Bmc Health Serv Res
-
Bmc Health Serv Res · Mar 2017
Medication-related calls received by a national telenursing triage and advice service in Australia: a retrospective cohort study.
Telenursing triage and advice services are increasingly being used to deliver health advice. Medication-related queries are common, however little research has explored the medication-related calls made to these services. The aim of this study was to examine the profile of medication-related calls to a national telenursing triage and advice service and the medications involved. ⋯ The telenursing triage and advice helpline offered quick and easily accessible advice, and provided reassurance to patients and callers with medication-related queries. The service also potentially diverted some patients from attending an ED unnecessarily.
-
Bmc Health Serv Res · Mar 2017
Understanding the implementation and adoption of a technological intervention to improve medication safety in primary care: a realist evaluation.
Monitoring for potentially hazardous prescribing is increasingly important to improve medication safety. Healthcare information technology can be used to achieve this aim, for example by providing access to prescribing data through surveillance of patients' electronic health records. The aim of our study was to examine the implementation and adoption of an electronic medicines optimisation system that was intended to facilitate clinical audit in primary care by identifying patients at risk of an adverse drug event. We adopted a sociotechnical approach that focuses on how complex social, organisational and institutional factors may impact upon the use of technology within work settings. ⋯ The use of an electronic medicines optimisation system may improve medication safety in primary care settings by identifying those patients at risk of an adverse drug event. To fully realise the potential benefits for medication safety there needs to be better utilisation across primary care and with a wider range of stakeholders. Engaging with all potential stakeholders and users prior to implementation of such systems might allay perceptions that the system is owned centrally and increase knowledge of the potential benefits.
-
Bmc Health Serv Res · Mar 2017
Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012.
Pakistan, being a developing country, presents the dismal picture of maternal and neonatal mortality and morbidity. The majority of maternal and neonatal deaths could be avoided if Continuum of Care (CoC) is provided in a structured pathway from pregnancy to birth and to the first week of life of the newborn child. This study aimed to analyse the trends of CoC at all three levels (antenatal care, skilled delivery and postpartum care) and to identify various factors affecting the continuation in receiving CoC in Pakistan during 2006 to 2012. ⋯ The findings show that women in Pakistan still lack the CoC. This calls for attention to develop and implement tailored interventions, focusing on the needs of women in Pakistan to provide CoC in an integrated manner, involving both public and private sectors by appropriately addressing the factors hindering CoC completion rates.
-
Bmc Health Serv Res · Mar 2017
GPs' and dentists' experiences and expectations of interprofessional collaboration: findings from a qualitative study in Germany.
Against the background of well-described associations between oral and general health, collaboration between dentists and general practitioners (GP) is crucial to provide therapeutic and preventive patient care. However, in the German health system, GPs and dentists are organizationally separated, implying that interprofessional collaboration can only occur informally and on a voluntary basis. Given the scarce evidence of interprofessional collaboration between dentists and GPs, an explorative study was conducted. This paper outlines the findings of this study with regard to GPs' and dentists' experiences and expectations of interprofessional collaboration. ⋯ The perceived medical knowledge deficits of the other profession as well as divergent expectations concerning the scope of collaboration hinder profound and regular interprofessional collaboration between GPs and dentists. These perceived knowledge deficits may be rooted in the separate education of dentists and GPs in Germany. Fostering interprofessional education is a promising way to improve cooperation between GPs and dentists in the long term.
-
Bmc Health Serv Res · Feb 2017
Multicenter Study Observational StudyLearning from 2523 trauma deaths in India- opportunities to prevent in-hospital deaths.
A systematic analysis of trauma deaths is a step towards trauma quality improvement in Indian hospitals. This study estimates the magnitude of preventable trauma deaths in five Indian hospitals, and uses a peer-review process to identify opportunities for improvement (OFI) in trauma care delivery. ⋯ Fifty-eight percent of all trauma deaths were classified as preventable. Two-thirds of the deaths with injury severity scores of less than 16 were preventable. This large subgroup of Indian urban trauma patients could possibly be saved by urgent attention and corrective action. Low-cost interventions such as airway management, fluid resuscitation, hemorrhage control and surgical decision-making protocols, were identified as OFI. Establishment of clinical protocols and timely processes of trauma care delivery are the next steps towards improving care.