Family physicians partnering for system change: a multiple-case study of Ontario Health Teams in development
Abstract Background The Ontario Health Team (OHT) model is a form of integrated care that seeks to provide coordinated delivery of care to communities across Ontario, Canada. Primary care is positioned at the heart of the OHT model, yet physician participation and representation has been severely ch...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-023-10070-0 |
| _version_ | 1797577186591375360 |
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| author | Colleen Grady Sophy Chan-Nguyen David Mathies Nadia Alam |
| author_facet | Colleen Grady Sophy Chan-Nguyen David Mathies Nadia Alam |
| author_sort | Colleen Grady |
| collection | DOAJ |
| description | Abstract Background The Ontario Health Team (OHT) model is a form of integrated care that seeks to provide coordinated delivery of care to communities across Ontario, Canada. Primary care is positioned at the heart of the OHT model, yet physician participation and representation has been severely challenged at planning and governance tables. The purpose of this multiple case study is to examine (1) processes and structures to enable family physician participation in OHTs and (2) describe challenges to family physician participation. Methods We chose a qualitative, exploratory multiple-case study approach following Yin’s design and methods. The study took place between June and December 2021.We conducted semi-structured interviews with OHT stakeholders in four communities and carried out an analysis of internal and external documents to contextualize interview findings. Thematic analysis was applied within case and between cases. Results Four OHTs participated in this study with thirty-nine participants (17 family physicians; 22 other stakeholders). Over 60 documents were analyzed. Within-case analysis found that structures and processes should be formalized and established to facilitate physician participation. Skepticism, burnout, heavy workload, and the COVID-19 pandemic were challenges to participation. Between-case analysis found that participation varied. Face-to-face communication processes were favoured in all cases and history of collaboration facilitated relationship-building. All cases faced similar challenges to physician participation despite regional differences. Conclusions The implementation of OHTs demonstrates that integrated care models can address critical health system issues through a collective approach. Physician participation is vital to the development of an OHT, however, recognition of their challenges (skepticism, burnout, COVID-19 pandemic) to participating must be acknowledged first. To ensure that models like OHTs thrive, physicians must be meaningfully engaged in various aspects and levels of governance and delivery. |
| first_indexed | 2024-03-10T22:05:33Z |
| format | Article |
| id | doaj.art-90a158d2fcd2481392dd3fd81f3ea544 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-10T22:05:33Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-90a158d2fcd2481392dd3fd81f3ea5442023-11-19T12:49:55ZengBMCBMC Health Services Research1472-69632023-10-0123111310.1186/s12913-023-10070-0Family physicians partnering for system change: a multiple-case study of Ontario Health Teams in developmentColleen Grady0Sophy Chan-Nguyen1David Mathies2Nadia Alam3Centre for Studies in Primary Care, Department of Medicine, Queen’s UniversityCentre for Studies in Primary Care, Department of Medicine, Queen’s UniversityMuskoka and Area Ontario Health TeamInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of TorontoAbstract Background The Ontario Health Team (OHT) model is a form of integrated care that seeks to provide coordinated delivery of care to communities across Ontario, Canada. Primary care is positioned at the heart of the OHT model, yet physician participation and representation has been severely challenged at planning and governance tables. The purpose of this multiple case study is to examine (1) processes and structures to enable family physician participation in OHTs and (2) describe challenges to family physician participation. Methods We chose a qualitative, exploratory multiple-case study approach following Yin’s design and methods. The study took place between June and December 2021.We conducted semi-structured interviews with OHT stakeholders in four communities and carried out an analysis of internal and external documents to contextualize interview findings. Thematic analysis was applied within case and between cases. Results Four OHTs participated in this study with thirty-nine participants (17 family physicians; 22 other stakeholders). Over 60 documents were analyzed. Within-case analysis found that structures and processes should be formalized and established to facilitate physician participation. Skepticism, burnout, heavy workload, and the COVID-19 pandemic were challenges to participation. Between-case analysis found that participation varied. Face-to-face communication processes were favoured in all cases and history of collaboration facilitated relationship-building. All cases faced similar challenges to physician participation despite regional differences. Conclusions The implementation of OHTs demonstrates that integrated care models can address critical health system issues through a collective approach. Physician participation is vital to the development of an OHT, however, recognition of their challenges (skepticism, burnout, COVID-19 pandemic) to participating must be acknowledged first. To ensure that models like OHTs thrive, physicians must be meaningfully engaged in various aspects and levels of governance and delivery.https://doi.org/10.1186/s12913-023-10070-0Primary careIntegrated careOntario Health TeamsFamily physicians |
| spellingShingle | Colleen Grady Sophy Chan-Nguyen David Mathies Nadia Alam Family physicians partnering for system change: a multiple-case study of Ontario Health Teams in development BMC Health Services Research Primary care Integrated care Ontario Health Teams Family physicians |
| title | Family physicians partnering for system change: a multiple-case study of Ontario Health Teams in development |
| title_full | Family physicians partnering for system change: a multiple-case study of Ontario Health Teams in development |
| title_fullStr | Family physicians partnering for system change: a multiple-case study of Ontario Health Teams in development |
| title_full_unstemmed | Family physicians partnering for system change: a multiple-case study of Ontario Health Teams in development |
| title_short | Family physicians partnering for system change: a multiple-case study of Ontario Health Teams in development |
| title_sort | family physicians partnering for system change a multiple case study of ontario health teams in development |
| topic | Primary care Integrated care Ontario Health Teams Family physicians |
| url | https://doi.org/10.1186/s12913-023-10070-0 |
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