Graduate student at the Institute of Health Policy, Management and Evaluation at the University of Toronto in Ontario.
Professor in the Institute of Health Policy, Management and Evaluation and the Department of Medicine at the University of Toronto, and Senior Scientist at Women's College Research Institute.
Can Fam Physician. 2019 Apr;65(4):e155-e162.
To explore the dynamics of primary care physicians' (PCPs') engagement with the Seamless Care Optimizing the Patient Experience (SCOPE) project.
Qualitative study using semistructured interviews.
Solo and small group primary care practices in urban Toronto, Ont.
A total of 22 of the 29 SCOPE PCPs (75.8%) were interviewed 14 to 19 months after the initiation of SCOPE.
Qualitative semistructured interviews were conducted to examine influencing factors associated with PCPs' engagement in SCOPE. Transcripts were analyzed using a grounded theory-informed approach and key themes were identified.
The SCOPE project provided practical mechanisms through which PCPs could access information and connect with resources. Contextual and historical factors including strained relationships between hospital specialists and community PCPs and PCPs' feelings of responsibility, isolation, disconnection, and burnout influenced readiness to engage. Provision of clinically useful supports in a trusting, collaborative manner encouraged PCPs' engagement in newer, more collaborative ways of working.
The SCOPE project provided an opportunity for PCPs to build meaningful relationships, reconnect to the broader health care system, and redefine their roles. For many PCPs, reestablishing connections reaffirmed their role in the system and enabled a more collaborative care model. Strategies for connecting community-based PCPs to the broader system need to consider contextual factors and the effects of new linkages and coordination on the identities and relationships of PCPs.
探索初级保健医生（PCPs）参与无缝护理优化患者体验（SCOPE）项目的动态变化。
使用半结构式访谈的定性研究。
安大略省多伦多市的单体和小组初级保健诊所。
29 名 SCOPE PCP 中有 22 名（75.8%）在 SCOPE 启动后 14 至 19 个月接受了采访。
进行定性半结构式访谈，以研究与 PCP 参与 SCOPE 相关的影响因素。使用扎根理论方法分析转录本，并确定关键主题。
SCOPE 项目提供了实用的机制，使 PCP 能够获取信息并与资源建立联系。包括医院专家与社区 PCP 之间关系紧张以及 PCP 感到有责任、孤立、脱节和倦怠等背景和历史因素，影响了参与的准备情况。以信任和协作的方式提供有临床实用价值的支持，鼓励 PCP 以更新、更协作的方式参与工作。
SCOPE 项目为 PCP 提供了建立有意义关系、重新融入更广泛的医疗保健系统和重新定义其角色的机会。对许多 PCP 来说，重新建立联系再次确认了他们在系统中的角色，并使更具协作性的护理模式成为可能。将社区为基础的 PCP 与更广泛的系统联系起来的策略需要考虑背景因素，以及新的联系和协调对 PCP 身份和关系的影响。
