BackgroundPatient satisfaction is an important element of quality improvement and patient-centered care, and is an indicator of the public’s confidence in the health care system. Although shorter wait times are believed intuitively to lead to higher satisfaction, studies have demonstrated the importance of many other factors which contribute to patients’ satisfaction with their wait time experiences. The current study explores the factors that shape patients’ satisfaction with their overall wait times (i.e. from symptom to treatment).MethodsWe conducted qualitative interviews with 60 breast, prostate, lung, or colorectal cancer patients to examine the reasons behind patients’ satisfaction or dissatisfaction with their wait time experiences. We purposefully recruited satisfied and unsatisfied participants from our larger survey sample. Using a semi-structured interview guide, patients were asked about their wait time experiences and the reasons behind their (dis)satisfaction. Interviews were transcribed verbatim and coded using a thematic approach.ResultsPatients’ perceptions of satisfaction with wait times were influenced by three interrelated dimensions: the interpersonal skills of treating physicians (which included expressions/demonstrations of empathy and concern, quality of information exchange, accountability for errors), coordination (which included assistance navigating the health system, scheduling of appointments, sharing information between providers, coordination in scheduling appointments, and sharing of information ), and timeliness of care (which referred to providers’ responsiveness to patients’ symptoms, coverage during provider absences, and shared sense of urgency between patient and providers). Providers’ willingness to “trouble shoot” and acknowledge errors/delays were particularly influential in patients' overall perception of their wait times.ConclusionsWe described three dimensions of wait-related satisfaction: physicians’ interpersonal skills, coordination of care, and timeliness of care, which are often interrelated and overlapping. Furthermore, while patients wait-related satisfaction was typically based on multiple interactions with different providers, positive or negative experiences with a single provider, often (but not always) the family physician, had a substantial impact on the overall satisfaction or dissatisfaction with wait time experiences. The findings provide a conceptual basis for the development of validated instruments to measure wait time-related patient satisfaction.
IntroductionGiven the recurrent risk of respiratory illness-based pandemics, and the important roles family physicians play during public health emergencies, the development of pandemic plans for primary care is imperative. Existing pandemic plans in Canada, however, do not adequately incorporate family physicians’ roles and perspectives. This policy and planning oversight has become increasingly evident with the emergence of the novel coronavirus disease, COVID-19, pandemic. This study is designed to inform the development of pandemic plans for primary care through evidence from four provinces in Canada: British Columbia, Newfoundland and Labrador, Nova Scotia, and Ontario.Methods and analysisWe will employ a multiple-case study of regions in four provinces. Each case consists of a mixed methods design which comprises: (1) a chronology of family physician roles in the COVID-19 pandemic response; (2) a provincial policy analysis; and (3) qualitative interviews with family physicians. Relevant policy and guidance documents will be identified through targeted, snowball and general search strategies. Additionally, these policy documents will be analysed to identify gaps and/or emphases in existing policies and policy responses. Interviews will explore family physicians’ proposed, actual and potential roles during the pandemic, the facilitators and barriers they have encountered throughout and the influence of gender on their professional roles. Data will be thematically analysed using a content analysis framework, first at the regional level and then through cross-case analyses.Ethics and disseminationApproval for this study has been granted by the Research Ethics of British Columbia, the Health Research Ethics Board of Newfoundland and Labrador, the Nova Scotia Health Authority Research Ethics Board and the Western University Research Ethics Board. Findings will be disseminated via conferences and peer-reviewed publications. Evidence and lessons learnt will be used to develop tools for government ministries, public health units and family physicians for improved pandemic response plans for primary care.
Family physicians play important roles throughout all stages of a pandemic response; however, actionable descriptions outlining these roles are absent from current pandemic plans. Using a multiple case study design, we conducted a document analysis and interviewed 68 family physicians in four Canadian regions. We identified roles performed by family physicians in five distinct stages of pandemic response: pre-pandemic, phased closure and re-opening, acute care crisis, vaccination, and pandemic recovery. In addition to adopting public health guidance to ensure continued access to primary care services, family physicians were often expected to operationalize public health roles (eg, staffing assessment centres), modulate access to secondary/tertiary services, help provide surge capacity in acute care facilities, and enhance supports and outreach to vulnerable populations. Future pandemic plans should include family physicians in planning, explicitly incorporate family physician roles, and ensure needed resources are available to allow for an effective primary care response.
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