Abstract:Primary care coronavirus disease 2019 (COVID-19) clinics were rapidly introduced across the UK to review potentially infectious patients. Evaluation of these services is needed to guide future implementation. This mixed-methods study evaluates patient demographics, clinical presentation, co-morbidities, service usage, and outcomes for the Islington COVID-19 service (London, UK) and from April to May 2020 and thematically analyses survey responses from 29 service clinicians and 41 GP referrers on their service … Show more
“… 11 , 12 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 The RPM models in eight studies did not include pulse oximetry as a monitoring tool for all participants but only for specific subgroups, and these studies were excluded. 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 One study was excluded owing to reporting irrelevant outcomes, focusing on therapeutic options with less emphasis on the RPM model. 43 Figure 2 PRISMA diagram showing the study selection process …”
“… 11 , 12 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 The RPM models in eight studies did not include pulse oximetry as a monitoring tool for all participants but only for specific subgroups, and these studies were excluded. 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 One study was excluded owing to reporting irrelevant outcomes, focusing on therapeutic options with less emphasis on the RPM model. 43 Figure 2 PRISMA diagram showing the study selection process …”
“…Primary care is a part of the health care system that is a relevant pillar in the management of medical crises, including the current COVID-19 pandemic [6][7][8][9][10]. The COVID-19 pandemic has demanded a rapid response from primary care with interventions in the health care system that are the subject of diverse qualitative and quantitative studies across the globe [7,[11][12][13][14][15][16].…”
Background
Primary care is a relevant pillar in managing not only individual, but also societal medical crises. The COVID-19 pandemic has demanded a rapid response from primary care with interventions in the health care system. The aim of this paper was to explore the responses of primary care practitioners (PCP) during the early COVID-19 pandemic and to analyze these with a view on the resilience of the primary health care system from the PCPs perspective.
Methods
Shortly after the first COVID-19 wave (July—October 2020) n = 39, semi-structured telephone interviews were conducted with PCP in practices and at Corona contact points (CCP) in Baden-Wuerttemberg (Germany). Qualitative content analysis was applied, and the evolved categories were related to in a framework for resilience.
Results
Primary care had an overall strong ability to adapt and show resilience, albeit with wide variance in speed and scope of the responses. When coping with uncertainty, the reasons given by PCPs in favor of opening a CCP mainly involved intrinsic motivation and self-initiative; the reasons against doing so were i.e. the lack of personal protective equipment, problems with space, and worries about organizational burden. A strong association existed between the establishment of a CCP and the use of resources (i.e. existing networks, personal protective equipment, exercising an office of professional political function). Our study predominantly found adaptive aspects for measures taken at medical practices and transformative aspects for setting up outpatient infection centers. PCPs played an important role in the coordination process (i.e. actively transferring knowledge, integration in crisis management teams, inclusion in regional strategic efforts) reaching a high level in the dimensions knowledge and legitimacy. The dimension interdependence repeatedly came into focus (i.e. working with stakeholders to open CCP, interacting among different types of primary care facilities, intersectoral interfaces). A need for regional capacity planning was visible at the time of the interviews.
Conclusions
The results can be used for practical and research-based institutional and capacity planning, for developing resilience in primary care and for augmentation by perspectives from other stakeholders in the primary health care system.
“…To the best of our knowledge, this evaluation is the first UK service evaluation of a third-sector neonatal COVID-19 response project. Due to speed and responsivity, the service was implemented before consideration of data collection tools, leading to missing data ( Hibberd et al, 2021 ).…”
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