Research Unit for General Practice, Bartholins Alle 2, 8000, Aarhus C, Denmark.
Department of General Practice, Institute for Public Health, Aarhus University, Bartholins Alle 2, 8000, Aarhus, Denmark.
BMC Prim Care. 2023 Jan 4;24(1):3. doi: 10.1186/s12875-023-01966-1.
Being a general practitioner for residents in many care homes may challenge communication with residents, relatives, and care home staff, and potentially lead to lower quality of care. Several countries have therefore introduced different solutions to reduce the number of general practitioners at each care home. In 2017, the designated general practitioner model was introduced at many Danish care homes. This study aimed to evaluate experiences from the interprofessional team-based collaboration between designated general practitioners and care home staff with regular contact with the designated general practitioners in an urban Danish setting.
A qualitative design was applied using semi-structured interviews. Eight interviews (three group interviews and five individual interviews) were conducted with four designated general practitioners and seven care home staff members at four care homes in an urban setting of Central Denmark Region, Denmark. The interviews were transcribed verbatim, and data were analysed using content analysis with inspiration from the theory of relational coordination. The study followed the guidelines addressed in the COREQ (Consolidated Criteria for Reporting Qualitative Research) framework.
The initiation of the designated general practitioner model was experienced to contribute to more clear, precise, and timely communication between care homes and the general practitioner. An improved mutual acknowledgement of roles and competencies was experienced between designated general practitioners, care home nurses, and sometimes also social and health care assistants. The more frequent visits by the general practitioners at the care homes, as a result of the designated general practitioner model, resulted in more face-to-face communication between care home staff and designated general practitioners. Professional differences in the interpretation of the patient's needs were still present, which at times caused a frustrating compromise of own professional competencies. An important reason for the overall perception of improved collaboration was attributed to the more frequent dialogue in which the care homes staff and the designated general practitioners exchanged knowledge that could be applied in future patient encounters.
The designated general practitioner model implied an improved collaboration between general practitioners and care homes staff. Clear, precise, and timely communication between care homes and the general practitioners, as well as mutual trust and acknowledgement was experienced to be essential for the collaboration. An important reason for the overall perception of an improved collaboration was attributed to the more frequent dialogue (more frequent general practitioner visits at the care homes) in which the care homes staff and the designated general practitioners exchange knowledge which again could be applied in future patient encounters.
作为许多养老院居民的全科医生，与居民、家属和养老院工作人员沟通可能会面临挑战，这可能会导致护理质量下降。因此，一些国家已经引入了不同的解决方案来减少每个养老院的全科医生数量。2017 年，丹麦许多养老院引入了指定全科医生模式。本研究旨在评估在丹麦城市环境中，指定全科医生与经常与指定全科医生接触的养老院工作人员之间基于跨专业团队合作的经验。
采用半结构化访谈进行定性设计。在丹麦中地区的四个城市养老院中，对四名指定全科医生和七名养老院工作人员进行了八次访谈（三次小组访谈和五次个人访谈）。访谈内容逐字记录，并使用关系协调理论进行内容分析。该研究遵循 COREQ（定性研究报告的统一标准）框架中规定的准则。
指定全科医生模式的启动被认为有助于养老院和全科医生之间更清晰、更准确和更及时的沟通。指定全科医生、养老院护士之间的相互角色和能力的认可得到了改善，有时还包括社会和保健助理。由于指定全科医生模式，全科医生更频繁地访问养老院，导致养老院工作人员和指定全科医生之间更多的面对面交流。对患者需求的专业解释上的差异仍然存在，这有时会导致令人沮丧的对自身专业能力的妥协。合作得到改善的整体感知归因于更频繁的对话，养老院工作人员和指定全科医生在对话中交流知识，这些知识可以应用于未来的患者接触。
指定全科医生模式意味着全科医生和养老院工作人员之间的合作得到改善。养老院和全科医生之间清晰、准确和及时的沟通，以及相互信任和认可被认为是合作的关键。合作得到改善的整体感知归因于更频繁的对话（养老院更频繁的全科医生访问），养老院工作人员和指定全科医生在对话中交流知识，这些知识可以应用于未来的患者接触。
