Snelle aanpassing praktijkorganisatie tijdens de coronapandemie

Huisartsenpraktijken pasten tijdens de coronapandemie hun organisatie aan, mede op basis van informatie en adviezen van hun beroepsorganisaties. De aanpassingen waren noodzakelijk om de zorg voor patiënten zo veel en zo veilig mogelijk doorgang te laten vinden, vaak op afstand. De pandemie zelf, de zorg op afstand en de strakkere geleiding van de patiëntenstroom zetten de kwaliteit van zorg en de patiëntveiligheid onder druk. De toegankelijkheid van de praktijken was soms beperkt, in de beleving van patiënten was dat sterker dan in werkelijkheid

Family medicine : jewel in the crown of equitable covid-19 care

The COVID-19 pandemic confronted general practices with unprecedented structural and organizational challenges to provide high-quality care. The pandemic has a disproportionally impact on people already living in a vulnerable position which inevitably results in enhancing pre-existing health inequities and generating new ones. Did general practitioners in Europe succeed in maintaining their key role in identifying vulnerable patients and limiting the growth of inequity? The PRICOV-19 study examines how general practices in 37 European countries and Israel (re)organized the practice to guarantee safe, effective, patient-centered, and equitable care. Because of the scale and multi-country design, PRICOV-19 can identify practice- and health care system characteristics associated with better care

Quick adaptation of the organisation of general practices during the COVID-19 pandemic in the Netherlands

BackgroundGeneral practices have adapted the practice organisation to the circumstances of the COVID-19 pandemic. In this article we describe several adjustments in general practices in the field of patient flow management, appointments, triage, referral and infection prevention. We also examined how practices relate to the policy of the government and of the professional organisations during the pandemic.MethodsA cross-sectional online survey was conducted among a sample of 893 general practitioners (GPs) during February and March 2021. The response rate was 17%. Because the questionnaire concerns practices and not individual GPs, one practice owner per practice received an invitation with a link to the online questionnaire. One reminder has been sent.ResultsGeneral practices adapted their organisation during the corona pandemic, partly based on information and advice from their professional organisations. The adjustments were necessary to ensure that patient care continued as much and as safely as possible, often remotely. The use of video consultations quickly increased from 6% to 65% of the practices. The cooperation with neighbouring practices improved and practices felt supported by the professional organisations.ConclusionsThe pandemic itself, remote care and stricter patient flow management have put pressure on the quality of care and patient safety. The accessibility of the practices was sometimes limited. In the perception of patients, this was stronger than in reality

COVID-19 : threat or opportunity for quality improvement (QI) in primary care?

Purpose - Getting familiar with the results of the PRICOV-19 study, a multi-country study on quality of care and patient safety in primary care in times of the COVID-19 pandemic. - Obtaining insight into the results of case studies in Norwegian nursing homes. - Reflecting on the threats and opportunities regarding quality of care the respondents experienced in their own practice and in general practice in their country. - Gaining inspiration from the experiences of colleagues and the input of experts to turn threats into opportunities. - Formulating a plan for QI in your own practice (structure, process, outcome) Context - Getting to know each other and the program of the workshop (10’) - Presentation of the results of the studies described above incl. what was identified as a threat /opportunity for QI in primary care and in the national health care system (15’) - Thematic small-group sessions: sharing experiences and reflecting on how the experienced threats could be turned into an opportunity (40’). The themes are: (1) patient safety; (2) integration of public health into primary care (3) equity and care for vulnerable population groups; (4) care for the caregiver; and (5) keeping up with guidelines in a rapidly changing world; (6) interprofessional collaboration - Plenary session with expert panel (20’) - Participants formulate a personal intention for action within the next three weeks. (5’) Participants are inspired to find solutions for the threats COVID-19 poses in their own working context and this is written down in a concrete plan for the near future. State of the art The COVID-19 pandemic presented primary care with unprecedented organizational and structural challenges, such as amended tasks like teleconsultations, intensive collaboration with services of secondary care and other general practices in the geographical area, and limited availability of resources in terms of staff members, infrastructure, and protective equipment. At the same time, these challenges can be opportunities for change and quality improvement in general practice

Active outreach to vulnerable patients during COVID-19 : a common practice or exception in primary health care?

