Primary care engagement in health system change: a scoping review of common barriers and effective strategies

BMC Primary Care

Research

Judith Belle Brown¹  Michael Sergio Taglione² 

[1] Department of Family Medicine, Western University, 1465 Richmond Street, N6G 2M1, London, ON, Canada;Department of Family and Community Medicine, University of Toronto, 500 University Avenue, M5G 1V7, Toronto, ON, Canada;Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, M5T 3M6, Toronto, ON, Canada;

关键词: Primary health care;    Family medicine;    Stakeholder engagement;    Health system change;    Health systems research;    Scoping review;   

DOI  :  10.1186/s12875-023-02117-2

 received in 2022-07-05, accepted in 2023-07-20,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe complexity of health systems necessitates coordination between a multitude of stakeholders to enact meaningful change. Primary care physicians are a crucial partner to engage, as their investment and participation are critical to the success of any system-level initiative. The aim of this scoping review is to identify common barriers and effective strategies when engaging primary care physicians in designing and implementing health system change.MethodsA scoping review was performed. A literature search was performed in March 2020 using five databases. 668 unique articles were identified and underwent a title and abstract review. 23 articles met criteria for full text review and 10 met final inclusion criteria. A backward citation analysis identified two articles. 12 articles underwent data extraction and thematic analysis.ResultsSeveral barriers to engagement were identified including a lack of trust between primary care physicians and decision-makers, strong professional physician identity, clinically irrelevant and complex proposals, and a lack of capacity and supports. Described strategies to overcome these barriers included building trust and relationships, contextual engagement strategies, working with physician leadership, enabling open and intentional communication channels, designing clinically relevant and straightforward initiatives, and considering financial incentives.ConclusionsBarriers to primary care engagement should be addressed with contextually designed strategies and a focus on relationship building, collaborative efforts, and implementing relevant and feasible initiatives. Further research should explore how to best develop relationships with primary care, working with collective voices of primary care physicians, and to better understanding the impact of financial incentives on engagement.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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