Addressing administrative burden in family medicine: a local quality improvement initiative.

BACKGROUND

Administrative burden absorbs approximately 40% of family physicians’ time in Canada, reducing direct care and fueling burnout and access challenges. Inconsistent definitions hinder measurement and solutions. This quality improvement (QI) initiative uses an integrated knowledge translation approach to clarify definitions and prioritise actionable, community-level changes.

SPECIFIC AIMS: Collaborate with family physicians to better define administrative burden within the context of one community and identify actionable priorities to share with local stakeholders.

METHODS

A QI study using an integrated knowledge translation approach involving five Family Health Organizations within one Family Health Team, located in [redacted]. Results were analysed using qualitative thematic analysis and quantitative results were analysed using descriptive statistics.

INTERVENTIONS: Facilitated small group stakeholder sessions followed by collection of real-world examples of administrative burden submitted by family physicians.

RESULTS

Eight elements of administrative burden were included in the final revised definition: excess volume, health system inefficiencies, misallocated tasks and responsibilities, impacts on therapeutic or professional relationships, increased cognitive and emotional load, ineffective communication, low-value tasks and inadequate compensation. 146 physician submissions of administrative burden were received, of which 138 were analysed. The most common category of administrative burden was excess volume (n=85).

CONCLUSION

A locally adapted, physician-informed definition of administrative burden underscores the personal and cognitive impacts often overlooked by system-level descriptions of administrative burden. Excess documentation, especially duplication, and communication failures between stakeholders were the most common and actionable contributors. The design of the study with family physicians resulted in three key recommendations: (1) send it once, send it right; (2) reconnect with family physicians and (3) act now. Researchers also recommended collecting quantifiable data on contributors of administrative burden. These findings inform practical, community-oriented interventions that complement provincial and national efforts to reduce administrative burden, decrease physician burnout and increase time for patient care.