Table of Contents
International Journal of Family Medicine
Volume 2016, Article ID 5926303, 8 pages
Research Article

Improving System Integration: The Art and Science of Engaging Small Community Practices in Health System Innovation

1University Health Network-Toronto General Hospital, Toronto, ON, Canada M5G 2C4
2Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada M5G 1V7
3Women’s College Hospital, Toronto, ON, Canada M5S 1B2
4Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada M5S 1A1
5Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6
6Department of Medicine, University of Toronto, Toronto, ON, Canada M5S 1A1

Received 13 September 2015; Revised 18 December 2015; Accepted 22 December 2015

Academic Editor: Paul Van Royen

Copyright © 2016 Pauline Pariser et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This paper focuses on successful engagement strategies in recruiting and retaining primary care physicians (PCPs) in a quality improvement project, as perceived by family physicians in small practices. Sustained physician engagement is critical for quality improvement (QI) aiming to enhance health system integration. Although there is ample literature on engaging physicians in hospital or team-based practice, few reports describe factors influencing engagement of community-based providers practicing with limited administrative support. The PCPs we describe participated in SCOPE: Seamless Care Optimizing the Patient Experience, a QI project designed to support their care of complex patients and reduce both emergency department (ED) visits and inpatient admissions. SCOPE outcome measures will inform subsequent papers. All the 30 participating PCPs completed surveys assessing perceptions regarding the importance of specific engagement strategies. Project team acknowledgement that primary care is challenging and new access to patient resources were the most important factors in generating initial interest in SCOPE. The opportunity to improve patient care via integration with other providers was most important in their commitment to participate, and a positive experience with project personnel was most important in their continued engagement. Our experience suggests that such providers respond well to personalized, repeated, and targeted engagement strategies.