Table 1 Characteristics of case settings and embedded sites

Embedded sites

6 Family Practices; Mix of urban (5 sites) and rural (1 site); mix of academic (4 sites) and non-academic practices (2 sites).

6 Emergency Departments; Mix of urban (4 sites) and rural sites (2 sites), mix of academic (5 sites) and non-academic hospitals (1 site)

5 Hospitals; mix of rural/non-academic (1 site), and urban/academic hospitals (4 sites)

3 Hospitals; All urban sites, all academic hospitals (3 sites)

Interview Data

Semi-structured Interviews (16); 7 PAs, 8 Physicians, 1 Clinic Manager

Semi-structured Interviews (13); 7 PAs, 5 Physicians, 1 RPN

Semi-structured Interviews (12); 5 PAs, 3 Surgeons, 2 Surgical Residents, 2 IP Directors (MD, RPN)

Semi-structured Interviews (5); 4 PAs, 1 Physician

Document Data

Documents: medical directives, integration tool kits, HFO website/ communications, Patient’s First Document, 2011 College of Family Physicians of Canada position statement on PAs

Documents: medical directives, job postings, HFO website/ communications, organizational websites, media/news

Documents: medical directives, job postings, HFO website/ communications, organizational websites, media/news; OHA position statement on PAs; surgery department handbooks

Documents: medical directives, HFO website/ communications, organizational websites; OHA position statement on PAs

Description of PA role

Certified Canadian (civilian and military) and United States trained PAs with 2–9 year of family medicine experience at the time of data collection.

PAs were all Canadian Certified (CCPA) and had been practicing in emergency medicine for 4–9 years at the time of data collection.

PAs were all Canadian Certified (CCPA) and had been practicing in general surgery for 2.5–5.5 years at the time of data collection.

PAs were all Canadian Certified (CCPA) and had been practicing at their hospital site for 2–5.5 years at the time of data collection.

PA-MD supervisor relationship

PA/MD work collaboratively, often in parallel. Relationships are longitudinal. PA usually supervised by 1 primary physician.

PA/MD work in same general department, but might be assigned to different areas to different patient cohorts (i.e. triage or assigned different CTAS level patients). PA works with multiple supervising physicians.

PA/surgeon work in same department, but surgeon often in OR. PA present on the ward and for consults within the ED and hospital. PA works with multiple rotating supervising physicians. PA is continuously available.

PA/MD work in same department, but may divide patients between team or may be assigned different tasks. PA works with multiple supervising physicians, so becomes centre of continuity.