Exploring Context and the Factors Shaping Team-Based Primary Healthcare Policies in Three Canadian Provinces: A Comparative Analysis
Open accessAbstract
This paper discusses findings from a high-level scan of the contextual factors and actors that influenced policies on team-based primary healthcare in three Canadian provinces: British Columbia, Alberta and Saskatchewan. The team searched diverse sources (e.g., news reports, press releases, discussion papers) for contextual information relevant to primary healthcare teams. We also conducted qualitative interviews with key health system informants from the three provinces. Data from documents and interviews were analyzed qualitatively using thematic analysis. We then wrote narrative summaries highlighting pivotal policy and local system events and the influence of actors and context. Our overall findings highlight the value of reviewing the context, relationships and power dynamics, which come together and create "policy windows" at different points in time. We observed physician-centric policy processes with some recent moves to rebalance power and be inclusive of other actors and perspectives. The context review also highlighted the significant influence of changes in political leadership and prioritization in driving policies on team-based care. While this existed in different degrees in the three provinces, the push and pull of political and professional power dynamics shaped Canadian provincial policies governing team-based care. If we are to move team-based primary healthcare forward in Canada, the provinces need to review the external factors and the complex set of relationships and trade-offs that underscore the policy process.
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More workforce turnover and availability issues occur among rural and remote primary healthcare teams.
“Misfeldt et al. [48] found more workforce turnover and availability issues among rural and remote PHC teams.”
From Factors influencing sustainability and scale-up of rural primary healthcare memory clinics: perspectives of clinic team members (2022) · cites this paper as [48]
Interprofessional primary care teams that allocate more time for planning and discussion are better able to tailor implementation and adapt to a changing context, resolve issues, and improve collaboration.
“Studies of factors affecting interprofessional primary care team function, including in rural areas, found that teams allocating more time for planning and discussion were better able to tailor the implementation and adapt to a changing context [49], resolve issues [48], and improve collaboration [26].”
From Factors influencing sustainability and scale-up of rural primary healthcare memory clinics: perspectives of clinic team members (2022) · cites this paper as [48]
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- Authors
- Misfeldt, R., Suter, E., Mallinson, S., Boakye, O., Wong, S., & Nasmith, L.
- Affiliations
- Alberta Health Services (CA)
- University of Calgary (CA)
- University of British Columbia (CA)
- Corresponding author
- Misfeldt, Renée
- Venue
- Healthcare Policy | Politiques de Santé
- Publisher
- Longwoods Publishing
- Published
- 2017-08-31
- Volume
- 13
- Issue
- 1
- Pages
- 74-93
- ISSN
- 1715-6572 (ISSN-L)
- 1715-6580
- PMC
- PMC5595215
- OpenAlex
- W2756369433
- Cited by
- 18
- References
- 18
- Citations by year
- 2025: 3 · 2024: 5 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 1 · 2017: 1
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- cc-by-nc
- Locations
- Healthcare policy (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Practices
- Keywords
- primary health care teams, health policy, policy windows, power relations, physician influence, political leadership, health system actors, British Columbia, Alberta, Saskatchewan, Canadian provinces
- MeSH terms
- Alberta, British Columbia, Health Policy, Humans, Patient Care Team, Policy Making, Primary Health Care, Saskatchewan
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