Ms Jolyn Johal1,2, Dr Heather Block1, Dr Ali Dymmott1, Dr Elsa Dent3, Helen Exley2, Prof Stacey George1,2
1Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia, 2Adelaide PHN, Adelaide, Australia, 3Institute for Evidence-Based Healthcare, Bond University, , Australia
Biography:
Jolyn is a PhD student who is exploring primary care delivery in residential aged care homes in Australia, as part of an enterprise PhD co-funded by Flinders University and Adelaide PHN. She is an Accredited Practising Dietitian who has worked as a Senior Dietitian at the University Hospital in Singapore for 6 years. Since moving to Adelaide, she has worked in multiple research and clinical roles, including as an Aged Care Dietitian in residential aged care facilities in Adelaide, which was what sparked her interest in pursuing a PhD in primary care in residential aged care facilities.
Abstract:
Background:
In Australia, older adults are entering residential aged care homes (RACHs) older and frailer. Primary care practitioners are well placed to meet their complex needs to improve health and reduce health system demands, yet levels of services are insufficient in RACHs. This scoping review aimed to identify barriers and enablers to primary care access and adoption in Australian RACHs.
Methods:
A systematic approach in line with JBI methodology was adopted. Medline, CINAHL, AgeLine, Cochrane, Scopus, JBI, and Google Scholar were searched for articles in the past 5 years.
Results:
Of 1705 unique records screened, 28 primary studies were included, which were predominantly qualitative or mixed methods. They described barriers and enablers to general practitioner, nurse practitioner, pharmacy, allied health, oral health and dental services, which can be classified into eight intertwined categories: Policy Level, 1. Funding and Resources; Organisational Level, 2. Employment and Service Models, 3. Referrals, Pathways, and Platforms, 4. Management and Culture, 5. Collaboration, Coordination and Communication; Individual Level, 6. Workload, Job Satisfaction and Security, 7. Attributes, Skills and Preparedness for Role, 8. Recipient Needs, Attitudes and Preferences.
Conclusions:
Barriers and enablers to primary care services in RACHs are interconnected and span policy, organisational and individual levels. Future initiatives may tap into existing resources/tools to proactively tackle the identified barriers, while weaving identified enablers into strategies (e.g., co-designing service models involving regular planned visits). As aged care reforms bring opportunities and challenges, future studies are warranted to evaluate their impact and adapt service delivery to benefit residents.