Patient Care: Primary, Secondary, and Tertiary PDF

THE CONCEPT OF PATIENT CARE PRIMARY, SECONDARY AND TERTIARY PROFESSIONAL PRACTICE AND PATIENT CARE HMD 10502 ZULAILY YACOB  At some point or other, we...

THE CONCEPT OF PATIENT CARE PRIMARY, SECONDARY AND TERTIARY PROFESSIONAL PRACTICE AND PATIENT CARE HMD 10502 ZULAILY YACOB  At some point or other, we may have heard health professionals talk about primary, secondary or tertiary health care. These terms, which are used throughout the world, refer levels of care, for cases ranging from mild to serious. ZULAILY YACOB  Health care or healthcare is the maintenance or improvement of health via the prevention, diagnosis, and treatment of disease, illness, injury, and other physical and mental impairments in human beings. Health care is delivered by health professionals (providers or practitioners) in allied health fields. DEFINATIO Physicians and physician associates are a part of these health professionals. NS Dentistry, assistant medical officer, midwifery, nursing, medicine, optometry, audiology, pharmacy, psychology, occupational therapy, physical therapy and other health professions are all part of health care. It includes work done in providing primary care, secondary care, and tertiary care, as well as in public health. ZULAILY YACOB PRIMARY CARE The primary care level is the “gatekeeper”, the first point of medical consultation. As a patient we are usually seen by a primary care physician, also called a general practitioner or family physician. Primary care is provided at a doctor’s office, health center or Urgent Care center. The Emergency Room is also often a source of primary care for the un- or under-insured. ZULAILY YACOB  According to the New England Healthcare Institute, demand for primary care continues to grow as patients become older and sicker. At the same time, there’s an PRIMARY increasing shortage of general CARE practitioners. To meet the demand, physicians are starting to utilize nurse practitioners and physician assistants ( assistant medical assistant in Malaysia) ZULAILY YACOB  SECONDARY CARE Medical specialists and other health professionals, who typically don’t have initial contact with patients, provide secondary care. For example, a primary care physician might refer a patient to a cardiologist, rheumatologist, or a urologist or other specialty physician. Some secondary care physicians do not require a patient to have a referral from a primary care practitioner. ZULAILY YACOB SECONDARY CARE Another category of secondary care is hospital care, or acute care. The term covers care as an admitted patient in a hospital, a visit to a hospital ER, attendance in childbirth, medical imaging (radiology) services and care within an intensive care unit. Physical therapists, respiratory therapists, speech therapists, occupational therapists and other allied health professionals often work in secondary care. ZULAILY YACOB TERTIARY CARE Patients being treated requiring a higher level of care in a hospital may be considered to be in tertiary care. Physicians and equipment at this level are highly specialized. Tertiary care services include such areas as cardiac surgery, cancer treatment and management, burn treatment, plastic surgery, neurosurgery and other complicated treatments or procedures. A fourth level of care, quarternary care, is a more complex level of tertiary care. Uncommon, highly specialized and experimental treatments and procedures are considered to be at the quarternary care level. ZULAILY YACOB  GENERAL OUTLOOK OF PUBLIC HEALTH ZULAILY YACOB LEVEL OF CARE ZULAILY YACOB ZULAILY YACOB PATIENT CARE ZULAILY YACOB  1. Respect for patients’ values, PICKER’S preferences and expressed needs EIGHT Involve patients in decision- PRINCIPLES making, recognizing they are individuals with their own unique OF values and preferences. PATIENT- Treat patients with dignity, respect CENTERED and sensitivity to his/her cultural CARE values and autonomy. ZULAILY YACOB  2. Coordination and integration of care During focus groups, patients expressed PICKER’S feeling vulnerable and powerless in the EIGHT face of illness. Proper coordination of care can alleviate those feelings. Patients PRINCIPLES identified three areas in which care OF coordination can reduce feelings of vulnerability: PATIENT- Coordination of clinical care CENTERED Coordination of ancillary and CARE support services Coordination of front-line patient care ZULAILY YACOB  3. Information and education In interviews, patients expressed their PICKER’S worries that they were not being EIGHT completely informed about their condition or prognosis. To counter this fear, PRINCIPLES hospitals can focus on three kinds of OF communication: Information on clinical status, PATIENT- progress and prognosis CENTERED Information on processes of care CARE Information to facilitate autonomy, self-care and health promotion ZULAILY YACOB  4. Physical comfort The level of physical comfort patients PICKER’S report has a significant impact on EIGHT their experience. Three areas were PRINCIPLES reported as particularly important to OF patients: PATIENT- Pain management CENTERED Assistance with activities and daily living needs CARE Hospital surroundings and environment ZULAILY YACOB  5. Emotional support and alleviation of fear and anxiety PICKER’S Fear and anxiety associated with illness EIGHT can be as debilitating as the physical PRINCIPLES effects. Caregivers should pay particular attention to: OF Anxiety over physical status, PATIENT- treatment and prognosis CENTERED Anxiety over the impact of the illness on themselves and family CARE Anxiety over the financial impact of illness ZULAILY YACOB  6. Involvement of family and friends This principle addresses the role of family and PICKER’S friends in the patient experience. Family dimensions of patient-centered care were EIGHT identified as follows: PRINCIPLES Providing accommodations for family and friends OF Involving family and close friends in PATIENT- decision making CENTERED Supporting family members as caregivers CARE Recognizing the needs of family and friends ZULAILY YACOB  7. Continuity and transition Patients expressed concern about PICKER’S their ability to care for themselves after discharge. Meeting patient EIGHT needs in this area requires the PRINCIPLES following: OF Understandable, detailed information regarding medications, PATIENT- physical limitations, dietary needs, etc. CENTERED Coordinate and plan ongoing CARE treatment and services after discharge ZULAILY YACOB  8. Access to care Patients need to know they can access care when it PICKER’S is needed. Focusing mainly on ambulatory care, the following areas were of importance to the patient: EIGHT Access to the location of hospitals, clinics PRINCIPLES and physician offices OF Availability of transportation PATIENT- Ease of scheduling appointments Availability of appointments when needed CENTERED Accessibility to specialists or specialty CARE services when a referral is made Clear instructions provided on when and how to get referrals. ZULAILY YACOB SUMMRY ZULAILY YACOB ZULAILY YACOB