Juggling efficiency. An ethnographic study exploring healthcare seeking practices and institutional logics in Danish primary care settings

Andersen, Rikke Sand; Vedsted, Peter

doi:10.1016/j.socscimed.2015.01.037

Cited by 30 publications

(32 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…During this encounter, individuals must present their experiences in a manner which is acceptable to the GP, striving to articulate embodied sensations through the constraints of language (Heath, 2008). People must also negotiate the interaction in order to ensure that the GP responds to their complaints in an acceptable and timely manner, therefore transforming reported symptoms into signs of pathology (Andersen & Vedsted, 2015).…”

Section: Contextual Model Of the Patient Intervalmentioning

confidence: 99%

The role of social context in symptom appraisal and help-seeking among people with lung or colorectal symptoms: A qualitative interview study

et al. 2018

View full text Add to dashboard Cite

Prolonged diagnostic intervals are associated with poorer outcomes, and the patient interval appears to be a substantial contributor to the overall length of the diagnostic interval. This study sought to understand how the broader context of people's lives influenced symptom appraisal and help-seeking, comparing experiences by length of the patient interval. Patients referred with a suspicion of lung or colorectal cancer were invited to complete a questionnaire about their symptoms, with 26 respondents purposively sampled to take part in a semi-structured interview about their patient intervals. Embodied experience, appraisal, help-seeking decision-making and consultation were identified as component stages of the patient interval, with the factors affecting movement between these stages located in one of four contextual domains: individual experience, interpersonal relationships, healthcare system interactions and social and temporal context. The length of the patient interval was related to the type of symptom(s) experienced, discussion of symptoms with others and the social responsibilities people held during symptomatic periods. A contextual model of the patient interval illustrates the stages and domains of this interval, as grounded in the data from this study. The model has potential application to future studies examining the patient interval for a range of symptoms.

show abstract

Section: Contextual Model Of the Patient Intervalmentioning

confidence: 99%

The role of social context in symptom appraisal and help-seeking among people with lung or colorectal symptoms: A qualitative interview study

et al. 2018

View full text Add to dashboard Cite

show abstract

“…In such health care settings, clinical effectiveness refers to the quality of care provided by physicians and registered nurses (e.g., Crosson et al, ) as well as the quality of their clinical decision making (e.g., McGinn et al, ). For its part, clinical efficiency refers to the optimal allocation of resources and competences in clinical processes (e.g., Andersen & Vedsted, ; Schade, Sullivan, de Lusignan, & Madeley, ) and to the cost, time, and workflow constraints of these processes (e.g., Wagholikar et al, ).…”

Section: Theoretical Backgroundmentioning

confidence: 99%

IT‐based clinical knowledge management in primary health care: A conceptual framework

Raymond

Paré

Maillet

2017

Knowl Process Manag

View full text Add to dashboard Cite

Primary health care medical practices have made sizable information technology investments in recent years, primarily deploying electronic medical record (EMR) systems as well as Web‐based e‐learning applications. The basic assumption here is that developing information technology‐based knowledge management capabilities may significantly improve the innovation and clinical performance of these organizations. Increasing uncertainty in their environment requires them to develop greater absorptive capacity (ACAP), that is, an organizational learning capability to deal with the external sources of this uncertainty. In applying ACAP theory to primary care settings, this study seeks to answer the following research questions: What are the e‐learning and EMR capabilities developed by primary care medical practices in response to increasing environmental uncertainty? To what extent does the development of an e‐learning capability influence the development of an EMR capability? To what extent does building ACAP contribute to positive outcomes in terms of medical practices' innovation and clinical performance?

show abstract

“…Whilst there is some evidence that patients may modify their behaviour in response to organisational practices [11], evidence is conflicting as to whether early solicitation increases the expression of ACs within primary care consultations, with studies both supporting [20] and refuting [8] this idea. Neither has existing research found soliciting ACs to significantly increase consultation length [8,20].…”

Section: Discussionmentioning

confidence: 99%

“…Factors such as patient presentation (whether or not the patient exhibits cues suggestive of ACs) and choice (whether or not the patient wishes to disclose their ACs, and/or trusts the GP enough to do so) have been highlighted elsewhere as influencing disclosure [11,15,35]. However, the influence of the GP's own emotional state and GP 'burn-out', though acknowledged broadly within the medical literature [36,37], has not been implicated in reluctance to solicit ACs.…”

Section: Discussionmentioning

confidence: 99%

“…Previous research, however, suggests such solicitations occur in only a minority of consultations [9], and where attempted, is usually towards the close of the consultation, once the presenting concern has been addressed [4,10]. This may mean a number of patients leave with unvoiced ACs [10][11][12], although prevalence estimates range widely from 20-89% of consultations [10,13].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Soliciting additional concerns in the primary care consultation and the utility of a brief communication intervention to aid solicitation: A qualitative study

Summers

Moore

Ekberg

et al. 2016

Patient Education and Counseling

View full text Add to dashboard Cite

M.Soliciting additional concerns in the primary care consultation and the utility of a brief communication intervention to aid solicitation: a qualitative study.Patient Education and Counseling http://dx.doi.org/10.1016/j.pec. 2015.12.005 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Abstract ObjectiveTo investigate the perspectives of general practitioners (GPs) on the practice of soliciting additional concerns (ACs) and the acceptability and utility of two brief interventions (prompts) designed to aid the solicitation. MethodsEighteen GPs participating in a feasibility randomised controlled trial were interviewed.Interviews were semi-structured and audio-recorded. Data were analysed using a Framework Approach. ResultsParticipants perceived eliciting ACs as important for: reducing the need for multiple visits, identifying serious illness early, and increasing patient and GP satisfaction. GPs found the prompts easy to use and some continued their use after the study had ended to aid time management. Others noted similarities between the intervention and their usual practice.Nevertheless, soliciting ACs in every consultation was not unanimously supported. ConclusionThe prompts were acceptable to GPs within a trial context, but there was disagreement as to whether ACs should be solicited routinely. Some GPs considered the intervention to aid their prioritisation efficiency within consultations. Practice implicationsSome GPs will find prompts which encourage ACs to be solicited early in the consultation enable them to better organise priorities and manage time-limited consultations more effectively.

show abstract

Juggling efficiency. An ethnographic study exploring healthcare seeking practices and institutional logics in Danish primary care settings

Cited by 30 publications

References 22 publications

The role of social context in symptom appraisal and help-seeking among people with lung or colorectal symptoms: A qualitative interview study

The role of social context in symptom appraisal and help-seeking among people with lung or colorectal symptoms: A qualitative interview study

IT‐based clinical knowledge management in primary health care: A conceptual framework

Soliciting additional concerns in the primary care consultation and the utility of a brief communication intervention to aid solicitation: A qualitative study

Contact Info

Product

Resources

About