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Background: Integrated Primary Care Teams (IPCTs) have four key characteristics (intensive interdisciplinary practice; advanced nursing practice with an expanded role; group practice; increased proximity and availability) aimed at strengthening primary care in Quebec, Canada. The purpose of this paper is to examine the care experience over time of patients who have an IPCT as their primary source of care. Methods: We used a quasi-experimental longitudinal design based on a pre-and-post administered survey at a 2-year interval without a control group. We measured patient-reported accessibility, continuity, comprehensiveness, responsiveness and outcomes of care. Results: Results showed that patients who were newly registered with an IPCT had a significant increase in reported care experience, whereas patients who have been registered with an IPCT for 2 years prior to the first round of data collection had already high reported care experience that was maintained over time. Moreover, linear regression models showed statistically significant different increases in the dimensions of care experience by site and patients’ characteristics. Conclusions: Our results suggest that the IPCT model is tailored to the needs of its target populations, resulting in improved Patient Reported Experience Measures. These results imply that broader implementation of innovative and flexible community-based care models should be considered by policymakers.

Background: Access to both valid and reliable nursing-sensitive indicators is currently limited in primary care. Purpose: The objectives were to (1) measure primary care nursing indicators using a wound care tracer condition and (2) study the associations between process and outcome indicators. Methods: We conducted a longitudinal study in an ambulatory care clinic in Quebec, Canada. The sample included 482 episodes of care. We studied 5 indicators related to processes and 3 to outcomes. Results: Performance levels were moderately high for indicators of initial assessment and duration and low for those of continuity and education. Associations between nursing follow-up and continuity indicators and 3 outcome indicators were highly significant. Conclusion: Continuity and nursing follow-up are associated with improved outcomes. Increasing these indicators' performance level can improve both nursing processes and patient outcomes.

Les pratiques utilisées pour soutenir la participation des personnes en situation de pauvreté comme cochercheures dans le cadre de recherche-action participative (RAP) ont été peu décrites. Après avoir présenté le cadre de réalisation d'une RAP sur la sécurité alimentaire, nous abordons des défis significatifs rencontrés pour pérenniser la participation des personnes les plus marginalisées à la gouvernance d'un projet de recherche, au-delà du rôle alibi auquel elles sont trop souvent cantonnées dont : la création de liens de confiance, le développement d'une vision commune, l'identification des contraintes à la participation, la tenue en compte des relations de pouvoir. Nous présentons des stratégies d'action développées, afin de relever les défis et enjeux en présence, en nous appuyant sur un guide co-construit par notre équipe de recherche. Des voies sont proposées pour impulser le déploiement des pratiques AVEC les personnes ayant vécu la pauvreté dans la gouvernance de projets de recherche. ABSTRACT. The practices used to support people living in poverty who are participating as co-researchers in a participatory action research (PAR) project have been little documented. After presenting the framework for carrying out a PAR on food security, we discuss the significant challenges encountered in sustaining the participation of the most marginalized people, beyond the alibi role to which they are too often confined, including the creation of bonds of trust, the development of a shared vision, the identification of constraints to participation, and the consideration of power relations. We present action strategies developed based on a guide co-constructed by our research team. We suggest ways to promote the deployment of participatory practices in the governance of research projects. MOTS-CLÉS. Recherche action participative, Personnes en situation de pauvreté, Pauvreté, Méthodologies participatives, Gouvernance participative, Principes et stratégies de recherche, Empowerment.

BackgroundThe use of audit and feedback (A&F) interventions in health care has been demonstrated to generally be effective on medical teams. However, literature suggests that the response of nurses to this type of intervention may differ from that of other types of health professionals, in relation to their roles, power, and to the configuration of nursing care activities. To our knowledge, no review has been conducted on A&F interventions with nurses. The objective of this systematic review is to examine the evidence of measured and perceived effects of A&F interventions on nurses’ performance.MethodsA mixed methods systematic review design with thematic and narrative synthesis is used. Studies reporting quantitative and qualitative data on the effects of A&F interventions specific to nursing care are considered for inclusion. Studies will be appraised for quality using the Mixed Methods Appraisal Tool. Quantitative and qualitative data will be summarized in narrative and tabular form and will be synthetized using a segregated methodologies approach.DiscussionResults will describe the characteristics of A&F with nurses, as well as the measured and perceived effects specific to nursing care. The associations between the characteristics and the effects as well as the concordance between measured and perceived effects will be presented. We anticipate that combining the evidence from qualitative and quantitative studies will allow us to provide relevant insight that can inform the design of better suited A&F interventions for nurses. Audit and feedback interventions demonstrate potential for improving the performance of nursing care. As their effectiveness varies greatly depending on the context and the professionals involved, a better understanding of the associations between its characteristics and the measured and perceived effects is valuable for improving the effectiveness of A&F.Systematic review registrationPROSPERO CRD42018104973Electronic supplementary materialThe online version of this article (10.1186/s13643-019-0956-1) contains supplementary material, which is available to authorized users.