07 January 2019

At the healthcare centre in the Hageby district of Norrköping, patients can be seen on a drop-in basis – without ringing to make an appointment.

Caring male doctor smiles while talking to a baby boy in a free clinic. The boy's mom is holding him. Photo credit asiseeit“This is a new way of working for us, and it has turned out well”, says Rikard Wärdig, senior lecturer in healthcare research at LiU.
In the Hageby district of Norrköping, more than 50 per cent of residents were born abroad. And many of these have trouble with the system of phoning the healthcare centre to book a doctor’s appointment. Instead, they often go to the centre, where they sit and wait. This has been the case for many years, until the staff decided to change their procedures in line with this behaviour. So since 2012 the centre has offered a drop-in service during weekday mornings, staffed by a few nurses and one doctor.

Less unnecessary confusion

Rikard Wärdig, omvårdnadsforskare 2018Rikard WärdigRikard Wärdig has followed operations at the centre, and recently published an initial study where he interviews some 15 doctors and nurses, to get their opinions on the drop-in service. The study shows that the model works well, is good for patient security and reduces unnecessary misunderstandings.
“The healthcare worker sees the patient in person, directly, whereas with a phone call, language issues can make it difficult for the nurse to assess the patient’s condition, which can lead to a number of misunderstandings”, says Rikard Wärdig.
He gives an example where a patient seeks care after being bitten by “super-small birds”.
“It turned out to mosquito bites, which in other countries can be life-threatening. When he quickly got to see a doctor, his anxiety disappeared.”

Risk of infection

The drop-in arrangement has led to more satisfied customers, and the staff find their work enjoyable and more stimulating. The nurses have more opportunity to give advice on self-care, and now there are always Somali- and Arabic-speaking interpreters present, which greatly benefits operations.
However there are also some disadvantages, Rikard Wärdig points out.
“The risk of infection, for instance. Patients can turn up with stomach flu, which in some countries can be life-threatening, so they seek medical help. To reduce the risk of infection, the waiting room has been reconfigured.”

Long waiting times

Another negative is that the patients are not assessed based on how serious their condition is. Instead, they take a number, and wait their turn. Sometimes the wait has been long.
“There should be a system where the patients with the most urgent needs get to see the doctor first. Also, the drop-in arrangement means that the elderly, as well as people with physical disabilities sometimes don’t come, because the queue can be long. But they can also ring and make an appointment with a doctor.”

Better patient security

So there are shortcomings, but the benefits are greater, since patient security is improved when the patients do not have to first be assessed by a nurse on the phone, according to Rikard Wärdig.
He has other studies of healthcare centres under way. One is about patients from abroad: their age, origin, education level and what type of care they seek help for. Another is how Swedish-born patients experience the drop-in service. The studies are to be completed in 2019 and 2020.
“We have to find ways to offer recent arrivals in Sweden good healthcare. This approach is interesting, and can serve as a good example for other healthcare centres.”

Translation: Martin Mirko

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