Expert-informed and stakeholder-reviewed interprofessional triage model for primary care practices: a mixed-method study.

Abstract

To date, traditional primary care practices are often organized around the capacities of one or more physicians. New models of primary care practices involving other health professionals such as advanced practice nurses (APNs) require modified triage models for more adequate patient allocation. Therefore, a modified triage model was developed, informed by experts and reviewed by stakeholders. A convergent mixed-method design with four phases was employed. The study was conducted in Swiss primary care practices. Readiness for change of health professionals working in these primary care practices was surveyed. Triage was reviewed and modified according to expert recommendations, and its feasibility explored in two Delphi rounds with health professionals and stakeholders. Health professionals in primary care practices were interested in improving access to care. Observed triage continued to focus primarily on physicians. The modified triage model was viewed to be practicable, offering a potential way to support more systematic allocation of patients to physicians, APNs, and other health professionals depending on the reason for consultation. Drawing on international guidelines on triage in primary care practices, expert opinion on who seeks care in these practices, and review by stakeholders led to a modified triage model to include other health professionals than primary care physicians. This study did not involve patients but focused on triage in primary care practices. Hence, no trial registration was obtained.