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Table 6 Experiences Working in Primary Care during COVID-19: Four Themes and Representative Quotes

From: Interprofessional primary care during COVID-19: a survey of the provider perspective

Theme and Sub-themes Sample Quotes
Shifting Roles
 Explicit Role Change “I have been redeployed to the hospital so am working more in acute care. I have found though the primary care team to be less inclusive of allied health in COVID planning and decision making.”
“Shift in my role to more system planning locally, COVID-19 related activities (assessment centre), Long Term Care swabbing. Less typical primary care activities (prevention etc).”
 Implicit Role Change “I have had to quickly adjust my role to meet the needs of our patients and organization at this time. Thus, my role in some ways looks different than how I provide care typically.”
“More acute management versus chronic management.”
 Role Halted “There is little I can do for most of my clients via telephone other than check-in and ensure they have everything they need at home.”
“Many are cancelling services for nutrition counselling.”
“Leadership team has instructed to cut back on all non-essential occupational therapy services.”
 No role change, modality change “The biggest change has been working from home and not seeing patients in person. Other than that a lot of the workload is the same.”
Access
 Changing capacity “With fewer non-clinical interruptions throughout the day, I’ve been able to increase my capacity for clinical care.”
“I hope that moving forward we can continue to implement providing MORE care over the phone or via [videoconferencing]. I can see MORE patients during the day due to COVID with these changes of most care being provided over the phone.”
“I find that I’m able to reach more pts. in a day than previously, when in person visits were scheduled. This may be d/t the fact that most pts. and caregivers are also home during the day and able to participate in call.”
 Improved availability “It has reaffirmed the importance/necessity of in-person visits for many patients. It has also opened up the door to other possibilities as phone/virtual visits are possible and potentially even easier/more accessible for some patients.”
“Patients loving the phone access.”
“Several patient populations such as busy moms or seniors prefer phone follow-up as saves time or does not involve driving to appts.”
 Seeking health care “I realize people are living with their ailments rather than seeking medical care immediately.”
 Technology barriers “Difficult with those who are hearing impaired like many seniors.”
“Difficult to assess non-verbal when performing geriatric assessments. Difficult to assess cognition.”
“Depending on age demographics of patients and their comfort with technology, I am sometimes limited in what I can accomplish over the phone.”
Working in Teams
 Supporting each other “Supporting and understanding.”
“Great team support.”
“Our entire team work and support each other daily.”
 Working together to create solutions “The team has rallied and come together and is functioning well to ensure patients are given high quality care despite challenges.”
“Overall I’d have to say it’s been a learning experience in collaboration. I find our FHT has really pulled together and offered to help each other with programs/initiatives.”
 Missing team connection “I have certainly missed the camaraderie of working as a co-located team, and I am getting fewer “quick questions” from my colleagues. “
 Organizational leadership “When collaboration amongst all providers of care from clerical to physicians and IHPs can be done the improvement seen in morale and patient care is significant. When Admin appears out of touch and not engaged with the team the negative impact is more emphasized as it is already a period of uncertainty and fear for many team members.”
“I have felt incredibly supported by our management with recognition that this is different and hard and employees are managing various roles at home (not only remote working).”
“It has been very challenging, lacking a lot of guidance and consistent direction from physicians/management in our office.”
Personal Impact
 Isolating “Working from home has been unusual and isolating as I am accustomed to working with patients and colleagues in person.”
 Uncertainty and stress “Nothing is the same and it changes day to day.”
“Worries about how COVID-19 may affect self, family and colleagues - especially having to come into the clinic during the early days of the pandemic.”
 Mental and emotional toll “It is mentally and emotionally draining, as it is so hard to be effective without face to face visits or efficient when the service delivery has change [d] so much.”
“Constant COVID conversations with clients in distress constantly requires more time for self care, while balancing own family and needs.”
 Meaningful “For those families that are able to have appointments with me, I know I am making an impact.”
“My experience has been very positive-life changing actually. From a personal perspective, seeing our health team band together to support our community and to be witness to it is something I have no words for.”
“Honoured to be part of a Family Health Team.”
“Very exhilarating -proud to be a part of this.”
Inadequate Guidance
  “I feel that the hospital and media are all hyped on the hospital but everyone has forgot about primary care.”
“It has been hard to triage patients to determine whether or not they are considered “emergency or urgent care” as defined by our [professional] college.”
“Lack of decisions from the health system about how allied heath can support province-wide goals/plan. Individual teams/centres left to figure this out for themselves. Frustration among allied staff who do not have clear direction as to what essential service they can provide”