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Background: Family practice is an important setting for health promotion and prevention in Germany. However, there is a research gap regarding the involvement of nonmedical practice staff in health promotion. Therefore, our aim is to gain an indepth understanding of the role health care assistants (HCAs) can play regarding health promotion in family practice. Methods: We conducted 21 qualitative semi-structured interviews via telephone with 14 physicians and 7 HCAs, inquiring both professional groups about the role of HCAs concerning health promotion in their practice. The interviews were evaluated separately for both professions using thematic analysis. Results: In addition to organizational tasks such as making an appointment and communicating with physicians, HCAsmainly take on a key function as the first contact person in all practices: They recognize preventive needs, select eligible patients early at the reception and actively address them about preventive services. In some practices, HCAs carry out health-promoting measures such as training courses. However, with regard to further delegation of tasks, physicians in particular expressed concerns as they did not want to overburden HCAs. Conclusions: HCAs often take on organizational activities with regard to health promotion in family practice, but due to their function in the practice structure, they can also shape the practice as a health-promoting setting for patients. In addition, HCAs navigate patients with regard to preventive and health-promoting services. In accordance with their key role as initial contact, it should be worked out together with HCAs how health promotion can be addressed in a structured way at first contact. [ABSTRACT FROM AUTHOR]

Background Family practices are the primary contact for inquiries relating to COVID-19. This study reveals the reasons why German family practices are called during the pandemic and which burden is associated with patients' inquiries related to COVID-19 among practice assistants (PAs). Methods On April 28, 2021 a cross-sectional flash mob study was conducted in family practices across Germany. The study material and invitation were disseminated via social media and postal or electronic mails. During half a day, participating practices counted every incoming call. For calls addressing COVID-19, the reason, duration, and perceived stress level were documented. Descriptive statistics and regression analyses were performed using SPSS. Results 5,646 calls, 1,826 of which were related to COVID-19 (32.3 %), were documented by 73 practices (practice average: 25.0 ± 17.7) within a single Wednesday morning. Most calls addressed vaccination (n = 1,050, 59.0 %). During 22.0 % (n = 388) of COVID-19-related calls, PAs felt stressed, which was mainly influenced by the call duration (calls of 5 minutes and longer were perceived significantly more stressful [OR 8.94, 95 % CI 6.47--12.37]). Feeling well-prepared to meet patients' inquiries relating to COVID-19 was a protective factor for the average stress perceived per PA. Overall, less than 10 % of calls on COVID-19 were transferred to a physician. Conclusions Family practice teams experience a high volume of partly stressful phone calls about COVID-19 but are often able to handle the pandemic challenges. PAs play a central role in advising the practice population on issues related to COVID-19. This deserves greater recognition. [ABSTRACT FROM AUTHOR]

Background In this paper, we investigated which aspects had influenced the involvement of Health Care Assistants (HCAs) in the coordination and recruitment of a clinical study for the implementation of an online self-management program for patients with asthma in primary care practices. Methods In eleven family practices, the person (HCA or physician) who, according to the cooperation agreement, had taken over the local study coordination, was invited to participate in a semistructured interview. The evaluation was carried out with a summarizing content analysis. Results According to the cooperation agreement, HCAs took on the coordination function in four and doctors in seven practices; in at least two other practices, however, HCAs took on essential coordination functions. Important reasons for doctors to take over the coordination themselves were the routine workload of HCAs, part-time employment or concerns about the development of internal competition. With regard to addressing possible study participants, doctors saw better chances of success in themselves because of their authority. A reward for the HCAs was seen as desirable. Conclusions In the accompanying study, the doctors were often reluctant to pass on important functions to the HCA. The successful integration of HCAs in clinical trials appears to be a complex task that requires a respectful and trusting cooperation between the participants that grows over time. [ABSTRACT FROM AUTHOR]

Background Health care assistants (HCA) are the first point of contact for patients in family physician practices. The presented work deals with the SARS-CoV2 pandemic from the perspective of HCA and the possible conclusions from their experiences. So far no systematic study has investigated this subject yet. Methods Practices in four German federal states were randomly selected and HCAs were asked to participate in guided telephone interviews. The interviews were analysed qualitatively according to Kuckartz. Results In 2020, from August to December, 28 interviews were conducted with 34 HCAs (23 single, 4 double and one triple interview). The HCAs reported additional work due to the pandemic: organizational restructuring to ensure compliance with hygiene guidelines, increased need of advice, testing, new billing procedures, procurement of protective clothing, and information while information flow was experienced as unstructured. Financial losses in the practices due to patient absenteeism, fear of infection, private stress factors and lack of appreciation on the part of politics and society were the main concerns of the interviewees. Patient care in the practices was assessed as assured, but negative effects for patients were seen due to the suspension of early detection screenings. The care of SARS-CoV-2 infected patients was mostly well managed. Conclusions To support HCAs in the pandemic, relief is needed: testing/vaccination centers, clear testing and billing rules. To increase safety, sufficient protective equipment and comprehensible and reliable information for HCAs and patients are important. An intensive exchange within the team helps to cope with the new demands in the course of the pandemic. Appreciating the extra work of HCAs during the pandemic (not only) by means of bonus payments could contribute to strengthening the reputation of the profession. [ABSTRACT FROM AUTHOR]

