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Observational Study
. 2022 Aug;18(1):46-59.
doi: 10.12927/hcpol.2022.26905.

Are Family Medicine Clinics Improving Access to Care through Organizational Changes Driven by Healthcare Reform?

Isabel Rodrigues  1 , Marie Authier  2
Affiliations
Observational Study

Are Family Medicine Clinics Improving Access to Care through Organizational Changes Driven by Healthcare Reform?

Isabel Rodrigues et al. Healthc Policy. 2022 Aug.

Abstract
in English, French

Purpose: This observational descriptive study reports organizational changes after the last reform in 18 family medicine units (FMUs) affiliated with the University of Montreal in Québec.

Method: Two self-administered surveys on access to care were administered to FMU directors between December 2016 and January 2017, and in August 2018.

Results: Between surveys, the number of registered patients increased substantially. All clinics recruited new patients, and most offered walk-in services (89%) and moved toward an advanced access scheduling model (83%). For licensed practical nurses, there was a median increase from 0 to 3 and for nurse clinicians, from 2 to 3, that helped the development of collaborative teamwork.

Conclusion: Despite the added teaching mission, the response of the FMU network has been dynamic, has adapted to the major changes and has continued to actively improve access to care for their communities. Challenges still remain regarding work on key priorities for improving access management.

Objectif:: Cette étude descriptive observationnelle fait état des changements organisationnels, après la dernière réforme, dans 18 unités de médecine de famille (UMFs) affiliées à l'Université de Montréal au Québec.

Méthode:: Deux questionnaires auto-administrés sur l'accès aux soins ont été soumis aux directeurs des UMFs entre décembre 2016 et janvier 2017, et en août 2018.

Résultats:: Entre les deux questionnaires, le nombre de patients inscrits a considérablement augmenté. Toutes les cliniques ont recruté de nouveaux patients et la plupart ont offert des services sans rendez-vous (89 %) et ont adopté un modèle avancé pour la planification de l'accès (83 %). Il y a eu une augmentation médiane de 0 à 3 des infirmières auxiliaires et de 2 à 3 des infirmières cliniciennes, ce qui a favorisé le développement du travail d'équipe collaboratif.

Conclusion:: Malgré la mission d'enseignement supplémentaire, la réaction du réseau des UMFs a été dynamique, s'est adaptée aux changements majeurs et a permis d'améliorer activement l'accès aux soins pour les communautés concernées. Il reste des défis quant aux priorités clés pour améliorer la gestion de l'accès.

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Figures

Figure 1.
Figure 1.
Number of registered patients in 2016 and changes between 2016 and 2018
Figure 2.
Figure 2.
Changes in the level of funding (according to the number of registered patients)
See this image and copyright information in PMC

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