A qualitative study exploring the influence of clinic funding on the integration of family practice nurses in Newfoundland and Labrador

Abstract

Aim This study explores the contributions of family practice nurses in primary care across Newfoundland and Labrador funded by fee‐for‐service and alternate payment plans to examine the influence of funding arrangements on nursing roles/activities. Design A qualitative descriptive design was employed. Methods Semi‐structured telephone interviews were conducted between March‐July 2018 with physicians and Registered Nurses working in primary care settings in Newfoundland and Labrador. Interviews were transcribed verbatim, and a content analysis approach was used to identify recurring themes. Results Clinic funding was instrumental in the integration of family practice nurses into primary care settings and influenced roles/activities. In fee‐for‐service practices, nurses work with physicians and focus on one‐on‐one patient care in office‐based settings, whereas nurses in alternate payment plans practices work more independently, in a wider range of settings and with emphasis on both individual and group‐based encounters. Compared with alternate payment plans practices, fee‐for‐service practices tend to be more restrictive due to physician billing requirements.

Family Practice Nursing in Newfoundland and Labrador: Are Reported Roles Reflective of Professional Competencies for Registered Nurses in Primary Care?

“…In our original study ( Mathews et al, 2020 ), eight interviews were conducted (five family practice nurses and three family physicians; six females and two males), ranging from 19–36 minutes in length. Participants worked in a variety of settings, including fee-for-service and globally-funded practices, and in both rural and urban communities.…”

“…We found substantial variation in the expression of professional competencies among the participants in our study. Our original study found that the funding model under which family practice nurses work in NL influences the nature and scope of their role ( Mathews et al, 2020 ). Across Canada, provinces use a variety of funding models to finance family practice nurses, including global funding, capitation, and enhanced fee-for-service.…”

“…A detailed description of the methods, including how study participants were recruited for the original study, is published elsewhere ( Mathews et al, 2020 ). Participants were family physicians and family practice nurses working in primary care settings in NL.…”

“…We conduct a secondary analysis of qualitative interviews with family physicians and family practice nurses. The interviews were originally conducted by the study authors to examine the contributions of family practice nurses in primary care across NL in practices funded by fee-for-service and alternate payment plans ( Mathews et al, 2020 ). The national competencies for family practice nurses examined in this present study were published after the original interview data were collected ( Canadian Family Practice Nurses Association, 2019 ; Lukewich et al, 2020 ).…”

“…The national competencies for family practice nurses examined in this present study were published after the original interview data were collected ( Canadian Family Practice Nurses Association, 2019 ; Lukewich et al, 2020 ). The original study and results focused on the impact of funding structures on family practice nursing roles, and are published elsewhere ( Mathews et al, 2020 ).…”