Background Trained practice personnel play an important role in successfully recruiting patients and carrying out health services research in family medicine. Up to now, little is known about the everyday tasks performed by health care assistants (HCA) when trials are conducted in family practices. Methods In 2017, a cross-sectional survey of HCAs was used to find out how responsibilities are divided up when trials are conducted in family practices. The survey was conducted during a practice visit to prepare practice personnel for their participation in a prospective cohort study. Some of the questions concerned the experiences HCAs had made during previous trials. The collected data were evaluated descriptively. Results The HCAs were responsible for most of the administrative work, many of which involved direct contact with patients, for example, in making appointments (81 %), collecting questionnaires (74 %), gathering signatures (59 %) and sending out invitations (55 %). According to the HCAs, the physicians took sole responsibility for checking inclusion and exclusion criteria and carrying out explanatory discussions in 30 % of cases. In- and exclusion criteria were checked by both physician and HCA in 21 % of cases, while they shared responsibility for explanatory discussions 26 % of the time. The HCAs said they were solely responsible for these tasks in 29 % and 28 % of cases respectively. Conclusions It would appear that HCAs are not only responsible for administrative work but also for providing information and orientation to patients. Physicians and HCAs both require basic training in Good Clinical Practice (GCP), which should also explicitly deal with the distribution of responsibilities. [ABSTRACT FROM AUTHOR]

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Copyright of HeilberufeSCIENCE is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The coronavirus pandemic did not only result in changes in the provision and utilization of health care services in general practice but also in an increased workload for physicians and medical practice assistants. The VeCo practice study retrospectively explores the experiences of both professional groups two years after the start of the pandemic., Methods: In March and April 2022, general practitioners and medical practice assistants in the three German federal states of Berlin, Brandenburg and Thuringia were asked to complete a paper-based questionnaire., Results: 657 general practitioners and 762 medical practice assistants completed the questionnaire. Both professional groups agreed to statements indicating a reduction in regular health care provisions. Nevertheless, 74% of the physicians and 82.9% of the medical practice assistants considered the health care provided to their patients during the pandemic as good. This was only possible through considerable additional effort and stress. While more than half of both groups reported that work was still enjoyable, three quarters of both groups stated that the challenges arising from the pandemic outstripped their capacity. Both groups would like to receive more recognition from society (medical practice assistants 93.2%, general practitioners 85.3%) and from their patients (87.7% and 69.9%, respectively)., Discussion: General practitioners and medical practice assistants reduced regular health care provision but were still able to maintain a good quality of care for their patients during the pandemic. It became clear that more appreciation and adequate financial compensation are necessary to ensure long-term sustainability of GP care., Conclusion: The subjective view of general practitioners and medical practice assistants on their health care provision shows that appreciation and adequate financial renumeration, particularly when working under most difficult conditions, are necessary to increase the attractiveness of a career in general practice, for both physicians and medical practice assistants., (Copyright © 2023. Published by Elsevier GmbH.)

Background: Staff appraisals can provide employees and their supervisors with the opportunity to improve their communication and collaboration. However, one can assume that staff appraisals are not yet common instruments for human resources management in physician practices. The aim of this study was to develop a discussion guide for medical assistants (MAs) in general practices to support MAs in preparing, carrying out and documenting staff appraisals., Methods: MAs were recruited through their professional organization [Verband medizinischer Fachberufe e. V.] and social media (06/2020-10/2020). An early draft of the discussion guide was devised comprising an introduction, a checklist for logistic preparation, a documentation sheet and a section to prepare the content of the meeting. The discussion guide was revised based on interviews with MAs who also rated the instrument. Data collection, analyses and the revision of the guide were carried out in an iterative process to the point where no further significant suggestions for improvement were made., Results: In total, 20 interviews were conducted. Revisions were based on recommendations pertaining to a) how to interact with the supervisor (e. g., raising awareness of and responding to changes of the topic; anticipating counterarguments, scheduling of follow-up meetings), b) the choice of topics, c) additional measures to respond to MAs' needs (e. g., rotation to distribute tasks), and d) the preparation of the staff appraisal (e. g., rehearsals with an experienced colleague). Both the likelihood to use the guide in the future and its usefulness for staff appraisals were considered to be high., Discussion and Conclusion: We developed a discussion guide for and with MAs in general practices which can be helpful in preparing, conducting and documenting staff appraisals. This serves the purpose of bringing one's psychosocial working conditions to the supervisor's attention and to possibly improve them. To further improve the tool, future research should explore the experiences of MAs and physicians who actually use the discussion guide., (Copyright © 2022. Published by Elsevier GmbH.)

