Experiences of a new work model among primary care staff when treating patients with hypertension – a qualitative study

TL;DR

A new nurse-led work model for hypertension care was tested, and it improved efficiency and job satisfaction when supported by management and teamwork.

Contribution

The study introduces a nurse-led work model for hypertension care and identifies factors for successful implementation.

Findings

The new work model was appreciated by staff and improved workload and treatment efficiency.

Successful implementation required management support, teamwork, and staff experience.

Structured protocols alone were insufficient without personal qualities and cooperation.

Abstract

Hypertension care requires considerable resources from primary healthcare, and efficient work models are desirable both to improve treatment outcome and to ease staff workload. This study’s objective was to describe how healthcare staff experienced the implementation of a new nurse-led work model for hypertension care.

Qualitative content analysis was used for data analysis. Digitally conducted interviews with 14 physicians, nurses and managers from six of the eleven primary healthcare centres participating in an intervention to improve hypertension care in the Västra Götaland region. The intervention included training of healthcare professionals in a new nurse-led team work model using standardized protocols for treatment and follow-up.

Results: The intervention was appreciated, even requested, by both nurses, physicians and managers. The clearly defined division of tasks in the team provided structure, safety, and eased the workload. Treatment was streamlined and the work was perceived as more professional and stimulating. However, implementation of the new work model, including task shift, required close cooperation between nurses and physicians, trust and dedication. Implementation failed if the staff turnover was high, or if management support lacked. Personal qualities, judgement, experience and learning by cooperating with each other, were highlighted as important additional factors for competence and professionally performed hypertension care.

Conclusion: Healthcare can benefit from this intervention, but manager support and involvement of both nurses and physicians are crucial factors for successful implementation. Structured protocols cannot replace experience and personal qualities but provide appreciated support and increased safety.

Introducing a work model including task shifting between physician and nurse might be a way to streamline hypertension care.Support from the management was crucial for a successful implementation of the new nurse-led work model.Clearly defined teamwork eased the workload and streamlined treatment, but required involvement of both nurses and physicians.In addition to structure and protocols, personal qualities and experience were considered important for a professionally performed hypertension care.

Support from the management was crucial for a successful implementation of the new nurse-led work model.

Clearly defined teamwork eased the workload and streamlined treatment, but required involvement of both nurses and physicians.

In addition to structure and protocols, personal qualities and experience were considered important for a professionally performed hypertension care.