PT  - JOURNAL ARTICLE
AU  - Mylaine Breton
AU  - Isabelle Gaboury
AU  - Christine Beaulieu
AU  - Maxime Sasseville
AU  - Catherine Hudon
AU  - Sabina Abou Malham
AU  - Lara Maillet
AU  - Arnaud Duhoux
AU  - Isabel Rodrigues
AU  - Jeannie Haggerty
TI  - Revising the advanced access model pillars: a multimethod study
AID  - 10.9778/cmajo.20210314
DP  - 2022 Jul 01
TA  - CMAJ Open
PG  - E799--E806
VI  - 10
IP  - 3
4099  - http://www.cmajopen.ca/content/10/3/E799.short
4100  - http://www.cmajopen.ca/content/10/3/E799.full
SO  - CMAJ2022 Jul 01; 10
AB  - Background: The advanced access model was developed 20 years ago and has been implemented in several countries. We aimed to revise and operationalize the pillars and subpillars of the advanced access model based on its contemporary practice by professionals in primary health care.Methods: This multimethod sequential study was informed by a literature review and an expert panel of provincial and local decision-makers, primary health care clinic members (family physicians, nurses and administrative staff), patients and researchers from the province of Quebec. Throughout the consultation process, participants were asked to develop a common vision of the pillars and subpillars that make up the advanced access model and to react to suggested definitions or content.Results: The revised advanced access model is defined by 5 pillars, of which 2 were updated from the original model (“Appointment system” and “Interprofessional practice”), 1 was merged with a revised pillar (“Develop contingency plans” with “Planning of needs and supply”) and 1 underwent major transformations (“Backlog reduction” to “Continuous adjustment”). A new pillar concerning communication emerged from the consultation process. Subsequent steps for operationalizing definitions of subpillars confirmed the nature of the revised advanced access pillars and stabilized their content.Interpretation: The overall consultation process resulted in a revised contemporary advanced access model, with strong consensus among participating experts. The revised model will be used to develop a reflective tool for primary health care professionals to evaluate their advanced access practice.