RT Journal Article
SR Electronic
T1 Engaging primary care physicians in care coordination for patients with complex medical conditions
JF Canadian Family Physician
JO Can Fam Physician
FD The College of Family Physicians of Canada
SP e155
OP e162
VO 65
IS 4
A1 Elizabeth Lockhart
A1 Gillian A. Hawker
A1 Noah M. Ivers
A1 Tara O’Brien
A1 Geetha Mukerji
A1 Pauline Pariser
A1 Ian Stanaitis
A1 Laura Pus
A1 G. Ross Baker
YR 2019
UL http://www.cfp.ca/content/65/4/e155.abstract
AB Objective To explore the dynamics of primary care physicians’ (PCPs’) engagement with the Seamless Care Optimizing the Patient Experience (SCOPE) project.Design Qualitative study using semistructured interviews.Setting Solo and small group primary care practices in urban Toronto, Ont.Participants A total of 22 of the 29 SCOPE PCPs (75.8%) were interviewed 14 to 19 months after the initiation of SCOPE.Methods Qualitative semistructured interviews were conducted to examine influencing factors associated with PCPs’ engagement in SCOPE. Transcripts were analyzed using a grounded theory–informed approach and key themes were identified.Main findings The SCOPE project provided practical mechanisms through which PCPs could access information and connect with resources. Contextual and historical factors including strained relationships between hospital specialists and community PCPs and PCPs’ feelings of responsibility, isolation, disconnection, and burnout influenced readiness to engage. Provision of clinically useful supports in a trusting, collaborative manner encouraged PCPs’ engagement in newer, more collaborative ways of working.Conclusion The SCOPE project provided an opportunity for PCPs to build meaningful relationships, reconnect to the broader health care system, and redefine their roles. For many PCPs, reestablishing connections reaffirmed their role in the system and enabled a more collaborative care model. Strategies for connecting community-based PCPs to the broader system need to consider contextual factors and the effects of new linkages and coordination on the identities and relationships of PCPs.