Revue réaliste des modèles de services de première ligne
Background: It increasingly appears that the sustainability of health systems depends in part on expanding the care provided by primary care teams. There are many examples of successful primary care models in several countries. However, Quebec generally fails to meet its objectives of accessibility, equity and efficiency. There is growing evidence on the importance of nursing care in primary health services, but it provides little actionable advice on how to reform primary care models given the diversity of clinical settings. The complexity of the interventions needed to reform primary care models is a challenge. Objective: This research reports the results of a realist review on optimizing the contribution of interprofessional and nursing teams in primary health care. Method: An analysis of the literature based on the realist review and the logic analysis was conducted to determine the desirable structural characteristics of health care services models that tend to an extended or optimized contribution of interprofessional teams. Results: The realist review helped to develop two analytical typologies to establish coherent operating bases to improve the performance of models of primary health services. Practice implications : These typologies ultimately aim to facilitate the use of evidence for decision makers to support the necessary transformation processes of primary health care in Quebec.
Performance Accessibility Comprehensiveness Primary care Nursing contribution Realist review Logic analysis