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During the four years of this initiative (2002–06), it undertook a wide range of activities.
To increase the proportion of the population having access to PHC organizations accountable for the planned provision of a defined set of comprehensive services to a defined population, activities focused on:
To increase emphasis on health promotion, disease and injury prevention, and management of chronic diseases, all PHC team areas worked on, and succeeded in:
To expand 24/7 access to essential services, activities focused on:
To establish interdisciplinary PHC teams of providers, so that the most appropriate care is provided by the most appropriate provider, activities focused on:
To facilitate coordination and integration with other health services, activities focused on:
Despite some rather formidable challenges (majority of physicians being paid on a fee-for-service basis, NL’s large geography and small population, maintaining an Aboriginal health system along with the provincial one), NL has managed to advance its PHC reform agenda through this initiative. Eight PHC teams have been initiated, with three more team areas in the early stages of proposal implementation, and three more finalizing proposals. Proposals were based on population needs. Large numbers of professionals participated in team development and worked on scopes of practice processes, and early evaluation results show positive shifts towards increased teamwork. All PHC team areas established Community Advisory Committees, and all PHC teams, in cooperation with the provincial Wellness Strategy and Regional Wellness Coalition, increased support for wellness initiatives. The CDM Collaborative was implemented in the seven rural PHC team areas, and is in the early implementation stage in urban settings. The evaluation processes were formalized for all PHC team areas and for special projects (such as enhanced sharing of information). Partnerships were forged with academic institutions for professional education and development, as well as with the Newfoundland and Labrador Centre for Health Information to move forward with a number of information management initiatives for evaluation and future direction (sharing of electronic health information, telehealth, electronic medical record [EMR], and the PHC classification system ICPC2).
The provincial framework and the infrastructure that was developed supported PHC renewal activities in the province and will continue to provide support for future PHC team areas. These will also support implementation of all provincial health strategies at the service delivery level. PHC renewal will also be sustained by collaboration with stakeholders, capacity building for providers/leaders, seeking opportunities to integrate the BBT modules and standards of practice processes into professional practice; self-paced learning and web-based adaptations of some of the tools; leadership for PHC at the executive level of the Regional Integrated Health Authorities (RIHAs); exploring opportunities to continue with Memorial University of Newfoundland and the College of North Atlantic for professional education and development; and integrating the provincial leadership for PHC into the current Department of Health and Community Services structure.
The initiative’s organizers believe that much of what has been developed—proposals, scopes of practice, BBT modules, CDM Collaborative—will be useful to other departments and divisions within the Department of Health and Community Services, to the RIHAs, as well as to other jurisdictions and organizations.
This initiative was supported by the Primary Health Care Transition Fund. The views expressed herein do not necessarily represent those of the federal government. The above information was prepared on the basis of the initiative’s final report, in consultation with its author.