C2 - Sustaining Change: A FHT Structure that Works

Theme 2. Optimizing capacity of interprofessional teams

Presentation Materials (Members only)

Presentation Slides: Sustaining Change

Learning Objectives

In an effort to be patient-centred, the Guelph FHT since inception adopted the decentralized model/approach in allocating IHPs across all 22 practices where every practice gets its share from FHT funded IHPs depending on # of physicians, population served and roster size. In other words each practice is a “patient medical home. Attendees will gain understanding of how this model works, how to allocate, manage resources, promote ownership and accountability, tailor services according to population needs and embrace collaborative team approach to population health. It is important to note that there is no perfect structure fits all organisations but it crucial to understand your stakeholders and plan your approach to organisational structure accordingly.

Summary

We broadly agree on the core objectives that health care systems should pursue. The list is strikingly straightforward: universal access for all people, effective care for better health outcomes, efficient use of resources, high-quality services and responsiveness to patient concerns. It is a formula that resonates across the spectrum but the diversity of health system configurations that has developed in response to broadly common objectives leads quite naturally to questions about the advantages and disadvantages inherent in different arrangements, and which approach is “better” or even “best” given a particular context and priorities. The logic of a decentralized model is based on an intrinsically powerful idea. It is, simply stated, that smaller organizations, properly structured and steered, are inherently more agile and accountable than are larger organizations. With ownership, delegation and autonomization often implemented, decentralized GFHT structure provides efficiency in terms of reducing the risk of bottlenecks and improving access at practice level, thus increasing the overall throughput capacity of Guelph primary care system Objectives of decentralization

  • To improve clinical efficiency through developing skills and knowledge of practice based IHPs to manage more diversified patient portfolio.
  • To increase allocative efficiency through better matching of FHT services to practice preferences for improved patient care.
  • To empower individual practices through taking the lead in planning and initiating services that meets patients needs.
  • To increase team accountability through collaborative and holistic approach to patient health.
  • To increase quality of health services through integration of services and improved IM systems and access for vulnerable groups.
  • To increase equity through allocating resources to better meet the needs of particular groups.

Presenters

  • Guelph FHT:
    • Sam Marzouk, Director, Operations and Finance
    • Sylvia Scott, Director, Clinical and Professional Services