Abstract
BackgroundAdvanced practitioner services, such as those nurse practitioners and pharmacist prescribers provide, are an opportunity to improve health care delivery. In New Zealand, these practitioners remain underutilised, despite research suggesting they offer safe and effective care, and considerable international literature recording patient satisfaction with these roles. This study aimed to explore factors underlying consumer satisfaction with primary health care nurse practitioner and pharmacist prescriber services.MethodsAs part of a larger realist evaluation, 21 individuals receiving advanced practitioner services participated in semi-structured interviews. These interviews were transcribed and coded against context–mechanism–outcome configurations tested and refined throughout the research.ResultsStudy findings emphasise the importance of consumer confidence in the provider as a mechanism for establishing advanced practitioner roles. Underlying this confidence is a recognition that these practitioners work in a more accessible manner, engage at the individual’s ‘level’, and operate with passion.ConclusionsThis research offers learnings to re-engineer service delivery within primary health care to make best use of the entire health care team by including consumers in the design and introduction of new roles.
Highlights
Advanced practitioner services, such as those nurse practitioners and pharmacist prescribers provide, are an opportunity to improve health care delivery
nurse practitioner (NP)/pharmacist prescriber (PP) know them personally and deliver care in a way that incorporates the individual into the care team
Services delivered by these providers were individualised and empowered interviewees to understand their own conditions. Such findings are supported by earlier literature [18,19,20,21,22,23,24, 43], and the myriad of existing frameworks and discussions on key aspects of patient-centred care [3, 44]
Summary
Advanced practitioner services, such as those nurse practitioners and pharmacist prescribers provide, are an opportunity to improve health care delivery. A challenge in the current primary health care climate of general practitioner (GP) shortages [1, 2] and constrained spending is how best to introduce new workforce roles to enable patient-centred care [3] and continuity of service provision. This is important in New Zealand’s culturally diverse population, where the indigenous. The creation of nurse practitioner (NP) and pharmacist prescriber (PP) roles intended to improve patient health service access and make better use of workforce skills [5,6,7] Growth in numbers for these professions has fallen below early projections [10, 11]
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