Introduction
Background: Indicators and a Logic Model
Methods
Data collection
Analysis
Results
Characteristic | Provider (n = 39) | Patient (n = 68) |
---|---|---|
Clinic site (n) | ||
1 | 13 | 37 |
2 | 26 | 31 |
Provider position (n) | ||
Primary care physician | 8 | - |
Primary care nurse | 8 | |
Nurse Practitioner | 2 | |
Pharmacist | 1 | |
Social Worker/PHC coordinator/Case manager | 4 | |
Clinic staff (n) | 7 | |
Medical office assistant/secretary | 2 | |
Alcohol & Drug counselor | 1 | |
Aboriginal support worker | 1 | |
Elder | 2 | |
Office manager | 2 | |
Executive director | 1 | |
Outreach worker | ||
Age | ||
Mean (SD) | 47.5 (13.0) | 46 (8.7) |
Gender (%) | ||
Female | 62 | 50 |
Male | 38 | 47 |
Transgender | - | 3 |
Ethnicity (%) | ||
Caucasian | 49 | 21 |
Aboriginal | 31 | 75 |
South Asian | 3 | - |
Asian (e.g. Chinese, Filipino, etc.) | 5 | - |
Other | 12 | 4 |
Highest Level of Education (%) | ||
Less than high school | - | 41 |
High School | 7 | 38 |
College/post-secondary | 18 | 10 |
Undergraduate | 36 | 3 |
Graduate studies or more | 33 | - |
Employment Status (n) | ||
Full-time | 12 | 14 |
Part-time | 17 | 1 |
Other | - | 2 |
Not employed | - | 51 |
Number of Years employed at health centre | ||
Mean (SD) | 4.0 (4.0) | - |
Suggested Modification of Existing Monitoring and Performance Indicators
PHC Activities: management level
PHC Logic Model | Examples from Pan-Canadian PHC Indicators (CIHI) | Study recommendations |
---|---|---|
Input-Fiscal Resources | Objective: Provider payment methods that align with primary health care goals -PHC provider remuneration method -Average PHC provider income by funding model |
Recommended Areas for Development of New Indicators
-source(s) of funding -stability of funding |
Activity-Management level | Objective: To increase the number of PHC organizations who are responsible for providing planned services to a defined population: - PHC outreach services for vulnerable/special needs populations - Specialized programs for PHC vulnerable/special needs populations - Support for PHC vulnerable/special needs populations |
Suggested Modification of Monitoring and Performance Indicators
-Increase operability of currently available indicators to elucidate how PHC organizations can successfully deliver PHC services to vulnerable/special needs populations: -weekly team meetings of all clinic staff -collaboration and input from all clinic staff on care plan and management -number and type of places where care is delivered (e.g., clinic, home, street) -supportive environment where management rewards respectful interactions between all staff -supportive environment where patients feel comfortable |
Activity-Clinic level | Objective: To facilitate integration and coordination between health care institutions and health care providers to achieve informational and management continuity of patient care -Use of standardized tools for coordinating PHC -Collaborative care with other health care organizations -intersectoral collaboration -PHC team effectiveness | -number of patients receiving assistance for housing, food stamps, obtaining welfare -number of patients who have charts with trauma history recorded -Use of appropriate skill mix (e.g., physician, nurse, social worker, drug and alcohol counselor, elder) to provide complex PHC -Support for individual staff to develop and enhance respectful communication amongst staff and patients (e.g. time for critical self-reflection, opportunities for providing/receiving support feedback) |
Output-quality: Whole Person Care | Objective: To enhance the provision of whole-person comprehensive PHC services, including episodic and ongoing care with increased emphasis on health promotion, disease and injury prevention and management of common mental health conditions and chronic diseases: - Scope of PHC services - Health risk screening - Smoking cessation advice in PHC - Alcohol consumption advice in PHC - PHC initiatives for reducing health risks - Smoking rate - Fruit and vegetable consumption rate - Overweight rate - Heavy drinking rate - PHC resources for self-management of chronic conditions - Time with PHC provider - Client/patient participation in PHC treatment planning |
Recommended Areas for Development of New Indicators
- Assessment of individual's social environment -Assessment of individual's emotional health -Treating individual as a person (not a case or a disease) |