Program overview :
Promising Practices for Strengthening Primary Care in Northern, Rural and Remote Communities
June 2023
Northern, rural and remote communities are implementing practices that improve access to safe, high-quality primary care. This includes ensuring that care is culturally safe, provided closer to home and community, and meets patient and provider needs.
Healthcare Excellence Canada, in partnership with those delivering primary care in northern, rural and remote communities, has summarized these practices into short summaries. These summaries are meant to help raise the profile of promising practices and generate discussion about how similar approaches could be adapted and applied elsewhere. The summaries offer details about:
- How the practice works
- Evaluation and impact, including provider and patient perspectives
- Key success factors that support sustainability, including community and patient partnership
- Ways these practices could be spread
- Resourcing and costs
These summaries feature proven promising practices as well as emerging practices that have the potential to improve access to safe, high-quality care in northern, rural and remote communities.
Promising practice summaries
Advanced Access Quality Improvement (QI) Coaching Support Model (New Brunswick and Quebec)
Advanced Access is a method of scheduling that improves timely access to care for patients. The Advanced Access QI coaching support model has helped primary care clinics and providers successfully implement advanced access through providing tailored change management supports, including workshops to identify priority areas for scheduling/access improvements; support for implementation and evaluation; and group mentoring. Evaluations show that this model has contributed to improved appointment availability, reduced walk in consultations, reduced workload for healthcare providers and improved work satisfaction among administrative and clinical staff.
Community Health Centre Model (Ontario)
Of the more than 100 community health centres (CHC) in Ontario, 21 primarily serve communities that are northern, rural or remote. CHCs are community governed organizations that integrate health and social services to offer team-based, interprofessional primary care with a central focus on addressing social determinants of health. Evaluations show CHCs provide increased availability and access to healthcare and social supports, including reductions in avoidable emergency visits and hospitalizations and improved outcomes of care.
Integrated Virtual Care (Ontario)
This model allows patients who do not have a family doctor to be attached to a family physician (who works predominantly remotely) with support from a broad team of allied health professionals based at a local health centre. Patients receive in-clinic, at home and virtual care options, depending on their individual needs and preferences. Key outcomes include an increase in the number of unattached patients permanently connected with a family physician, as well as more screenings and referrals.
Real Time Virtual Supports (British Columbia)
Real time virtual supports (RTVS) have increased access to virtual collegial support for healthcare providers serving 135 rural, remote and Indigenous communities, as well as increased patient access to timely, appropriate virtual care. Specialized 24/7 instant access to emergency medicine providers, maternity and child health advice, and critical care and internal medicine support is available through peer pathways. This approach has led to a stronger community of practice among rural healthcare providers and more appropriate patient care at a lower cost.
Regional Virtual Care Clinic (Newfoundland and Labrador)
A new approach to primary care service delivery was needed due to primary care provider shortages, an increasing number of unattached patients, growing waitlists and wait times, high use of emergency departments for non-urgent issues, and case management for high-risk patient populations. This model of care taps into new human resources to support care coordination for unattached and underserved populations. This collaborative approach has decreased wait times, improved care experience and safety for patients, and is expected to reduce avoidable emergency department visits.
Virtual Primary and Community Care Clinic (British Columbia)
The Virtual Primary and Community Care Clinic (VPCCC) was developed by Northern Health to respond to the needs of the largest rural health region in British Columbia, serving 300,000 people across more than two-thirds of the province. The VPCCC serves patients who are not attached to a primary healthcare provider, require reliable access to primary and community care or more urgent and emergent care, or need care on evenings or weekends. A survey of patients who accessed VPCCC in 2023 showed improved access and experience of care, as well as reduced avoidable emergency departments visits.
Why this work matters
People who live in northern, rural and remote communities often face poorer access to primary care compared to their urban-dwelling counterparts. Healthcare providers who work in these communities also face unique challenges in providing care. Learn more about Strengthening Primary Care in Northern, Rural and Remote Communities, a new program designed to help address these challenges and improve access to safe, high-quality, team-based primary care closer to home and community.
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