The experience of an innovative interdisciplinary model of primary care delivery in changing organizational dynamics: a grounded theory study.

Abstract

Introduction: Changing dynamics are pushing institutions to focus on care delivery innovation. To address the shortage of general practitioners (GPs), an Italian health district recently introduced a new primary care model called Primary Health Point (PHP) to provide primary integrated care to its population.

Aim: To investigate the healthcare professionals' (HCPs) experience regarding the introduction of the PHP and to describe its process of care delivery.

Methods: Qualitative study design with a grounded theory approach and convenience sampling. Interviews were conducted using a semi structured guide to explore the experience of HCPs working at the PHP. The development of open coding was followed by the creation of categories. The analysis was conducted utilizing NVivo software.

Results: Twelve HCPs working at the PHP were interviewed and highlighted the model structure. The themes were the context and the antecedents that identified the most common health complaints and the patients with more needs and reflected on the traditional GP model; the process, which highlighted the complexity of interdisciplinary teamwork and the role of the Family and Community Nurse (FCN) in the new model; the outcome identified the factors mediating satisfaction with the care delivered by the PHP.

Conclusions: The PHP has been considered a possible alternative to the GP model by its end users. It addresses disease pathway coordination, referrals, and medication management, focusing on chronic and older adult populations. It features interdisciplinary workflows with rotating physicians and consistent family nurse support. Proactive monitoring and a focus on disease education benefit fragile patients.