Start2VIHP: people management in the general practice

In short

The general practitioner sector is under strain. The current way of running practices is based on the needs of the population from 30 years ago. It is not prepared for today's needs or those of the future. The traditional model, where one general practitioner does everything, is no longer sustainable. Many GPs are quitting or looking for ways to optimize their practices. One solution lies in task delegation, where a GP assigns certain tasks to other professionals (usually nurses or practice assistants) while retaining overall responsibility.

Despite the limited capacity for innovation among GPs, pioneers are already experimenting with task delegation. They are seeking optimal ways to evolve from a traditional to an interdisciplinary practice. There is a need for concrete guidance, supportive tools, and knowledge in making decisions, recruiting, and selecting (intake management) a nurse, as well as in training and integrating them (onboarding).

Good intake management facilitates attracting talent, promotes employee retention, and increases productivity. Improved onboarding shortens the time it takes for new employees to reach the desired performance level. Opportunities exist to adapt and apply existing human resources and management knowledge—such as optimizing organizational structures and competency and career management—to GP practices.

Despite the potential economic and societal benefits, such as increased revenue and higher job satisfaction, GPs (and practices) face tangible obstacles when implementing task delegation to a nurse. These barriers include a lack of knowledge and experience, ethical-legal, economic, and technical requirements, and resistance among healthcare professionals. In this project, we are collaborating with all stakeholders to develop solutions to these barriers.

In a co-creative process, we focus on two target groups:

Flemish general practices (both those that already collaborate with a nurse and those that do not) and their (future) healthcare providers. These practices represent highly diverse organizational forms, ranging from very small setups (e.g., two-GP practices) to medium-sized organizations (e.g., Wit-Gele Kruis). These target groups face limitations in conducting research and development independently.

Service-oriented companies (e.g., social secretariats, service providers, temporary employment agencies, and consultancy firms for the healthcare sector) and technology companies (e.g., coaching and ICT firms) aimed at optimizing existing offerings and developing (new) high-quality solutions tailored to the needs of general practices. These companies are generally small but operate with a high intensity of research and development. 

In addition, we collaborate with:

• Organizations representing the interests of general practices and their staff.
• Educational institutions at universities and colleges focused on innovative collaboration between healthcare professionals in general practices, leadership in healthcare, competency development, and organizational and change management.

Need and Relevance

General practices are in crisis: the organizational model is based on the needs of 30 years ago, not those of the present or future. General practitioners want to change but encounter barriers. Task delegation and new organizational models for general practices are the future.

Several innovation leaders are already experimenting with this, and policy is also investing heavily in it. General practices are seeking optimal implementation of the organizational model with task delegation.

Innovation is stalling due to a lack of tools, knowledge, competencies, and experience for optimal deployment of nurses. And so we (once again) lose a lot of time and money because nurses are not optimally deployed, are not performing their profitable tasks, and are therefore dropping out.

There are many opportunities to apply management knowledge to general practices to support nurse recruitment management and onboarding.

On the one hand, general practitioners are insufficiently aware of this offering, and on the other, there is a mismatch between the available resources and the needs of general practitioners. By optimizing these areas, we aim to create both economic added value (increased revenue, increased capacity, lifting the patient freeze, higher job satisfaction, reduced turnover, and reduced absenteeism) and societal added value (quality and efficiency of care).

From approach to impact

We have four steps in this project:

Activity 1:

Determining implementation conditions for the various stakeholders.

To achieve a feasible and effective implementation, mapping all ongoing processes, needs, and expectations of the stakeholders involved is crucial. In this phase, we conduct implementation research from five perspectives: patient perspective, care-specific (all general practice members), ethical-legal, organizational (technological, communication), and economic. We also connect with our own student population and that of our academic mentors at the University of Antwerp and Ghent University. We are convinced that consulting and involving them as senior researchers will also offer significant added value in this phase. This activity consists of three work packages that will start simultaneously.

Activity 2:

Co-creatively design and validate tools to support the two core processes in two types of pilot projects: inflow management (2A) and onboarding (2B) of nurses in general practice.

Activity 3:

Demonstrating the economic and societal impact of a strong implementation of nurses in general practice.

Activity 4:

Knowledge dissemination regarding the adoption of the results in Flemish general practices and their value chain.

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