Shannon L. Sibbald

The burden of chronic diseases impacts individuals, families, and societies in most, if not all countries around the world (Bookey-Bassett et al., 2017; Hajat & Stein, 2018). The World Health Organ...

The Canadian workforce faces significant and complex health human resource (HHR) challenges. The implementation of interprofessional models of team-based c

Introduction: Chronic obstructive pulmonary disease (COPD) is alarmingly prevalent in Southwestern Ontario, with a high incidence rate when compared to other regions in Canada, however, it is not known whether this is accurately reflected in available programming and resources within the region. As such, we sought to describe the state of programming and resources across the health sector within one region in Southwestern Ontario, Canada for people living with COPD. Methods: Environmental scanning methodology was used to collect information and identify patterns across public-facing content on COPD programs located within the Middlesex-London region, within 200 km of the region, and/or available virtually to the region’s residents. Primary data were collected between January 2024 and February 2025 via web-searching and expert consultation. Programs were included if they were 1) primarily aimed at addressing COPD; 2) currently offered physically within the Middlesex-London region and/or within 200 km of London and/or currently offered virtually to Canadians, specifically; 3) offered at a primary care, acute care, community care or rehabilitation location (if offered physically), and; 4) specifically aimed at an Indigenous group/population or mentioned a component of the program that was/could be Indigenous (exclusively for the Indigenous search). Results: We found 51 COPD programs available to the Middlesex-London population, all of which were available to patients at no cost. One Indigenous COPD program was found. Geographical, infrastructural, navigational, and personal barriers to access were highlighted. Conclusions: This scan identified numerous COPD programs for Middlesex-London residents but revealed critical gaps in program integration, accessibility, and Indigenous-specific care. Coordinated efforts among health care providers and policy makers are needed to develop seamless care pathways and ensure accessibility to culturally safe programming, ultimately improving outcomes for people living with COPD in this region and beyond.

The Building an Integrated Community Care Model was a two-year program to support older adults in receiving home and community care services from organizations within the VCS sector in the City of Sarnia and Lambton County, Ontario, Canada. The ICCM program launched with grant funding from the Ontario Ministry of Health. A goal-based evaluation design was used to assess the implementation and impact of the program. We collected and analyzed data from monthly status reports, surveys of service providers, and client/patient satisfaction surveys, data from key informant interviews, one focus group with service providers, and a reflective discussion. Providers were able to overcome challenges and achieve benefits linked to short-term outcomes. Shared goals amongst providers facilitated the implementation and integration of services. Socially isolated older adults were better served, new partnerships were formed, and community-based initiatives were created. A supportive network of service providers and system planners was created, enhancing the capacity of providers to meet community needs. This was a complex initiative with multiple organizations coming together in a voluntary governance structure to implement disparate projects. Learnings may be useful to others seeking to implement and assess integrated community care programs for older adults.

Purpose: This study updates and expands upon the seminal review by Strandberg-Larsen and Krasnik (2009) by examining evaluation methods for integrated healthcare delivery published between 2009 and 2022. Integrated care aims to enhance care coordination and patient-centeredness by bridging healthcare silos; however, evaluating such complex systems remains a challenge. Design/methodology/approach: A rapid review methodology was employed, following Cochrane Rapid Review guidance. Four databases (EMBASE, MEDLINE/PubMed, Web of Science and Cochrane Library) were searched using a comprehensive set of integrated care-related terms. Inclusion criteria were based on structural, cultural and process aspects of integration, as well as methodological criteria such as theoretical grounding, data type and internal validity. A 10-point framework was used to classify identified studies. Findings: Out of over 40,000 initial records, 11 studies met the inclusion criteria. Quantitative approaches were dominant, with only one study using a mixed-methods design. Tools such as the Practice Integration Profile and B3-Maturity Model addressed structural readiness, while others emphasized cultural elements like collaboration and accountability. Process-focused evaluations offered insights into coordination and stakeholder experiences. Findings reveal an over-reliance on quantitative tools and call for the integration of qualitative measures to better capture the dynamic, context-specific nature of integrated care. Originality/value: This review provides updated, evidence-informed recommendations for evaluating integrated healthcare systems. It advocates for holistic, flexible and mixed-methods frameworks to support health leaders and policymakers in advancing integrated care.

