Decentralized diagnostics of beta haemolytic streptococci group A--introduction of a developmental model for microbiological consultation in primary health care

Talking at work--professional advice-seeking at primary health care centres

OBJECTIVES

To describe professional advice- and information-seeking at primary health care (PHC) centres.

DESIGN

Prospective cross-sectional data collection using semi-structured interviews. Statistical analysis of association between team-based and centralized organization, profession and pattern of advice-seeking.

SETTING

4 urban PHC centres in Ostergötland County, Sweden.

PARTICIPANTS

199 PHC centre staff members (25 doctors, 70 nurses, 49 nurses' aides, 12 medical laboratory technologists, 24 secretaries, 19 physiotherapists). Nine (4%) staff members did not participate in the study (4 doctors, 3 nurses, 1 nurses' aide, and 1 secretary).

MAIN OUTCOME MEASURES

Number of staff using an advice source.

RESULTS

For organizational advice, PHC centre managers were consulted at the centrally organized PHC centres, while staff at centres using team organization more often consulted outside sources. Having no one to ask for advice on patient communication was more common in the centralized organization. Regarding medical advice, only nurses' aides differed by consulting their own profession rather than doctors. For patient communication problems, the professions shared an intra-professional advice pattern.

CONCLUSIONS

The PHC centre staff maintain parallel overlapping networks of professional advice-seeking. The observed networks can also be seen to answer simultaneous demands from patients, the local health care administration, social services and professional authorities. Straightforward ways to develop the professional communication at PHC centres would be to visualize these multiple dependencies and to support their optimal function in the organization.