Information in primary health care

Wood, Frances; Palmer, Judith; Ellis, David; Simpson, Sharon Anne; Bacigalupo, Ruth

doi:10.1046/j.1365-2532.1995.1240295.x

Cited by 15 publications

(17 citation statements)

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“…This (and the fact the informaticist was part time) accounted for the longer than desirable turnaround time (median 9 days). However, although slower than the recently reported ATTRACT service, 13 satisfaction with the timescales was high and requested timescales were met for 82% of the questions. We also collected more data on the process involved in providing the service and obtained a more thorough ongoing evaluation by requesting feedback on every question handled.…”

Section: Box 4 Comments On the Usefulness Of The Informaticist Servicementioning

confidence: 60%

“…The reasons for choosing a GP as informaticist were threefold 16 : + doctors often ask colleagues for answers to questions [2][3][4] ; + a GP is likely to understand the precise nature and context of the question; + a GP is ideally placed to help a colleague "frame" a question. 13 Here we describe the service, including the search methods and resources used, and the time taken to answer questions. We also describe the evaluation of the service by means of questionnaires and semi-structured interviews.…”

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confidence: 99%

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A clinical informaticist to support primary care decision making

Swinglehurst¹,

Pierce²,

Fuller³

2001

Quality and Safety in Health Care

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Results-All 100 clinicians in two primary care groups were approached. Thirty four agreed to participate, of whom 22 asked 60 questions over 10 months. Participants were highly satisfied with the summaries they received. For one third of questions the clinicians stated they would change practice in the index patient, and for 55% the participants stated they would change practice in other patients. Answering questions thoroughly was time consuming (median 130 minutes). The median turnaround time was 9 days; 82% of questions were answered within the timeframe specified by the questioner. Without the informaticist, one third of questions would not have been pursued. Conclusion-The clinical informaticist service increased access to evidence for busy clinicians. Satisfaction was high among users and clinicians stated that changes in practice would occur. However, uptake of the service was lower than expected (22% of those oVered the service). Further research is needed into how this method of increasing access to evidence compares with other strategies, and whether it results in improved health outcomes for patients.

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Section: Box 4 Comments On the Usefulness Of The Informaticist Servicementioning

confidence: 60%

mentioning

confidence: 99%

A clinical informaticist to support primary care decision making

Swinglehurst¹,

Pierce²,

Fuller³

2001

Quality and Safety in Health Care

View full text Add to dashboard Cite

show abstract

“…12 We developed a service based in primary care in which a "clinical informaticist," a GP with further training in evidence-based medicine, provided evidence-based answers to questions, addressing the barriers of lack of time and skills. 7 13 We envisaged that the service could be used in a way analogous to a pathology laboratory, the clinician asking for evidence to answer a question and acting on the results in the context of the individual patient. The informaticist did not oVer specific advice on patient management.…”

mentioning

confidence: 99%

“…The reasons for choosing a GP as informaticist were threefold 16 : + doctors often ask colleagues for answers to questions 2-4 ; + a GP is likely to understand the precise nature and context of the question; + a GP is ideally placed to help a colleague "frame" a question. 13 Here we describe the service, including the search methods and resources used, and the time taken to answer questions. We also describe the evaluation of the service by means of questionnaires and semi-structured interviews.…”

mentioning

confidence: 99%

A clinical informaticist to support primary care decision making

Swinglehurst¹

2001

Quality in Health Care

View full text Add to dashboard Cite

The clinical informaticist service increased access to evidence for busy clinicians. Satisfaction was high among users and clinicians stated that changes in practice would occur. However, uptake of the service was lower than expected (22% of those offered the service). Further research is needed into how this method of increasing access to evidence compares with other strategies, and whether it results in improved health outcomes for patients.

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“…It was a strong theme, emerging from 10 qualitative studies. [11, 26, 27, 33, 34, 36, 40, 42, 46, 49]. ‘I think EBM is predicated upon there being well-supported and financed independent reviewers who are doing the meta-analyses and the broader views which have become the key to evidence-based medicine and then selecting which ones are quality enough to include.…”

Section: Resultsmentioning

confidence: 99%

A real-world approach to Evidence-Based Medicine in general practice: a competency framework derived from a systematic review and Delphi process

2017

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BackgroundEvidence-Based Medicine (EBM) skills have been included in general practice curricula and competency frameworks. However, GPs experience numerous barriers to developing and maintaining EBM skills, and some GPs feel the EBM movement misunderstands, and threatens their traditional role. We therefore need a new approach that acknowledges the constraints encountered in real-world general practice. The aim of this study was to synthesise from empirical research a real-world EBM competency framework for general practice, which could be applied in training, in the individual pursuit of continuing professional development, and in routine care. We sought to integrate evidence from the literature with evidence derived from the opinions of experts in the fields of general practice and EBM.MethodsWe synthesised two sets of themes describing the meaning of EBM in general practice. One set of themes was derived from a mixed-methods systematic review of the literature; the other set was derived from the further development of those themes using a Delphi process among a panel of EBM and general practice experts. From these two sets of themes we constructed a real-world EBM competency framework for general practice.ResultsA simple competency framework was constructed, that acknowledges the constraints of real-world general practice: (1) mindfulness - in one’s approach towards EBM itself, and to the influences on decision-making; (2) pragmatism – in one’s approach to finding and evaluating evidence; and (3) knowledge of the patient – as the most useful resource in effective communication of evidence. We present a clinical scenario to illustrate how a GP might demonstrate these competencies in their routine daily work.ConclusionWe have proposed a real-world EBM competency framework for general practice, derived from empirical research, which acknowledges the constraints encountered in modern general practice. Further validation of these competencies is required, both as an educational resource and as a strategy for actual practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-017-0916-1) contains supplementary material, which is available to authorized users.

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Information in primary health care

Cited by 15 publications

References 0 publications

A clinical informaticist to support primary care decision making

A clinical informaticist to support primary care decision making

A clinical informaticist to support primary care decision making

A real-world approach to Evidence-Based Medicine in general practice: a competency framework derived from a systematic review and Delphi process

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