Quality circles to identify barriers, facilitating factors, and solutions for high-quality primary care for asylum seekers

Lack of exchange of relevant information between providers

Trustful interprofessional cooperation of university and local resident physicians in one clinic

Consequent use of a previously introduced paper-based patient health record¹¹

Loss of information due to insufficient documentation/poor readability

Dual documentation in two record systems (one of the university hospital, one of the local resident doctors)

Unclear how to archive medical and laboratory results

Availability of a previously introduced paper-based personal health record¹¹

Clarification with the university hospital’s administration to only use one documentation software

Design of a pattern to standardise documentation in the software

Software training for resident physicians was performed

Installation of a software module to import laboratory results and training of staff how to use it

Unclear how to handle patients with psychotropic dependency

Shortcomings in assuring follow-up visits and continuity of care

Lack of guidelines or standards for frequent reasons of consultation and infectious diseases

Lack of time to address psychosocial causes of symptoms

Interprofessional, interdisciplinary team

Composition of a detoxification contract in various languages that all patients with psychotropic dependency have to sign

Exchange with staff of advisory services for asylum seekers for social and legal issues during a quality circle meeting

Guideline for diagnostics of infectious diseases will be elaborated in cooperation with the Department of Tropical Medicine

Lack of interpreters

Lack of support staff for medical and administrative tasks

Support by medical students

Employment of interpreters for frequent languages

Employment of nurses

Lack of drug supplies and vaccinations

Shortage and lacking standardisation of necessary equipment

Lack of well-functioning soft- and hardware (such as record system and printers)

Existence of an in-house pharmacy

Adequate facility

Design of a checklist and implementation of a daily tour through the facility by a designated person to assure availability of equipment

Uncertainties among healthcare professionals about the scope of care covered by Asylum Seekers’ Benefits Act

Uncertainties related to issuing medical certificates with relevance for the asylum procedure

Invitation of an advocate specialised in asylum law is planned

Unclear self-concept of the walk-in clinic: emergency department versus primary care practice

Work is considered a meaningful task

Work is considered interesting because of wide range of cases

High level of commitment from all staff

High number of family members attending consultations

Cultural differences in communication and behaviour

Thankful patients

Workshop on cultural competence was offered

Lack of discretion (staff comes in without knocking)

Room divider was bought

Registration: lack of triage mechanisms to identify patients with acute conditions

Registration: previous healthcare provision is not considered leading to redundancies in diagnostics and channeling to wrong specialisation

Emergency case is not complete

Checklist for content of emergency case and a responsible person for regular controls were defined