The latest medical research on Retrieval Medicine

To identify barriers and facilitators contributing to the successful implementation of the allied health assistant role in private disability practice to better meet population needs.

Eight participants were interviewed, including three allied health assistants, three allied health professionals, and two managers with allied health backgrounds.

More barriers were reported than facilitators, with four key themes identified. Financial risk was a barrier when employing allied health assistants. This risk was mediated by providing part-time employment or having allied health assistants in dual roles. Reduced confidence from allied health professionals and assistants to complete delegation work was the second barrier. A facilitator was increasing allied health assistants' task variation, which participants reported increased retention. Finally, a positive working relationship between allied health professionals and assistants facilitates delegation.

This research offers private disability providers insight into the realities of employing an allied health assistant. It also suggests that formal training programs for both allied health assistants and professionals require increased focus on delegation in the private disability sector. On a government level, a review of the NDIS price guide for allied health assistant rates is needed if private providers are to better meet the requirements for NDIS participants in regional areas.

To explore the impact of COVID-19 pandemic disruptions on general practice trainees interdependent learning, from the perspectives of trainees and the whole of the practice team.

Audio-recorded semi-structured interviews were conducted with all participants following an initial survey. Thematic analysis and the theory of interdependent learning were used to understand how supervision and training was both disrupted and sustained during the pandemic period. Reporting is informed by the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Learning affordances were transformed by the rapid implementation of physical distancing and other infection control measures. Telehealth consultations and remote working impacted on the interdependent relationship between the work environment, supervision team and trainees.

Practice staff identified new ways of working that arose through this period, including changes to practice team roles and the supervisory dynamic that enabled patient care and trainee learning to continue. Social connectedness was important to the trainees and the implications for future training need to be further evaluated.

Patient perception of quality of care is an essential component in evaluating healthcare delivery. This article reports data from primary health care (PHC) centers before Greece's most recent PHC reform. The study was undertaken to offer some baseline information about patient experience, support the decision-making processes taking place, and provide valuable input for future policy-making comparisons in Greece.

The research was conducted across the 16 PHC centers of Epirus, a region of north-western Greece, from June to September 2017, with 532 patients rating the importance of different aspects of three main healthcare domains (clinical behavior, support and services, and organization of care) of PHC provision. The Greek version of the European Task Force on Patient Evaluations of General Practice (EUROPEP) questionnaire was implemented for research purposes. Univariate comparisons were performed for patients with and without chronic disease, using Pearson's χ2 test for categorical data.

Study findings support that the organization of care domain is of highest importance and priority, with clinical behavior and support and services following closely. Among recruited patients, on average, only 2.1% of patients with a chronic disease were satisfied (rated 4 or 5 on the Likert scale) with the organization of care aspects under consideration, compared to 18.4% of patients without a chronic disease. Furthermore, only 4% of patients with a chronic disease were satisfied with the aspects examined in the clinical behavior domain, compared to 27% of patients without a chronic disease. Finally, 18% of sampled patients with a chronic disease reported being satisfied with the quality of support and services provided, compared to 38% of patients without a chronic disease.

It is necessary to back up available past information to afterwards estimate reform imprinting on expectations and perceptions. The items and aspects of EUROPEP, in line with the new tasks of the personal doctor within the PHC system that patients perceive as most essential, can be used to prioritize quality improvement activities to strengthen PHC delivery in Greece. Communication skills, practices, and behavioral change skills seem to need more attention for an efficient PHC model.

Australia's remote health sector has chronic understaffing issues and serves an isolated, culturally diverse population with a high burden of disease. Workplace health and safety (WHS) impacts the wellbeing and sustainability of the remote health workforce. Additionally, poor WHS contributes to burnout, high turnover of staff and reduced quality of care. The issue of poor WHS in Australian very remote primary health clinics was highlighted by the murder of remote area nurse (RAN) Gayle Woodford in 2016. Following her death, a national call for change led by peak bodies and Gayle's family resulted in the development of many WHS recommendations and strategies for the remote health sector. However, it is unclear whether they have been implemented. The aim of this study is to identify which WHS recommendations have been implemented, from the perspective of RANs.

A cross-sectional online survey of 173 RANs was conducted during December 2020 and January 2021. The survey was open to all RANs who had worked in a very remote (MM 7 of the Modified Monash (MM) Model) primary health clinic in Australia more recently than January 2019. A convenience sampling approach was used. The survey tool was developed by the project team using a combination of validated tools and remote-specific workplace safety recommendations. Broad recommendations, such as having a safe clinic building, safe staff accommodation, local orientation, and 'never alone' policy, were broken down into specific safety criteria. These criteria were used to generate workplace safety scores to quantify how well each recommendation had been met, and clustered into the following domains: preparation of staff, safe work environment and safe work practices. Descriptive statistics were used and the safety scores between different states and territories were also compared.

Overall, the average national workplace safety score was 53% (standard deviation (SD) 19.8%) of recommendations met in participants' most recent workplace, with median 38.5% (interquartile range (IQR) 15.4-61.5%) of staff preparation recommendations, median 59.4% (IQR 43.8-78.1%) of safe work environment recommendations, and median 50.0% (IQR 30.0-66.7%) of safe work practices recommendations met. Within domains, some recommendations had greater uptake than others, and the safety scores of different states/territories also varied. Significant variation was found between the Northern Territory (57.5%, SD 18.7%) and Queensland (41.7%, SD 16.7%) (p<0.01), and between South Australia (74.5%, IQR 35.9%) and Queensland (p<0.05). Last, many RANs were still expected to attend after-hours call-outs on their own, with only 64.1% (n=107/167) of participants reporting a 'never alone' policy or process in their workplace.

The evidence from this study revealed that some recommended safety strategies had been implemented, but significant gaps remained around staff preparation, fatigue management and infrastructure safety. Ongoing poor WHS likely contributes to the persistently high turnover of RANs, negatively affecting the quality and continuity of health care in remote communities. Variation in safety scores between regions warns of a fragmentation of approaches to WHS within the remote health sector, despite the almost identical WHS legislation in different states/territories. These gaps highlight the need to establish and enforce a national minimum standard of workplace safety in the remote health sector.