On a European collaboration to identify organizational models, potential shortcomings and improvement options in out-of-hours primary health care

Abstract Background: Out-of-hours care (OOHC) provision is an increasingly challenging aspect in the delivery of primary health care services. Although many European countries have implemented organizational models for out-of-hours primary care, which has been traditionally delivered by general practitioners, health care providers throughout Europe are still looking to resolve current challenges in OOHC. It is within this context that the European Research Network for Out-of-Hours Primary Health Care (EurOOHnet) was established in 2010 to investigate the provision of out-of-hours care across European countries, which have diverse political and health care systems. In this paper, we report on the EurOOHnet work related to OOHC organizational models, potential shortcomings and improvement options in out-of-hours primary health care. Needs assessment: The EurOOHnet expert working party proposed that models for OOHC should be reviewed to evaluate the availability and accessibility of OOHC for patients while also seeking ways to make the delivery of care more satisfying for service providers. Outcomes: To move towards resolution of OOHC challenges in primary care, as the first stage, the EurOOHnet expert working party identified the following key needs: clear and uniform definitions of the different OOHC models between different countries; adequate—ideally transnational—definitions of urgency levels and corresponding data; and educational programmes for nurses and doctors (e.g. in the use of a standardized triage system for OOHC). Finally, the need for a modern system of data transfer between different health care providers in regular care and providers in OOHC to prevent information loss was identified.

[1]  P. Giesen,et al.  EurOOHnet—the European research network for out-of-hours primary health care , 2014, The European journal of general practice.

[2]  M. Wensing,et al.  GP cooperative and emergency department: an exploration of patient flows. , 2013, Journal of evaluation in clinical practice.

[3]  Kim M. Nazi The Personal Health Record Paradox: Health Care Professionals’ Perspectives and the Information Ecology of Personal Health Record Systems in Organizational and Clinical Settings , 2013, Journal of medical Internet research.

[4]  N. Terry Meaningful Adoption: What We Know or Think We Know About the Financing, Effectiveness, Quality, and Safety of Electronic Medical Records , 2013, The Journal of legal medicine.

[5]  R. Grol,et al.  Nurse telephone triage in Dutch out-of-hours primary care: the relation between history taking and urgency estimation , 2012, European journal of emergency medicine : official journal of the European Society for Emergency Medicine.

[6]  M. Habiba,et al.  Potentially avoidable emergency department attendance: interview study of patients' reasons for attendance , 2011, Emergency Medicine Journal.

[7]  David J. Martin,et al.  Management of out-of-hours calls by a general practice cooperative: a geographical analysis of telephone access and consultation. , 2011, Family practice.

[8]  Linda Huibers,et al.  Safety of telephone triage in out-of-hours care: A systematic review , 2011, Scandinavian journal of primary health care.

[9]  G. Perkins,et al.  Variability in cardiac arrest survival: the NHS Ambulance Service Quality Indicators , 2011, Emergency Medicine Journal.

[10]  R. Grol,et al.  Quality of After-Hours Primary Care in the Netherlands: A Narrative Review , 2011, Annals of Internal Medicine.

[11]  T. Bodenheimer,et al.  Redesigning After-Hours Primary Care , 2011, Annals of Internal Medicine.

[12]  Linda Huibers,et al.  Validity of telephone and physical triage in emergency care: the Netherlands Triage System. , 2011, Family practice.

[13]  M. Wensing,et al.  Diagnostic scope in out-of-hours primary care services in eight European countries: an observational study , 2011, BMC family practice.

[14]  S. Hunskaar,et al.  Minor ailments in out-of-hours primary care: An observational study , 2011, Scandinavian journal of primary health care.

[15]  O. Senn,et al.  Out-of-hours demand in primary care: frequency, mode of contact and reasons for encounter in Switzerland. , 2011, Journal of evaluation in clinical practice.

[16]  A. Edwards,et al.  Exploring patients’ self-reported experiences of out-of-hours primary care and their suggestions for improvement: a qualitative study , 2010, Family practice.

[17]  M. Nothacker,et al.  Nutzung von Routinedaten zur Einschätzung der Versorgungsqualität: Eine kritische Beurteilung am Beispiel von Qualitätsindikatoren für die „Nationale Versorgungsleitlinie Chronische Herzinsuffizienz“ , 2011 .

[18]  S. Störk,et al.  [Using routine data for quality of care assessments: a critical review, taking quality indicators for the "National Disease Management Guideline for Chronic Heart Failure" as an example]. , 2011, Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen.

[19]  A. Edwards,et al.  Delays in response and triage times reduce patient satisfaction and enablement after using out-of-hours services. , 2010, Family practice.

[20]  P. Van Royen,et al.  What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care , 2010, BMC health services research.

[21]  John L Campbell,et al.  Out-of-hours care: do we? , 2010, The British journal of general practice : the journal of the Royal College of General Practitioners.

[22]  Michel Wensing,et al.  Out-of-hours care in western countries: assessment of different organizational models , 2009, BMC health services research.

[23]  C. Bröer,et al.  Apprehensive parents: a qualitative study of parents seeking immediate primary care for their children. , 2009, The British journal of general practice : the journal of the Royal College of General Practitioners.

[24]  Steven L Bernstein,et al.  The effect of emergency department crowding on clinically oriented outcomes. , 2009, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[25]  T. Tomasik,et al.  Utilization of the out of hours service in Poland: an observational study from Krakow , 2008, BMC health services research.

[26]  J. Thesen,et al.  [Locations, facilities and routines in Norwegian out-of-hours emergency primary health care services]. , 2007, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke.

[27]  R. Grol,et al.  General practice cooperatives: long waiting times for home visits due to long distances? , 2007, BMC Health Services Research.

[28]  C. V. van Uden,et al.  After-hours care in the United Kingdom, Denmark, and the Netherlands: new models. , 2006, Health affairs.

[29]  C. V. van Uden,et al.  Development of out-of-hours primary care by general practitioners (GPs) in The Netherlands: from small-call rotations to large-scale GP cooperatives. , 2006, Family medicine.

[30]  A. Kelly,et al.  Out-of-hours co-operatives: General practitioner satisfaction with governance and working arrangements , 2006, The European journal of general practice.

[31]  James Munro,et al.  The impact of NHS Direct on the demand for out-of-hours primary and emergency care. , 2005, The British journal of general practice : the journal of the Royal College of General Practitioners.

[32]  David Dunt,et al.  A systematic review of the effect of different models of after-hours primary medical care services on clinical outcome, medical workload, and patient and GP satisfaction. , 2003, Family Practice.

[33]  F. Olesen,et al.  Out of hours service in Denmark: evaluation five years after reform , 1998, BMJ.

[34]  E Glucksman,et al.  Primary care in the accident and emergency department: I. Prospective identification of patients , 1995, BMJ.