Stakeholder Participation in Primary Care System Change: A Case Study Examination of the Introduction of the First Nurse Practitioner-Led Clinic in Ontario

摘要: Purpose: To examine stakeholder participation in the primary care system change process that led to introduction of first Nurse Practitioner-Led Clinic Ontario. Design: Qualitative case study guided by principles and theory. Setting: Northern Community Ontario, Canada. Participants: Purposeful sample healthcare providers, managers health policy stakeholders. Procedures: This was bound place (Sudbury), time (January 2006–January 2008), activity (stakeholder participation), (introduction an innovation, during a change). Semi-structured individual interviews were conducted with participants who represented clinic, local community, province. Public documents, such as newspaper articles published 2 year boundary for this professional organization publications, also examined. Interviews analyzed using qualitative content analysis public documents reviewed key messages complement interview findings. Field notes written data collection used provide additional depth, contribute insights data, ascribe meaning results. Main Findings: Sixteen Twenty which yielded most specific information relevant boundaries activities selected reviewed. Six main themes are reported: felt need, two visions (one one Family Health Teams [FHTs]), vision processes related ensuring became or continued be reality Ontario’s (shaping, sharing, protecting vision), activities, sustaining spreading vision. Conclusions: In case, influenced decisions contributor introduce Stakeholders motivated various needs engage innovation care. One common both those supported opposed it need improved patient access STAKEHOLDER PARTICIPATION IN PRIMARY CARE SYSTEM CHANGE iii