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Cited by 79Nursing Roles and PracticesPrimary Care and Health OutcomesNursing Education, Practice, and Leadership

Nurse practitioners, canaries in the mine of primary care reform

Open access
Contandriopoulos, Damien, Brousselle, Astrid, Breton, Mylaine, Sangster-Gormley, Esther, Kilpatrick, Kelley, Dubois, Carl-Ardy, Brault, Isabelle, Perroux, Mélanie·2016·Health Policy
DOI 10.1016/j.healthpol.2016.03.015
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Abstract

A strong and effective primary care capacity has been demonstrated to be crucial for controlling costs, improving outcomes, and ultimately enhancing the performance and sustainability of healthcare systems. However, current challenges are such that the future of primary care is unlikely to be an extension of the current dominant model. Profound environmental challenges are accumulating and are likely to drive significant transformation in the field. In this article we build upon the concept of "disruptive innovations" to analyze data from two separate research projects conducted in Quebec (Canada). Results from both projects suggest that introducing nurse practitioners into primary care teams has the potential to disrupt the status quo. We propose three scenarios for the future of primary care and for nurse practitioners' potential contribution to reforming primary care delivery models. In conclusion, we suggest that, like the canary in the coal mine, nurse practitioners' place in primary care will be an indicator of the extent to which healthcare system reforms have actually occurred.

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  • Increased involvement of non-physicians such as Registered Nurses and Nurse Practitioners has long been recognized as an effective way to enhance access to primary care services.

    “Increased involvement of non-physicians such as Registered Nurses (RNs) and Nurse Practitioners (NPs) has long been recognized as an effective way to enhance access to primary care services.6-12”

    From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [6]

    In §4, Results (page not supplied), the paper says evidence favors interprofessional primary care teams in which nurses and nurse practitioners work to their full scope, and describes greater reliance on non-physicians as part of reform. It does not establish that increasing their involvement is an effective way to enhance access to primary care services; §4 raises accessibility as a question for teams to address rather than reporting that outcome. (LLM, conf=0.81)

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3 of the 68 references couldn’t be matched to a known paper.

Research works printed but not linked: 6

  1. Health Council of Canada. Bulletin 7: how do Canadian primary care physicians rate the health system? Results from the 2012 Com- monwealth Fund International Health Policy Survey of Primary Care Physicians. Ottawa: Health Council of Canada; 2013.
  2. Health Council of Canada. Bulletin 8: where you live matters: Canadian views on health care quality. Results from the 2013 Com- monwealth Fund International Health Policy Survey of the General Public. Ottawa: Health Council of Canada; 2014.
  3. Thille P, Rowan MS. The role of nurse practitioners in the delivery of primary health care: a literature review. Report Prepared for Health Canada. Ottawa, ON: Rowan Research & Evaluation; 2008.
  4. Abbott A. The system of professions. Chicago: The University of Chicago Press; 1988.
  5. Government of Québec. Le ministre Yves Bolduc annonce la créa- tion de 500 postes d'infirmières praticiennes spécialisées en soins de première ligne. Press release, 14 July 2010. Québec: Government of Québec, Ministère de la Santé de des Services sociaux (MSSS); 2010.
  6. OIIQ. La légalisation de la pratique de l'infirmière spécial- isée et de l'infirmière praticienne. In: La vision contemporaine de l'exercice infirmier au Québec (chapter 3); 2001. Mon- treal: Brief presented to the Ministerial working group on health professions and human relations [Groupe de travail ministériel sur les professions de la santé et des relations humaines]. Montreal, QC: Ordre des Infirmières et Infirmiers du Québec (OIIQ); http://collections.banq.qc.ca/ark:/52327/bs1564727 [accessed 10.06.15].

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Authors
Contandriopoulos, D., Brousselle, A., Breton, M., Sangster-Gormley, E., Kilpatrick, K., Dubois, C.-A., Brault, I., & Perroux, M.
Affiliations
  • Université de Montréal (CA)
  • Université de Sherbrooke (CA)
  • Hôpital Maisonneuve-Rosemont (CA)
Corresponding author
Contandriopoulos, Damien
ORCID
Venue
Health Policy
Publisher
Elsevier BV
Published
2016-06
Volume
120
Issue
6
Pages
682-689
ISSN
0168-8510 (ISSN-L)
DOI
10.1016/j.healthpol.2016.03.015
OpenAlex
W2328708996
Cited by
79
References
68
Citations by year
2026: 5 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 1 · 2021: 5 · 2020: 39 · 2018: 11 · 2017: 6 · 2016: 2
FWCI
11.78
Type
journal article
Language
en
Open access
Licence
Locations
  • Health Policy (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • UVic’s Research and Learning Repository (University of Victoria) (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Education, Practice, and Leadership
Keywords
nurse practitioners, primary care reform, disruptive innovation, future of primary care, primary care models, health system transformation, Quebec
MeSH terms
Decision Making, Humans, Nurse Practitioners, Organizational Innovation, Patient Care Team, Primary Health Care, Quebec, Health Care Reform, Nurse's Role

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