Abstract
Background: In the face of rising healthcare costs and constrained budgets, primary care systems are increasingly being asked to achieve more with fewer resources. This financial reality places a significant strain on practices striving to deliver high-quality, comprehensive care while meeting complex patient needs. To address these challenges, practice facilitators have emerged as a valuable resource in primary care, offering targeted support to build practice capacity, enhance efficiency, and drive quality improvement efforts. By collaborating directly with practice teams, facilitators help to streamline workflows, implement evidence-based interventions, and foster a culture of continuous improvement. As healthcare systems continue to face financial pressures, the role of practice facilitators in optimizing primary care performance is more critical than ever.
Approach: The Health Innovation Group developed a training program to grow the practice facilitator workforce across multiple jurisdictions within Canada. The program focuses on building core competencies in Quality Improvement, Facilitation, Primary Care Context, Patient’s Medical Home, Information for Action, and Leadership. The program's design was guided by a scientific planning committee with an international membership of physicians, nurses, academics, clinicians, and practice facilitators. Patient/public insights and involvement in developing the Patient’s Medical Home model of care were significant and informed the core elements of continuity, respect for preferences, and commitment to shared decision-making. This training has been accessed by medical associations, health authorities, and other healthcare organizations to build their organizational capacity to improve the sustainability of primary care.
Results: Health Innovation Group has trained over 100 practice facilitators and supported them with ongoing coaching and networking opportunities. These practice facilitators have been able to report the following results in building a more sustainable primary care system:
- Nova Scotia – reduction of over 10000 patients from the unattached patient registry
- Newfoundland – 380 patients added to primary care providers panels
- Ontario – currently deploying practice facilitators to enhance team integration of primary care teams
- Alberta – 15% increase in patients receiving recommended screening and preventive care, impacting over 1.6 million patients
Results achieved without additional resources provided to primary care teams demonstrate increased system capacity, capability, and sustainability.
Implications: Integrating trained practice facilitators into primary care has demonstrated measurable improvements in patient access, preventive care, and system capacity across multiple Canadian jurisdictions, even without additional financial resources. This approach offers a scalable solution for building a more sustainable primary care system, enhancing efficiency, and addressing the increasing demand for high-quality care in an environment of constrained budgets. Future opportunities to deploy practice facilitators include decreasing the carbonization of primary care practices or introducing strategies for primary care to be more inclusive to patient populations. The success of this training, support, and deployment underscores the critical role of practice facilitators in strengthening primary care infrastructure and supporting the long-term sustainability of healthcare delivery.