Promising practices for strengthening access to primary care in northern, rural and remote communities
The Strengthening Primary Care program brought together 20 teams of primary care providers, organizations and communities from northern, rural and remote communities across Canada to improve access to primary care.
- Topics
- Primary and community care
- First Nations, Inuit and Métis priorities
- Audience
Healthcare leader
Community organization
Point of care provider
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Promising Practices
With support from the program, the teams introduced promising practices — approaches that improved access to safe, including culturally safe, team-based primary care — by meeting the unique needs of communities, patients and providers while encouraging collaboration and shared learning across Canada. One of the 20 teams (Newfoundland and Labrador Health Services) advanced five unique promising practices to respond to the needs of people and providers throughout their province.
Addressing family doctor shortages with virtual care (Petawawa Centennial Family Health Centre, ON)
The Integrated Virtual Care (IVC) program connects patients to their family doctor and primary care team in a region where 20% of residents lack access to primary care. The program has expanded to three primary care clinics, enrolled over 6,500 new patients, and reduced avoidable emergency department visits.
Optimizing team-based primary care (CISSS Montérégie Centre, QC)
The Advanced Access Quality Improvement Coach Model provides primary care practices with the tools and skills to better align patient needs with available resources. So far, 37 primary care clinics across Canada have adopted this model. In just six months, four clinics in Quebec have already reported promising results.
Expanding Access to Team-Based Care (NL Health Services, Conception Bay North, NL)
To address the shortage of team-based primary care, the Family Care Team Access model connects private clinic doctors with allied health professionals within family care teams. This innovative approach ensures seamless referrals and better coordination of care. In just three months, private family doctors are reporting an increased capacity to work at the top of the scope of practice.
Improving Primary Care Through Community Collaboration (Algonquin Family Health Team in collaboration with NOSM University, ON)
The Annex, a nurse practitioner-led clinic in Huntsville, increases access to team-based primary care in a region where over 4,000 residents are without a family doctor. Located in a community library, The Annex has reduced avoidable emergency visits, supported recovery for discharged patients, and earned praise from patients and providers alike.
Addressing After-Hours Primary Care Needs with Regional Nurse On-Call (Cree Board of Health and Social Services of James Bay, QC)
The Regional Nurse On-Call (RNOC) program is a centralized virtual triage service addressing after-hours primary care in Cree communities of Northern Quebec, where nursing shortages have created challenges. The program has triaged over 6,200 calls, resolving more than 50% of cases over the phone and reducing avoidable visits to local clinics.
Enhancing Health Centre Services in Nunavut (Government of Nunavut, NU)
Piloting extended hours in Rankin Inlet, Pond Inlet, and Kugaaruk, Nunavut’s Department of Health is bridging gaps in community care. Guided by Inuit Societal Values, this initiative aims to reduce after-hours registrations and improve both patient and staff experiences. Early feedback highlights its potential to improve access and reduce system strain.
Pathways from Emergency to Primary Care (Nova Scotia Health, Neil’s Harbour, NS)
To improve same-day and next-day access to primary care and reduce emergency department visits, Nova Scotia Health introduced a Registered Nurse (RN) prescriber to the primary care team in Neil’s Harbour. Since implementation, 23% of patients with less urgent needs have been redirected from the emergency department to primary care, with additional same-day appointments preventing unnecessary ER visits.
Point-of-Care Renal Screening (Prairie Mountain Health, MB)
To address barriers in early detection and treatment of kidney disease among Indigenous communities, Prairie Mountain Health launched a point-of-care renal screening initiative. This program provides culturally safe, team-based preventative care in four First Nations and one Métis community, improving access to early diagnosis and specialist referrals. Since launch, 142 individuals have been screened, with those at risk receiving timely interventions.
Type 2 Diabetes Remission Services (Rural Coordination Centre of BC, BC)
The Rural Coordination Centre of BC is working with the communities of Tumbler Ridge and Port Alberni to integrate food-based approaches into diabetes care. More than 200 healthcare providers have been trained to assist patients on their remission journey, and community pharmacies now offer point-of-care diabetes testing, improving accessibility.
Better Health Innovation Access to Team-based Primary Care
ConnectWell Community Health
Canadian Health Advanced by Nutrition and Graded Exercise Program
Pacific Northwest Division of Family Practice
es zúmin’ Primary Care Centre
Líl̓wat Health & Healing
Expanded Primary Healthcare Team
Saskatchewan Health Authority
Global Spine Model of Care
Cross Lake Band Health Services
Improve Access and Receptiveness for Cancer Screening in First Nations Communities
(Sunset Country Family Health Team)
Mobile Primary Healthcare Teams
NL Health Services - Central Zone
Primary Care Pop Up – Carbonear Impact Clinic
NL Health Services - Eastern Zone 2
Mobile Care for Screening and Treatment
NL Health Services - Labrador-Grenfell Zone
Patient Pathways to Family Care Team Services
NL Health Services - Western Zone
Staying Healthy Clinic Improve Access for Older Adults with Chronic Conditions and/or Declining Health
Horizon Health Network
Virtual Care in Remote First Nations Clinics
Vancouver Island Health Authority
Virtual Care via Mobile Internet in Northern Communities
Northern Interior Rural Division of Family Practice
Webinar Series
Healthcare teams across Canada are enhancing access to safe, team-based primary care in northern, rural and remote communities.
The Strengthening Primary Care program supported 20 teams across the country to advance innovative practices to improve access to primary care to meet the distinct needs and goals of their communities, patients and providers, while also sharing and learning with others across Canada. Newfoundland and Labrador Health Services, one of the teams, advanced five unique promising practices to respond to the needs of people and providers throughout their province.
This series is for healthcare leaders, providers, policymakers, and community partners looking to consider how to adapt and apply evidence-informed solutions in their own settings.
Join us in this two-part webinar series to learn about some of the promising practices that have improved access to team-based primary care in their communities.
We’ll discuss:
Details about the practices, including evaluation and impacts
Key success factors and lessons learned to support implementation, sustainability and spread.
Common and unique strategies the teams used to embed community, health workforce and Indigenous partnerships into their practices.
Ways the practices could be adapted and applied elsewhere.
Speakers/Panelists
Larry K. Bremner (Métis), Partner, Proactive Information Services Inc. and program coach
Linda E. Lee, Partner, Proactive Information Services Inc. and program coach
Janine van den Heuvel, Chief Executive Officer, Algonquin Family Health Team
Maya Nakajima, Government of Nunavut
Jessica Brennan, Regional Manager, Conception Bay North, Placentia & Whitbourne, NL Health Services
Hosts
Colleen Ferris, Director, Innovations and Strategic Development, Healthcare Excellence Canada
Speakers/Panelists
Larry K. Bremner (Métis), Partner, Proactive Information Services Inc. and program coach
Linda E. Lee, Partner, Proactive Information Services Inc. and program coach
Isabelle Gaboury PhD, Professor, Université de Sherbrooke
Dr. Jonathan Fitzsimon, Medical Lead, Integrated Virtual Care
Frederic Lemieux, Assistant Director of Professional Service and Quality Assurance-Health, Cree Board of Health and Social Services of James Bay
Host
Jennifer Major, Senior Program Lead, Innovations and Strategic Development, Healthcare Excellence Canada
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