1. December 7, 2004 Leaders’ Forum on Interdisciplinary Collaboration In Primary Health Care

2. www.eicp-acis.ca Canadians Expect… Access to services 24 hours a day/seven days a week; Services delivered in community non- hospital settings; More emphasis on prevention and health promotion; and Better continuity of care and chronic disease management.

3. www.eicp-acis.ca Canadian Coalition on Enhancing Preventative Practices of Health Professionals Health Professional Organizations all on the same page…

4. www.eicp-acis.ca EICP Objectives To develop a set of Guiding Principles and a Framework to enhance interdisciplinary collaboration in Primary Health Care (PHC); To have the Principles and Framework broadly supported by PHC practitioners, as evidenced through ratification by the national organizations; and To support the national organizations and other stakeholders in the implementation of the Principles and Framework.

5. www.eicp-acis.ca Initiative Commitments INCLUSIVE INDEPENDENT TRANSPARENT ACCESSIBLE RESPECTFUL EVIDENCE-BASED RESPONSIBLE FLEXIBLE

6. www.eicp-acis.ca Project Life Cycle Development & Implementation Research Initiation & Planning Closure

7. www.eicp-acis.ca A Framework That Fits Changes in Primary Health Care ResearchCommunicationEvaluation

8. www.eicp-acis.ca Individual Providers & Health Service Organizations Policy Context Public Health & Social Context Individuals & Families Conceptual Framework Definition, objectives, examples in Canada, cost- effectiveness, impact on patient/client outcomes. PHC structures, providers’ payment mechanisms, liability and regulatory frameworks, PHC reform. Attitudes and perceptions, quality of life, job satisfaction, continuing education, operational issues. Population health, public access to PHC services, public perception of IDC and PHC.

9. www.eicp-acis.ca EICP Communications

10. www.eicp-acis.ca Evaluation Framework EVALUATION FACTORS: (to be agreed on) Outcomes Achievement Progress on immediate, intermediate outcomes Cost effectiveness Unintended outcomes Project Performance Management and financial performance Success Factors (from project charter) Inclusiveness, independent Transparent, respectful Evidence based, responsible Appropriateness, relevance Engage Stakeholders Design Evaluation Component Develop Instruments Gather Credible Evidence Justify Conclusions Ensure Use and Share Lessons Learned

11. www.eicp-acis.ca Change Commitment Curve VIII. Internalization VII. Institutionalization VI. Adoption V. Installation IV. Positive Perception III. Understand the Change II. Awareness of Change I. Contact Unawareness Confusion Negative Perception Decision not to Attempt/ Support Installation Change Aborted After Initial Utilization Change Aborted After Extensive Utilization Commitment Phase Acceptance Phase Preparation Phase Degree of Support for the Change Time © ODR

12. www.eicp-acis.ca Research Reports

13. www.eicp-acis.ca Enhancing Interdisciplinary Collaboration in Primary Health Care in Canada Successful collaboration has the following characteristics: Client focus and evidence based; Shared vision; Trust and mutual support; Effective communication and learning; and Clear roles and responsibilities. Successful models depend on A supportive organizational structure; and The interpersonal traits of team members.

14. www.eicp-acis.ca Providers and Organization Report Attitudes and Perceptions of IDC Personal motivation and commitment are critical; Practicing collaboratively can lead to higher work satisfaction; Inter-professional tensions can develop from a lack of understanding of the professional identity of others; Team effectiveness is enhanced when discrepancies in status and power are minimized; and Grassroots involvement in the planning of collaborative initiatives has resulted in successful outcomes.

15. www.eicp-acis.ca Providers and Organization Report: Organizational Factors Co-location is preferable, virtual networks show some success; ‘Team’ approach requires structured learning activities; Face to face Communication is critical in the start-up phase; Electronic health records are vital; and ‘Measuring’ collaboration is critical to accountability.

16. www.eicp-acis.ca Public Health and the Social Context for Interdisciplinary Collaboration Report Chronic diseases is threatening the sustainability of the Canadian health system; Only 50–60 per cent of patients with chronic diseases are receiving appropriate evidence- based interventions; Integrated, interdisciplinary teams of PHC providers resulting in improved outcomes; and The highest health status in the world and the highest quality of care should be the vision for a redesigned primary health care system.

