title: Complexities of Introducing Group Medical Visits With Nurse Practitioners in British Columbia.
abstract: In Canada, increasing numbers of people with chronic conditions have prompted calls for innovative approaches to delivering primary care. These approaches may include group medical visits (GMVs) and the introduction of nurse practitioners (NPs). We examined why NPs in the province of British Columbia were not using GMVs. This case study is part of a larger research project that examined the impact of GMVs with NPs for patients with chronic conditions. We completed open-ended interviews with seven NPs working in primary care. Interviews were audiotaped and transcribed. Data were analyzed using interpretive descriptive approaches. Three major themes emerged: (a) advantages of GMVs, (b) questioning the fit of GMVs in current practice contexts, and (c) navigating scope of practice and role constraints that affect NPs' ability to use GMVs. Power dynamics and hierarchies may influence NPs' ability to adapt to GMVs. Consideration of practice environments and structures that enable the NPs ability to diffuse and utilize health-care innovative care delivery methods is needed.
authors: 1 School of Nursing, University of British Columbia, Port Moody, Canada.
authors: Laura
authors: L
authors: Housden
authors: 2 School of Nursing and Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada.
authors: Sabrina T
authors: ST
authors: Wong
authors: 3 School of Nursing, University of British Columbia, Vancouver, Canada.
authors: Annette J
authors: AJ
authors: Browne
authors: 4 Department of Family Practice, University Boulevard, Vancouver, BC, Canada.
authors: Martin
authors: M
authors: Dawes
mesh_terms: D001955:British Columbia; D006126:Group Processes; D006801:Humans; D009722:Nurse Practitioners / Q000458:organization & administration*; D024802:Nurse's Role; D010348:Patient Care Team / Q000458:organization & administration*; D018802:Patient-Centered Care; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research
keywords: advanced practice nursing; chronic disease management; group visits; innovation; primary care