Physician and Nurse Perspectives of an Interprofessional and Integrated Primary Care-Based Program for Seniors

Authors

  • Ainsley Elizabeth Moore Department of Family Medicine, McMaster University
  • Kalpana Nair Department of Family Medicine, McMaster Unveristy
  • Christopher Patterson Department of Internal Medicine, Division of Geriatric Medicine, McMaster Univeristy
  • Joy White Department of Family Medicine, McMaster University
  • Shelly House Department of Family Medicine, McMaster University
  • Amjed Kadhim-Saleh Department of Epidemiology and Community Health, Queen's University
  • John Riva Department of Family Medicine, McMaster University

DOI:

https://doi.org/10.22230/jripe.2013v3n1a95

Keywords:

Interprofessional, Primary care, Geriatrics, Qualitative

Abstract

Background: In Canada, primary care practitioners provide the majority of care for elderly patients. Increasing volume and complexity of care compounded by a shortage of specialized geriatric services has lead to problems of fragmented, inefficient,and often ineffective service for this population. Integrated models that bridge primary and secondary care have emerged as a major theme in health reform to address such challenges for care of the elderly. Although primary care practitioners are important stakeholders necessary for successful uptake and sustainability of such integrated models, this perspective has been largely unexplored.

Methods and Findings: We used a qualitative thematic approach to bring forward front-line perspectives of nurses and physicians who referred their patients to a newly developed integrated, multidisciplinary program for seniors that was introduced into their primary care clinic. Referrers experienced improved care processes, improved quality of care, as well as an enhanced experience when managing their elderly patients. Unclear assignment of roles and responsibilities created confusion for referring practitioners and their patients.

Conclusions: Understanding benefits, limitations, and changes to front-line practitioner experience provides insight into important factors contributing to buy-in and sustainability of integrated programming for the elderly in this setting.

Author Biographies

Ainsley Elizabeth Moore, Department of Family Medicine, McMaster University

Ainsley Moore, assistant Professor of Family Medicine, McMaster University has practiced for 13 years in a large family health team. This has allowed her to pursue her interest in caring for frail seniors, and to appreciate team-based care. Since joining McMaster (2007), she has focused on understanding how the Canadian primary care system will respond to the challenges of aging, and how collaborative interprofessional initiatives are ideally suited to address such challenges. She has developed an interprofessional program for frail seniors and has been awarded The Canadian Institute of Health Research fellowship: Bridging Scientific Domains in Medication Safety and Effectiveness.

Drs Moore, Patterson, Nair, and Ms White contributed to the concept and design of the program. Mr. Kadhim and Dr. Nair contributed to data gathering. Dr. Moore, Ms White, and Mr. Kadhim contributed to data analysis. All authors contributed to interpretation of results, preparing the manuscript for submission, and provided final approval for publication.

Kalpana Nair, Department of Family Medicine, McMaster Unveristy

Kalpana Nair has research interests are related to the patient perspective, seniors, evaluation of health services, qualitative research methods, mixed methods research, interdisciplinarity, and chronic disease management. She is currently involved in studies related to pain management in primary care, quality in family practice, and management of care for seniors.  Kalpana completed her PhD in July 2011 and her dissertation focussed on understanding and assessing interdisciplinarity in health research teams.  Kalpana is a past recipient of a CIHR Doctoral Award and was a CIHR Strategic Training Fellow in the Transdisciplinary Understanding and Training on Research – Primary Health Care (TUTOR-PHC) program.

Christopher Patterson, Department of Internal Medicine, Division of Geriatric Medicine, McMaster Univeristy

Dr. Chris Patterson is an associate professor in the Department of Internal Medicine, Division of Geriatric Medicine, McMaster University.

Joy White, Department of Family Medicine, McMaster University

Joy White is an advanced practice nurse and clinician educator in the Department of Family Medicine, McMaster University, Hamilton, Ontario. She has recently completed her Master's in Nursing. Her area of expertise is care of community dwelling older adults, which she has provided through her role as a visiting nurse prior to joining McMaster. She leads an interprofessional primary care-based team that provides care for elderly patients.

Shelly House, Department of Family Medicine, McMaster University

Shelly House is a clinical pharmacist with McMaster Family Health Team

Amjed Kadhim-Saleh, Department of Epidemiology and Community Health, Queen's University

Amjed Kadhim-Saleh is a graduate student at Queen’s University pursuing a Master of Science in Epidemiology and Community Health. He has completed his Bachelor of Health Sciences Honours (BHSc) from McMaster University in 2010. Amjed’s graduate thesis focuses on validating computer-based diagnostic algorithms for chronic disease surveillance. He is currently working at the Centre for Studies in Primary Care and conducting primary chart abstraction from the Kingston and Calgary networks of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). Amjed’s research interests focus on chronic diseases within the primary care context.

John Riva, Department of Family Medicine, McMaster University

John Riva is a Masters of Science candidate in the Health Research Methodology program at McMaster University. In July 2008, he was appointed as an Assistant Clinical Professor to the Department of Family Medicine at McMaster University in Hamilton, Ontario.  He leads problem-based learning (PBL) sessions to medical students at the Michael G. DeGroote School of Medicine. He has maintained a clinical chiropractic practice in a Family Health Team for over 10 years and is as clinical preceptor to medical, midwifery, and pharmacy students from McMaster University and the

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Published

2013-03-27

Issue

Section

Articles: Empirical Research