Perceptions and experiences of family physicians on the roles of administrative staff during COVID-19: Findings from a cross-provincial qualitative study

Abstract

Abstract Background Administrative staff in primary care undertake numerous tasks to support patient care delivery. Although their roles are often overlooked, administrative staff are essential to the coordination and operations of primary care clinics. The COVID-19 pandemic introduced additional clinical and administrative tasks, including transitioning to virtual appointments and triaging patients for urgency, changing typical workflows. In Canada, existing pandemic plans for primary care did not account for these administrative tasks, nor the support that family physicians would require to continue to provide patient access to primary care. This research seeks to understand the administrative roles in primary care, with a particular focus on the roles of administrative staff, to help inform future pandemic planning. Methods We present findings from a qualitative case study across four regions in Canada: Vancouver Coastal health region in British Columbia, Ontario Health West region, the province of Nova Scotia, and the Eastern Health region of Newfoundland and Labrador. We conducted semi-structured qualitative interviews with family physicians (n=68) across the four regions and thematically analysed the data. Results We identified five salient themes in the data, including 1) applying public health guidelines, 2) educating patients on COVID-19 and COVID-19 services, 3) re-organizing patient visits, 4) maintaining adequate staffing, and 5) recognizing administrative staff contributions. During the COVID-19 pandemic, family physicians took on numerous additional roles to reduce the risk of transmission of the virus with the support of their administrative staff. Family physicians emphasized the challenges of maintaining adequate staffing, and the importance of administrative staff in enabling the provision of primary care. Conclusions The COVID-19 pandemic exposed existing gaps in primary care, such as the lack of clinical training for administrative staff, and challenges that should be addressed in future pandemic planning such as timely and consistent guidance and clearly delineated professional roles. Given the vital role of administrative staff, their tasks and responsibilities should be included in future pandemic plans.