| Origin | Domains | Quote | |
|---|---|---|---|
| GP | Patient | ||
| 1. Personal connection | |||
| X | X | Organise introductory meetings | P: ‘When I visit my GP, he does not look at me and constantly looks at his screen. My husband and I both had this experience. Is my GP really interested in me and my problem?’ |
| X | Improve open consultation and listening skills | ||
| X | Perform home visits | ||
| X | Ensure the EMR is up to date and is read by GPs | ||
| X | Have a personal connection between GP and patient | ||
| 2. GP accessibility and availability | |||
| X | Implement e-health: consultation by video calls and emails | GP: ‘Personally, I am available to terminal patients directly or via colleagues. If this is not possible due to circumstances, I communicate this with my patient. In my experience, the thought that your expertise is within reach is comforting to these patients.’ | |
| X | Organise walk-in hours with own GP | ||
| X | Ensure direct GP accessibility and availability outside office hours for own patients with complex needs, particularly palliative care needs | ||
| X | Reduce waiting times for own GP | ||
| X | X | Reduce part-time employment | |
| 3. Communication about (dis)continuity | |||
| X | X | Communicate GP availability and staff changed to the patients of the practice | P: ‘I would consider it very pleasant if the website showed the office hours of our GP and the availability, that is, holidays. Preferably a notification well ahead of the absence so that I am not unexpectedly confronted with my GP’s absence when I call my practice for an appointment.’ |
| X | Encourage patients to ask for their own GP when scheduling appointment | ||
| X | Inform patients about the aim and structure of the out-of-office hours care | ||
| 4. GP responsibility | |||
| X | X | Promote a proactive GP attitude by periodically, or on occasion, initiating contact instead of depending on patient initiative | P: ‘Unfortunately, we do not have a “total body doctor”. However, an annual check-up combined with a positive consultation experience would be appreciated. In particular for older people, just like a technical examination for cars!’ |
| X | Stimulate GPs to only prescribe recurrent prescriptions for their own patients | ||
| X | X | Instruct assistants to schedule patients with follow-up consultations with same doctor, barring emergency consultations | |
| 5. Triage dependent on severity and urgency | |||
| X | X | Instruct assistants to schedule complex patients with same doctor, barring emergency consultations | P: ‘The role of the practice assistant is crucial in my opinion. She has to compromise between a (too) busy schedule and the (non)importance of seeing your own GP.’ |
| X | Optimise the EMR to help assistants with scheduling, that is, preferred GP pop-up | ||
| X | Plan small medical issues or emergencies with locums or nurse physicians to give regular GP more time for complex cases | ||
| 6. Time for the patient | |||
| X | Increase the compensation per consultation | GP: ‘Improve the organisation of out-of-office hours care, in particular with regard to GP with practices. During the day, continuity is essential, emergency care is less continuity-dependent. Enable combining out-of-office hours care with day care, and so create a small workload and provide flexibility.’ | |
| X | X | Reduce administrative burden and work load | |
| X | Reform organisation of out-of-office hours care | ||
| X | X | Increase the time per consultation | |
| X | Increase GP availability for direct patient care to at least 3 days a week | ||
| 7. Actions by third parties | |||
| X | Introduce a nationwide EMR | GP: ‘Sufficient transfer of care between inside and outside office care. For example, by having a nationwide EMR [...] In my opinion, the IT should be adapted drastically to the 21st century.’ | |
| X | X | Optimise collaborations with hospitals and mental healthcare organisations | |
| 8. Team continuity | |||
| X | X | Promote small-scale practices: fewer patients and fewer GPs per practices and stimulate regular employment | GP: ‘In a small-scale practice, personal continuity is better ensured, because the assistants know their patients and the lines of communication are shorter. In a large health centre, I supervised several nurse physicians, medical trainees, GP trainees etc. Although I liked these collaborations, the continuity of care was limited.’ |
| X | X | Reduce changes of doctors by stimulating regular employment | |
| X | X | Improve working atmosphere | |
| X | Increase pay of support staff to improve job attractiveness | ||
| X | X | Ensure a sufficient number of staff | |
| 9. GP vocational training | |||
| X | Include importance of personal continuity in GP education | GP: ‘[…] More attention in education programmes that being a GP is not ‘just’ a job, that it requires a certain dedication and servitude (like judges). This should be a part of the application procedure.’ | |
EMR = electronic medical record.