Evidence tells us that, with a team-based approach to primary care, patients experience more timely access to care, better care coordination and improved management of their chronic diseases. At present, about 25-30% of Ontarians can access team-based primary care. The logical question is – how do we expand access to primary care teams and get the best value from this investment? The Association of Family Health Teams of Ontario (AFHTO) has combed the research literature to find the answer. From this we present a set of principles for optimizing the value of teams and offer an initial set of recommendations to get started.
Recommendations to move forward:
Immediate steps to optimize current capacity:
- Stabilize the work force with sufficient funding for recruitment and retention.
- Continue to support the field to:
- Strengthen governance and leadership, and the ability to meet evolving expectations and relationships.
- Accelerate performance measurement.
- Optimize their current team capacity.
Work with the field to develop common understanding of needs and capacity:
- Identify the skills, data and leadership needed for population-based needs assessment and planning. Involve the people who receive care and their primary care providers in the assessment and planning process.
Where there is sufficient capacity:
- Enable more family physicians and nurse practitioners to participate as full collaborators in teams, based on their commitment to the necessary processes and behaviours for effective teamwork.
- Harness the will and expertise of local champions in primary care to lead the development of innovative regional solutions to spreading interdisciplinary team capacity more broadly in their communities, recognizing that different strategies and solutions will emerge to meet unique local realities across the province.
Throughout, do not expand access to teams unless:
- Family physicians are ready to commit to minimum requirements for meaningful collaboration and communication.
- Capacity is sufficiently developed, such that additional demand can be managed without causing unacceptable increases in waits for appointments and/or decreases in quality of care.