Following the funding trail: financing, nurses and teamwork in Australian general practice
| Autor: | Kathryn Dwan, Sally Hall, Rachael Yates, Bonnie Sibbald, Marjan Kljakovic, Julie Porritt, Christopher Pearce, Christine Phillips |
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| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Financing Government Scrutiny media_common.quotation_subject Health Personnel General Practice Implementation Science [NCEBP 3] Health informatics Health administration Financial management Interviews as Topic Nursing Medicine Cooperative Behavior health care economics and organizations media_common Finance Patient Care Team Teamwork Primary Health Care business.industry Health Policy Public health Nursing research lcsh:Public aspects of medicine Australia lcsh:RA1-1270 Incentive Nursing Staff business Research Article |
| Zdroj: | BMC Health Services Research, 11, 38-38 BMC Health Services Research, Vol 11, Iss 1, p 38 (2011) BMC Health Services Research BMC Health Services Research, 11, pp. 38-38 |
| ISSN: | 1472-6963 |
| Popis: | Contains fulltext : 97927.pdf (Publisher’s version ) (Open Access) BACKGROUND: Across the globe the emphasis on roles and responsibilities of primary care teams is under scrutiny. This paper begins with a review of general practice financing in Australia, and how nurses are currently funded. We then examine the influence on funding structures on the role of the nurse. We set out three dilemmas for policy-makers in this area: lack of an evidence base for incentives, possible untoward impacts on interdisciplinary functioning, and the substitution/enhancement debate. METHODS: This three year, multimethod study undertook rapid appraisal of 25 general practices and year-long studies in seven practices where a change was introduced to the role of the nurse. Data collected included interviews with nurses (n = 36), doctors (n = 24), and managers (n = 22), structured observation of the practice nurse (51 hours of observation), and detailed case studies of the change process in the seven year-long studies. RESULTS: Despite specific fee-for-service funding being available, only 6% of nurse activities generated such a fee. Yet the influence of the funding was to focus nurse activity on areas that they perceived were peripheral to their roles within the practice. CONCLUSIONS: Interprofessional relationships and organisational climate in general practices are highly influential in terms of nursing role and the ability of practices to respond to and utilise funding mechanisms. These factors need to be considered, and the development of optimal teamwork supported in the design and implementation of further initiatives that financially support nursing in general practice. |
| Databáze: | OpenAIRE |
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