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Sequential simulation (SqS) of a patient journey: an intervention to engage GP receptionists in integrated care

Sequential simulation (SqS) of a patient journey: an intervention to engage GP receptionists in integrated care

Paice, Lis, Weldon, Sharon-Marie ORCID: 0000-0001-5487-5265, Ralhan, Shvaita, Bello, Fernando and Kneebone, Roger Lister (2015) Sequential simulation (SqS) of a patient journey: an intervention to engage GP receptionists in integrated care. In: International Journal of Integrated Care. Ubiquity Press. ISSN 1568-4156 (Online) (doi:

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Our aim was to develop an engaging intervention for educating general practice (GP) receptionists about integrated care and the importance of their role in the ‘bigger picture’. The work took place in North West London, population two million, one of England’s 14 ‘Integration Pioneers.’ We held four training workshops featuring a sequential simulation (SqS) for GP receptionists. Between 40 and 49 GP receptionists attended the workshop, as well as 5-6 patients and 8-9 healthcare professionals.

We developed the SqS from stories local patients told us. It featured an elderly woman living with complex co-morbidity, recently discharged from hospital. Emerging from an unsatisfactory GP appointment, she encounters first a GP receptionist, then a pharmacist and finally her carer. None of them address her concerns adequately and she finally calls for an ambulance to take her back to hospital. The SqS provided the focus for facilitated table discussions which included at least one patient and healthcare professional per table as well as the receptionists. The participants were encouraged to suggest ways in which the encounters could have been handled more helpfully. These ideas were then fed back into a larger group discussion and incorporated into a repeat simulation, using the suggested ideas.

A questionnaire evaluation at the end of three of the sessions was completed by 71% (94/131) of the receptionists. Of these, 53% (50/94) described the SqS as ‘excellent’ and 46% (43/94) as ‘good’ as a learning experience. Further evidence of educational benefit was expressed through comments such as: ‘The simulations really got me thinking about the patient as a human with many problems and situations.’ Feedback from GPs who released their receptionists to attend these events has been positive and there is continuing demand for more such events to be provided and for the whole primary care team to be included.

SqS is an innovative practical way of presenting care scenarios in order to create a shared focus, engage the emotions of the participants and bring the principles of integrated care to life. The table discussions provide an opportunity to share multiple perspectives, reactions and ideas and to practice co-producing solutions with patients. SqS is a useful way of preparing frontline staff to participate in integrated care and may provide a stimulus for the change in attitudes and culture needed to make integrated care a success.

Item Type: Conference Proceedings
Title of Proceedings: International Journal of Integrated Care
Additional Information: 15th International Conference on Integrated Care, 25-27 March 2015, Edinburgh, UK.
Uncontrolled Keywords: Sequential Simulation; Simulation; GP receptionists; Co-design; Engagement; Integrated care
Faculty / School / Research Centre / Research Group: Faculty of Education, Health & Human Sciences
Faculty of Education, Health & Human Sciences > School of Health Sciences (HEA)
Last Modified: 12 Jun 2017 16:30

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