No Band-Aids for papercuts: understanding and addressing challenges of administrative workload in primary care in Canada
Bibliographic record
Abstract
BACKGROUND: The challenges associated with administrative workload in primary care have been widely acknowledged and discussed, yet little qualitative research has been conducted to understand experiences of administrative workload among primary care clinicians and administrative staff or to inform strategies to address it. OBJECTIVE: To understand experiences of administrative workload in primary care and how areas of concern might be addressed. METHODS: We conducted thirty-six (36) semi-structured qualitative interviews with family physicians, nurse practitioners, and administrative staff working in primary care clinics in the Canadian provinces of Nova Scotia and New Brunswick. We used Braun and Clarke's approach to reflexive thematic analysis, which resonated with our critical qualitative approach and critical relativist epistemology. FINDINGS: We identified three themes using inductive and descriptive analysis. The first pertains to working without the right tools or guidelines to support administrative processes. The second theme highlights tensions within teamwork surrounding administrative work, which negatively impact team collaboration. The third theme recognizes that primary care components are interconnected and interdependent, and that this needs to be considered when addressing challenges of administrative workload. CONCLUSION: Inefficient tools (e.g. some electronic medical records, lack of interconnectivity between information systems, lengthy forms), lack of documentation of processes, lack of training, loss of autonomy over decision-making, interprofessional tensions embedded in system challenges, and Band-Aid solutions to complex problems all increased administrative workload in primary care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".