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What can we learn from experiences in general practice during the COVID-19 pandemic? A qualitative study
BACKGROUND: Experiences with organizational changes in daytime general practices and out-of-hours (OOH) services during the COVID-19 pandemic may help to address the challenges in general practice care that were already a concern before the crisis. This study aimed to describe these experiences and...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294327/ https://www.ncbi.nlm.nih.gov/pubmed/37370101 http://dx.doi.org/10.1186/s12913-023-09654-7 |
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author | Rijpkema, Corinne Bos, Nanne Brandenbarg, Daan Homburg, Maarten Beugel, Gina Barkema, Wietske S. olde Hartman, Tim Muris, Jean Peters, Lilian Berger, Marjolein Verheij, Robert A. Ramerman, Lotte |
author_facet | Rijpkema, Corinne Bos, Nanne Brandenbarg, Daan Homburg, Maarten Beugel, Gina Barkema, Wietske S. olde Hartman, Tim Muris, Jean Peters, Lilian Berger, Marjolein Verheij, Robert A. Ramerman, Lotte |
author_sort | Rijpkema, Corinne |
collection | PubMed |
description | BACKGROUND: Experiences with organizational changes in daytime general practices and out-of-hours (OOH) services during the COVID-19 pandemic may help to address the challenges in general practice care that were already a concern before the crisis. This study aimed to describe these experiences and the potential usefulness of the organizational changes for future general practice care and any future pandemics. METHODS: Semi-structured interviews were performed among 11 directors of OOH services, and 19 (locum) general practitioners (GPs) or practice managers, who were purposively sampled. Video or telephone interviews were performed in two rounds: between November 2020 and January 2021 and between May 2021 and August 2021. The data were analyzed using thematic analysis methods. RESULTS: Three themes emerged from the data: (1) Changes in the triage procedures; in GP practices and OOH services, stricter triage criteria were implemented, and GPs were more actively involved in the triage process. These measures helped to reduce the number of ‘low urgency’ face-to-face consultations. (2) Changes in GP care; there was a shift towards video and telephone consultations, allowing GPs to spend more time with patients during the remaining face-to-face consultations. For chronic patients, the shift towards telemonitoring appeared to encourage self-care, and postponing face-to-face consultations for regular checkups appeared to be unproblematic for stable patients. (3) Coordination of GP care and information communication flow during the COVID-19 pandemic; OOH directors perceived a lack of consistency in the information from various governmental and non-governmental parties on containment measures and guidelines related to COVID-19, making it difficult to act on them. The COVID-19 pandemic intensified collaboration between GPs, OOH services, and other healthcare professionals. CONCLUSIONS: The results of this study indicate that some of the organizational changes, such as stricter triage, remote consultations, and changes in managed care of chronic patients, may help in tackling the pre-existing challenges in GP care from before the COVID-19 pandemic. However, more extensive research and continuous monitoring are necessary to establish the effects on patients and their health outcomes. To navigate future pandemics, the intensified collaboration between health professionals should be maintained, while there is considerable room for improvement in the provision of unambiguous information. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-09654-7. |
format | Online Article Text |
id | pubmed-10294327 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102943272023-06-28 What can we learn from experiences in general practice during the COVID-19 pandemic? A qualitative study Rijpkema, Corinne Bos, Nanne Brandenbarg, Daan Homburg, Maarten Beugel, Gina Barkema, Wietske S. olde Hartman, Tim Muris, Jean Peters, Lilian Berger, Marjolein Verheij, Robert A. Ramerman, Lotte BMC Health Serv Res Research BACKGROUND: Experiences with organizational changes in daytime general practices and out-of-hours (OOH) services during the COVID-19 pandemic may help to address the challenges in general practice care that were already a concern before the crisis. This study aimed to describe these experiences and the potential usefulness of the organizational changes for future general practice care and any future pandemics. METHODS: Semi-structured interviews were performed among 11 directors of OOH services, and 19 (locum) general practitioners (GPs) or practice managers, who were purposively sampled. Video or telephone interviews were performed in two rounds: between November 2020 and January 2021 and between May 2021 and August 2021. The data were analyzed using thematic analysis methods. RESULTS: Three themes emerged from the data: (1) Changes in the triage procedures; in GP practices and OOH services, stricter triage criteria were implemented, and GPs were more actively involved in the triage process. These measures helped to reduce the number of ‘low urgency’ face-to-face consultations. (2) Changes in GP care; there was a shift towards video and telephone consultations, allowing GPs to spend more time with patients during the remaining face-to-face consultations. For chronic patients, the shift towards telemonitoring appeared to encourage self-care, and postponing face-to-face consultations for regular checkups appeared to be unproblematic for stable patients. (3) Coordination of GP care and information communication flow during the COVID-19 pandemic; OOH directors perceived a lack of consistency in the information from various governmental and non-governmental parties on containment measures and guidelines related to COVID-19, making it difficult to act on them. The COVID-19 pandemic intensified collaboration between GPs, OOH services, and other healthcare professionals. CONCLUSIONS: The results of this study indicate that some of the organizational changes, such as stricter triage, remote consultations, and changes in managed care of chronic patients, may help in tackling the pre-existing challenges in GP care from before the COVID-19 pandemic. However, more extensive research and continuous monitoring are necessary to establish the effects on patients and their health outcomes. To navigate future pandemics, the intensified collaboration between health professionals should be maintained, while there is considerable room for improvement in the provision of unambiguous information. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-09654-7. BioMed Central 2023-06-27 /pmc/articles/PMC10294327/ /pubmed/37370101 http://dx.doi.org/10.1186/s12913-023-09654-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Rijpkema, Corinne Bos, Nanne Brandenbarg, Daan Homburg, Maarten Beugel, Gina Barkema, Wietske S. olde Hartman, Tim Muris, Jean Peters, Lilian Berger, Marjolein Verheij, Robert A. Ramerman, Lotte What can we learn from experiences in general practice during the COVID-19 pandemic? A qualitative study |
title | What can we learn from experiences in general practice during the COVID-19 pandemic? A qualitative study |
title_full | What can we learn from experiences in general practice during the COVID-19 pandemic? A qualitative study |
title_fullStr | What can we learn from experiences in general practice during the COVID-19 pandemic? A qualitative study |
title_full_unstemmed | What can we learn from experiences in general practice during the COVID-19 pandemic? A qualitative study |
title_short | What can we learn from experiences in general practice during the COVID-19 pandemic? A qualitative study |
title_sort | what can we learn from experiences in general practice during the covid-19 pandemic? a qualitative study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294327/ https://www.ncbi.nlm.nih.gov/pubmed/37370101 http://dx.doi.org/10.1186/s12913-023-09654-7 |
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