The Development of Playbooks to Support Community-Driven Integrated Care

Background: In August 2020, all seven departments of the Government of Northwest Territories (GNWT) signed a Memorandum of Understanding (MOU), committing to address longstanding challenges in care systems, especially concerning children, youth, and families. This commitment focused on supporting the planning, development, and implementation of an Integrated Service Delivery (ISD) initiative for early childhood development (ECD) for children under 6 years old and their families or caregivers.The aim was to establish a comprehensive government approach invested in supportive social programs, addressing root causes, and integrating cultural and community healing. To pursue healthy child growth and development, the ECD working group was formed within the GNWT made up of the seven government departments and led by the Health and Social Services (HSS) department and Education department.The key objective of this working group was to create a model for integrated service delivery that could support establishing integrated service delivery for ECD and also be scaled to other integrated care initiatives. To achieve this, the HSS department, in partnerships with a consulting firm, spearheaded the development of a curriculum that could support community development and capacity building. Following this curriculum, communities can learn how to self-identify and collectively co-design ISD within their community to address their most pressing community needs and with backbone support from the GNWT.

Approach: The curriculum development was developed following a thorough discovery phase, which included a population needs assessments, current state mapping, community engagement, a jurisdictional scan and evidence and best-practices reviews. This phase provided a comprehensive understanding of the landscape, including trends, population needs, and evidence-based strategies to support ISD in communities.Building on the insights from the discovery phase, a design phase followed, engaging stakeholders in brainstorming sessions and iterative development of curriculum materials such as playbooks, presentations, and implementation supports.The resulting curriculum was tailored to NWT and centred around how to establish ISD that is grounded in cultural safety, anti-indigenous racism and supported relationship-based care. This approach was called establishing New Ways of Working.

Results: The resulting curriculum consists of six workbooks, guiding communities through practical steps to establish integrated, culturally safe, and community-aligned approaches. These workbooks include:. Establishing Foundations - building a team, setting up the project and learning about New Ways of Working 2. Establishing Readiness - completing a readiness assessment and formal application to participate in the curriculum3. Building Capacity - understanding community needs, mapping current assets and determining priorities4. Co-Creation - working across sectors and organizations to co-create ISD strategies and activities to address community needs5. Implementation and Reflection - operationalizing ISD initiatives and monitoring progress and success6. Evaluating and Sharing - reflecting on lessons learned, continuing to quality improve and share across communities of practiceSupplementary resources, including case studies and implementation roadmaps, were also developed to support implementation efforts.

Implications: This work is still underway with the finalization of the workbooks and implementation supports. This initiative holds significant promise for supporting ISD in the Northwest Territories. Its comprehensive, culturally sensitive, and community-driven approach has the potential to serve as a model for other regions looking to achieve similar goals. Future steps include pilot testing the approach in communities.