Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science




Garnett, Anna.

2nd Supervisor

Donelle, Lori.


Statement of research problem: Nurse practitioner led clinics (NPLC) in Ontario (ON) represent a model of care that is potentially well-situated to improve primary healthcare delivery. There is currently limited knowledge about this model of cares impact on patients with chronic disease. This study explored current chronic disease management practices implemented by Nurse Practitioners (NP) within NPLCs across ON.

Methods: Using a qualitative interpretive description methodology, eleven in-depth semi-structured interviews were conducted with nurse practitioners practicing within NPLCs in Ontario.

Results: Results indicate NPLCs successfully support patients with chronic disease through provision of on-site multidisciplinary care, continuity in service provision and increased access to primary healthcare services.

Conclusions: Findings suggest that NPLCs are beneficial in supporting patients to manage chronic disease. This paper provides insights into the NP-led primary healthcare model and how it can facilitate access to services, foster patient self-management and provide a successful alternative model of care.

Summary for Lay Audience

There is an increased demand for primary healthcare services in Ontario due to continued prevalence of chronic disease. The nurse practitioner role within Canada has continued to expand since its initial creation in the 1960s to include positions within primary healthcare settings. A new model of primary healthcare began operation in Ontario in 2007 called the nurse practitioner led clinic (NPLC), which included nurse practitioners as primary healthcare providers within a team of multiple health care professionals. There is currently limited knowledge about this model of care and its impact on patients with chronic disease. Therefore, it is important to understand this model of care further to explore its potential effectiveness at providing high quality primary healthcare services to Canadians.

In this study eleven nurse practitioners currently practicing in eight different NPLCs in Ontario were interviewed. Study findings indicate that this model of care can successfully support clients in managing chronic disease. Researchers realized the social determinants of health including housing, food security, medication coverage and access to basic needs directly impacted an individual’s ability to manage their own health. The experiences of nurse practitioner providers are presented and analyzed in this thesis. The findings provide policy makers, educators, and nurse leaders with insights about the primary healthcare practices implemented by nurse practitioners within NPLCs in Ontario.