Chadborn, NH, Devi, R orcid.org/0000-0003-2834-8597, Goodman, C et al. (3 more authors) (2022) General practitioners’ role in improving health care in care homes: a realist review. Family Practice. ISSN 0263-2136
Abstract
Background
Despite recent focus on improving health care in care homes, it is unclear what role general practitioners (GPs) should play. To provide evidence for future practice we set out to explore how GPs have been involved in such improvements.
Methods
Realist review incorporated theory-driven literature searches and stakeholder interviews, supplemented by focussed searches on GP-led medication reviews and end-of-life care. Medline, Embase, CINAHL, PsycInfo, Web of Science, and the Cochrane library were searched. Grey literature was identified through internet searches and professional networks. Studies were included based upon relevance. Data were coded to develop and test contexts, mechanisms, and outcomes for improvements involving GPs.
Results
Evidence was synthesized from 30 articles. Programme theories described: (i) “negotiated working with GPs,” where other professionals led improvement and GPs provided expertise; and (ii) “GP involvement in national/regional improvement programmes.” The expertise of GPs was vital to many improvement programmes, with their medical expertise or role as coordinators of primary care proving pivotal. GPs had limited training in quality improvement (QI) and care home improvement work had to be negotiated in the context of wider primary care commitments.
Conclusions
GPs are central to QI in health care in care homes. Their contributions relate to their specialist expertise and recognition as leaders of primary care but are challenged by available time and resources to develop this role.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2022. This is an open access article under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0) (https://creativecommons.org/licenses/by/4.0/) |
Keywords: | end-of-life care, general practice, long-term care facilities, medication review and optimization, nursing homes, quality improvement |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Nursing Adult (Leeds) |
Funding Information: | Funder Grant number NIHR National Inst Health Research RIS1495955 / RC48LC |
Depositing User: | Symplectic Publications |
Date Deposited: | 28 Jul 2022 15:20 |
Last Modified: | 07 Jun 2023 15:02 |
Status: | Published online |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/fampra/cmac071 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:189007 |