Nursing roles and responsibilities in general practice: three case studies.

Area of Science:

• Healthcare Management
• Primary Care
• Nursing Workforce Studies

Background:

• Primary care teams now include diverse roles: registered nurses, nurse practitioners, physician assistants, and various assistants.
• Understanding interprofessional collaboration is crucial in evolving primary care settings.
• The study addresses the need to analyze health professional skill-mix configurations and their impact on patient access.

Purpose of the Study:

• To describe health professional skill-mix configurations in three primary care practices.
• To analyze inter- and intra-professional collaboration and communication.
• To explore how expanded nursing roles can improve patient access to care.

Main Methods:

• A multiphase, integrative, qualitative, and skill-mix framework analysis was employed.
• Methods included document review, observation, and interviews with key stakeholders.
• The study compared nursing skill-mix across three distinct case study settings.

Main Results:

• Three distinct models of primary care provision were identified, each with unique nursing skill-mixes and innovations.
• These models demonstrated significant flexibility and adaptability to local needs and circumstances.
• Variations in skill-mix and role utilization were observed within and between practices.

Conclusions:

• Maximizing nurses' scope of practice, alongside care model adjustments, can improve patient access.
• Enhanced multidisciplinary cooperation and coordination are key to mitigating workforce shortages.
• Flexible skill-mix strategies are essential for responsive and efficient primary care delivery.