Sofia Llahana’s Post

The Silent Struggle: The Unseen Realities of General Practice As a former trainee in Emergency Medicine and Intensive Therapy Unit (ITU), I have witnessed the harrowing and often heroic efforts of hospital doctors who labor tirelessly through night shifts, battling life-threatening conditions with unwavering determination. However, it is with a heavy heart and a deep sense of duty that I write to shed light on the often-overlooked plight of General Practitioners (GPs) – the cornerstone of our healthcare system. In the shadows of their hospital counterparts, GPs have silently shouldered the burden of an ever-increasing workload, driven by a commitment to patient care that goes far beyond the scope of their official duties. This quiet endurance stems from a misplaced sense of inferiority, a belief that their contributions are somehow less significant because they do not contend with the immediate life-and-death scenarios seen in hospital wards. This perception is not only unjust but also dangerously misleading. The reality of general practice today is far more brutal than it appears. GPs are the frontline defenders of our communities' health, providing holistic, continuous care that spans the entire spectrum of human ailments. They are the ones who manage chronic diseases, offer preventive care, and provide the first line of defense against emerging health threats. Yet, they do this in an environment that is increasingly unsustainable. The pressures faced by GPs are multifaceted. Administrative tasks have ballooned, leaving less time for direct patient care. The emotional toll of being the first point of contact for patients' anxieties and fears is immense. Furthermore, the financial compensation does not reflect the complexity and scope of their responsibilities. This discrepancy must be addressed urgently. The Fuller Stocktake Model's vision of hub-based care, which reallocates funding from individual practices to Primary Care Networks (PCNs), is a step in the wrong direction. This approach risks dismantling the personal touch that defines general practice. By distributing sub-standard staff across multiple practices, we erode the sense of belonging and continuity that patients and practitioners alike depend on. A sense of belonging is not a luxury; it is essential for the delivery of compassionate and effective care.

It is these breaks in the process that impact both patient and nurse experience, as well as patient outcomes. Regina M. Clark, CSP, I'm so sorry that you had that experience, and so grateful that you are okay. The breaks in process are what prompted Dina Readinger, EMBAand I to host the nurse leader listening tour, and collaborate with 26 professionals to write #HealingHealthcare Evidence-Based Strategies to Mend Our Broken System. Broken processes require vetted solutions; I know that you will add incredible value to your nursing audience. https://lnkd.in/e_79K5RU

Check out this wonderful article about Soft Skills in Medicine.

What does the ideal clinical dashboard look like for Anthony Laflen, VP of Value-Based Care Innovation at PointClickCare? The top three data points are: 1️⃣ Patient health status data – vital signs, heart rate, blood pressure, medical issues, or chronic conditions 2️⃣ Medication adherence or medication management 3️⃣ Utilization metrics – hospital readmission rates, frequency of doctor visits, staffing levels, etc. Check out Skilled Nursing News’ latest article to learn how he has created these dashboards in his work at PointClickCare! Read here: https://bit.ly/3AabdZM

15 years ago in safety history (26 APR 2009) Louise Batz of San Antonio TX , then 65, died in one of the many patient safety events in the US. (One thought leader estimates 251,000 patient deaths every year from medical error - another estimates only 98,000 patient deaths every year.) Louise Batz had joint replacement (both knees) on 14 APR 2009. Poor medication safety left her on life support. Family withdrew life support after days of no hope for recovery, and their mom died in hospital. Three lessons which are still as valid today as they were in 2009: 1. Listen to family. Family thought a med for nausea, morphine for pain, and Meperidine for pain was too much. They urged mom's nurse to give only the morphine, thinking mom's pain and nausea were well-controlled. 2. Monitor after med administration. The med process is ordering, dispensing, administration, AND monitoring. Mom was unmonitored after administration. The first sign of trouble was mom actually in trouble. 3. Continuous monitoring. What is better than a nurse frequently monitoring the patient after administration of meds? Technology continuously monitoring patient condition AND a nurse who is monitoring by frequent nursing assessment - that is better. My ask this week of safety leaders in healthcare, especially nursing leaders, is to share the story of Louise Batz. Discuss your expectations for family being involved as part of the care team. Discuss practice standards for patient monitoring after med administration. Discuss the use of tech for patient monitoring - tech you have and tech you need. The paradox of safety leadership is leaders who discuss safety the most have the fewest safety events. Be that leader who talks about safety all the time, even though safety is borderline great. #safety #hro #derisking #safetyleadership

The CAREFUL view of Clinical Handover Handover involves the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or groups of patients, to another person, or professional group on a temporary or permanent basis. This can include: 1. peer-to-peer #handover, usually at shift end; 2. internal referrals between teams for the purpose of shared care or consultation; and 3. transfers between institutions or discharges resulting in a change in setting. All of these can also be considered as transitions of care and are subject to similar risks. Read more in our blog below 👇

Service Standards : Service Standards are described as benchmarks decided by any organisation for measuring the quality of services rendered to the community. THE COMMON SERVICE STANDARDS DESCRIBE AS : 1. Area 2. Activity 3. Standard Time 1. Admission Process Time taken for completion of patient registration from the time of arrival at the admission desk Service Standard: 20 minutes 2. Time taken for allocating bed to patient from the time of completion of the registration process Service Standard: 15 minutes 3. Initial Assessment of Patient in Emergency : Time taken for completion of initial assessment by Nurse in EMERGENCY Service Standard: 5 minutes 4. Critical Care Unit: Time taken for completion of initial assessment by Nurses Service Standard: Immediate 5. Critical Care Unit: Time taken for completion of initial assessment by Medical Officer Service Standard: Immediate minutes Other Service Standards are : 1.    Bed Occupancy Rate -100 2.    Average length of stay-4-5 Days 3.    Surgical Productivity index- More than 10 4.    Diagnostic Services Index 5. Night-time Cesarean rate 6.    Equipment utilization index-30% 7.    OT swab positivity rate 8.    Postoperative rate-Less than 5% 9.    Biomedical Waste generation rate 10.  Equipments downtime index 11.  Hospital gross death rate 12.  Hospital inpatient referral outrate 13.  Condemnation rate

As I read through the literature on team-based care, I note how remarkably physician-centric it is. The messages seem to be: - we need teams to address the physician shortage - with teams, physicians can offload stuff to other professions - physicians can then deal with the complex stuff This is problematic. Chronic disease management requires teams that function to serve the patient and the informal care partner. Complex needs are best met when professions can fully exercise their scope of practice. Often, nurse practitioners, pharmacists, or other providers do the complex stuff better than physicians. In a well-functioning team where accountability is mutual and to the patient, work is shared, duplication reduced, everyone's work load improves, and the patient ultimately benefits. Thoughts?

Applying the Hub and Spoke model to primary care...Patient at the center (the hub) and the Healthcare professionals (the spokes) around the patient. Also must include a fully accessible (all providers) eHR, portable with the patient.