Ali Rafik Shukor1, Sandra Edelman2, Dean Brown3, Cheryl Rivard4. 1. Regional Primary Care Evaluator for the Vancouver Coastal Health Authority in Vancouver, British Columbia, Canada (ali.shukor@vch.ca). 2. Manager of Public Health and Chronic Disease Services for the North Shore Division of Community Family Health in Vancouver, British Columbia, Canada (sandra.edelman@vch.ca). 3. Medical Director of the North Shore Division of Community Family Health in Vancouver, British Columbia, Canada (dean.brown@vch.ca). 4. Project Manager for the Vancouver Coast Health Authority in Vancouver, British Columbia, Canada (cheryl.rivard@vch.ca).
Abstract
INTRODUCTION: Designing, delivering, and evaluating high-performing primary health care services for complex and vulnerable subpopulations are challenging endeavors. However, there is a relative paucity of research evidence available to support such work. OBJECTIVE: To provide a case study using HealthConnection Clinic, a public primary care center located in Metropolitan Vancouver's North Shore. METHODS: Developmental evaluation approach operationalizing the 10 Building Blocks of High-Performing Primary Care framework using qualitative and quantitative methods. RESULTS: The clinic provided valuable insights to policymakers and researchers related to development of the Building Blocks' foundational elements, particularly engaged leadership, empanelment, and data-driven improvement. The study highlighted the key enablers, achievements, challenges, and barriers related to operationalizing each Building Block. The Building Blocks were a useful heuristic that enabled the development and evaluation of primary care for complex subpopulations. Particularly salient from a Canadian policy perspective was the demonstration that system integration was possible when highly engaged leaders from a Regional Health Authority and a Division of Family Practice shared a common vision and purpose. HealthConnection Clinic's entrepreneurial spirit has enabled the development of innovative, evidence-based tools such as the AMPS complexity assessment tool (attachment, medical conditions, psychological/mental health/addictions challenges, and socioeconomic status), designed to identify and assess biopsychosocial complexity and needs. The study also highlighted the importance of incorporating community orientation and equity into developmental work. CONCLUSION: The study demonstrates how the Building Blocks approach can be adapted to operationalize high-performing primary care standards in settings serving complex and vulnerable populations.
INTRODUCTION: Designing, delivering, and evaluating high-performing primary health care services for complex and vulnerable subpopulations are challenging endeavors. However, there is a relative paucity of research evidence available to support such work. OBJECTIVE: To provide a case study using HealthConnection Clinic, a public primary care center located in Metropolitan Vancouver's North Shore. METHODS: Developmental evaluation approach operationalizing the 10 Building Blocks of High-Performing Primary Care framework using qualitative and quantitative methods. RESULTS: The clinic provided valuable insights to policymakers and researchers related to development of the Building Blocks' foundational elements, particularly engaged leadership, empanelment, and data-driven improvement. The study highlighted the key enablers, achievements, challenges, and barriers related to operationalizing each Building Block. The Building Blocks were a useful heuristic that enabled the development and evaluation of primary care for complex subpopulations. Particularly salient from a Canadian policy perspective was the demonstration that system integration was possible when highly engaged leaders from a Regional Health Authority and a Division of Family Practice shared a common vision and purpose. HealthConnection Clinic's entrepreneurial spirit has enabled the development of innovative, evidence-based tools such as the AMPS complexity assessment tool (attachment, medical conditions, psychological/mental health/addictions challenges, and socioeconomic status), designed to identify and assess biopsychosocial complexity and needs. The study also highlighted the importance of incorporating community orientation and equity into developmental work. CONCLUSION: The study demonstrates how the Building Blocks approach can be adapted to operationalize high-performing primary care standards in settings serving complex and vulnerable populations.
Authors: Justin W Timbie; Claude M Setodji; Amii Kress; Tara A Lavelle; Mark W Friedberg; Peter J Mendel; Emily K Chen; Beverly A Weidmer; Christine Buttorff; Rosalie Malsberger; Mallika Kommareddi; Afshin Rastegar; Aaron Kofner; Lisa Hiatt; Ammarah Mahmud; Katherine Giuriceo; Katherine L Kahn Journal: N Engl J Med Date: 2017-06-21 Impact factor: 91.245
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