General practice role in community care

WORKSHOP

Maciej Godycki-ĆwirkoJarosław Krawczyk

Department of Family and Community MedicineMedical University of Lodz, Poland

What is community?

–A way of living

–One’s hometown

–One’s country

–Transnational organisations (EU)

What is community?

–A group of people living in the same defined area sharing the same basic values, organization and interests.

–A population which is geographically focused but which also exists as a discrete social entity.

What is community?

–The area outside of a hospital or other long-term health care institution.

Community care or

care in community?

Community care or care in the community?

Services offered by health institutions:routine health careaccidents and emergencies serviceshome visitsdriving license testsinsurance medical checks and certificateschild immunization

Community care or care in the community?

Services offered by other institutions:domiciliary care serviceshome help servicesday centre provisionaids and adaptationsresidential and nursing carehospital discharge arrangements meals-on-wheels services assessment of care needs

Community participation

A social process where people activelypursue identification of their needs, take decisions and establish mechanisms to meet those needs.

Five dimensions influencing participation: – needs assessment– leadership– resource mobilization– management– organization

Community carewith

community participation

CASE

A home visit to a 58-year-old man released from the hospital

Reason for the call: immobile, mild dysuria Had a cardiac arrest/IHD 5 years agoDivorced, lives with his son, unemployed

A 58-year-old man released

from the hospital

Health needs:

?

Exercise

Perform a medical assessment

• Use: – the SOAP approach– write a hypothetical note

A 58-year-old man released from the hospital

SUBJECTIVE: Mild dysuria, wound pain, depressive, weak, taking nitrates, a beta-blocker, ACEI, statin

• Other medical history:– Cardiac arrest/IHD 5 years ago

• Additional information:– Divorced– Living with his son– Unemployed

A 58-year-old man released from the hospital

OBJECTIVE:• pale• a bleeding and purulent wound in the

lower part of the abdomen• catheters in both kidneys• HR 68’, BP 120/70 • no other abnormalities

A 58-year-old man released from the hospital

ASSESSMENT (medical diagnosis):

• Tumor of urinary bladder (inoperative)

• Abdominal wound (neoplasm infiltration?)

• Anaemia (?)

• Stable IHD

A 58-year-old man released from the hospital

PLAN (medical needs):• Wound-dressing every two days

• Blood test

• Catheters need to be changed every

week at the local hospital ward

• Referral to a radiotherapy unit

• Prescription of medicines for IHD

A 58-year-old man released from the hospital

Community needs:

?

WORKSHOP

Assess the patient’s community care needs and access to community care services.

• Use: – The survey tool for needs assessment– The survey tool for services assessment

Plenary discussion

• The patient’s problems and community care needs

• Community care services

• The gap between community care needs and community care services