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Introducing a triage and Nurse on Call model in primary health care - a focus group study of health care staff's experiences
Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing. Center for Clinical Research Dalarna, Uppsala University, Falun.
Center for Clinical Research Dalarna, Uppsala University, Falun; Uppsala University, Uppsala.ORCID iD: 0000-0002-1515-7567
Dalarna University, School of Health and Welfare, Caring Science/Nursing. Center for Clinical Research Dalarna, Uppsala University, Falun.ORCID iD: 0000-0002-0681-9768
Dalarna University, School of Health and Welfare, Caring Science/Nursing.ORCID iD: 0000-0002-3964-196X
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2023 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 23, no 1, article id 1299Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: With the increased demand for health care services and with simultaneous staff shortages, new work models are needed in primary health care. In November 2015, a Swedish primary health care centre introduced a work model consisting of a structured patient sorting system with triage and Nurse on Call. The aim of this study was to describe the staff's experiences of introducing the triage and Nurse on Call model at the primary health care centre.

METHODS: Five focus group discussions with staff (n = 39) were conducted 4 years after the introduction of the work model. Groups were divided by profession: medical secretaries, nursing assistants, physicians, primary health care nurses, and registered nurses. The transcribed text from the discussions was analysed using qualitative inductive content analysis.

RESULTS: The analysis generated one overarching theme: The introduction of triage and Nurse on Call addresses changed preconditions in primary health care, but the work culture, organization, and acquisition of new knowledge are lagging behind. The overarching theme had five categories: (1) Changed preconditions in primary health care motivate new work models; (2) The triage and Nurse on Call model improves teamwork and may increase the quality of care; (3) Unclear purpose and vague leadership make introducing the work model difficult; (4) Difficulties to adopt the work model as it challenges professional autonomy; and (5) The triage and Nurse on Call model requires more knowledge and competence from nurses in primary health care.

CONCLUSIONS: This study contributes with knowledge about implications of a new work model in primary health care from the perspective of health care staff. The work model using triage and Nurse on Call in primary health care was perceived by participants to increase availability and optimize the use of resources. However, before introduction of new work models, it is important to identify barriers to and facilitators for successful improvements in the local health care context. Additional education for the health care staff is important if the transition is to be successful. Complementary skills and teamwork, supported by a facilitator seems important to ensure a well-prepared workforce.

Place, publisher, year, edition, pages
2023. Vol. 23, no 1, article id 1299
Keywords [en]
Accessibility of health services, Focus groups, Nurse on Call, Primary health care, Qualitative content analysis, Triage
National Category
Nursing
Identifiers
URN: urn:nbn:se:du-47319DOI: 10.1186/s12913-023-10300-5ISI: 001107663300002PubMedID: 38001493Scopus ID: 2-s2.0-85177754687OAI: oai:DiVA.org:du-47319DiVA, id: diva2:1815305
Available from: 2023-11-28 Created: 2023-11-28 Last updated: 2024-01-15Bibliographically approved

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Gelin, MariaGesar, BeritKällberg, Ann-SofieEhrenberg, AnnaGustavsson, Catharina

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