Welcome to the 26th WONCA Europe Virtual Conference Programme Scheduling

The conference will officially run on Central European Summer Time (CEST). To convert the conference times to your local time Click Here

The viewing of sessions and E-Posters cannot be accessed from this conference calendar. All sessions and E-Posters are accessible via the Main Lobby in the virtual platform. 

Icons Legend:  - Fully Live Session  - On Demand with Live Q&A  - Pre-Registration Required
 

            

Displaying One Session

Hall 6

ORAL PRESENTATIONS
Session Type
ORAL PRESENTATIONS
Date
09.07.2021, Friday
Session Time
10:30 AM - 12:00 PM
Room
Hall 6
Session Icon
Pre-Recorded with Live Q&A

FINDING MEANING IN THE CONSULTATION

Date
09.07.2021, Friday
Session Time
10:30 AM - 12:00 PM
Room
Hall 6
Lecture Time
10:30 AM - 10:41 AM
Session Icon
Pre-Recorded with Live Q&A

Abstract

Abstract Body

The ability to offer individualised care to patients remains a key component of general practice. This is more important now than ever, in the context of remote consulting. Many consultation frameworks address only generic skills and largely ignore the extent to which the clinician is able to establish a human connection, to understand what an illness means to their patient and to help them navigate through it, particularly when there is uncertainty and complexity within the consultation. We therefore introduce a new four domain model whose aim is to encourage consultations that are individualised and create meaning for both patient and clinician.

Aim and Objectives

We plan an interactive session where we use case studies (anonymised but based on real life scenarios), to invite delegates to consider questions such as:

Is continuity of care still practical and important?

Do I feel comfortable in using myself as part of the treatment for my patients (doctor as drug)?

What are the limitations of 'Ideas, Concerns, Expectations' ?

Do we need something more to help us understand our patients’ experiences and help them to make sense of their situation?

How can we have better interactions and promote individualised care?

We go on to describe a new four domain consultation model, which incorporates the hermeneutic window where assumptions, meanings and roles are interpreted in a way which is particular to the individual. Our article, 'Finding Meaning in the Consultation' which introduced this new model was published in the British Journal of General Practice in 2020.

Hide

OPTIMA FORMA – TOWARDS A PATIENT-CENTRED MULTIMORBIDITY APPROACH FOR CHRONIC DISEASE MANAGEMENT IN PRIMARY CARE

Date
09.07.2021, Friday
Session Time
10:30 AM - 12:00 PM
Room
Hall 6
Lecture Time
10:41 AM - 10:52 AM
Session Icon
Pre-Recorded with Live Q&A

Abstract

Abstract Body

Background:

To reduce the burden of chronic diseases on society and individuals, European countries implemented disease management programmes (DMPs) that focus on a single chronic disease. However, (i) the scientific evidence that these DMPs reduce the burden of a chronic disease in terms of health-related quality of life is not convincing, (ii) patients with multimorbidity may receive overlapping or conflicting treatment advice, and (iii) the single disease approach conflicts with the core competencies of primary care, i.e. medical generalistic, person-centred, and continuous care. The aim of this study was to develop a holistic, person-centred and integrated approach for the management of patients with chronic diseases and multimorbidity in primary care.

Methods:

A mixed-methods study was conducted in the Netherlands from January 2019 to December 2020. First, we performed a scoping review to construct a theoretical model. Second, 57 healthcare professionals commented on the model in online qualitative questionnaires. Third, 9 patients with chronic conditions were interviewed on the model by phone. Finally, the model was presented to 3 local primary care cooperatives and finalized after their comments.

Results:

A stepwise software-supported approach was developed, including (i) assessing patient’s integral health status using (web-based) questionnaires and physical measurements; (ii) discussing the results with a case-manager, after which (iii) treatment goals are formulated, suitable interventions in the primary care network are selected and an evaluation is planned.

