Objective 1

The Team’s first objective is:

• to identify factors responsible for success or failure of current CDPM initiatives linked to the PC reform, by conducting a Realist Synthesis of their quantitative and qualitative evaluations;

PACE in MM Team has searched the literature on:

• Three building blocks:
  • Chronic care models
  • Self-management and
  • Primary care reform

• Three innovations:
  • appropriateness for multimorbidity
  • patient-centred partnerships between patients and providers
  • patient-centred coordination

This Team proposes to work with naturally occurring initiatives which show promise in combining these six elements (i.e. the three building blocks and the three innovations) and will provide important data on successes at three stages, each stage paralleling one of the three Objectives of the proposal: early on when an initiative is new; at a second stage when an initiative is innovating and incorporating evidence and theory; and at a third stage when innovative programs are spreading to other regions.

A preliminary Environmental Scan has been performed to identify relevant CDPM initiatives: 28 in QC and 36 in ON (64 in total). Most of them showed interest in collaborating with the team. Some of those initiatives function at the practice level while others at the regional level and one half of those initiatives have evaluations.

STUDY #1.1:  Updating the Environmental Scan on CDPM Initiatives in QC and ON (Months 1 - 2).

STUDY #1.2: Realist Synthesis (RS) of Existing CDPM Initiatives (Months 1 - 12)

Two Deliverables for Objective 1:

• A compendium of CDPM initiatives in QC and ON, along with a list of those that have robust evaluations.
• A report on their results and a comprehensive synthesis of their success and failure and their associated explanations.