Articles: professional-practice.
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General practice experienced significant challenges throughout the COVID-19 pandemic. There has been little exploration of the experiences of nurses working in general practice and the impact on care delivery, job satisfaction, workload, stress and professional support. Understanding these experiences can inform future practice. ⋯ The pandemic has laid bare challenges faced by nurses in general practice. Nurses require specific support to maintain professional wellbeing and to aid retention.
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Primary care professionals deliver the majority of end-of-life care to patients. However, extensive pressures and constraints can contribute to variable and substandard care quality. We will report on the preliminary results from an independent evaluation of the 'Daffodil Standards for Advanced Serious Illness and End-of-Life Care', created by the Royal College of General Practitioners and Marie Curie. ⋯ The results will be used to inform and refine the design illustrative case studies to capture best available learning and identify exemplars of best practice for later phases of the study.
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The articles in this issue are divided into 3 categories: 1) increasing our understanding of people's (patients') behaviors; 2) changing how we practice Family Medicine; and 3) rethinking common clinical problems. These categories include multiple topics: nonprescription antibiotic use, recording electronic smoking/vaping, virtual wellness visits, an electronic pharmacist consult service, documenting social determinants of health, medical-legal partnerships, local professionalism, implications of peripheral neuropathy, harm-reduction informed care, decreasing cardiovascular risk, persistent symptoms, and colonoscopy harm.
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Historical and recent population health issues necessitate the goal of educating and preparing a transdisciplinary workforce with population health knowledge and competence to be able to develop, implement, and evaluate innovative and feasible solutions that not only address multifaceted community health problems downstream but also to be able to predict and prevent those factors that contribute to an inequitable health burden upstream. To identify where population health education is already shared among multiple disciplines, the Centers for Disease Control and Prevention's Academic Partnerships to Improve Health program conceptualized the Health In All Education initiative that was implemented in partnership with the Association for Prevention Teaching and Research. ⋯ This article introduces the Health in All Education Learning Outcomes Framework, a set of shared population health concepts identified on the basis of discipline-representative consensus. The following domains were identified as having transdisciplinary applicability on the basis of established public health curricula, competency, and learning outcome models: determinants of health, evidence-based approaches, population health focus, interprofessional practice, community collaboration, environmental health, occupational health, global health, diversity/cultural competence, health systems, finance and budgeting, and health law and policy.
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Annals of family medicine · May 2023
Refining Vendor-Defined Measures to Accurately Quantify EHR Workload Outside Time Scheduled With Patients.
Accurately quantifying clinician time spent on electronic health record (EHR) activities outside the time scheduled with patients is critical for understanding occupational stress associated with ambulatory clinic environments. We make 3 recommendations regarding EHR workload measures that are intended to capture time working in the EHR outside time scheduled with patients, formally defined as work outside of work (WOW): (1) separate all time working in the EHR outside of time scheduled with patients from time working in the EHR during time scheduled with patients, (2) do not exclude any time before or after scheduled time with patients, and (3) encourage the EHR vendor and research communities to develop and standardize validated, vendor-agnostic methods for measuring active EHR use. Attributing all EHR work outside time scheduled with patients to WOW, regardless of when it occurs, will produce an objective and standardized measure better suited for use in efforts to reduce burnout, set policy, and facilitate research.