. 2023 Feb 16;23(1):98.

doi: 10.1186/s12877-023-03798-1.

Nurse practitioner/physician collaborative models of care: a scoping review protocol

Katherine S McGilton^{1

2}, Lynn Haslam-Larmer^{3

4}, Aria Wills^{3

4}, Alexandra Krassikova³, Jessica Babineau^{5

6}, Ben Robert^{7

8}, Carrie Heer^{9

10}, Carrie McAiney^{11

12}, Gail Dobell¹³, Jennifer Bethell^{3

14}, Kelly Kay^{15

16}, Margaret Keatings¹⁷, Sharon Kaasalainen¹⁸, Sid Feldman^{19

20}, Souraya Sidani²¹, Ruth Martin-Misener²²

Affiliations

¹ KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada. kathy.mcgilton@uhn.ca.
² Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada. kathy.mcgilton@uhn.ca.
³ KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada.
⁴ Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada.
⁵ Library & Information Services, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada.
⁶ The Institute for Education Research, University Health Network, Toronto, Canada.
⁷ Perley Health, 1750 Russell Road, Ottawa, ON, K1G 5Z6, Canada.
⁸ Faculty of Medicine, University of Ottawa, 451 Smyth Road #2044, Ottawa, ON, K1H 8M5, Canada.
⁹ Brant Community Healthcare System, 200 Terrace Hill Street, Brantford, ON, N3R 1G9, Canada.
¹⁰ Bruyère Research Institute, 85 Primrose Ave, Ottawa, ON, K1R 6M1, Canada.
¹¹ Schlegel-UW Research Institute for Aging, Waterloo, ON, N2J 0E2, Canada.
¹² School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
¹³ Ontario Health, 130 Bloor Street West, Toronto, ON, M5S 1N5, Canada.
¹⁴ Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.
¹⁵ Provincial Geriatrics Leadership Ontario, Toronto, Canada.
¹⁶ Ontario Institute for Studies in Education and the Institute for Life Course and Aging, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada.
¹⁷ The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
¹⁸ School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
¹⁹ Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A2E1, Canada.
²⁰ Department of Family and Community Medicine, Temerty Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
²¹ Daphne Cockwell School of Nursing, Toronto Metropolitan University, 250 Victoria Street, Toronto, ON, M5B 2K9, Canada.
²² School of Nursing, Dalhousie University, Room G26, Forrest Bldg., 5869 University Avenue, Halifax, NS, B3H 4R2, Canada.

PMID: 36797669
PMCID: PMC9934505
DOI: 10.1186/s12877-023-03798-1

Nurse practitioner/physician collaborative models of care: a scoping review protocol

Katherine S McGilton et al. BMC Geriatr. 2023.

. 2023 Feb 16;23(1):98.

doi: 10.1186/s12877-023-03798-1.

Authors

Affiliations

¹ KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada. kathy.mcgilton@uhn.ca.
² Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada. kathy.mcgilton@uhn.ca.
³ KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada.
⁴ Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada.
⁵ Library & Information Services, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada.
⁶ The Institute for Education Research, University Health Network, Toronto, Canada.
⁷ Perley Health, 1750 Russell Road, Ottawa, ON, K1G 5Z6, Canada.
⁸ Faculty of Medicine, University of Ottawa, 451 Smyth Road #2044, Ottawa, ON, K1H 8M5, Canada.
⁹ Brant Community Healthcare System, 200 Terrace Hill Street, Brantford, ON, N3R 1G9, Canada.
¹⁰ Bruyère Research Institute, 85 Primrose Ave, Ottawa, ON, K1R 6M1, Canada.
¹¹ Schlegel-UW Research Institute for Aging, Waterloo, ON, N2J 0E2, Canada.
¹² School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
¹³ Ontario Health, 130 Bloor Street West, Toronto, ON, M5S 1N5, Canada.
¹⁴ Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.
¹⁵ Provincial Geriatrics Leadership Ontario, Toronto, Canada.
¹⁶ Ontario Institute for Studies in Education and the Institute for Life Course and Aging, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada.
¹⁷ The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
¹⁸ School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
¹⁹ Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A2E1, Canada.
²⁰ Department of Family and Community Medicine, Temerty Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
²¹ Daphne Cockwell School of Nursing, Toronto Metropolitan University, 250 Victoria Street, Toronto, ON, M5B 2K9, Canada.
²² School of Nursing, Dalhousie University, Room G26, Forrest Bldg., 5869 University Avenue, Halifax, NS, B3H 4R2, Canada.

PMID: 36797669
PMCID: PMC9934505
DOI: 10.1186/s12877-023-03798-1

Abstract

Background: Before the COVID-19 pandemic, many long-term care (LTC) homes experienced difficulties in providing residents with access to primary care, typically delivered by community-based family physicians or nurse practitioners (NPs). During the pandemic, legislative changes in Ontario, Canada enabled NPs to act in the role of Medical Directors thereby empowering NPs to work to their full scope of practice. Emerging from this new context, it remains unclear how NPs and physicians will best work together as primary care providers. NP/physician collaborative models appear key to achieving optimal resident outcomes. This scoping review aims to map available evidence on existing collaborative models of care between NPs and physicians within LTC homes.

Methods: The review will be guided by the research question, "What are the structures, processes and outcomes of collaborative models of care involving NPs and Physicians in LTC homes?" This scoping review will be conducted according to the methods framework for scoping reviews outlined by Arksey and O'Malley and refined by Levac et al., Colquhoun et al., and Daudt et al., as well as the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Statement. Electronic databases (MEDLINE, Embase + Embase Classic, APA PsycInfo, Cochrane Central Register of Controlled Trials, AMED, CINAHL, Ageline, and Scopus), grey literature, and reference lists of included articles will be searched. English language studies that describe NP and physician collaborative models within the LTC setting will be included.

Discussion: This scoping review will consolidate what is known about existing NP/physician collaborative models of care in LTC homes. Results will be used to inform the development of a collaborative practice framework for long-term care clinical leadership.

Keywords: Collaboration; Knowledge synthesis; Long-term care; Models of care; Nurse practitioner; Physician; Scoping review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Cited by

Establishing primary care physician commitment in Canadian long-term care homes: a protocol for a modified e-Delphi study.
Dash D, Potter M, Siu HY, Quail P, Katz P, McCarthy LM, Peck S, Tripp D, Costa AP, Rochon P, Savage RD, Jones A, Stall N. Dash D, et al. BMJ Open. 2025 Feb 7;15(2):e093277. doi: 10.1136/bmjopen-2024-093277. BMJ Open. 2025. PMID: 39920077 Free PMC article.

References

1. Ontario Long-Term Care Association. This is long-term care 2019. 2019. Available from: https://www.oltca.com/OLTCA/Documents/Reports/TILTC2019web.pdf. Accessed 19 Oct 2021.
1. National Institute on Ageing. NIA Long term care COVID-19 tracker, 2020–2021 (pandemic LTC deaths). Available from: https://www.cihi.ca/en/covid-19-resources/impact-of-covid-19-on-canadas-.... Accessed 5 May 2022.
1. McGilton KS, Krassikova A, Boscart V, Sidani S, Iaboni A, Vellani S, et al. Nurse practitioners rising to the challenge during the Coronavirus Disease 2019 pandemic in long-term care homes. Gerontologist. 2021;61(4):615–623. doi: 10.1093/geront/gnab030. - DOI - PMC - PubMed
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Nurse practitioner/physician collaborative models of care: a scoping review protocol

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Nurse practitioner/physician collaborative models of care: a scoping review protocol

Authors

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