Learning from Providers: Insights to Strengthen Integrated Home and Community Care in Ontario

Background: Home and community care providers are central to achieving better outcomes for people receiving care at home, yet many face challenges related to workload, coordination, and system navigation. In Ontario, seven pilot programs are testing new models of integrated home care. Although provider perspectives are recognized as critical to system performance, they are too infrequently incorporated as core evaluation elements. Understanding the experiences of providers working with patients in the home care setting is essential to building a resilient and supported workforce capable of delivering person-centred care.

 

Approach: We conducted a cross-sectional Provider Experience Survey between November 2024 and February 2025 to capture baseline perceptions of providers who would be working in or alongside the home care integration projects. Surveys were distributed to care coordinators, nurses, physicians, and allied health professionals. The survey included items across six domains: care coordination, workplace culture, autonomy, digital and virtual care, burnout and job satisfaction, and demographics. An additional open-ended question asked, “Do you have any suggestions for how your work experience could be improved?” Open-ended responses were analyzed using open coding to identify major themes and subthemes.

Themes were reviewed collaboratively to ensure completeness and consistency. Descriptive summaries were developed with illustrative quotes, and conceptually aligned quantitative survey findings were reviewed alongside each qualitative theme.

 

Results: The overall response rate was 38% (n=145). Six core themes were identified through qualitative analysis of 58 open-ended responses: compensation disparities and financial strain; workload and staffing challenges; leadership and organizational support; documentation burden and inefficiencies; communication and information-sharing gaps; and patient-centred care. Providers described how challenges in staffing, compensation, documentation, leadership, and policy directly affected patient outcomes. When resources were stretched and priorities misaligned, patients experienced longer wait times, rushed visits, fragmented communication, and uneven quality of care.

Quantitative data echoed these concerns: only 56% of respondents agreed or strongly agreed that “it is possible to provide high-quality care to all my patients or clients.” Although the majority of qualitative comments reflected frustration or concern, respondents who provided open-ended feedback tended to rate quantitative items more positively than those who did not, suggesting that those most engaged in reflecting on their experience also recognized areas of progress and potential for improvement.

 

Implications: Findings highlight the critical link between workforce experience and the delivery of high-quality, patient-centred home care. Providers’ reflections point to a system under strain, where challenges related to staffing, compensation, and documentation hinder the very goals of integration. These results reinforce the need for continued investment in home care improvement projects that engage providers as partners in design and implementation. Understanding provider experience is essential to shaping sustainable models of care that support the workforce, improve coordination, and advance equitable, person-centred outcomes. For international audiences, the results offer transferable lessons on what matters most to providers and how these factors connect to improved, patient-centred care.