algorithm, that we call PCS ED use; 2) built and validated predictive models for these outcomes using administrative claims data; 3) compared the performance of models predicting any ED use, number of ED visits, and PCS ED use; 4) enhanced these models by adding enrollee characteristics from electronic medical records, neighborhood characteristics, and payor/provider characteristics, and explored differences in performance between the original and enhanced models. In the MarketScan sample, 10.6% of enrollees had at least 1 ED visit, with about half of utilization scored as PCS. For the top risk group (those in the 99.5th percentile), the model’s sensitivity was 3.1%, specificity was 99.7%, and positive predictive value (PPV) was 49.7%. The model predicting PCS visits yielded sensitivity of 3.8%, specificity of 99.7%, and PPV of 40.5% for the top risk group. In the MCN sample, 14.6% (±0.1%) had at least 1 ED visit during the prediction period, with an overall rate of 18.8 (±0.2) visits per 100 persons and 7.6 (±0.1) PCS ED visits per 100 persons. Measuring PCS ED use with a threshold-based approach resulted in many fewer visits counted as PCS, discarding information unnecessarily. Out of 45 practices, 5 to 11 (11-24%) had observed values that were statistically significantly different from their expected values. Models predicting ED utilization using age, sex, race, morbidity, and prior use only (claims-based models) had lower R2 (ranging from 2.9% to 3.7%) and poorer predictive ability than the enhanced models that also included payor, PCP type and quality, problem list conditions, and covariates from the EMR, Census tract, and MCN provider data (enhanced model R2 ranged from 4.17% to 5.14%). In adjusted analyses, age, claims-based morbidity score, any ED visit in the base year, asthma, congestive heart failure, depression, tobacco use, and neighborhood poverty were strongly associated with increased risk for all 3 measures (all P<.001).
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Ellison, Jeffrey. "Collaborative Models of Care in the Appalachian Region of Tennessee: Examining Relationships Between Level of Collaboration, Clinic Characteristics, and Barriers to Collaboration." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etd/2435.

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Decades of research have shown that there are significant advantages to maintaining close communicative and collaborative relationships between primary care and behavioral health providers. Fiscal, structural, and systemic barriers, however, often restrict the degree to which such interprofessional collaboration can occur. In the present study the authors examined relationships between primary care clinics in the Appalachian region’s characteristics (i.e., clinic type, rurality, and clinic size), barriers (i.e., fiscal, structural, and systemic) reported to using increased collaboration, and the level of collaboration used at a particular clinic. For the present study 136 surveys were completed by providers working in primary care practices across the Appalachian region of Tennessee. The results showed that only about one fifth of the primary care clinics in Appalachian Tennessee reported engaging in moderate to high levels of primary care behavioral health (PCBH) collaboration (e.g., colocated or integrated models of care). Among community health clinics, however, nearly half reported moderate or high levels of collaboration. The findings of this study underscore the importance policy change (e.g., changes in reimbursement patterns, increases in incentives, introduction of PCBH models in training programs) in facilitating the uptake of high levels of PCBH collaboration in Appalachian Tennessee (especially in regards to nonpublicly funded clinics). Further, the methodology used in this study could provide policymakers and researchers in other regions of the U.S. with a means for obtaining baseline data regarding local trends in PCBH collaboration and could serve as first step in developing a standardized methodology for comparing the overall uptake of PCBH collaboration models across regions.
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Books on the topic "Primary care (Medicine) Victoria Administration"

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1943-, Lawrence Martin, and Schofield Theo, eds. Medical audit in primary health care. Oxford: Oxford University Press, 1993.

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Rummery, Kirstein. Working together: Primary care involvement in commissioning social care services. Manchester: National Primary Care Research and Development Centre, 1997.

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Starfield, Barbara. Primary care: Concept, evaluation andpolicy. New York, NY: Oxford University Press, 1994.