Conclusion:

We developed a holistic, person-centred, integrated approach for the management of patients with chronic diseases and multimorbidity in primary care. This approach will be tested in a pilot study in 2021 to establish its feasibility and potential effects.

Hide

CONTINUITY OF RELATIONAL CARE IMPROVES HEALTH: NATIONAL INTERVENTION RESULTS AND A TOOLKIT TO HELP YOU IN YOUR OWN PRACTICE

Date
09.07.2021, Friday
Session Time
10:30 AM - 12:00 PM
Room
Hall 6
Lecture Time
10:52 AM - 11:03 AM
Session Icon
Pre-Recorded with Live Q&A

Abstract

Abstract Body

Background

Evidence shows seeing the same clinician over time reduces morbidity, mortality, and the use of health resources. It’s beneficial for both patient and clinician. The Health Foundation funded five UK sites, covering 0.5 million patients, (between 2019 and 2021) to explore how to improve levels of continuity of care and to assess the impact. In this presentation, we share the learning. It includes a comprehensive Toolkit providing clear, practical advice from healthcare colleagues and patients

Aims and learning objectives

To increase awareness of the link between continuity of care and positive outcomes for both patients and clinicians

To share the outcomes of the Health Foundation continuity programme.

To present the Toolkit to enable participants to support both practice staff and patients with their continuity of care improvement journey.

Methods and timetable

We propose to:

Review the evidence that relational continuity improves healthcare (15 minutes)

Outline the findings from the Health Foundation Programme. (15 minutes)

Host an Interactive Session including a demonstration of the Toolkit (60 minutes)

We will take participants through sections of the Toolkit and using the chat function and polls enable reflections and questions on their own practice.

Participants can try the Toolkit prior to its national launch with the UK Royal College of General Practitioners in Summer 2021.

Results/Conclusions

Participants will learn why and when continuity of care is important to both patient and clinician wellbeing. Using the learning from the Health Foundation Programme and access to the new national Toolkit we will equip them to embark on improving continuity of care in their practice.

Hide

PERSON-CENTRED CARE IN PRIMARY CARE: WHAT WORKS FOR WHOM, HOW, AND IN WHAT CIRCUMSTANCES?

Date
09.07.2021, Friday
Session Time
10:30 AM - 12:00 PM
Room
Hall 6
Lecture Time
11:03 AM - 11:14 AM
Session Icon
Pre-Recorded with Live Q&A

Abstract

Abstract Body

Background and purpose

Person-centred care (PCC) is the corner stone of primary care. However, insights into when PCC does (not) work, for whom, why and how, are lacking. In this study the objective is to identify the relationships between the context, the mechanisms, and the outcomes resulting from this interaction by means of rapid realist review (RRR).

Methods

Peer-reviewed and non-peer-reviewed literature reporting on PCC in primary care were included. Selection and appraisal of documents was based on relevance and rigour according to the Realist and Meta-Review Evidence Synthesis: Evolving Standards (RAMESES) guidelines. Data on context, mechanisms, and outcomes (CMO) were extracted. CMO-configurations were set up to establish a programme theory (PT).

Results

The PT demonstrates interaction of multiple context items, such as addressing PCC (including (low) health literacy) in the care policy, patients having a social support network, and training of healthcare providers (HCPs). Information technology optimization is needed to tailor patient information, make it available, and to integrate information for HCPs. Mechanisms include taking into account the patient preferences and social/cultural differences, involving patient groups in the organization of care and the development of (new) tools, building strong collaborations between HCPs and patients to stimulate shared decision-making, and offering tailored communication and self-management support. The interaction between context and mechanisms lead to outcomes: higher compliance, better health outcomes, and provision of tailored care.

Conclusion

Embedding all factors within their mutual coherence is necessary for effective PCC in primary care. In doing so, this study proposes a PT.