Copyright of Medizinische Klinik (Urban & Vogel) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Pragmatic randomized controlled trials are able to make an essential contribution to the further development of evidence-based treatment recommendations for primary care patients. However, drug trials are regulated by specific guidelines and have not yet become a routine task in GP practices. Within the scope of a multi-center, double-blind, randomized controlled trial on treating urinary tract infections in women with and without antibiotics (REGATTA), the feasibility of pharmaceutical studies in GP practices was evaluated by means of a questionnaire sent out to participating physicians and practice nurses., Methods: Using a self-designed, non-validated questionnaire, the perspectives, attitudes and experiences of participating physicians and practice nurses were assessed anonymously. In this way, we identified both hindering and beneficial factors affecting the conduct of drug trials in German GP practices., Results: 39 physicians and 48 practice nurses participated in the survey. 95 % of the physicians and 88 % of the practice nurses indicated that the implementation of drug trials with all their regulatory requirements is, in principle, possible in GP practices. In particular, the high amount of time and documentation necessary were identified as barriers. The implementation can be facilitated by formulating a research question that is relevant to practice and patients and by support from the study center., Conclusion: Although participation in a drug trial is an additional burden in everyday practice, it is considered feasible and worthwhile by the GPs and practice nurses involved. Due to an assumed selection bias, the predominantly positive experiences of the respondents may be overestimated and transferable only to a limited extent., (Copyright © 2022. Published by Elsevier GmbH.)

Introduction: Against a background of falling staff levels, rising care needs and the expectation that health care assistants (HCAs) are to be more actively involved in the provision of health care in the future, job satisfaction plays an important role in motivating HCAs to pursue the profession over the long term., Question: How satisfied are HCAs with various aspects of their work and what socio-demographic factors have an influence on job satisfaction?, Methods: The data analysed was obtained from six different research projects (2011-2017). In all the projects, the job satisfaction of HCAs was surveyed using a standardised seven-step Warr-Cook-Wall questionnaire. The analysis of the 10 items was carried out both descriptively and using ordinal regression analysis to identify predictors., Results: Total of 2,371 HCAs were satisfied with their job situation (mean 5.2± 1.6), whereby satisfaction was lowest with regard to salary (mean 3.73± 1.9) and employee recognition (mean 4.76± 1.8). HCAs that had completed additional training to become specially qualified Health Care Assistants in the Family Practice (VERAH) or Non-physician Practice Assistants (NPA) (n=452) were more satisfied in their jobs in almost all respects, compared to health care assistants that had no additional qualification (n=1,676) (mean 5.67± 1.4 vs. 5.16± 1.5, p ˂ 0.00). Overall satisfaction was positively influenced by higher age, qualification as a VERAH/NPA, higher workload, and urban location of the practice., Conclusion: Measures to raise the attractiveness of the profession of HCA might include an increase in possibilities to undergo additional training, appropriate remuneration and adequate employee recognition. In this way, the largest occupational group in outpatient care could be provided with a satisfactory professional future., (Copyright © 2021. Published by Elsevier GmbH.)

Background: The delegation of traditional GP tasks to qualified medical assistants (MFA) includes several modalities based on extended qualification curricula known as "Nicht-ärztliche Praxisassistentin" (NäPa) [non-physician practice assistant], also known as the "Entlastende Versorgungsassistentin" (EVA) and the "Versorgungsassistentin in der Hausarztpraxis" (VERAH and VERAH Plus) [professional healthcare assistants in the family practice]. Delegation to MFA has gained importance in recent years due to an increasing workload of general practitioners in Germany., Objectives: This article examines the characteristics of general practitioners (GPs) currently delegating activities to MFAs with and without extended qualification based on the three mentioned modalities (EVA, VERAH and VERAH Plus). In addition, we explore whether the delegated activities are delivered in the office, at the patient's home or in the nursing home and how GPs perceived the potential of future delegation., Materials and Methods: Between April and August 2016, we conducted an anonymous postal survey of a representative randomized sample of general practitioners in North Rhine-Westphalia (n = 2,404). The questionnaire contained questions about practice staff, setting for delivery of the delegated activity as well as the perceived added values of and barriers to delegation. We compare characteristics of GPs delegating to MFA with extended qualification to those delegating to standard qualified MFA., Results: The response rate was 32 % (n = 762). Almost one third of the respondents (n = 239) delegated tasks to MFAs with extended qualification. These GPs are more likely to be younger and male and less likely to be working alone in individual practice. They delegate more activities to be delivered in all settings than GPs employing MFAs without extended qualification., Discussion and Conclusions: GPs benefit from delegating to MFA with extended qualification as shown by the associated added values and setting of deployment for delivery of tasks. Delegation to non-medical staff should be considered by more GPs as a means of supporting healthcare delivery. In addition to legal changes, further procedures are needed to encourage GPs to get more actively involved with the issue of delegation and consider to further develop the competence of their staff and deploy them accordingly., (Copyright © 2020. Published by Elsevier GmbH.)