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Nick, Goodwin, ed. Towards managed primary care: The role and experience of primary care organizations. Aldershot, Hants, England: Ashgate Pub., 2005.

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Clinical risk management in primary care. Oxford: Radcliffe Pub., 2005.

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Kuartei, Stevenson. Goals of the Division of Primary and Preventive Health Outlook (PPHO). Koror, Palau]: [Division of] Primary and Preventive Health, Bureau of Public Health, Ministry of Public Health, Republic of Palau, 2002.

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Duffy, Marion. Facilitating groups in primary care: A manual for team members. Abingdon: Radcliffe Medical Press, 2000.

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Primary care: Concept, evaluation, and policy. New York: Oxford University Press, 1992.

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D, Engel John, ed. Restoring primary care: Reframing relationships and redesigning practice. Oxford: Radcliffe Pub., 2011.

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Richard, Gray, ed. The primary care guide to mental health. Cumbria, U.K: M & K Pub., 2012.

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Book chapters on the topic "Primary care (Medicine) Victoria Administration"

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Soczywko, Julita, and Dorota Rutkowska. "The Patient/Provider Relationship in Emergency Medicine." In Advances in Healthcare Information Systems and Administration, 74–105. IGI Global, 2018. http://dx.doi.org/10.4018/978-1-5225-3946-9.ch005.

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Emergency medicine is a rapidly developing medical specialty which focuses on the diagnostic process, initial stabilization, and the treatment of patients suffering from acute illnesses or injuries. Emergency care can be provided in prehospital settings by emergency medical services, as well as in emergency departments. The primary providers of emergency care are: emergency medicine physicians, emergency nurses, and paramedics. Emergency medical personnel are required to be prepared to take decisive action at any time of day or night. It is essential for them to possess basic knowledge relating to psychology and an ability to utilize interpersonal communication skills. A critical role of medical workers in emergency settings is to provide a patient with emotional support coupled with medical assistance. Interpersonal communication skills depend on the personal abilities of an individual, however, these skills can be also enhanced through training and work experience.
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"Medicines management and nurse prescribing." In Oxford Handbook of Primary Care and Community Nursing, edited by Judy Brook, Caroline McGraw, and Val Thurtle, 127–50. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198831822.003.0005.

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This chapter begins with non-medical prescribing and the practical aspects of making NHS prescription forms, the dispensing of medication, administration, and what to do in case of errors. It then describes medicine concordance and adherence, and patient involvement in decisions about medicines. Circumstances in which patients may be eligible for reduced fees or free medicines are listed. The competency framework for all prescribers is included, as well as guidance on how to write a prescription. Prescribing for special groups that may have different reactions to drugs is explained. Principles of medication reviews are outlined, followed by the governance, prescription, and administration of controlled drugs. The chapter also includes information on antimicrobial stewardship and the storage, transportation, and disposal of medicines.
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Magruder, Kathryn M., and Derik E. Yeager. "Screening for Depression in Primary Care: Can It Become More Efficient?" In Screening for Depression in Clinical Practice. Oxford University Press, 2009. http://dx.doi.org/10.1093/oso/9780195380194.003.0012.

