title: Improving System Integration: The Art and Science of Engaging Small Community Practices in Health System Innovation.
abstract: 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
  
  
  METHODS
  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.
authors.affiliation: University Health Network-Toronto General Hospital, Toronto, ON, Canada M5G 2C4; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada M5G 1V7.
authors.forename: Pauline
authors.identifier: 0000-0002-0422-9983
authors.initials: P
authors.lastname: Pariser
authors.affiliation: Women's College Hospital, Toronto, ON, Canada M5S 1B2.
authors.forename: Laura
authors.initials: L
authors.lastname: Pus
authors.affiliation: Women's College Hospital, Toronto, ON, Canada M5S 1B2.
authors.forename: Ian
authors.initials: I
authors.lastname: Stanaitis
authors.affiliation: University Health Network-Toronto General Hospital, Toronto, ON, Canada M5G 2C4; Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada M5S 1A1.
authors.forename: Howard
authors.identifier: 0000-0002-4869-3913
authors.initials: H
authors.lastname: Abrams
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada M5G 1V7; Women's College Hospital, Toronto, ON, Canada M5S 1B2; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6.
authors.forename: Noah
authors.initials: N
authors.lastname: Ivers
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6.
authors.forename: G Ross
authors.initials: GR
authors.lastname: Baker
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lockhart
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6; Department of Medicine, University of Toronto, Toronto, ON, Canada M5S 1A1.
authors.forename: Gillian
authors.initials: G
authors.lastname: Hawker