title: The integration of occupational therapy into primary care: a multiple case study design.
abstract: BACKGROUND
  For over two decades occupational therapists have been encouraged to enhance their roles within primary care and focus on health promotion and prevention activities. While there is a clear fit between occupational therapy and primary care, there have been few practice examples, despite a growing body of evidence to support the role. In 2010, the province of Ontario, Canada provided funding to include occupational therapists as members of Family Health Teams, an interprofessional model of primary care. The integration of occupational therapists into this model of primary care is one of the first large scale initiatives of its kind in North America. The objective of the study was to examine how occupational therapy services are being integrated into primary care teams and understand the structures supporting the integration.
  
  
  METHODS
  A multiple case study design was used to provide an in-depth description of the integration of occupational therapy. Four Family Health Teams with occupational therapists as part of the team were identified. Data collection included in-depth interviews, document analyses, and questionnaires.
  
  
  RESULTS
  Each Family Health Team had a unique organizational structure that contributed to the integration of occupational therapy. Communication, trust and understanding of occupational therapy were key elements in the integration of occupational therapy into Family Health Teams, and were supported by a number of strategies including co-location, electronic medical records and team meetings. An understanding of occupational therapy was critical for integration into the team and physicians were less likely to understand the occupational therapy role than other health providers.
  
  
  CONCLUSIONS
  With an increased emphasis on interprofessional primary care, new professions will be integrated into primary healthcare teams. The study found that explicit strategies and structures are required to facilitate the integration of a new professional group. An understanding of professional roles, trust and communication are foundations for interprofessional collaborative practice.
authors.affiliation: School of Rehabilitation Therapy, Queen's University, 31 George Street, Kingston, ON, K7L 3N6, Canada. catherine.donnelly@queensu.ca
authors.forename: Catherine
authors.initials: C
authors.lastname: Donnelly
authors.forename: Christie
authors.initials: C
authors.lastname: Brenchley
authors.forename: Candace
authors.initials: C
authors.lastname: Crawford
authors.forename: Lori
authors.initials: L
authors.lastname: Letts
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000379:methods*; D005192:Family Health; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008297:Male; D009788:Occupational Therapy / Q000193:education / Q000458:organization & administration*; D009864:Ontario; D019982:Organizational Case Studies; D010348:Patient Care Team / Q000458:organization & administration*; D011314:Preventive Health Services; D011320:Primary Health Care / Q000458:organization & administration*; D024382:Professional Role; D012423:Rural Health; D014504:Urban Health