TY - JOUR
T1 - Streamline triage and manage user expectations: lessons from a qualitative study of GP out-of-hours services
AU - Shaw, Christine
AU - Egbunike, Jennifer N
AU - Porter, Alison
AU - Button, Lori A
AU - Kinnersley, Paul
AU - Hood, Kerry
AU - Bowden, Sue
AU - Bale, Sue
AU - Snooks, Helen
AU - Edwards, Adrian
PY - 2010/3/1
Y1 - 2010/3/1
N2 - BackgroundSeveral models of GP out-of-hours provision exist in the UK but there is little detail about their effectiveness to meet users' needs and expectations. AimTo explore users' needs, expectations, and experiences of out-of-hours care, and to identify proposals for service redesign. SettingService providers in urban (GP cooperative), mixed (hospital based), rural (private) locations in Wales. ParticipantsSixty recent service users or carers (20 in each location). MethodSemi-structured telephone interviews; thematic analysis. ResultsUsers' concerns were generally consistent across the three different services. Efficiency was a major concern, with repetitive triage procedures and long time delays at various stages in the process being problematic. Access to a doctor when required was also important to users, who perceived an obstructive gatekeeping function of preliminary contacts. Expectations moderated the relationship between user concerns and satisfaction. Where expectations of outcome were unfulfilled, participants reported greater likelihood of reconsulting with the same or alternative services for the same illness episode. Accurate expectations concerning contacts with the next administrative, nursing, or medical staff professional were managed by appropriate information provision. ConclusionUsers require more streamlined and flexible triage systems. Their expectations need to be understood and incorporated into how services advise and provide services for users, and actively managed to meet the aims of both enhancing satisfaction and enabling users to cope with their condition. Better information and education about services are needed if users are to derive the greatest benefit and satisfaction. This may influence choices about using the most appropriate forms of care.
AB - BackgroundSeveral models of GP out-of-hours provision exist in the UK but there is little detail about their effectiveness to meet users' needs and expectations. AimTo explore users' needs, expectations, and experiences of out-of-hours care, and to identify proposals for service redesign. SettingService providers in urban (GP cooperative), mixed (hospital based), rural (private) locations in Wales. ParticipantsSixty recent service users or carers (20 in each location). MethodSemi-structured telephone interviews; thematic analysis. ResultsUsers' concerns were generally consistent across the three different services. Efficiency was a major concern, with repetitive triage procedures and long time delays at various stages in the process being problematic. Access to a doctor when required was also important to users, who perceived an obstructive gatekeeping function of preliminary contacts. Expectations moderated the relationship between user concerns and satisfaction. Where expectations of outcome were unfulfilled, participants reported greater likelihood of reconsulting with the same or alternative services for the same illness episode. Accurate expectations concerning contacts with the next administrative, nursing, or medical staff professional were managed by appropriate information provision. ConclusionUsers require more streamlined and flexible triage systems. Their expectations need to be understood and incorporated into how services advise and provide services for users, and actively managed to meet the aims of both enhancing satisfaction and enabling users to cope with their condition. Better information and education about services are needed if users are to derive the greatest benefit and satisfaction. This may influence choices about using the most appropriate forms of care.
KW - out-of-hours medical care
KW - family medicine
KW - qualitative evaluation
U2 - 10.3399/bjgp10X483490
DO - 10.3399/bjgp10X483490
M3 - Article
C2 - 20202350
SN - 1478-5242
VL - 60
SP - e83 - e97
JO - British Journal of General Practice
JF - British Journal of General Practice
IS - 572
ER -