The Role of the General Practice Manager in Research: more than just the first point of contact

Problem

General practice provides 83% of health care in Australia and general practice-based research is essential to ensure the care provided in this setting is evidence-based and delivered effectively. To facilitate research uptake in general practice, studies must be designed in ways that accommodate practice routine. While the practice manager (PM) co-ordinates day to day routine, there has been little investigation of their role in supporting and facilitating research. To inform future general practice-based research trial designs we investigated the role of the PM in facilitating the implementation of a research intervention in Australian general practice by examining their knowledge, attitudes and involvement in the Australia Chlamydia Control Effectiveness Pilot (ACCEPt). ACCEPt is a randomised controlled trial with a multifaceted intervention designed to increase general practice-based chlamydia testing. We believe this sub-study to be the first undertaken in Australia to investigate the PMs’ role in research.

Approach

Purposive sampling identified 23 PMs from 65 working in general practices randomised to the ACCEPt intervention. Semi-structured telephone interviews were conducted between April and September 2014. Interview data was thematically analysed using a summative content analysis approach.

Findings

PM roles varied between practices, however all championed research, although most (21/ 23) had not research training or experience prior to ACCEPt. The findings suggest the PMs’ involvement was vital to establishing, facilitating and managing ACCEPt at the general practice level. PMs described their central management positions within the structure of general practice as pivotal to directly liaising with General Practitioners on research matters, delegating tasks and maintaining the profile of study in their practice. Almost all PMs had the capacity to embed the non-clinical tasks associated with ACCEPt into their current workloads, which they saw as crucial to sustaining the trial and limiting its impact on practice routine.

Consequences

PMs saw a role for themselves in facilitating multi-faceted interventions such as ACCEPt. Their facilitation and coordination of ACCEPt at the practice level influenced the uptake and sustainability of the intervention. We believe these findings offer some new insights in to implementing general practice-based interventions trials. While filling a gap in the literature, this study also highlighted the need for a wider systematic examination of the PM role and exploration of their training needs to maximise their potential to contribute to general practice-based research.