Explain the Roles of nurse practitioners and family physicians in community health centres.Research Roles of nurse practitioners and family physicians in community health centres.

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Explain the Roles of nurse practitioners and family physicians in community health centres.Research Roles of nurse practitioners and family physicians in community health centres.

Research Roles of nurse practitioners and family physicians in community health centres
Simone Dahrouge MSc PhD Laura Muldoon MD MPH CCFP FCFP Natalie Ward MSc PhD William Hogg MSc MClSc MD CM FCFP Grant Russell MB BS FRACGP MFM PhD Rebecca Taylor-Sussex MA
Abstract Objective To describe the models of practice used by nurse practitioners (NPs) and FPs in community health centres (CHCs), and to examine the roles of NPs and FPs in these models.
Design Cross-sectional study using an organizational survey completed by managers of the CHC sites, as well as administrative data on patient sociodemographic characteristics and encounter activities.
Setting A total of 21 CHCs (13 main sites and 8 satellite sites) operating in eastern Ontario during the period from December 1, 2006, to November 30, 2008.
Participants A total of 44 849 patients, 53 full-time equivalent FPs, and 41 full-time equivalent NPs.
Main outcome measures Family physicians and NPs models of practice, the sociodemographic characteristics and medical profiles of patients who were treated in each model of practice, and FPs and NPs use of time.
Results Patients were attributed to 1 of 3 models of practice in CHCs based on the proportion of visits to FPs and NPs: FP care (53% of patients), NP care (29%), and shared care (18%). Patients who received care in the NP model of practice were younger and more likely to be female, be homeless, and not have postsecondary education. Patients who received care in the FP model of practice had more complex medical conditions (cardiovascular disease, mental illness, lung disease, and diabetes) and more annual visits. Patients who received care in the shared care model had intermediate profiles. Nurse practitioners performed more off-site care and walk-in visits. Family physicians and NPs spent a similar proportion of time performing various duties such as direct clinical care and administration tasks.
Conclusion Although NPs mainly cared for their own patient panels (in the NP care model), they did share some patients with FPs and provide some care to patients under the FP model of practice. Patients who were cared for by FPs and NPs had quite different characteristics.
editors key points This study documented differences in patient profiles and care provision among the practice models of nurse practitioners (NPs) and FPs in 21 Ontario community health centres.
Nurse practitioners and FPs dedicated a similar proportion of their time to performing various face-to-face duties outside of the clinic but tended to be involved in different types of activities. Nurse practitioners provided more walk-in care and fewer same-day appointments than FPs did. Nurse practitioners also performed more street outreach functions. Nurse practitioner appointments were also slightly longer than FP appointments were. On-call services were considerably more likely to be covered by FPs than NPs.
Compared with FPs, NPs saw patient panels that were less medically complex but more socially complex.
This article has been peer reviewed. Can Fam Physician 2014;60:1020-7
Vol 60: noVember noVembre 2014 | Canadian Family Physician Le Mdecin de famille canadien 1021
Recherche
points de repre dU rdACteUr Dans cette tude, on a voulu dterminer ce qui diffrencie les modes de pratique des infirmires praticiennes (IP) et des MF pour ce qui est des types de patients et des soins dispenss, et ce, dans 21 centres de sant communautaires de lOntario.
Les infirmires praticiennes et les MF consacraient la mme proportion de leur temps des rencontres avec des patients lextrieur de la clinique, mais leurs activits taient souvent diffrentes. Par rapport aux MF, les infirmires praticiennes faisaient plus de sans-rendez-vous et donnaient moins de rendez-vous le jour mme. Elles assumaient aussi plus de fonctions lextrieur de la clinique. La dure de leurs rendez-vous tait aussi plus longue que celle des MF. En-dehors des heures normales, les services taient beaucoup plus souvent fournis par les MF que par les IP.
Par rapport aux patients des MF, ceux des IP avaient des conditions mdicales moins graves mais des problmes sociaux plus complexes.
Cet article a fait lobjet dune rvision par des pairs. Can Fam Physician 2014;60:1020-7
Rles respectifs des infirmires praticiennes et des mdecins de famille dans les centres de sant communautaires
Simone Dahrouge MSc PhD Laura Muldoon MD MPH CCFP FCFP Natalie Ward MSc PhD William Hogg MSc MClSc MD CM FCFP Grant Russell MB BS FRACGP MFM PhD Rebecca Taylor-Sussex MA
Rsum Objectif Dcrire les modes de pratique propres aux infirmires praticiennes (IP) et aux MF dans les centres de sant communautaires (CSC) et vrifier les rles respectifs des MF et des IP dans ces modles de pratique.
Type dtude tude transversale laide dune enqute organisationnelle complte par les gestionnaires des CSC, laide des donnes administratives sur les caractristiques sociodmographiques des patients et sur les activits de contact.
Contexte Un total de 21 CSC (23 sites principaux et 8 sites satellites) oprant dans lest de lOntario entre le 1er dcembre 2006 et le 30 novembre 2008.
Participants Un total de 44 849 patients, 53 MF quivalents temps plein et 41 IP quivalents temps plein.
Principaux paramtres ltude Les modles de pratique des MF et des IP, les caractristiques sociodmographiques et les profils mdicaux des patients traits selon chacun des modles de pratique et lemploi du temps des MF et des IP.
Rsultats Les patients ont t rpartis dans un des 3 modles de pratique utiliss dans les CSC en fonction de la proportion de leurs rencontres avec des MF ou des IP : rencontres avec des MF (53 % des patients), avec des IP (29 %) et avec les deux (18 %). Les patients soigns dans le modle de pratique des IP taient plus jeunes et plus susceptibles dtre des femmes, dtre sans domicile fixe et davoir une scolarit ne dpassant pas le secondaire. Les patients traits dans le modle de pratique des MF avaient des conditions mdicales plus complexes (diabte, maladie cardiovasculaire ou pulmonaire et problmes de sant mentale) et plus de visites annuelles. Les patients du modle des soins partags avaient des profils intermdiaires. Les IP faisaient plus de soins lextrieur du centre et plus de sans rendez-vous. Mdecins praticiens et IP consacraient une proportion semblable de leur temps diffrentes tches comme des soins cliniques directs ou des tches administratives.
Conclusion Quoique les IP soignent principalement des patients de leur propre groupe (selon le modle de soins propre aux IP), elles partageaient certains patients avec les MF et leur prodiguaient certains soins selon le modle de pratique des MF. Les patients traits conjointement par des MF et des IP avaient des caractristiques plutt diffrentes.
1022 Canadian Family Physician Le Mdecin de famille canadien | Vol 60: noVember noVembre 2014
Research | Roles of nurse practitioners and family phy

 

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