학술논문

Comparing the implementation of advanced access strategies among primary health care providers.
Document Type
Article
Source
Journal of Interprofessional Care. Mar/Apr2024, Vol. 38 Issue 2, p209-219. 11p.
Subject
*HEALTH services accessibility
*ACADEMIC medical centers
*CROSS-sectional method
*PRIMARY health care
*HUMAN services programs
*COMPARATIVE studies
*SURVEYS
*INTERPROFESSIONAL relations
*NURSES
*RESEARCH funding
Language
ISSN
1356-1820
Abstract
The advanced access (AA) model is among the most recommended innovations for improving timely access in primary health care (PHC). Originally developed for physicians, it is now relevant to evaluate the model's implementation in more interprofessional practices. We compared AA implementation among family physicians, nurse practitioners, and nurses. A cross-sectional online open survey was completed by 514 PHC providers working in 35 university-affiliated clinics. Family physicians delegated tasks to other professionals in the team more often than nurse practitioners (p =.001) and nurses (p <.001). They also left a smaller proportion of their schedules open for urgent patient needs than did nurse practitioners (p =.015) and nurses (p <.001). Nurses created more alternatives to in-person visits than family physicians (p <.001) and coordinated health and social services more than family physicians (p =.003). During periods of absence, physicians referred patients to walk-in services for urgent needs significantly more often than nurses (p =.003), whereas nurses planned replacements between colleagues more often than physicians (p <.001). The variations among provider categories indicate that a one-size-fits-all implementation of AA principles is not recommended. [ABSTRACT FROM AUTHOR]