In 2018, the Government of British Columbia announced a new primary and community care strategy focused on improving health care delivery and access across the province. The strategy identified the importance of interdisciplinary team-based care in supporting the needs of British Columbians and providing comprehensive care to patients. As part of the strategy, the government announced the provision of new Urgent Primary Care Centres (UPCCs) and expansion of Community Health Centres (CHCs), as well as establishing Primary Care Networks (PCNs) to support a team-based approach to care.
As the strategy is implemented across the province, primary care evaluation has a core role in supporting healthcare improvement through sharing and building on existing knowledge, identifying learning opportunities and informing decision-making.
The evaluation workstream builds on previous ISU work supporting PCN and CHC evaluation planning and the initial development of the Team-based care Evaluation and Adoption Model (TEAM) Framework.
The goal of the workstream is to support communities, the Ministry of Health and other stakeholders with primary care evaluation across British Columbia (BC).
We are working with the Ministry of Health and other key stakeholders to develop and implement a Provincial level PCN Evaluation Plan. Current work is focused on developing a draft Provincial PCN Evaluation Framework and exploring potential evaluation questions and indicators relating to access to care, governance, accountability and the foundations of team-based primary and community care.
We are working with the BC Association of CHCs (BCACHC), the BC Primary Health Care Research Network (BCPHCRN), and other key stakeholders to co-develop a Provincial CHC Evaluation Model. As part of this work, we recently completed a pilot project in a sample of CHCs to explore the process and feasibility of data collection to capture the broad range of services and substantial impacts of CHCs across BC.
We developed the TEAM Framework to support team-based care evaluation, providing provincial consistency while allowing for local adaptability and focusing on both formative evaluation within projects and summative evaluation over time.
Capacity and Access Measures in Primary Care (CAMP)
We are supporting primary care evaluation and innovation through work in the Capacity and Access Measures in Primary Care (CAMP) project. CAMP uses a combination of publicly available and administrative data, as well as short survey instruments, that provide the key elements for an accurate description of how primary care is currently organized, at the clinic level. These data elements are the building blocks for robust measures of:
- CAPACITY – how many patients can be seen, by how many providers, in a typical week
- ACCESS – how and when do patients receive care
- COMPREHENSIVENESS – the “basket of services” that a patient can access at a clinic
Primary Care Capacity Estimator (CapEs)
We are currently developing a Capacity Estimator (CapEs) tool for primary care. Our goal in this project is to build a simple, yet functional interactive web app that will aid in planning for primary care clinics or primary care networks. It will help planners estimate primary care need and explore how to meet that need using different compositions of clinicians.
Through a simple web interface, trained users will be able to adjust a few key parameters related to primary care need (e.g. population/panel size, clinical complexity) and match that with clinical capacity (FTEs for a range of primary care providers and eventually allied health providers) and observe the ways in which changes to these parameters impact the utilization of health services across a team.
As part of this work we will be pulling together existing evidence on capacity and looking at grant opportunities to build more robust evidence and models to build a better CapEs.