Exploring the Barriers and Facilitators to the Integration of the Nurse Practitioner as Most Responsible Provider Model of Care in a Hospital Setting

Abstract

Background: Since 2012, nurse practitioners (NPs) in Ontario have the professional capacity to assume the role of the most responsible provider (MRP) in hospitals; however, few have implemented this model. Aim: To explore the barriers and facilitators to the integration of the NP as MRP model of care in a hospital setting. Methods: A qualitative descriptive design with secondary data collected from a larger study, was used with principles from integrated knowledge translation. Findings: Thirteen barriers and eleven facilitators were found, such as: (i) challenges with off hour coverage; (ii) funding and remuneration; (iii) discrepancies in the employment standards regulations; and (iv) lack of a critical mass. Facilitators included the plan for role implementation, establishment of trust and leadership from the team. Conclusion: Many barriers, predominantly at the healthcare system-level, make it difficult to integrate the NP as MRP model of care in hospitals.