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Screening for depression has been so widely advocated that the burden of proof has shifted to skeptics who argue against it. Yet only recently has sufficient evidence accrued to judge dispassionately the advantages and disadvantages of screening. Here we discuss the evidence for specific tools and specific strategies in improving the outcome of depression screening in primary care. In 1978, the Institute of Medicine defined primary care as ‘‘care that is accessible, comprehensive, coordinated, continuous, and accountable.’’ While the definition has evolved over time,2 these fundamental characteristics are still valid today. Included in the primary care mission is to serve as the first line for detection and either treatment or referral of common mental disorders, including depression. The inclusion of first-line mental health services as a component of primary care distinguishes primary care (including outpatient clinics in managed care organizations, community hospitals, Veterans Administration hospitals, teaching institutions, and other medical centers) from care in more specialized clinical settings. The comprehensiveness of primary care and the obligation of its providers for first-line care make it a logical and appropriate venue for mental health screening. Complicating the issue, however, are the time constraints on primary care providers. Although the amount of time spent per patient visit is about 20 minutes in the United States, the recommended services that should be provided in that short period of time are daunting. It is therefore imperative that these recommended services—in particular preventive health services— be provided in the most efficient manner possible. Services that cannot be provided efficiently and fit within the busy, fast-paced world of primary care are at risk of being omitted. This is especially true for preventive mental health services. Screening for depression is such a service; therefore, it is critical that primary care providers make use of the best and most efficient depression screening approaches possible. In this chapter, we will address issues related to screening for depression in the primary care context. We will start by briefly reviewing the epidemiology of depression as related to primary care. Next, we will provide a critical examination of the applicability to depression screening of the World Health Organization’s criteria.
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Creed, Fiona. "Administration of Oral Medication." In Nursing OSCEs. Oxford University Press, 2012. http://dx.doi.org/10.1093/oso/9780199693580.003.0017.

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Medication administration is a key skill and it is vital that you are able to demonstrate safety in all aspects of the medication administration process in order to avoid harm or death to your patient. The NMC (2004, 2010) reiterates this point, highlighting that the administration of medicines is an important aspect of a nurse’s professional practice. They argue that it is not simply a mechanistic task, but one that requires thought, exercise and professional judgement. Studies suggest that medicine administration is one of the highest risk processes that a nurse will undertake in clinical practice (NPSA 2007b; Elliot and Lui 2010). Medication administration errors are one of the most common errors reported to the National Patient Safety Agency (NPSA). Indeed in a 12-month period in 2007, 72,482 medication errors were reported with 100 of these causing either death or severe harm to the patient (NPSA 2009). The frequency of these errors has led to a number of changes in the medication administration process. Alongside these important recommendations, most higher education establishments will want to ensure safety of medicine administration and may test this vital skill using an OSCE to ensure that you are adequately prepared for safe administration of medication in practice. There are a number of important laws and key documents that relate to the administration of medication and it is important that you understand these as they all impact upon your practice when administering medication to a patient. You may also be tested on your knowledge in relation to these areas so it is important that you have read these. Important documents you will need to know include: ● The laws that relate to medication in the UK, ● NMC Standards for Medicines Management (2010) (www.nmc-uk.org), ● Local policies related to hospital/Primary Care Trust (PCT) regulation of medication (refer to local guidance). There are a number of laws that influence the manufacturing, prescription, supply, storage and administration of medication. Whilst you will not need to study the intricacies of these laws you will need to understand the main issues each law covers.
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Vincent, Ben. "Views of the clinic: non-binary perceptions and experiences of general healthcare services." In Non-Binary Genders, 133–68. Policy Press, 2020. http://dx.doi.org/10.1332/policypress/9781447351917.003.0006.

