Expanding the scope of practice for healthcare providers enhances access to care and allows teams to fully utilize their education and training. This approach ensures that patients receive the highest quality care from the most appropriate professional in the right setting and at the right time, tailored to their individual needs. 

With the growing prevalence of chronic diseases and multimorbidity, the demand for healthcare services often exceeds what physicians can handle alone. As healthcare professionals take on additional responsibilities, patients often feel more supported and engaged in their care, leading to higher satisfaction with their overall healthcare experience. When organizations empower other members of the interprofessional team to take on such responsibilities as prescribing medications, administering vaccines, and managing therapies, patients benefit from improved access to timely and essential care. Delegating tasks across a diverse team of healthcare providers increases system efficiency, alleviates the workload on physicians, and facilitates more effective care delivery.

The resources listed below can help your organization expand the contributions made by different members of your interprofessional health care team. 

# Nursing Staff

The tools linked below can help your organization identify and address gaps between the current and full scope of practice for registered nurses and registered practical nurses (RNs and RPNs) in your primary health care setting. 

# Gap Analysis 

Gap analysis is a process of finding gaps between the full scope of practice for a profession and the current functions being fulfilled by that profession in your organization. If your RNs and RPNs are not practicing to full scope, a gap analysis can help you figure out what's missing from their role and find opportunities to make the most of their expertise. 

These two tools from the Registered Nurses Association of Ontario (RNAO) can guide you in doing a gap analysis.

  • Primary Solutions for Primary Care outlines the full RN and RPN scope of practice. 
  • The Gap Analysis Tool will lead you through a process of comparing the current roles of RNs and RPNs in your organization to the full scope of practice. For each of the 30+ role description recommendations in the Primary Solutions document, you can flag whether your RNs and RPNs are performing the task consistently, inconsistently, or not at all, and then record change strategies for incorporating those tasks into their roles. 

# Barriers and Enablers of Full-Scope Practice

To expand the scope of practice for nurses, it is crucial to address both the enablers and barriers to implementation. This article, How Do We Achieve Full scope?  is part of a Primary Care Nurse Toolkit produced by RNAO. It identifies some of the key enablers for your organization to enhance and barriers to address in order to reach the improvement goals identified in your gap analysis. 

  • Key enablers include effective team communication, trust, role clarity, access to education, and a supportive organizational culture. 
  • Barriers identified include staff readiness, time constraints, lack of resources, and heavy workloads.

# Social Workers for Mental Health and Chronic Disease Management

A pressing need in primary heallth care is mental health. Social workers have an essential role to play in addressing this need. 

Social Work and Primary Care a brand-new report that emphasizes the importance of integrating social workers more fully into primary care as a way to meet rising demand for mental health and chronic disease management. Social workers in primary care provide a range of services, including assessments, crisis management, counseling, and support for patients with complex health needs. 

The report also discusses several barriers to fully utilizing social workers, including underrepresentation in primary care teams as well as pay disparities. It calls for increased access to social workers in primary care across Canada, ensuring they can practice to their full scope and are better represented in leadership roles. 

# Community Health Workers and Community Ambassadors

For decades, Alliance members have embraced the roles of Community Health Workers and Community Ambassadors.  are something that Alliance members have embraced for years. This report, published in Healthcare Policy, describes the vital ways community health workers contribute to advancing health equity in Canada. They assist patients in accessing necessary care, deliver health education, and offer guidance and counseling to those in need. 

The report argues that formally recognizing and supporting these roles, alongside integrating community health workers and Multicultural Health Brokers into health systems, can significantly enhance care delivery and address barriers faced by marginalized communities. 

# Other Interprofessional Roles in Primary Care

Team Primary Care is a project of Health Canada that aims to build a strong interprofessional primary care workforce across the country, as a key step in addressing the crisis in access to care. They are building capacity for effective interprofessional collaboration in primary care settings by sharing innovations that are ready for spread, developing learning and QI tools for better collaboration, helping organizations integrate new staff, and supporting people to work to the full scope of their professional practice. 

To support this last goal, Team Primary Care convened an Interprofessional Collaborative Table with representatives from 30 professions within primary care. Researchers and leaders from 25 of these professions were funded to develop learning resources that would empower richer integration of their professions into interprofessional primary care. Resources include pre- and post-licensure training, tools to support workflow and role integration, and detailed role descriptions to support decision-makers.  This page contains links to all of these resources.

# More Tools and Resources Coming Soon

Watch this space for

  • Best practice tools
  • Case examples 

Can't wait to get started? Email QI@AllianceON.org for guidance and coaching support.