Background: In partnership with PHSS, a community care agency in London, Ontario, we describe the person‐centred planning model. Person‐centred plans (PCPs) are mandated in the community care sector and created annually through discussions with the person‐supported, staff, family/friends and community members. PCPs are individualised, integrated into daily activities and contribute towards larger goals.Methods: We interviewed 18 persons‐supported and one family member. Participants were individuals with developmental, medical, or complex physical needs and supported by PHSS. We explored goals, accomplishments, the individualisation of PCPs, experiences with the process, and supports/barriers.Results: PCPs are tailored to the person‐supported's needs and preferences, linked to daily activities, and guide larger goals. PCPs are facilitated by the person‐supported's goals and capacity and organisational factors (e.g., funding, staffing).Conclusions: This study evaluates person‐centred planning from the perspectives of persons‐supported, providing insights to enhance these processes within community care settings.

Physician engagement is critical to the success of primary care transformation, yet strategies to support meaningful engagement remain understudied. Despite existing research, gaps persist in understanding how physician engagement unfolds within system-level initiatives in primary care. This paper examines physician engagement through the development of the London Middlesex Primary Care Alliance (LMPCA), a regional initiative uniting primary care providers in Southwestern Ontario to advocate for system improvements and support health system transformation, including the Middlesex-London Ontario Health Team (ML-OHT). Rather than centering solely on physician perspectives, our study explores physician engagement as part of a broader collaborative effort involving healthcare administrators and support personnel. Data were collected through interviews (n = 13; including primary care physicians, healthcare administrators, and administrative support personnel), document analysis, and an environmental scan. Findings highlight the importance of grassroots leadership, governance structures, and system-level supports in driving physician engagement. The role of a primary care transformation lead emerged as a key facilitator, while lack of compensation for system-level work remained a barrier. This study provides insights into the formation of a sustainable, self-governing primary care organization and offers considerations for scaling engagement strategies while mitigating burnout and ensuring long-term participation.

In response to the ever-changing and complex nature of public health, education and training for public health professionals needs to focus on competencies and transferable skills. To do this effectively, pedagogy must be more sophisticated and shift away from didactic and traditional lecturing techniques. Many health professional education pedagogies encourage a more competency-focused approach. A common technique adopted by many business schools is case-based learning (CBL). CBL is an active learning approach that enables students to apply their knowledge to simulated real-life scenarios (cases), working toward developing an action plan to solve problems based on provided data. CBL incorporates an interactive, learner-driven environment within the classroom. The Master of Public Health (MPH) program at the Schulich School of Medicine and Dentistry, Western University uses CBL in their 12-month compressed MPH degree. In addition, the program aims to achieve the protégé effect in the third term by having students develop their own case meant for use in the MPH classroom. Drawing on the literature on pedagogical best practices, we believe this case-writing experience elevates learning by offering opportunities to cultivate the critical and creative thinking skills essential for public health professionals. Students develop, synthesize, integrate, and refine a case study to demonstrate their learning across the program’s core competencies. This work contributes to the growing body of literature on experiential and integrative learning by showcasing how case-based approaches can effectively foster competency development in public health education.

Background: The introduction of Ontario Health Teams in Canada is a step toward achieving an equitable integrated system of care. The Middlesex-London Ontario Health Team (MLOHT) has been developed in parallel to the London-Middlesex Primary Care Alliance (LMPCA), a grassroots network for primary care physicians, health care administrators, and nurse practitioners. Key in the growth of the LMPCA was hiring a primary care transformation lead to support in engagement. This qualitative case study aims to describe the implementation of a primary care transformation lead within an integrated care setting through feedback from healthcare personnel. Methods and Findings: Family physicians, healthcare administrators, and administrative support personnel were recruited from the LMPCA and the MLOHT and interviewed. This analysis revealed 4 key components central to the role of a primary care transformation lead: (re)-building relationships, flexibility and adaptability, importance of role clarity, and motivation for change. Findings suggested that a primary care transformation lead can improve workflow among physicians by assisting in administrative tasks. Through streamlining information for primary care physicians, and building community networks, transformation leads can also enhance communication. Additionally, they can maintain an open environment for physicians to share their challenges to collaboratively develop solutions. Conclusion: This study exemplifies the role of primary care transformation leads in improving workflow, building networks, decreasing administrative burden, and facilitating an open environment in a primary care setting.