Treatment Harms in Paediatric Primary Care.

The aim of this study was to describe the epidemiology in children of harms detectable from general practice records, and to identify risk factors. The SHARP study examined 9076 patient records from 44 general practices in New Zealand, with an enrolled population of 210,559 patients. "Harm" was defined as disease, injury, disability, suffering, and death, arising from the health system.

Epidemiology of healthcare harm in New Zealand general practice: a retrospective records review study.

Objectives: To determine the epidemiology of healthcare harm observable in general practice records.

Design: Retrospective cohort records review study.

Setting: 72 general practice clinics were randomly selected from all 988 New Zealand clinics stratified by rurality and size; 44 clinics consented to participate.

Medication-related harm in New Zealand general practice: a retrospective records review.

Background: The extent of medication-related harm in general practice is unknown.

Aim: To identify and describe all medication-related harm in electronic general practice records. The secondary aim was to investigate factors potentially associated with medication-related harm.

Research using electronic health records: Balancing confidentiality and public good.

General practitioners are increasingly approached to participate in research and share de-identified patient information. Research using electronic health records has considerable potential for improving the quality and safety of patient care. Obtaining individual patient consent for the use of the information is usually not feasible.

Exploring the value of social network 'care maps' in the provision of long-term conditions care.

Objectives: There is renewed attention to the role of social networks as part of person-centred long-term conditions care. We sought to explore the benefits of 'care maps' - a patient-identified social network map of their care community - for health professionals in providing person-centred care.

Methods: We piloted care maps with 39 patients with long-term conditions in three urban and one rural general practice and two hospital wards.

Characteristics of a stratified random sample of New Zealand general practices.

INTRODUCTION Practice size and location may affect the quality and safety of health care. Little is known about contemporary New Zealand general practice characteristics in terms of staffing, ownership and services. AIM To describe and compare the characteristics of small, medium and large general practices in rural and urban New Zealand.

Moral Economy and Moral Capital in the Community of Clinical Practice.

This New Zealand study used focused ethnography to explore the activities of communities of clinical practice (CoCP) in a community-based long-term conditions management program within a large primary health care clinic. CoCP are the informal vehicles by which patient care was delivered within the program. Here, we describe the CoCP as a micro-level moral economy within which values such as trust, respect, authenticity, reciprocity, and obligation circulate as a kind of moral capital.

Training generalist doctors for rural practice in New Zealand.

Targeted postgraduate training increases the likelihood young doctors will take up careers in rural generalist medicine. This article describes the postgraduate pathways that have evolved for these doctors in New Zealand. The Cairns consensus statement 2014 defined rural medical generalism as a scope of practice that encompasses primary care, hospital or secondary care, emergency care, advanced skill sets and a population-based approach to the health needs of rural communities.

Shared care requires a shared vision: communities of clinical practice in a primary care setting.

Aims And Objectives: To understand how a vision of care is formed and shared by patients and the primary care professionals involved in their care.

Background: To achieve the best health outcomes, it is important for patients and those who care for them to have a mutual understanding about what is important to the patient in their everyday life and why, and what care is necessary to realise this vision. Shared or team care does not necessarily translate to a consistent and integrated approach to a patient's care.

Epidemiology of Patient Harms in New Zealand: Protocol of a General Practice Records Review Study.

Background: Knowing where and why harm occurs in general practice will assist patients, doctors, and others in making informed decisions about the risks and benefits of treatment options. Research to date has been unable to verify the safety of primary health care and epidemiological research about patient harms in general practice is now a top priority for advancing health systems safety.

Objective: We aim to study the incidence, distribution, severity, and preventability of the harms patients experience due to their health care, from the whole-of-health-system lens afforded by electronic general practice patient records.

Communities of clinical practice in action: Doing whatever it takes.

Burgeoning numbers of patients with long-term conditions requiring complex care have placed pressures on healthcare systems around the world. In New Zealand, complex patients are increasingly being managed within the community. The Community of Clinical Practice concept identifies the network of carers around an individual patient whose central participants share a common purpose of increasing that patient's well-being.

A Change in Students' Perceptions of Peer and Faculty Attitudes to Rural Medicine following the Introduction of a Rural Health Rotation.

Introduction. In 2000, the Dunedin School of Medicine (one of Otago Medical School's 3 clinical schools) introduced 7-week rural placement. A survey of students conducted before attending the placement showed that most students did not perceive faculty to have a positive view of rural health.

The Safe and Effective Clinical Outcomes (SECO) clinic: learning responsibility for patient care through simulation.

Background: This article describes a simulated General Practice clinic for medical students, which incorporates specific features to aid learning of clinical problem solving.

Description: We outline the overall objectives of the simulation, explain the concept, and describe how the clinic works. The clinic is novel in that it utilises clinical outcomes as measures for student success in the consultation.

Public and private funding of general practice services for children and adolescents in New Zealand.

Objective: To measure public and private funding of general practice services for New Zealand children.

Methods: Computerized records from 111 general practices provided private payments for 118,905 general practice services to children aged 6-17 years. Government subsidies and public insurance payments provided public funding amounts for seven services.

Rural hospitals in New Zealand: results from a survey.

Aim: To describe the variety and range of work that New Zealand rural hospitals perform, and to examine the factors that might influence either of these, including: the characteristics of the doctors who work in rural hospitals; the facilities available; and environmental factors (such as geographical isolation and the size of the catchment population).

Method: Structured postal questionnaire.

Results: There are about 44 rural hospitals in New Zealand, depending on definition.

Otago rural hospitals study: what do utilisation rates tell us about the performance of New Zealand rural hospitals?

Aim: To provide a description of the role and function of Otago Province's three main rural hospitals, utilising analysis of hospital discharge data for the period July 2001 to June 2002.

Methods: Calculation of hospitalisation rates based on analysis of information contained in the National Minimum Dataset (Hospital Events); Census data from Statistics New Zealand; and local knowledge of hospital utilisation by geographical district.

Results: A comparison between the rural Otago population and New Zealand (as a whole) show age-standardised hospitalisation rates of 19,847 vs 19,930 per 100,000, and a mean length of hospital stay of 4.

The new rural health curriculum at Dunedin School of Medicine: how has it influenced the attitudes of medical students to a career in rural general practice?

Aim: To evaluate the effect of the new fifth-year rural health curriculum developed at Dunedin School of Medicine on the attitudes of students to a career in rural general practice.

Methods: A structured questionnaire was administered to all fifth-year medical students immediately before and after participation in the rural health curriculum at DSM during 2000 and 2001.

Results: There were statistically significant positive changes in the students' responses to each question regarding their attitudes towards rural general practice.