A qualitative study of the impact of the implementation of advanced access in primary healthcare on the working lives of general practice staff

被引：23
作者：
Ahluwalia S. [1 ]
Offredy M. [2 ]
机构：
[1] Watling Medical Centre, HA8 0NR, London
[2] Faculty of Health and Human Sciences, University of Hertfordshire, Hatfield, AL10 9AB, College Lane
来源：
BMC Family Practice | / 6卷 / 1期
关键词：
General Practitioner; Minor Illness; Advance Access; Role Offering; General Practice Staff;
D O I：
10.1186/1471-2296-6-39
中图分类号：
学科分类号：
摘要：
Background: The North American model of 'advanced access' has been emulated by the National Primary Care Collaborative in the UK as a way of improving patients' access in primary care. The aim of this study was to explore the impact of the implementation of advanced access on the working lives of general practice staff. Methods: A qualitative study design, using semi-structured interviews, was conducted with 18 general practice staff: 6 GPs, 6 practice managers and 6 receptionists. Two neighbouring boroughs in southeast England were used as the study sites. NUD*IST computer software assisted in data management to identify concepts, categories and themes of the data. A framework approach was used to analyse the data. Results: Whilst practice managers and receptionists saw advanced access as having a positive effect on their working lives, the responses of general practitioners (GPs) were more ambivalent. Receptionists reported improvements in their working lives with a change in their role from gatekeepers for appointments to providing access to appointments, fewer confrontations with patients, and greater job satisfaction. Practice managers perceived reductions in work stress from fewer patient complaints, better use of time, and greater flexibility for contingency planning. GPs recognised benefits in terms of improved consultations, but had concerns about the impact on workload and continuity of care. Conclusion: AA has improved working conditions for receptionists, converting their perceived role from gatekeeper to access facilitator, and for practice managers as patients were more satisfied. GP responses were more ambivalent, as they experienced both positive and negative effects. © 2005 Ahluwalia and Offredy; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 34 条
  • [1] Airey C., Errens B., National Surveys of NHS Patients: General Practice 1998, (1999)
  • [2] The NHS Plan
  • [3] Kendrick T., Kerry S., How many surgery appointments should be offered to avoid undesirable numbers of 'extras'?, Br J Gen Pract, 49, 441, pp. 273-276, (1999)
  • [4] Murray M., Patient care: Access, British Medical Journal, 320, 7249, pp. 1594-1596, (2000)
  • [5] Murray M., Tantau C., Same-day appointments: Exploding the access paradigm, Fam Pract Manag, 7, 8, pp. 45-50, (2000)
  • [6] Freeman G.K., Horder J.P., Howie J.G., Hungin A.P., Hill A.P., Shah N.C., Wilson A., Evolving general practice consultation in Britain: Issues of length and context, Bmj, 324, 7342, pp. 880-882, (2002)
  • [7] Murfin D., Standards of access and quality in primary care, J R Soc Med, 94, 39 SUPPL., pp. 43-45, (2001)
  • [8] Campbell S., Steiner A., Robison J., Webb D., Raven A., Roland M., Is the quality of care in general medical practice improving? Results of a longitudinal observational study, Br J Gen Pract, 53, 489, pp. 298-304, (2003)
  • [9] Longridge L., Divert the demand, Primary Care Management, 11, 10, pp. 28-30, (2001)
  • [10] Lamb A., Why advanced access is a retrograde step, Br J Gen Pract, 52, 485, (2002)
1234