Context: Timely access is a key pillar of effective primary healthcare (PHC). The Advanced Access (AA) model, developed to increase timely access, has been promoted and adopted in primary care settings in various countries. Ongoing PHC professional and organizational development to improve AA practice and to enhance patient care could be enhanced with a reflective tool with respect to AA.
Objective: To develop a self-administered tool that will allow PHC providers to reflect on their AA individual and group practices and to formulate recommendations for improvements of AA.
Study Design: A modified Delphi methodology is being used to develop the tool, while operationalizing contemporary AA guiding principles and components.
Setting: The Delphi panel includes 26 experts in AA: primary care providers; managers; decision makers; patients; and researchers from the province of Quebec. In addition, a core team of nine researchers is closely following each step of the consultation.
Population studied: Experts on AA.
Outcome Measures: AA guiding principles and components. Strategies to improve AA will also be identified throughout the process.
Results: Based on literature and field experience, a consensus from a pre-Delphi face-to-face meeting with 32 AA experts confirmed five pillars: 1) Planning of needs and supply; 2) Continuous adjustment; 3) Appointment system; 4) Collaborative practice; and 5) Communication. Eighteen sub-pillars also emerged from the meeting. As a second step, a three-round Delphi consultation will aim to achieve consensus on the sub-pillars as well as indicators, for reflection on individual and group AA practices. Delphi panelists are being asked to rate the importance of each sub-pillar and indicator, specifically, with respect to their potential for modification and improvement of AA practice. The final step will consist of piloting the resulting reflective tool and assessing its psychometrics.
Conclusions: A co-constructed AA reflective tool, based on PHC providers’ experience, will provide PHC practitioners scores regarding the AA pillars, as well as personalized feedback on their practice and guidance on concrete ways to improve individually or as a group.