Journal of evaluation in clinical practice
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Patients often experience complications when transitioning from hospital to home. These complications are frequently related to poor monitoring. An interactive voice response system (IVRS) could improve post-discharge monitoring. ⋯ Using an IVRS, we were able to identify several important new health concerns arising following hospital discharge. Subtle changes could increase the feasibility and utility of IVRS technology in improving post-discharge outcomes.
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Infertility management in primary care is variable. National Institute of Clinical Excellence have recommended hysterosalpingography (HSG) as a first-line investigation for tubal assessment. Aim To explore general practitioners' (GPs) perceptions of, and attitudes to, the initial management of the infertile couple and their views on open access to HSG. ⋯ GPs recognize an advocacy role and many take on a significant degree of clinical responsibility welcoming the introduction of a new technology in primary care. Nevertheless, GPs feel that they lack proficiency and have little opportunity to rehearse the necessary skills. These findings contribute to an understanding of the management of infertility, an infrequently presenting problem in primary care.
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There was local concern over possible delays in the diagnosis and referral of patients with suspected colorectal cancer and interest in understanding more about patients' experiences of diagnosis. ⋯ Feeding back qualitative data from patients together with audit results seemed a powerful lever to stimulate action about hospital delays. Average waiting times dropped quickly and remained low due to the continuing national focus upon them. Seeking GP views may have promoted the use of referral pro formas, but monitoring waiting times distracted from a more thorough evaluation of their use. Qualitative data from patients raised awareness of their experience, but was time-consuming to collect and we had limited success in using it for specific initiatives around communication and support.
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To explore stakeholder perspectives of the implementation of a new, national integrated nurse-led telephone advice and consultation service [National Health Service 24 (NHS 24)], comparing the views of stakeholders from different health care organizations. ⋯ As the delivery of unscheduled primary health care crosses professional boundaries and locations, different organizations and professional groups must develop new ways of partnership working, developing trust and confidence in each other. The results of this study highlight, for the first time, the key importance of understanding the professional ownership and identity of individual organizations, in order to facilitate the most effective mechanisms to enable that partnership working.