![]() ![]() Primary care and public health collaborations can strengthen community-based primary health care while addressing the Quadruple Aims with an emphasis on reducing health inequities but requires attention to collaboration barriers and enablers. Cases achieved outcomes addressing the Q-Aims such as improving access to services, addressing population health through outreach to at-risk populations, reducing costs through efficiencies, and improving provider experience through capacity building. Enablers included clear goals, trusting and inclusive relationships, role clarity, strong leadership, strong coordination and communication, and optimal use of resources. Perceived barriers included ineffective communication processes, inadequate time for collaboration, geographic challenges, lack of resources, and varying organizational goals and mandates. Barriers and enablers differed among cases. Common precipitators were having a shared vision and/or community concern. ResultsĪims of collaborations included: provider capacity building, regional vaccine/immunization management, community-based health promotion programming, and, outreach to increase access to care. This provided an opportunity to explore how primary care and public health collaboration could serve in transforming community-based primary health care with the potential to address the Quadruple Aims. Data sources included a survey using the Partnership Self-Assessment Tool, focus groups, and document analysis. Ten case studies were conducted in three provinces (Nova Scotia, Ontario, and British Columbia) to elucidate experiences of primary care and public health collaboration in different settings, contexts, populations and forms. This study aimed to explore the nature of Canadian primary care - public health collaborations, their aims, motivations, activities, collaboration barriers and enablers, and perceived outcomes. Concurrently, collaboration between primary care and public health has been the focus of current research, looking for integrated community-based primary health care models that best suit the health needs of communities and address health equity. ![]() It is at the forefront of Canadian reform debates aimed to improve a complex and often-fragmented health care system. The Quadruple Aim advocates for: improving patient experience, reducing cost, advancing population health and improving the provider experience. Third, if we want to take seriously “population health” goals, we need to think very differently and consider broader health determinants Triple Aim innovation targeted at healthcare systems will not deliver the goals.Health systems in Canada and elsewhere are at a crossroads of reform in response to rising economic and societal pressures. Second, we know that scarcity can be recognized and managed, even in politically complex systems, and so we urge the Triple Aim proponents to embrace more fully notions of resource stewardship. First, the emphasis on improvement driven by performance measurement and pay-for-performance is troubling and flies in the face of emerging evidence. Our view is that, as a vision and set of goals for the healthcare system, the Triple Aim is all well and good, but as a pathway for system reform, as articulated by V&B, it misses the mark in at least three important respects. Their proposals are wide ranging and ambitious, looking for governments to act as the “integrators” within the healthcare system, and lead the reforms. Verma and Bhatia (2016) (V&B) argue that provincial governments in Canada now need to step up to the plate and lead on the implementation of a Triple Aim reform program here. Since its introduction to the USA, the Triple Aim is now being adopted in the healthcare systems of other advanced economies.
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