Implementing leading practices in regional-level primary care workforce planning: Lessons learned in Toronto.

Investment in capacity for implementation of leading practices in regional-level health workforce planning is essential to support equitable distribution of resources and deployment of a health workforce that can meet local needs. Ontario Health Toronto and the Canadian Health Workforce Network (CHWN) co-developed and operationalized an integrated workforce planning process to support evidence-based primary care workforce decision-making for the Toronto region. The resultant planning toolkit incorporates planning processes centred around engagement with stakeholders, including environmental scanning tools and a quantitative planning model. The outputs of the planning process include estimates of population need and workforce capacity and address challenges specific to Toronto, such as patient mobility, anticipated rapid population growth, and physician retirement. We highlight important challenges and key considerations in the development and operationalization of workforce planning processes, particularly at the regional level.

Awareness and Use of Community Services among Primary Care Physicians.

Primary care physicians play an important role in care coordination, including initiating referrals to community resources. Yet, it is unclear how awareness and use of community resources vary between physicians practising with and without an extended healthcare team. We conducted a cross-sectional survey of primary care physicians practising in Toronto, Canada, to compare awareness and use of community services between physicians practising in team- and non-team-based practice models. Team-based models included Community Health Centres and Family Health Teams - settings in which the government provides funding for the practice to hire non-physician health professionals, such as social workers, pharmacists, nurse practitioners, registered nurses and others. The survey was mailed to physicians, and reminders were done by phone, fax and e-mail. We used logistic regression to compare awareness between physicians in team-based (N = 89) and non-team-based (N = 138) models after controlling for confounders. We found that fewer than half of the physicians were aware of five of eight centralized intake services (e.g., ConnexOntario, Telehomecare). For most services, team-based physicians had at least twice the odds of being aware of the service compared to non-team-based physicians. Our findings suggest that patients in team-based practices may be doubly advantaged, with access to non-physician health professionals within the practice as well as to physicians who are more aware of community resources.