Implementing advanced access to primary care in an academic family medicine network: Participatory action research

To support the implementation of the advanced access model in a network of family medicine academic settings, and to identify solutions to teaching advanced access to family medicine residents.

Participatory action research study using descriptive methods.

A network of 11 academic family medicine settings, mostly located in the province of Quebec.

Eighteen academic-setting directors and deputy directors and 125 clinical preceptors.

The study was carried out from August 2015 through January 2017. Settings were represented by a "community of practice" of academic-setting directors and deputy directors. Data were collected via questionnaires, online surveys, and 4, 60-minute focus groups. Data were analyzed using descriptive statistics or thematic analysis. Findings were validated with the community of practice.

Nearly all of the academic family medicine settings implemented advanced access for their clinical preceptors (90.9%). Four main solutions to teaching advanced access were identified: establishing an optimal panel of patients; ensuring continuity of care during absences and away rotations; optimizing team collaboration; and creating a positive experience of immersion in advanced access.

An academic-setting community of practice contributed to sharing solutions that were instrumental in broadly implementing the advanced access model and that also paved the way for the integration of advanced access for future family physicians, further supporting timely access to primary care.