| Provincial |
Structure to link stakeholders and provide discussion forum Early participation of stakeholders in planning and evaluation Careful selection of initial sites or supervising physicians Provision of resources to support implementation (eg, implementation facilitator)
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Establishment of system for salary payment, computer access, etc Communicating PA role and mandate to related services Systemic barriers to PA test ordering or results Confusion about deliverables Dissatisfaction with physician compensation Relationship with PA education program Relationship with family physician community Ability to track effects of PA introduction
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| Site |
Culture supportive of innovation and experimentation “Fit” between PA and site culture, needs Readiness and support of staff teams Adequate preparation time, orientation for all involved Clear communication of roles and processes Mechanisms for early identification and resolution of problems
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Front-desk scheduling Staff education Clinic flow Tracking diagnostic tests or results Workload of administrative staff Communicating PA role to associated services Communicating PA role to patients Space for additional staff
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| Individual |
“Fit” between PA and supervising physician Physician willingness to invest time in PA orientation and training Skills and attitudes of PA Willingness of PA and physician to innovate and adapt
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Clarification of supervision processes Adapting orientation or supervision to increasing PA independence Development of communication processes Number of physicians to whom PA is assigned Workload management
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