Hide

HOW IS “CENTREDNESS” CONCEPTUALISED IN PEER-REVIEWED HEALTH LITERATURE? A SCOPING REVIEW

Date
09.07.2021, Friday
Session Time
10:30 AM - 12:00 PM
Room
Hall 6
Lecture Time
11:14 AM - 11:25 AM
Session Icon
Pre-Recorded with Live Q&A

Abstract

Abstract Body

Background and purpose

Patient-centredness is recognised as a core principle of primary care. Yet, the definitions of patient-centredness, including whether the preceding word is rightly patient-, person-, client-, or family, vary considerably. This review synthesises the concept of centredness across healthcare settings, disciplines, and nations to provide further conceptual clarity.

Methods

Scoping review following the JBI methodology to include literature about centredness within healthcare in five databases explicitly using “centredness” and “concept” within the search string. The method was prospectively uploaded to OSF. Articles were included if the concept of centredness was clearly detailed, and excluded if they focused solely on implementation. Extraction items were guided by LeMoigne’s Systemic Theory. The initial centredness coding tree was based on Mead and Bower’s framework. The coding tree was iteratively enriched as new concepts arose during two-weekly team meetings.

Results

23 004 studies were screened, 467 full text articles were reviewed, 157 studies met inclusion criteria. Preliminary concepts include: Sharing power; Sharing responsibility; Relationship; Seen as a person; Biopsychosocial; Provider as a person; Co-ordinated care; Access; Continuity of care. Few papers included the patient voice. Most justified the focus on centredness for efficiency and improved health outcomes; values of respect, equity and autonomy were common.

Conclusions

Our review includes all health disciplines and brings contextual understanding to centredness across different levels of the healthcare system. Beyond the variability in terminology, values may offer some consistency across disciplines. Our synthesis can assist clinicians, researchers and policy makers to understand centredness from a variety of perspectives across healthcare settings.

Hide

HOW TO PROVIDE PERSON-CENTERED CARE WITH A COMPUTER DECISION SUPPORT SYSTEM DURING TELEPHONE TRIAGE IN OUT-OF-HOURS PRIMARY CARE.

Date
09.07.2021, Friday
Session Time
10:30 AM - 12:00 PM
Room
Hall 6
Lecture Time
11:25 AM - 11:36 AM
Session Icon
Pre-Recorded with Live Q&A

Abstract

Abstract Body

Background:

Practicing person-centered care can be challenging for triage nurses during telephone triage at out-of-hours services in primary care (OHS-PC). In the Netherlands triage nurses use a computer decision support system (CDSS) called the Netherlands Triage Standard (NTS), which is intended to support clinical reasoning and decision making of triage nurses. Yet, this CDSS may also trigger interactional workability dilemmas if there is incongruence between the tool and the triage nurses’ decision making. Furthermore, the CDSS can give rise to interactional difficulties due to inefficient use of multiple choice either/or-questions by triage nurses.

Aim and learning objectives:

This workshop will provide insight into the difficulties of working with a CDSS while at the same time trying to provide person-centered care during telephone triage.

The learning objectives of this workshop are:

(i) Awareness on the occurrence of interactional workability dilemmas;

(ii) Knowledge of adaptive work strategies applied by triage nurses;

(iii) Awareness of undesirable implications of either/or-questions on the interaction.

Methods and timetable:

Results of an audio-stimulated recall interview study with 24 triage nurses, and a conversation analysis of 68 triage conversations will be presented (±30min). Based on these results, we will interactively discuss the similarities and differences in triagists’ working strategies among various countries when applying a CDSS (±30min), and brainstorm about possible solutions aiming at increasing person-centered care (±30min).

Conclusions:

This workshop focuses on struggles with CDSS when providing person-centered care, and will interactively discuss possible solutions for improvement of telephone triage at OHS-PC.

Hide

LIVE Q&A

Date
09.07.2021, Friday
Session Time
10:30 AM - 12:00 PM
Room
Hall 6
Lecture Time
11:36 AM - 11:56 AM
Session Icon
Pre-Recorded with Live Q&A