title: Impact of a quality improvement intervention on nurses' management of same-day primary care flow.
abstract: OBJECTIVE
  To evaluate the impact of an interdisciplinary intervention designed to improve the capacity of nurses to manage walk-in patient demand for primary health care.
  
  
  BACKGROUND
  Implementation of a programme to expand nursing practice is a complex process that requires the application of context-appropriate measures and adaptation when results do not meet expectations.
  
  
  METHODS
  A longitudinal, uncontrolled intervention study with a 3-year follow-up, from 2009 to 2012, was carried out in Catalonia (northeast Spain). The intervention included three training periods focused on clinical and instrumentation topics. The capacity of nurses to manage walk-in patient demand was assessed by determining the number of cases resolved and of return visits for the same complaint within 72 hours.
  
  
  RESULTS
  In total, 2751 patient care demands were evaluated. Resolved cases increased (χ(2)  = 54.624, df = 1, P < 0.001) and the number of return visits decreased (χ(2)  = 54.585, df = 1, P < 0.001) significantly from baseline to the end of the study period.
  
  
  CONCLUSIONS
  Nurses' capacity to manage walk-in patient demand improved after an interdisciplinary intervention using a mutually agreed upon, locally adapted approach.
  
  
  CONCLUSIONS
  To improve outcomes, nurses in management positions should systematically consider the need for skills training, specific academic courses, leadership development and, as appropriate, legislative initiatives.
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Girona, Spain.
authors.forename: Jeroni
authors.initials: J
authors.lastname: Jurado-Campos
authors.affiliation: IDIAP Jordi Gol, Barcelona, Spain.|Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.
authors.forename: Edurne
authors.initials: E
authors.lastname: Zabaleta-Del-Olmo
authors.affiliation: Equip d'Atenció Primària Olot, Institut Català de la Salut (ICS), Olot, Spain.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Anglada-Dilme
authors.affiliation: Equip d'Atenció Primària Olot, Institut Català de la Salut (ICS), Olot, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Sanchez-Vilanova
authors.affiliation: Equip d'Atenció Primària Olot, Institut Català de la Salut (ICS), Olot, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Rabassa-Ester
authors.affiliation: Equip d'Atenció Primària Olot, Institut Català de la Salut (ICS), Olot, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Barberi-Costa
authors.affiliation: Equip d'Atenció Primària Olot, Institut Català de la Salut (ICS), Olot, Spain.
authors.forename: Magda
authors.initials: M
authors.lastname: Pages-Pascual
authors.affiliation: Servei d'Atenció Primària Girona Sud, ICS, Girona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Canet-Ponsa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006302:Health Services Research; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D059017:Primary Care Nursing / Q000379:methods* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods / Q000458:organization & administration* / Q000706:statistics & numerical data; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration* / Q000706:statistics & numerical data; D013030:Spain; D055815:Young Adult
keywords: health services research; nurse's role; primary health care; quality improvement; training