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Chapter five scrutinises accounts of primary care services for the most part (with some mention of secondary care), focusing on the experiences and views participants reported of interactions with doctors and other staff. Experiences are subdivided into ‘gendered medicine’ – healthcare which is differentiated in gendered terms, such as smear tests – and generalizable healthcare experiences, such as arm pain. The chapter also addresses how clerical administration in medical institutions may affect non-binary patients. This includes discussion of how names and pronouns are used and recorded, and medical forms specifically discussed by participants – including feedback forms and documentation related to tertiary care. Whilst this chapter is structured around primary care, the cross-practice nature of administration renders a general discussion that cuts across all forms of care appropriate. Discussion of the key administrative process of referral brings this chapter to a close.
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"to trends in a profession which has incurred lessened emphasis on human contact as price for gaining control over disease through technology and laboratory resources. This new speciality clearly has its controversial components. The rhetoric of family medicine and its coverage by the mass media have served as a readily available symbol for a new version of personalized medicine. For some, this specialty is a move into a new direction of sophisticated caring, while to others it symbolizes a return to old-fashioned virtues of human concern. Within the health field itself, family medicine has evoked controversy. Its very existence has visibly influenced certain specialties such as internal medicine and pediatrics; one consequence is the trend of developing programs in primary care within these disciplines. In some states, legislatures have voted funds specifically earmarked to support family medicine, frequently governed by the perception that fostering family medicine is tantamount to providing physicians for rural America and other heretofore medically underserved areas. The spectrum of images identified with family medicine ranges from appearing as the great hope of holistic concerns in health care to being labeled a short-lived fluff and fashion. Questions need to be raised about how this new specialty fares when medical students choose their careers. Anticipatory perceptions and interests, held at the point of entry into medical school, need to be explored. These views and preferences must be monitored as they are exposed to the various socializing influences of the medical school career. A longitudinal study of medical student career choices, conducted at a midwestern state university, suggests certain suggestive insights into this issue. Although this study is designed to explore the entire range of specialty choices by medical students and to examine the factors underlying the selection of rural or urban practice sites, certain initial findings are specifically applicable to the choice of family medicine. Briefly, the design of the study involves the administration of a number of data collection instruments to medical students at the beginning of their first and second years, and then again at the end of their fourth year (Liccione & McAllister, 1974). Among the instruments used is the Colwill Medical Specialty Perception Inventory, which was administered at the end of the first year and at the end of the fourth year of the students' progression through the medical school. During the third and fourth years of this progression, in-depth interviews were conducted with each student. It is during this time that students rotate through eight-week clinical blocks of each major medical subspecialty. The interviews were systematically distributed to be associated with the range of clinical blocks. Each student was interviewed in connection with one of the blocks in his or her rotation; one interview before and one after the desig-." In Family Medicine, 92–98. Routledge, 2014. http://dx.doi.org/10.4324/9781315060781-17.

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Weinshenker, Brian G. "Weakness With Neck Flexion." In Mayo Clinic Cases in Neuroimmunology, edited by Andrew McKeon, B. Mark Keegan, and W. Oliver Tobin, 10–13. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197583425.003.0003.

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A 51-year-old woman sought care for difficulty “picking up” her right foot after walking for 30 minutes; with rest, the symptoms would subside. A few months later, she reported a “zinging” sensation in her right 4th and 5th fingers and down her right side with neck flexion. Brain magnetic resonance imaging showed tiny nonspecific lesions not suggestive of demyelinating disease and a single T2 hyperintensity at the cervicomedullary junction that did not enhance with gadolinium administration. Cerebrospinal fluid analysis showed 10 oligoclonal bands on isoelectric focusing electrophoresis and a mildly increased immunoglobulin G index of 0.73. The patient was diagnosed with solitary sclerosis, suspected to be a form of central nervous system demyelinating disease strongly related to multiple sclerosis. Treatment was based on a diagnosis of “primary progressive multiple sclerosis,” although the patient did not satisfy the criterion of dissemination in space. The patient was being treated with glatiramer acetate 40 mg 3 times weekly for a presumptive diagnosis of multiple sclerosis before evaluation at Mayo Clinic. After our evaluation, she was advised that no treatments at that time were efficacious to prevent deterioration in patients with primary progressive multiple sclerosis. The mainstay of treatment is physical medicine modalities, including principles of energy conservation and, when necessary, mobility aids, such as braces and canes. The presentation of disease in this patient suggested a chronic myelopathy. Her symptoms did not develop acutely and manifested only after she walked a distance. Symptoms involving the upper and lower extremities and precipitation of Lhermitte sign with neck flexion also suggested a spinal cord lesion, typically a demyelinating lesion. However, a single spinal cord lesion present at the cervicomedullary junction. Oligoclonal bands are detected in patients with central nervous system infections or paraneoplastic disorders that might be associated with myelopathy.
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