Evaluating Organisational Readiness for Advanced Access Implementation in Primary Healthcare: A Qualitative Study
4 affiliations
- 1Postgraduate Program in Family Health Federal University of Health Sciences of Porto Alegre (UFCSPA) Porto Alegre Rio Grande do Sul Brazil
- 2Undergraduate Nursing Program Federal University of Health Sciences of Porto Alegre (UFCSPA) Porto Alegre Rio Grande do Sul Brazil
- 3Department of Public Health Federal University of Health Sciences of Porto Alegre (UFCSPA) Porto Alegre Rio Grande do Sul Brazil
- 4Department of Nursing Federal University of Health Sciences of Porto Alegre (UFCSPA) Porto Alegre Rio Grande do Sul Brazil
Abstract
Rationale: Advanced access has been proposed to improve responsiveness in primary healthcare, but its sustainability depends on organisational conditions that are often insufficiently evaluated in territorially based public health systems.
Aims and Objectives: To evaluate multiprofessional perspectives on organisational readiness and implementation factors influencing the transition from traditional appointment scheduling to advanced access in primary healthcare.
Methods: A qualitative exploratory‐descriptive study with an interpretive perspective was conducted with 20 professionals working in Family Health Strategy teams in southern Brazil. Semi‐structured interviews were transcribed verbatim and analysed using thematic content analysis. Analysis was guided deductively by the organisational readiness for change framework and complemented by inductive coding.
Results: Six evaluation domains were identified: management and leadership; human resources and infrastructure; work processes; culture and internal relationships; communication and community; and workload and well‐being. Leadership support, territorial sizing, workforce stability, interprofessional coordination, qualified initial reception and communication with the community shaped implementation. Participants perceived advanced access as capable of improving access and reducing conflict, but warned that insufficient planning, fragile institutional support and workload intensification could compromise sustainability.
Conclusion: Advanced access should be evaluated as an organisational change rather than a technical adjustment to appointment books. Sustainable implementation requires readiness across governance, workforce, work processes, relational culture and community communication.
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BibTeX
@article{chies2026evaluating,
title = {{Evaluating Organisational Readiness for Advanced Access Implementation in Primary Healthcare: A Qualitative Study}},
author = {Gabriel Antônio Flores Chies and Gisele Teixeira de Souza and Maria Eugênia Bresolin Pinto and Alisia Helena Weis},
journal = {Journal of evaluation in clinical practice},
year = {2026},
month = nov,
doi = {10.1111/jep.70714},
url = {https://europepmc.org/article/PMC/PMC13730315},
note = {CC BY},
}
RIS
TY - JOUR
TI - Evaluating Organisational Readiness for Advanced Access Implementation in Primary Healthcare: A Qualitative Study
AU - Gabriel Antônio Flores Chies
AU - Gisele Teixeira de Souza
AU - Maria Eugênia Bresolin Pinto
AU - Alisia Helena Weis
PY - 2026
DA - 2026/11/03
JO - Journal of evaluation in clinical practice
DO - 10.1111/jep.70714
UR - https://europepmc.org/article/PMC/PMC13730315
AB - Rationale: Advanced access has been proposed to improve responsiveness in primary healthcare, but its sustainability depends on organisational conditions that are often insufficiently evaluated in territorially based public health systems. Aims and Objectives: To evaluate multiprofessional perspectives on organisational readiness and implementation factors influencing the transition from traditional appointment scheduling to advanced access in primary healthcare. Methods: A qualitative exploratory‐descriptive study with an interpretive perspective was conducted with 20 professionals working in Family Health Strategy teams in southern Brazil. Semi‐structured interviews were transcribed verbatim and analysed using thematic content analysis. Analysis was guided deductively by the organisational readiness for change framework and complemented by inductive coding. Results: Six evaluation domains were identified: management and leadership; human resources and infrastructure; work processes; culture and internal relationships; communication and community; and workload and well‐being. Leadership support, territorial sizing, workforce stability, interprofessional coordination, qualified initial reception and communication with the community shaped implementation. Participants perceived advanced access as capable of improving access and reducing conflict, but warned that insufficient planning, fragile institutional support and workload intensification could compromise sustainability. Conclusion: Advanced access should be evaluated as an organisational change rather than a technical adjustment to appointment books. Sustainable implementation requires readiness across governance, workforce, work processes, relational culture and community communication.
SN - 1356-1294
SN - 1365-2753
ER -