Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies
Abstract Background Health systems in Canada and elsewhere are at a crossroads of reform in response to rising economic and societal pressures. The Quadruple Aim advocates for: improving patient experience, reducing cost, advancing population health and improving the provider experience. It is at th...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-020-08610-y |
| _version_ | 1819225458514853888 |
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| author | Ruta K. Valaitis Sabrina T. Wong Marjorie MacDonald Ruth Martin-Misener Linda O’Mara Donna Meagher-Stewart Sandy Isaacs Nancy Murray Andrea Baumann Fred Burge Michael Green Janusz Kaczorowski Rachel Savage |
| author_facet | Ruta K. Valaitis Sabrina T. Wong Marjorie MacDonald Ruth Martin-Misener Linda O’Mara Donna Meagher-Stewart Sandy Isaacs Nancy Murray Andrea Baumann Fred Burge Michael Green Janusz Kaczorowski Rachel Savage |
| author_sort | Ruta K. Valaitis |
| collection | DOAJ |
| description | Abstract Background Health systems in Canada and elsewhere are at a crossroads of reform in response to rising economic and societal pressures. The Quadruple Aim advocates for: improving patient experience, reducing cost, advancing population health and improving the provider experience. It is at the forefront of Canadian reform debates aimed to improve a complex and often-fragmented health care system. Concurrently, collaboration between primary care and public health has been the focus of current research, looking for integrated community-based primary health care models that best suit the health needs of communities and address health equity. This study aimed to explore the nature of Canadian primary care - public health collaborations, their aims, motivations, activities, collaboration barriers and enablers, and perceived outcomes. Methods Ten case studies were conducted in three provinces (Nova Scotia, Ontario, and British Columbia) to elucidate experiences of primary care and public health collaboration in different settings, contexts, populations and forms. Data sources included a survey using the Partnership Self-Assessment Tool, focus groups, and document analysis. This provided an opportunity to explore how primary care and public health collaboration could serve in transforming community-based primary health care with the potential to address the Quadruple Aims. Results Aims of collaborations included: provider capacity building, regional vaccine/immunization management, community-based health promotion programming, and, outreach to increase access to care. Common precipitators were having a shared vision and/or community concern. Barriers and enablers differed among cases. Perceived barriers included ineffective communication processes, inadequate time for collaboration, geographic challenges, lack of resources, and varying organizational goals and mandates. Enablers included clear goals, trusting and inclusive relationships, role clarity, strong leadership, strong coordination and communication, and optimal use of resources. Cases achieved outcomes addressing the Q-Aims such as improving access to services, addressing population health through outreach to at-risk populations, reducing costs through efficiencies, and improving provider experience through capacity building. Conclusions Primary care and public health collaborations can strengthen community-based primary health care while addressing the Quadruple Aims with an emphasis on reducing health inequities but requires attention to collaboration barriers and enablers. |
| first_indexed | 2024-12-23T10:09:55Z |
| format | Article |
| id | doaj.art-0c121d9f5f3840ea845edc85d394439a |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-23T10:09:55Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-0c121d9f5f3840ea845edc85d394439a2022-12-21T17:51:00ZengBMCBMC Public Health1471-24582020-04-0120111610.1186/s12889-020-08610-yAddressing quadruple aims through primary care and public health collaboration: ten Canadian case studiesRuta K. Valaitis0Sabrina T. Wong1Marjorie MacDonald2Ruth Martin-Misener3Linda O’Mara4Donna Meagher-Stewart5Sandy Isaacs6Nancy Murray7Andrea Baumann8Fred Burge9Michael Green10Janusz Kaczorowski11Rachel Savage12School of Nursing, McMaster UniversitySchool of Nursing and Centre for Health Services and Policy Research, University of British ColumbiaSchool of Nursing, University of VictoriaDalhousie University, School of NursingMcMaster University, School of NursingDalhousie University, School of NursingMcMaster University, School of NursingMcMaster University, School of NursingMcMaster University, School of NursingDalhousie University Department of Family MedicineQueen’s University Centre for Studies in Primary CareDepartment of Family and Emergency Medicine, University of MontrealDalla Lana School of Public Health, University of TorontoAbstract Background Health systems in Canada and elsewhere are at a crossroads of reform in response to rising economic and societal pressures. The Quadruple Aim advocates for: improving patient experience, reducing cost, advancing population health and improving the provider experience. It is at the forefront of Canadian reform debates aimed to improve a complex and often-fragmented health care system. Concurrently, collaboration between primary care and public health has been the focus of current research, looking for integrated community-based primary health care models that best suit the health needs of communities and address health equity. This study aimed to explore the nature of Canadian primary care - public health collaborations, their aims, motivations, activities, collaboration barriers and enablers, and perceived outcomes. Methods Ten case studies were conducted in three provinces (Nova Scotia, Ontario, and British Columbia) to elucidate experiences of primary care and public health collaboration in different settings, contexts, populations and forms. Data sources included a survey using the Partnership Self-Assessment Tool, focus groups, and document analysis. This provided an opportunity to explore how primary care and public health collaboration could serve in transforming community-based primary health care with the potential to address the Quadruple Aims. Results Aims of collaborations included: provider capacity building, regional vaccine/immunization management, community-based health promotion programming, and, outreach to increase access to care. Common precipitators were having a shared vision and/or community concern. Barriers and enablers differed among cases. Perceived barriers included ineffective communication processes, inadequate time for collaboration, geographic challenges, lack of resources, and varying organizational goals and mandates. Enablers included clear goals, trusting and inclusive relationships, role clarity, strong leadership, strong coordination and communication, and optimal use of resources. Cases achieved outcomes addressing the Q-Aims such as improving access to services, addressing population health through outreach to at-risk populations, reducing costs through efficiencies, and improving provider experience through capacity building. Conclusions Primary care and public health collaborations can strengthen community-based primary health care while addressing the Quadruple Aims with an emphasis on reducing health inequities but requires attention to collaboration barriers and enablers.http://link.springer.com/article/10.1186/s12889-020-08610-yCanadaPublic healthPrimary careCollaborationCase studyTriple aim |
| spellingShingle | Ruta K. Valaitis Sabrina T. Wong Marjorie MacDonald Ruth Martin-Misener Linda O’Mara Donna Meagher-Stewart Sandy Isaacs Nancy Murray Andrea Baumann Fred Burge Michael Green Janusz Kaczorowski Rachel Savage Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies BMC Public Health Canada Public health Primary care Collaboration Case study Triple aim |
| title | Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies |
| title_full | Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies |
| title_fullStr | Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies |
| title_full_unstemmed | Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies |
| title_short | Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies |
| title_sort | addressing quadruple aims through primary care and public health collaboration ten canadian case studies |
| topic | Canada Public health Primary care Collaboration Case study Triple aim |
| url | http://link.springer.com/article/10.1186/s12889-020-08610-y |
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