Journey Mapping of the Primary Care Providers Experiences During Patient Visits

Purpose/Objective(s):  According to the Ontario College of Family Physicians Report, “A Profession in Crisis”, two-thirds of family doctors are looking to change or leave practice in the next 5 years for various reasons including administrative burden, and 1.3 million Ontarians are currently without a primary care provider (PCP). The purpose of this study was to explore PCPs’ experiences to identify opportunities for improvement when delivering care to patients. 

Methods:  An exploratory qualitative design was used to explore the experiences of PCPs providing primary care to patients. Six one-on-one interviews and two focus groups (n = 6 respondents/focus group) were conducted with family physicians (13) and nurse practitioners (5) within the Frontenac, Lennox & Addington (FLA) region using journey mapping, a co-design and an engagement tool. The qualitative data were thematically analyzed through open coding in NVivo software.

Results:  PCPs reported procedures used to prepare for patients visits included email and chart reviews, reviewing cases scheduled for the day and reviewing and preparing patient’s requirement (e.g., blood work and anticipating patients' needs). Challenges associated with preparation included difficulty predicting patient’s need, limited time for preparation, systemic barriers, limited information about patient’s concerns during appointment booking and technological issues with EMR system. Challenges encountered during patient visits included limited human resources, limited time slots for appointments, and dealing with elderly patients with cognitive impairments who attend appointments alone. PCPs also identified challenges in timely and informative communication with specialists. To improve patient care, PCPs recommended patient education on appropriate expectations within a single visit; increased administrative capacity to improve efficiency and reduce administrative burden; and streamlined approaches for making referrals and communicating with specialists.

Conclusions:  This study provides evidence-based recommendations and opportunities to improve PCPs’ experiences delivering care, leading to potential improvements in patient experience. The results identified areas where PCPs require support to increase efficiency and improve job satisfaction which may, in turn, increase retention and attachment.

Impact:  This study provides evidence-based recommendations and opportunities to improve primary care providers' experiences delivering care, leading to potential improvements in patient experience. The results identified areas where PCPs require support to increase efficiency and improve job satisfaction which may, in turn, increase PCP retention and attachment to primary care.