The Primary Care Clinic
This being the information age, the ease and availability of information has had a tremendous awareness among the population on matters concerning health Availability of online information about disease, treatment, prevention has lead to more people actively seeking medical services. Traditionally these services would only be found in the emergency department of large hospitals. However these large facilities have not been able to keep up with the increased demand for urgent services. This has led to the development and proliferation of urgent care facilities. These facilities are better placed to handle a higher patient turnover without overwhelming the system. The reason for this is that, the urgent care facilities are specifically designed to handle minor medical emergencies as efficiently as possible.
The level of education is usually closely related to health-seeking behaviour. In recent years, the average level of education has gone up. People with higher levels of education tend to be more health-conscious and have better health-seeking behaviour. In addition to this, they have better awareness of preventive services and actively seek them out. This has led to increase in demand for primary care facilities which are tasked with provision of community health promotion.
In the last 50 years, the focus of healthcare has shifted form mainly curative to preventive services. To this tune, there have been massive health promotion campaigns that have been carried out. Examples of such campaigns have included anti-smoking campaigns, cancer screening programs, proper nutrition and exercise campaigns. These have lead to increased demand and utilization of primary care centres which provide these services.
The modern world is a busy one. Therefore health might sometimes take a backseat to other activities. Social innovation has been directed at finding solutions that make doctor’s visits more convenient, hence urgent care clinics. Indeed in a survey carried out by found out that convenience was the main reason patients preferred urgent care centres to emergency room visits. The main reasons they cited for this preference were, shorter waiting times, provision of all services in one place and lack of appointments. Urgent care clinic were therefore more compatible with their busy schedules.
In 1978, primary health care became one of World Health Organization’s core policies. The adoption of this policy by countries affiliated to the United Nations has led to changes in national policy. Consequently, there has been a change in the focus of healthcare delivery systems. Primary healthcare has been found to be vital in attaining the healthcare goals of a country. It has therefore witnessed a boost from the government in a bid to set up more of such facilities.
The government is in charge of regulating the type and number of primary healthcare facilities entering the market. This is due to the fact that the government has to safeguard the interests of the public by ensuring only quality services are provided. This has to be weighed against the demand for such services. In the recent past, the demand for urgent care services has increased. The government has therefore had to permit more primary care facilities to be built. This has required political goodwill, diversion of funding to the venture, and change in legislation to authorize this new medical franchise.
Healthcare is costly, both to the individual and the government. Urgent care clinics however offer affordable services, with reduced burden to the healthcare system and the individual. A visit to an urgent care clinic is significantly cheaper compared to a trip to the emergency room for similar illness. In addition to this, clinics offer different payment strategies for patients who are not insured.
Urgent care clinics are generally more accessible than large hospitals. In impoverished regions of the country, money for transport may hinder access to a large hospital. This makes urgent care clinics a crucial part of healthcare to delivery to rural areas and inner cities.
Mission statement for a primary healthcare clinic
To provide quality, affordable, accessible patient-centred healthcare to all people, by a team of qualified professionals, encourage community participation, form partnerships with relevant sectors with the aim of improving the health of the community.
This mission statement will facilitate provision of services by providing a sense of direction for everyone working in the facility. It will go a long way towards improving cohesion among healthcare providers. Having a common goal will guide decision making from the simple everyday tasks to the complex issues that are common in medical practice. It will also be easier to configure a strategy of how to get to where the facility sees itself in the future since the mission statement contains all the values that are essential to the facility. With a clear, conclusive and concise mission statement it will be easier for the facility to self-evaluate and assess whether they are meeting their goals or falling short.
One of the directions that the above facility might take to become more profitable would be to become an urgent care facility. This direction would be favourable for both the community and the owner. Some of the factors that would favour this include the presence of a diverse suburban population who will require and utilize a wide range of services. Proximity to two large hospitals in the city means that there is a contingency plan for complex cases that can not be handled in the urgent care centre. Since majority of the population are not financially stable they will require services that are affordable and accessible such as those found in an urgent care clinic. This facility also has the human resource that is needed to run an urgent care facility. However, the major reason that would hinder this direction of growth would be the lack of appropriate infrastructure such as laboratory, radiology and pharmacy departments which are crucial to making quick diagnoses and administration of treatment.
Monitoring and evaluation remains a crucial part of implementation of innovative ideas. It is the only way that one can ascertain whether one’s invention is useful. Fir this primary healthcare clinic there are different measurables that can be used to evaluate whether the clinic is meeting its goals or not. They include:
This can be assessed using various parameters. Some example would include, how soon after booking an appointment one is seen, how often one has to reschedule, the number of avoidable emergency room visits. One of the simplest however would be getting the percentage of patients who are treated by their primary caregiver after making an appointment. A low percentage will mean that patients are unable to access their primary physician.
Patient-centred healthcare delivery
Patient satisfaction surveys can be used to gauge whether a healthcare delivery system is patient-centred. This can be measured by getting the percentage of patients who felt that their values, concerns and health information was handled in a respectful manner with complete confidentiality. The percentage will therefore be high where the facility is patient-centred.
Since one of the core values of the primary care facility is community health promotion, one of the indicators that can be measured would be the immunization of infants and school going children. High rates of fully immunized children mean that the facility is achieving its goal of health promotion within the community.
- Promotion of community health
Even with the recent emphasis on primary health care, there are some challenges with its universal application. However these can be viewed as opportunities for improvement. One such opportunity is changing government policy to channel more funding into primary healthcare facilities. This funding would be used to built infrastructure and purchase supplies. In the long term however, funding should be achieved by seeking public private partnerships. This will reduce the pressure on the government as the only source of funding.
To enable this primary care facility handle the increasing burden of patients, more health workers should be trained so as to reduce the overwhelming service provider to patients ratio. In this line, provision of incentives to physicians and all other cadres of healthcare workers may be needed in order to reach the rural areas. The government can also provide motivation to general practitioners by providing scholarship programs, and government sponsored learning.
Safety of the patients under the care of this facility, there needs to be proper oversight. The authority needs to ensure provision of quality services by verifying credentials of service providers, and inspecting such facilities to ascertain that they are up to code. In the long run, setting up a regulatory board in charge of quality assurance would maintain a high standard of care to all.
Continuous data collection at all points of care with the use of meticulous record keeping or electronic medical records will enable periodic reviews of the system to be made. It is with such reviews, that the effectiveness of urgent and primary care facilities can be reliably measured. The result of this will be provision of data that can be used as evidence when changing policy, acquiring more funding and designing health promotion strategies. Adoption of electronic medical records and creation of a national database will make this process easier on a larger scale.