The impact of funding models on the integration of registered nurses in primary health care teams: protocol for a multi-phase mixed-methods study in Canada
Abstract Background Family practice registered nurses co-managing patient care as healthcare professionals in interdisciplinary primary care teams have been shown to improve access, continuity of care, patient satisfaction, and clinical outcomes for patients with chronic diseases while being cost-ef...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Primary Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-022-01900-x |
| _version_ | 1797983880551071744 |
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| author | Maria Mathews Sarah Spencer Lindsay Hedden Julia Lukewich Marie-Eve Poitras Emily Gard Marshall Judith Belle Brown Shannon Sibbald Alison A. Norful |
| author_facet | Maria Mathews Sarah Spencer Lindsay Hedden Julia Lukewich Marie-Eve Poitras Emily Gard Marshall Judith Belle Brown Shannon Sibbald Alison A. Norful |
| author_sort | Maria Mathews |
| collection | DOAJ |
| description | Abstract Background Family practice registered nurses co-managing patient care as healthcare professionals in interdisciplinary primary care teams have been shown to improve access, continuity of care, patient satisfaction, and clinical outcomes for patients with chronic diseases while being cost-effective. Currently, however, it is unclear how different funding models support or hinder the integration of family practice nurses into existing primary health care systems and interdisciplinary practices. This has resulted in the underutilisation of family practice nurses in contributing to high-quality patient care. Methods This mixed-methods project is comprised of three studies: (1) a funding model analysis; (2) case studies; and (3) an online survey with family practice nurses. The funding model analysis will employ policy scans to identify, describe, and compare the various funding models used in Canada to integrate family practice nurses in primary care. Case studies involving qualitative interviews with clinic teams (family practice nurses, physicians, and administrators) and family practice nurse activity logs will explore the variation of nursing professional practice, training, skill set, and team functioning in British Columbia, Nova Scotia, Ontario, and Quebec. Interview transcripts will be analysed thematically and comparisons will be made across funding models. Activity log responses will be analysed to represent nurses’ time spent on independent, dependent, interdependent, or non-nursing work in each funding model. Finally, a cross-sectional online survey of family practice nurses in Canada will examine the relationships between funding models, nursing professional practice, training, skill set, team functioning, and patient care co-management in primary care. We will employ bivariate tests and multivariable regression to examine these relationships in the survey results. Discussion This project aims to address a gap in the literature on funding models for family practice nurses. In particular, findings will support provincial and territorial governments in structuring funding models that optimise the roles of family practice nurses while establishing evidence about the benefits of interdisciplinary team-based care. Overall, the findings may contribute to the integration and optimisation of family practice nursing within primary health care, to the benefit of patients, primary healthcare providers, and health care systems nationally. |
| first_indexed | 2024-04-11T06:54:14Z |
| format | Article |
| id | doaj.art-15f760b352894aaeb285ba662df988fa |
| institution | Directory Open Access Journal |
| issn | 2731-4553 |
| language | English |
| last_indexed | 2024-04-11T06:54:14Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj.art-15f760b352894aaeb285ba662df988fa2022-12-22T04:39:05ZengBMCBMC Primary Care2731-45532022-11-0123111010.1186/s12875-022-01900-xThe impact of funding models on the integration of registered nurses in primary health care teams: protocol for a multi-phase mixed-methods study in CanadaMaria Mathews0Sarah Spencer1Lindsay Hedden2Julia Lukewich3Marie-Eve Poitras4Emily Gard Marshall5Judith Belle Brown6Shannon Sibbald7Alison A. Norful8Department of Family Medicine, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family MedicineFaculty of Health Sciences, Simon Fraser UniversityFaculty of Health Sciences, Simon Fraser UniversityFaculty of Nursing, Memorial UniversityFaculté de médecine et des sciences de la santé, Université de SherbrookeDepartment of Family Medicine, Dalhousie UniversityDepartment of Family Medicine, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family MedicineDepartment of Family Medicine, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family MedicineSchool of Nursing, Columbia UniversityAbstract Background Family practice registered nurses co-managing patient care as healthcare professionals in interdisciplinary primary care teams have been shown to improve access, continuity of care, patient satisfaction, and clinical outcomes for patients with chronic diseases while being cost-effective. Currently, however, it is unclear how different funding models support or hinder the integration of family practice nurses into existing primary health care systems and interdisciplinary practices. This has resulted in the underutilisation of family practice nurses in contributing to high-quality patient care. Methods This mixed-methods project is comprised of three studies: (1) a funding model analysis; (2) case studies; and (3) an online survey with family practice nurses. The funding model analysis will employ policy scans to identify, describe, and compare the various funding models used in Canada to integrate family practice nurses in primary care. Case studies involving qualitative interviews with clinic teams (family practice nurses, physicians, and administrators) and family practice nurse activity logs will explore the variation of nursing professional practice, training, skill set, and team functioning in British Columbia, Nova Scotia, Ontario, and Quebec. Interview transcripts will be analysed thematically and comparisons will be made across funding models. Activity log responses will be analysed to represent nurses’ time spent on independent, dependent, interdependent, or non-nursing work in each funding model. Finally, a cross-sectional online survey of family practice nurses in Canada will examine the relationships between funding models, nursing professional practice, training, skill set, team functioning, and patient care co-management in primary care. We will employ bivariate tests and multivariable regression to examine these relationships in the survey results. Discussion This project aims to address a gap in the literature on funding models for family practice nurses. In particular, findings will support provincial and territorial governments in structuring funding models that optimise the roles of family practice nurses while establishing evidence about the benefits of interdisciplinary team-based care. Overall, the findings may contribute to the integration and optimisation of family practice nursing within primary health care, to the benefit of patients, primary healthcare providers, and health care systems nationally.https://doi.org/10.1186/s12875-022-01900-xMixed-methods researchResearch designPrimary careNursingFamily practice nurseHealth systems |
| spellingShingle | Maria Mathews Sarah Spencer Lindsay Hedden Julia Lukewich Marie-Eve Poitras Emily Gard Marshall Judith Belle Brown Shannon Sibbald Alison A. Norful The impact of funding models on the integration of registered nurses in primary health care teams: protocol for a multi-phase mixed-methods study in Canada BMC Primary Care Mixed-methods research Research design Primary care Nursing Family practice nurse Health systems |
| title | The impact of funding models on the integration of registered nurses in primary health care teams: protocol for a multi-phase mixed-methods study in Canada |
| title_full | The impact of funding models on the integration of registered nurses in primary health care teams: protocol for a multi-phase mixed-methods study in Canada |
| title_fullStr | The impact of funding models on the integration of registered nurses in primary health care teams: protocol for a multi-phase mixed-methods study in Canada |
| title_full_unstemmed | The impact of funding models on the integration of registered nurses in primary health care teams: protocol for a multi-phase mixed-methods study in Canada |
| title_short | The impact of funding models on the integration of registered nurses in primary health care teams: protocol for a multi-phase mixed-methods study in Canada |
| title_sort | impact of funding models on the integration of registered nurses in primary health care teams protocol for a multi phase mixed methods study in canada |
| topic | Mixed-methods research Research design Primary care Nursing Family practice nurse Health systems |
| url | https://doi.org/10.1186/s12875-022-01900-x |
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