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. 2023 Mar 3;13(3):e070956.
doi: 10.1136/bmjopen-2022-070956.

Evaluation of the implementation of single points of access for unattached patients in primary care and their effects: a study protocol

Mylaine Breton  1 , Catherine Lamoureux-Lamarche  2 , Véronique Deslauriers  2 , Maude Laberge  3   4 , Josée Arsenault  5 , Isabelle Gaboury  2 , Marie Beauséjour  2 , Marie-Pascale Pomey  6 , Aude Motulsky  7 , Annie Talbot  8 , Annie St-Yves  9 , Mélanie Ann Smithman  2 , Nadia Deville-Stoetzel  2 , Carine Sauvé  5 , Sabina Abou Malham  2
Affiliations

Evaluation of the implementation of single points of access for unattached patients in primary care and their effects: a study protocol

Mylaine Breton et al. BMJ Open. .

Abstract

Introduction: Attachment to a primary care provider is an important component of primary care as it facilitates access. In Québec, Canada, attachment to a family physician is a concern. To address unattached patients' barriers to accessing primary care, the Ministry of Health and Social Services mandated Québec's 18 administrative regions to implement single points of access for unattached patients (Guichets d'accès première ligne (GAPs)) that aim to better orient patients towards the most appropriate services to meet their needs. The objectives of this study are to (1) analyse the implementation of GAPs, (2) measure the effects of GAPs on performance indicators and (3) assess unattached patients' experiences of navigation, access and service utilisation.

Methods and analysis: A longitudinal mixed-methods case study design will be conducted. Objective 1. Implementation will be analysed through semistructured interviews with key stakeholders, observations of key meetings and document analysis. Objective 2. GAP effects on indicators will be measured using performance dashboards produced using clinical and administrative data. Objective 3. Unattached patients' experiences will be assessed using a self-administered electronic questionnaire. Findings for each case will be interpreted and presented using a joint display, a visual tool for integrating qualitative and quantitative data. Intercase analyses will be conducted highlighting the similarities and differences across cases.

Ethics and dissemination: This study is funded by the Canadian Institutes of Health Research (# 475314) and the Fonds de Soutien à l'innovation en santé et en services sociaux (# 5-2-01) and was approved by the CISSS de la Montérégie-Centre Ethics Committee (MP-04-2023-716).

Keywords: Organisation of health services; PRIMARY CARE; Protocols & guidelines.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Guichets d’accès première ligne (GAP) components. NP, nurse practitioner; PHC, primary healthcare.
Figure 2
Figure 2
Longitudinal mixed-methods case study design.
Figure 3
Figure 3
Guichets d'accès première ligne (GAP) indicators.
Figure 4
Figure 4
Dimensions of patient-reported experience measures. GAP, Guichets d’accès première ligne.
See this image and copyright information in PMC

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