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Related Experiment Video

Updated: Aug 26, 2025

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Revising the advanced access model pillars: a multimethod study.

Mylaine Breton1, Isabelle Gaboury2, Christine Beaulieu2

  • 1Faculty of Medicine and Health Sciences (Breton, Gaboury, Beaulieu, Hudon, Malham), Université de Sherbrooke, Longueuil, Que.; Faculty of Nursing (Sasseville), Université Laval, Québec, Que.; Centre de recherche du CHUS (Hudon), Sherbrooke, Que.; Faculty of Medicine (Rodrigues), Université de Montréal; École nationale d'administration publique (Maillet), Montréal, Que.; Faculty of Nursing (Duhoux), Université de Montréal; Faculty of Medicine and Health Sciences (Haggerty), McGill University, Montréal, Que. mylaine.breton@usherbrooke.ca.

CMAJ Open
|October 6, 2022
PubMed
Summary

The advanced access model was updated to reflect current primary health care practices. This revised model, featuring 5 pillars including a new communication component, aims to improve healthcare delivery.

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Area of Science:

  • Health Services Research
  • Primary Health Care Management
  • Healthcare Operations

Background:

  • The advanced access model, established two decades ago, requires contemporary revision.
  • Implementation across various countries highlights its significance in healthcare systems.

Purpose of the Study:

  • To revise and operationalize the pillars and subpillars of the advanced access model.
  • To align the model with current practices of primary health care professionals.

Main Methods:

  • A multimethod sequential study incorporating a literature review.
  • Expert panel consultations with decision-makers, primary health care staff, patients, and researchers.
  • Iterative development and validation of model components through participant feedback.

Main Results:

  • A revised advanced access model with 5 pillars: updated 'Appointment system' and 'Interprofessional practice', merged 'Develop contingency plans' with 'Planning of needs and supply', transformed 'Backlog reduction' to 'Continuous adjustment', and a new 'Communication' pillar.
  • Operationalization of subpillar definitions confirmed and stabilized the revised model's content.
  • Strong consensus achieved among participating experts on the revised model.

Conclusions:

  • The revised advanced access model offers a contemporary framework for primary health care.
  • This updated model will facilitate the development of a reflective tool for professionals.
  • The consensus-driven revision ensures relevance and applicability in current healthcare settings.