17. www.eicp-acis.ca Canadian Policy Context Report: Interdisciplinary Collaboration in Primary Health Care Regulatory silos exist, which require legislative action for change to move forward; Role and boundary blurring between providers may have potential implications for liability concerns; Resource allocation and payment methods remain a major part of collaboration and primary health care reform; and IDC requires governments to make necessary financial commitment, and providers who are willing to switch to publicly financed positions.

18. www.eicp-acis.ca Canadian Policy Context Report: Interdisciplinary Collaboration in Primary Health Care Health care professional associations need to have a unified ‘voice’ to counter pressures about pharmaceutical expansion and wait list concerns and support interdisciplinary collaboration. Future funding of interdisciplinary collaborative primary health care teams will likely require the creation of intermediary organizations between providers and governments/health authorities.

19. www.eicp-acis.ca Common Themes in Reports Principles of IDC: Trust and respect Communication soft skills Visionary leadership Team approach 24/7 access Health promotion/population health approach Framework Elements: Organizational structure (diverse models) Funding aspects Electronic health records Liability and regulatory issues Health human resources

20. www.eicp-acis.ca Leaders’ Forum Objectives Provide an opportunity for Board members to learn and share perspectives on the EICP Initiative; Update, discuss and rework the EICP Principles and Framework with Board members; Discuss the Root Causes and Critical Actions Required to Achieving Interdisciplinary Collaboration in Primary Health Care; and Review the Principles and Framework ratification process and the challenges required to develop commitment.

21. www.eicp-acis.ca Expectations My principal objective for this session is… ________________________ ________________________ ________________________ ________________________

22. www.eicp-acis.ca All I Really Needed to Know – I Learned in Kindergarten Share everything Play fair Don’t hit Put things back Say sorry when you hurt someone Clean up your own mess Flush When you go out in the world, watch out for traffic, hold hands and stick together R. Fulghum

23. www.eicp-acis.ca Introductions at your Tables Your name Practice/professional/ work setting

24. www.eicp-acis.ca Review of the Principles and Framework for Interdisciplinary Collaboration in Primary Health Care Two rounds of conversation Round # 1–– Interdisciplinary Collaboration Principles Report Back Round # 2— Framework Elements Report Back Synthesizing what we heard – after lunch

25. www.eicp-acis.ca Reviewing the Principles of Interdisciplinary Collaboration Round # 1 1.Based on the research, your experience and what you heard today, what stands out for you in the Principles of Interdisciplinary Collaboration? 2.What do you like and what concerns you? 3.What one or two modifications would your table group suggest? – add, delete, or change.

26. www.eicp-acis.ca Reviewing the Framework for Interdisciplinary Collaboration Round # 2 1.Based on the research, your experience and what you heard today, what stands out for you in the Framework Elements of Interdisciplinary Collaboration? 2.What do you like and what concerns you? 3.What one or two modifications would your table group suggest? – add, delete, or change.

27. www.eicp-acis.ca Synthesizing our Conversations Does this synthesis reflect your discussions this morning?

28. www.eicp-acis.ca Selected Framework Elements Funding Liability Regulations Health records Health human resources

29. www.eicp-acis.ca Moving Towards the Future of Interdisciplinary Collaboration in Primary Health Care What are the underlying root causes associated with your groups framework element? For each framework element identify up to 6 – 8 root causes and indicate their importance (I/VI)

30. www.eicp-acis.ca What You Will Return with to the Group Session DESCRIPTION OF THE UNDERLYING CAUSES, OF THE FRAMEWORK ELEMENTS I/VI

31. www.eicp-acis.ca How to think about the work… Lack of fundingPoorly prioritized budgets Privacy legislationInconsistency across jurisdictions ChallengeRoot Cause

32. www.eicp-acis.ca Moving Towards the Future of Interdisciplinary Collaboration in Primary Health Care What are the critical actions required to overcome the challenges associated with your groups framework element?

33. www.eicp-acis.ca What You Will Return with to the Group Session DESCRIPTION OF THE CRITICAL ACTIONS REQUIRED…

34. www.eicp-acis.ca Moving Towards the Future What do you need to move the Principles and Framework forward in your community? What can EICP do to help?

35. www.eicp-acis.ca