Introduction: The COVID-19 pandemic led directly and indirectly to an increased number of vulnerable population groups. General practitioners (GPs) were in the best position to identify vulnerable patients and limit the growth of health inequities. However, COVID-19 confronted GP practices with unprecedented structural and organizational challenges to provide high-quality care. Did GPs in Europe succeed in setting up outreach activities for maintaining their key role? Method: We used data from the PRICOV-19 study among GP practices in 38 European countries for the analyses. A scale on active outreach was constructed based on six items as the outcome variable. Using the software MLWin, multilevel Poisson analyses were performed on GP practices nested in countries. Results: The results showed a reliable 6-item scale on active outreach with an internal consistency coefficient of 0.69 (Cronbach alpha). According to preliminary analysis (using 2nd order PQL estimation) on 3,928 GP practices, the following practice characteristics were significantly negatively associated with the setup of outreach activities: monodisciplinarity (versus multidisciplinarity) and being a solo or duo GP practice (versus being a group practice). In addition, outreach activities were significantly more common in GP practices with above-average patients with chronic disorders. Conclusions: Further analyses are needed to verify and elaborate the current statements

Insights from Primary Care Practice during the COVID-19 Pandemic: Informing the Development of an EQuiP Position Statement for Advancing the Health Sector

The COVID-19 pandemic was a huge challenge for primary care (PC), its organisation and processes, the people working there and its interfaces with the wider healthcare system. The fight against COVID-19 has emphasised the critical role of PC: to serve as the first, and for most patients, the only point of contact with healthcare professionals during a pandemic surge. Mid-2020, an international research consortium led by Ghent University set up the PRICOV-19 study to research how PC practices in 37 European countries and Israel were organised during the COVID-19 pandemic to guarantee safe, efficient, effective, patient-centred, and equitable care. Also, the shift in roles and tasks and the wellbeing of staff members were researched. PRICOV-19 also aimed to study the association with practice- and healthcare system characteristics. In total, more than 5,000 PC practices filled in an online survey, making PRICOV-19 the largest and most comprehensive study on this topic ever done in Europe. The findings derived from PRICOV-19 have the potential to guide policymakers, politicians, national primary care colleges, and institutes tasked with training future General Practitioners (GPs) in enhancing the preparedness of primary care systems throughout Europe for the post-COVID-19 era, as well as for any future outbreaks of infectious diseases. The insights generated from this study can also be utilized to bolster primary care systems in mitigating the deleterious health effects of COVID-19 (or other future epidemics), easing the strain on hospitals, and supporting the implementation of effective vaccination and public health measures. It is worth noting that strengthening primary care is increasingly important given the mounting challenges posed by factors such as population ageing, the increasing burden of chronic diseases, and persistent societal inequities. Method: Presentation of the draft EQuiP position statement Interactive discussion about the different statements in the document: When the number of participants allows, the group will be divided into smaller groups, each focusing on one or two statements including the following themes: • The infrastructure, workforce and research • The role of telemedicine and digitalisation • The cooperation and communication between public health and primary care • The provision of equitable care and collaboration to deliver integrated care • The safety of care delivered • The well-being of the health workforce • Training of doctors and students within the practice Plenary reporting of the discussion in the small groups Formulating amendments to the text Ideally, the workshop should be scheduled in the morning to allow the primary authors to make any necessary revisions in the hours immediately following the session. Later in the afternoon, the updated text will be presented to all attending EQuiP members, and appropriate measures will be taken to ensure that the document is approved as an official EQuiP position statement. Aim: The objective of this workshop is to foster consensus among the current members of EQuiP regarding the insights gained from the PRICOV-19 data, specifically in relation to the organization and quality of primary care, and to develop recommendations for enhancing future preparedness in this field. By facilitating this discussion, the workshop aims to make a meaningful contribution to the ongoing refinement of the existing draft version of the EQuiP position statement. Ultimately, the insights and recommendations generated through this workshop will be instrumental in securing the statement's final approval and acceptance by conference attendees