How do general practices respond to a pandemic? Protocol for a prospective qualitative study of six Australian practices.

Grant Russell, University of Ottawa
Jenny Advocat, Monash University
Riki Lane, Monash University
Jennifer Neil, Monash University
Timothy Staunton-Smith, Monash University
Karyn E Alexander, Monash University
Simon Hattle, Monash University
Benjamin F Crabtree, Rutgers Robert Wood Johnson Medical School
William L Miller
Sumudu Neilya Setunge, Monash University
Elizabeth Ann Sturgiss, Australian National University


INTRODUCTION: The COVID-19 pandemic has transformed healthcare systems worldwide. Primary care providers have been at the forefront of the pandemic response and have needed to rapidly adjust processes and routines around service delivery. The pandemic provides a unique opportunity to understand how general practices prepare for and respond to public health emergencies. We will follow a range of general practices to characterise the changes to, and factors influencing, modifications to clinical and organisational routines within Australian general practices amidst the COVID-19 pandemic.

METHODS AND ANALYSIS: This is a prospective case study of multiple general practices using a participatory approach for design, data collection and analysis. The study is informed by the sociological concept of routines and will be set in six general practices in Melbourne, Australia during the 2020-2021 COVID-19 pandemic. General practitioners associated with the Monash University Department of General Practice will act as investigators who will shape the project and contribute to the data collection and analysis. The data will include investigator diaries, an observation template and interviews with practice staff and investigators. Data will first be analysed by two external researchers using a constant comparative approach and then later refined at regular investigator meetings. Cross-case analysis will explain the implementation, uptake and sustainability of routine changes that followed the commencement of the pandemic.

ETHICS AND DISSEMINATION: Ethics approval was granted by Monash University (23950) Human Research Ethics Committees. Practice reports will be made available to all participating practices both during the data analysis process and at the end of the study. Further dissemination will occur via publications and presentations to practice staff and medical practitioners.