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

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.