Australian general Practitioners' perspectives on their role in well-child health care.

BMC Family Practice (Impact Factor: 1.67). 01/2013; 14(1):2. DOI: 10.1186/1471-2296-14-2
Source: PubMed


In a General Practitioner (GP) setting, preventative medicine is reported as the predominant source of health care for the well-child. However, the role of the GP in well-child health care is not well understood in Australia. The aim of this study was to describe the role of the GP in providing services for well-children and families in Australia.

This was a qualitative descriptive study. Face-to-face interviews were held with 23 GPs to identify their role in the provision of well-child health care. Participants worked in a variety of general practice settings and 21 of the 23 GPs worked in the Greater Western Sydney area.

Five main themes were identified in the analysis: ‘prevention is better than cure’, ‘health promotion: the key messages’, ‘working with families’, ‘working with other health professionals’, and ‘barriers to the delivery of well-child health services’.

Participating GPs had a predominantly preventative focus, but in the main well-child care was opportunistic rather than proactive. The capacity to take a primary preventative approach to the health of children and families by GPs is limited by the increasing demands to manage chronic disease. Serious consideration should be given to developing collaborative models of care where GPs are joined up with services funded by State and Territory governments in Australia, such as the universal maternal child and family health nursing services that have well children and families as their prime focus.

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Available from: Virginia Schmied, Sep 15, 2014
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    • "Additional services for families are available through private midwives and CFHs, nurses working in pharmacies or private general medical practices (where they can see a doctor or a practice nurse). CFH nursing services continue to offer scheduled universal services at regular intervals until children start school (NSW Department of Health 2008, COAG 2009a), whereas general practitioners (GPs) offer CFH services opportunistically when families present for medical treatment or for immunisation (Jeyendra et al. 2013). This complex mix of maternity and CFH, public and private services in Australia makes the planning and coordination of care across various services challenging (Schmied et al., 2008b; The Allens Consulting Group 2009). "
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    ABSTRACT: To examine collaboration in the provision of universal health services for children and families in Australia from the perspective of midwives and child health and family health nurses.
    Journal of Clinical Nursing 06/2014; 24(1-2). DOI:10.1111/jocn.12635 · 1.26 Impact Factor
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    • "The CFH service includes, but is not limited to, developmental surveillance and health monitoring, promotion of parental social and emotional wellbeing, risk identification and health promotion [9,10]. General practice (general practitioners and practice nurses) also provide well child services opportunistically including developmental and preventative health care and immunisations [11]. These services attract an out-of-pocket fee with some subsidy through the public health insurance system called Medicare. "
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    ABSTRACT: In Australia, women who give birth are transitioned from maternity services to child and health services once their baby is born. This horizontal integration of services is known as Transition of Care (ToC). Little is known of the scope and processes of ToC for new mothers and the most effective way to provide continuity of services. The aim of this paper is to explore and describe the ToC between maternity services to CFH services from the perspective of Australian midwives and child and family health (CFH) nurses. This paper reports findings from phase two of a three phase mixed methods study investigating the feasibility of implementing a national approach to CFH services in Australia (the CHoRUS study). Data were collected through a national survey of midwives (n = 655) and CFH nurses (n = 1098). Issues specifically related to ToC between maternity services and CFH services were examined using descriptive statistics and content analysis of qualitative responses. Respondents described the ToC between maternity services and CFH services as problematic. Key problems identified included communication between professionals and services and transfer of client information. Issues related to staff shortages, early maternity discharge, limited interface between private and public health systems and tension around role boundaries were also reported. Midwives and CFH nurses emphasised that these issues were more difficult for families with identified social and emotional health concerns. Strategies identified by respondents to improve ToC included improving electronic transfer of information, regular meetings between maternity and CFH services, and establishment of liaison roles. Significant problems exist around the ToC for all families but particularly for families with identified risks. Improved ToC will require substantial changes in information transfer processes and in the professional relationships which currently exist between maternity and CFH services.
    BMC Pregnancy and Childbirth 04/2014; 14(1):151. DOI:10.1186/1471-2393-14-151 · 2.19 Impact Factor
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    • "While general practice also provides substantial child healthcare [20], limited literature exists on the role GPs play in providing well child health care [21]. Despite the emphasis placed on preventative health measures [22], elements of the universal CFH service schedule are generally only provided opportunistically by GPs during visits for immunisation and illness [21]. "
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    ABSTRACT: Continuity in the context of healthcare refers to the perception of the client that care has been connected and coherent over time. For over a decade professionals providing maternity and child and family health (CFH) services in Australia and internationally have emphasised the importance of continuity of care for women, families and children. However, continuity across maternity and CFH services remains elusive. Continuity is defined and implemented in different ways, resulting in fragmentation of care particularly at points of transition from one service or professional to another.This paper examines the concept of continuity across the maternity and CFH service continuum from the perspectives of midwifery, CFH nursing, general practitioner (GP) and practice nurse (PN) professional leaders. Data were collected as part of a three phase mixed methods study investigating the feasibility of implementing a national approach to CFH services in Australia (CHoRUS study). Representatives from the four participating professional groups were consulted via discussion groups, focus groups and e-conversations, which were recorded and transcribed. In total, 132 professionals participated, including 45 midwives, 60 CFH nurses, 15 general practitioners and 12 practice nurses. Transcripts were analysed using a thematic approach. 'Continuity' was used and applied differently within and across groups. Aspects of care most valued by professionals included continuity preferably characterised by the development of a relationship with the family (relational continuity) and good communication (informational continuity). When considering managerial continuity we found professionals' were most concerned with co-ordination of care within their own service, rather than focusing on the co-ordination between services. These findings add new perspectives to understanding continuity within the maternity and CFH services continuum of care. All health professionals consulted were committed to a smooth journey for families along the continuum. Commitment to collaboration is required if service gaps are to be addressed particularly at the point of transition of care between services which was found to be particularly problematic.
    BMC Health Services Research 01/2014; 14(1):4. DOI:10.1186/1472-6963-14-4 · 1.71 Impact Factor
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