Table 4 Issues related to health service encounters raised by chronically ill patients, and suggestions of patients, carers and health care professionals for overcoming them
Challenges raised by participants | Patients’ and carers’ suggestions | HCP suggestions and solutions |
|---|---|---|
•Communication and delivery of information |  | |
Inadequate explanation of illness, prescribed medication and side effects | HCPs provide patients with a written care plan in plain language | Improvement of health literacy |
Confusing and conflicting information provided | Professional organisations endorse guidelines | Better communication between different professional groups |
Practical examples of appropriate diets and concepts not provided (e.g., Glycemic Index) | NS | NS |
Lectures given by HCPs seem pointless | More interactive learning experiences such as support groups | Improved communication between patients and HCPs |
No explanation given about the side effects of medication | NS | Enhanced information technology infrastructure |
No help provided in accessing internet | NS | Enhanced information technology infrastructure |
CALD participants want information in their own language | GPs increase their awareness of cultural issues and exercise care in providing information to CALD patients | Improved communication between professionals and CALD groups |
HCP seen as inflexible and unaccommodating | NS | Need to improve accountability between service providers |
Outdated information about disease management | NS | Enhanced information technology infrastructure |
Insufficient information about community resources provided | Provide access to relevant data bases | Better co-ordination of care |
Poor communication by interns | Improved supervision by specialists before diagnosing conditions with a poor prognosis such as cancer | Need to improve accountability between service providers |
•Organisation of service delivery and waiting time to see HCP’s |  | |
Arranging appointments in urgent situations | On call doctors to give information and directions | Need to reduce communication gaps |
Arranging appointments when new symptoms appear | Electronic booking systems | Enhanced electronic infrastructure |
Long waiting time to make appointments and delays in seeing HCPs | Phone or SMS patients to inform them of possible delays | Need to reduce communication gaps |
Inflexible appointment times | Greater flexibility | NS |
Rigid eligibility criteria which exclude some people from inpatient or outpatient care | Revision of eligibility criteria of services to ensure they cover patients at different states of disease | Need to improve communication between various service providers |
•Facilitation of self care |  | |
Insufficient support for self-care | NS | NS |
Insufficient written information about what to do in different conditions | Handbooks and disease specific information packages | Enhanced communication |
Insufficient follow up and monitoring of patient’s condition as well as new symptoms | GP’s and case coordinators follow up, from hospital or private health insurance | Need to improve co-ordination of care by service providers |
•Single illness focus |  | |
GPs and specialist focus only on the immediate symptoms and conditions | Holistic approach to patient’s conditions with careful review of medical history | Need to improve fragmentation of services |
•Inclusion of patients and carers in decision making |  | |
Lack of trust in patient’s knowledge and understanding of signs and symptoms | NS | Need to improve health literacy |
Patients don’t feel hopeful and motivated about the future | Provide up to date information and review of the latest developments in lay language | Need to improve patients’ focus on management of conditions |
Failure to ask patients about their tolerance of available treatments | Â | Be sure to ask patients about any tolerance or compliance issues before prescribing medications |