Evaluating Organisational Readiness for Advanced Access Implementation in Primary Healthcare: A Qualitative Study
Gabriel Antônio Flores Chies, Gisele Teixeira de Souza, Maria Eugênia Bresolin Pinto, Alisia Helena WeisABSTRACT
Rationale
Advanced access has been proposed to improve responsiveness in primary healthcare, but its sustainability depends on organisational conditions that are often insufficiently evaluated in territorially based public health systems.
Aims and Objectives
To evaluate multiprofessional perspectives on organisational readiness and implementation factors influencing the transition from traditional appointment scheduling to advanced access in primary healthcare.
Methods
A qualitative exploratory‐descriptive study with an interpretive perspective was conducted with 20 professionals working in Family Health Strategy teams in southern Brazil. Semi‐structured interviews were transcribed verbatim and analysed using thematic content analysis. Analysis was guided deductively by the organisational readiness for change framework and complemented by inductive coding.
Results
Six evaluation domains were identified: management and leadership; human resources and infrastructure; work processes; culture and internal relationships; communication and community; and workload and well‐being. Leadership support, territorial sizing, workforce stability, interprofessional coordination, qualified initial reception and communication with the community shaped implementation. Participants perceived advanced access as capable of improving access and reducing conflict, but warned that insufficient planning, fragile institutional support and workload intensification could compromise sustainability.
Conclusion
Advanced access should be evaluated as an organisational change rather than a technical adjustment to appointment books. Sustainable implementation requires readiness across governance, workforce, work processes, relational culture and community communication.