From Planning to Practice: Implementing an Interprofessional Primary Care Team

How We Got There

The Challenge

A community health services organization was working with local partners to establish a Neighbourhood Primary Care Health Home with provincial funding for the IPCT expansion. The initiative aimed to connect vulnerable residents who were unattached to primary care with the services they needed.

The organization needed to bring a Community Health Centre, Family Health Teams, Family Health Organizations, and community partners together to design services, allocate resources, and establish operational infrastructure around a common vision for local primary care. It also needed to engage the communities it intended to serve throughout implementation.

The Solution

For the past two years, across multiple application rounds, Optimus has worked alongside the organization and its network partners to translate the health home concept into an operating service. Frequent co-design sessions with Family Health Teams, Family Health Organizations, and community partners helped shape the model and coordinate implementation.
Our team supported the planning and design of a central intake process and population health clinic, alongside budgeting and resource allocation. Hands-on project and change management helped partners put these plans into practice and navigate the changes involved in establishing the interprofessional team.
To strengthen operational infrastructure, Optimus also supported policy development, evaluation, data analysis and reporting, while providing ongoing strategic advice. Engagement and communications focused on building effective partnerships that support the vulnerable, unattached residents the network was designed to serve, helping connect service planning with the communities’ needs.

The Results

The initiative has established a functioning IPCT with the operational infrastructure needed to support service delivery at scale. Collaborative planning, partnership development and implementation support helped the organization and its network partners move from designing the model to delivering more comprehensive interprofessional primary care.

The team has achieved its patient attachment targets, connecting vulnerable residents who previously lacked a regular primary care provider with care. This outcome translates provincial investment into expanded access for the population the network was designed to serve.

The initiative has also developed a defensible care model that has secured provincial support and additional funding, providing a stronger foundation for continued development. Optimus continues to support implementation.