Current Projects
Papercuts

A Thousand Papercuts: Understanding and addressing changing administrative workload in primary care
Funding

Summary
There are more primary care providers per person than ever before in Canada. At the same time, Canadians struggle to access needed care and primary care providers report record levels of stress and overwork. There is an urgent need to understand factors contributing to the gap between growing per-capita supply of primary care providers and declining patient primary care visits. Administrative activities, including work related to caring for individual patients and clinic administration, may play a substantial role in understanding changing primary care workload, however this has not been carefully studied.
Objectives
This project will address three objectives and nested research questions, toward the overarching goal of reducing administrative workload, while ensuring efficient coordination of care in Nova Scotia and New Brunswick:​
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Determine how the volume of services requiring primary care coordination has changed over time.​
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​Use interviews with family physicians, nurse practitioners, and administrative team members to understand how administrative workload has changed.​
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Drawing on the findings of Objectives 1 and 2, with primary care providers and service planners, co-identify priority issues and co-develop practical response strategies to make administrative work more efficient.
Understanding and supporting coordination of care is central to people-centred, flexible, quality healthcare. A robust system of primary care is fundamental to addressing health inequalities in access to care, as limited primary care capacity and inadequate systems of coordination impact patients with more complex health and social needs most severely. Identifying practical strategies to make coordination more efficient can support innovative healthcare models, more seamless integration of virtual care into patients’ journeys, and strengthen primary care capacity more broadly.
Team Members
Nominated Principal Investigator
Ruth Lavergne
Co-Investigators & Collaborators
Agnes Grudniewicz, Catherine Moravac, Emily Marshall, Erin Palmer, Fiona Bergin, François Gallant, Joshua Tracey, Julie Easley, Lindsay Hedden, Maddi MacKay, Mathew Grandy, Melanie Mooney, Myles Leslie, Richard Boute, Roetka Gradstein, Ruth Martin-Misener, Sarah Sabri
Contact
Outputs
Papers & Preprints
Study Protocol
Lavergne MR, Moravac C, Bergin F, Buote R, Easley J, Grudniewicz A, Hedden L, Leslie M, McKay M, Marshall EG, Martin-Misener R, Mooney M, Palmer E, Tracey J. (2023). Understanding and addressing changing administrative workload in primary care in Canada: protocol for a mixed-method study. BMJ Open, 13(12): e076917.
Research Articles
Storseth O, McNeil K, Grudniewicz A, Correia R, Gallant F, Thelen R, Lavergne MR. (2025). Administrative burden in primary care. Canadian Family Physician, 71(6): 417-423.
Reports
Health Systems Research Lab, Papercuts team. (2025). A Thousand Papercuts: Understanding and addressing changing administrative workload in primary care. Final Report.