Organizational innovations related to Primary Care Access Points (GAP) for unattached patients in Quebec: a multi-case qualitative study.
Background: Being attached to a primary care (PC) provider is at the core of a strong primary health care system. Centralized waiting lists (CWL) for unattached patients have been implemented in eight provinces of Canada to support the attachment process. In Quebec, the Ministry of Health mandated t...
| Publicado en: | BMC Primary Care Vol. 25; no. 1; pp. 1 - 16 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
BioMed Central
10/12/2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180235269&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180235269 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 27314553 MZZU jtl: BMC Primary Care issn: 27314553 maglogo: N pubinfo: dt: 10/12/2024 vid: 25 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 180235269 180235269 180235269 10.1186/s12875-024-02614-y 180235269 ppf: 1 ppct: 15 formats: tig: atl: Organizational innovations related to Primary Care Access Points (GAP) for unattached patients in Quebec: a multi-case qualitative study. aug: au: Breton, Mylaine Deslauriers, Véronique Lamoureux-Lamarche, Catherine Smithman, Mélanie Ann Sauvé, Carine Beauséjour, Marie Laberge, Maude Motulsky, Aude Pomey, Marie-Pascale affil: https://ror.org/00kybxq39 Department of Community Health Sciences, Université de Sherbrooke, Campus de Longueuil, Longueuil, QC, Canada sug: subj: Access to Primary Care Diffusion of Innovation Organizational Development Organizational Change Implementation Science Human Qualitative Studies Quebec Waiting Lists Semi-Structured Interview Nurses Physicians Health Personnel Interview Guides Thematic Analysis Descriptive Statistics Data Analysis Software Funding Source Change Management ab: Background: Being attached to a primary care (PC) provider is at the core of a strong primary health care system. Centralized waiting lists (CWL) for unattached patients have been implemented in eight provinces of Canada to support the attachment process. In Quebec, the Ministry of Health mandated the implementation of Primary Care Access Points (GAP) across the province to help unattached patients navigate the health system while awaiting attachment through the CWL. Several local health territories developed complementary innovations to the GAP to respond to local population needs. This paper aims to describe five organizational innovations implemented locally. Methods: This multi-case qualitative study was conducted in four local health territories in the province of Quebec. Fifty-two semi-structured interviews with healthcare managers, nurses, physicians, other health professionals and administrative staff were conducted between April 2023 and April 2024. An interview guide was developed based on existing frameworks on the implementation of innovations and the evaluation of the GAP. Thematic analysis was conducted using NVivo software. Inductive and deductive approaches were used to develop relevant codes and themes. Logic models were built to describe the organizational innovations. Results: Five organizational innovations are described. First, a multidisciplinary clinic aimed at responding to patients with mental health issues was implemented. Second, a nurse clinic was implemented to provide temporary care for patients with unstable chronic illnesses. The third innovation is a mobile proximity clinic where unattached GAP patients are first evaluated by a paramedic before receiving care from a nurse. Fourth, a pharmacist trajectory was implemented to increase engagement of community pharmacists to respond to GAP patients. The last innovation is a decentralized GAP offering in-person nursing care to unattached GAP patients. Conclusions: Descriptions of these five innovations are key to inform other territories and provinces on ways to improve access for unattached patients while they are waiting to be attached. The introduction of the GAP and the organizational innovations, suggests a transition where access to PC services does not rely solely on attachment status. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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