The $10-million Innovation Fund negotiated by the Saskatchewan Medical Association (SMA) and the provincial government has “real power,” about 150 attendees heard during a two-day Innovation Fund kick-off event in March.

The Innovation Fund was unveiled as a key component of the 2022-26 negotiated Agreement to transform family medicine. The Fund’s intent is to support initiatives that advance the development of family physician-led, team-based care clinics in the community.

“You are going to do great things,” guest speaker Dr. Janet Reynolds of Calgary told physicians and clinic staff gathered in Saskatoon for the March 25-26 event. “The Innovation Fund has real power.”

Physicians were invited to submit an Expression of Interest to receive funding for a project. A total of 68 were submitted, 38 completed applications were received and 34 were approved. Physicians and clinic staff were invited to the kick-off event, where they heard from guest speakers and prepared to implement their projects over the next year. A milestone event conference is planned for a year from now to review progress and share learnings from the various projects. 

‘It’s about building something for the province’

“Ultimately the point is not just to build something just for your clinic,” said Dr. Sean Groves, a La Ronge family physician and member of the Innovation Fund Oversight Committee. “It’s about building something for the province that we can scale, build, and expand, and have other clinics copy great ideas.”

The objectives of the Innovation Fund were outlined by Dr. Kirsty Sanderson, a Moose Jaw family physician:

1. Accelerate the implementation of the College of Family Physicians Patient’s Medical Home (PMH) model in family medicine clinics.
2. Improve work-life balance within funded clinics to support retention and recruitment efforts.
3. Improve patient access and quality care within clinics through team-based support.
4. Strengthen collaboration among successful Innovation Fund applicants and Health Networks.

Dr. Sanderson is co-chair of the Innovation Fund Oversight Committee, which includes representatives from the Ministry of Health and the Saskatchewan Health Authority.

‘We have to make this happen’

Dr. Ginger Ruddy, also a member of the committee, said the Innovation Fund and the Transitional Payment Model (TPM) negotiated in the Agreement build on a common vision among stakeholders for primary care renewal in Saskatchewan. The TPM and Innovation Fund are having an impact, she said, noting that about 80 per cent of fee-for-service family physicians providing longitudinal care have signed on to the TPM, while the kick-off event is a key step in launching Innovation Fund team-based care projects.

Key to the Patient’s Medical Home model is having a team working closely together to serve patients. Clinics intend to use the Fund to hire a range of team members. Some examples include a nurse, medical office assistant, nurse practitioner, LPN, social worker, elder, or pharmacist.

“The goal is to have to supports around each person in this room so that the changes that you make can be durable and meaningful for your patients,” Dr. Ruddy said.

“The Patient’s Medical Home is a model that has been shown to achieve better outcomes for patients at lower costs for the system, so we can do more for the patients, but also provide a better patient experience, a better provider experience, and improved health equity,” Dr. Ruddy said. “There are too many populations in our communities that aren’t getting optimal care, and that is having wide-ranging health consequences for themselves and for the generations of their families. We can do better, and this is one of the evidence-based approaches to getting to a level of care that we all deserve.”

Studies have shown greater provider and patient satisfaction under a PMH. Patients have access to a wider range of clinicians, a better understanding of their medical conditions, an improved ability to manage their own health, and enough time with their doctor. Physicians and medical graduates show high levels of satisfaction, which aids retention and recruitment. Medical students must be shown that family medicine is a career path that is sustainable and rewarding.

“We have to make this happen if we want people to choose this line of care,” Dr. Ruddy said. “The PMH framework lays out a roadmap to get toward that kind of care that we would like to. It’s change that’s complex, it’s not a straightforward journey, but it’s one that we have the tools to achieve.”

“Don’t let perfection get in the way of progress.”

Dr. Reynolds, a family physician and medical director at Crowfoot Village Family Practice (CVFP), spoke about her experiences with team-based care initiatives implemented at CVFP.

She described a day in the life of the clinic, which has 25,000 patients each served by teams consisting of physicians, nurses, and clerical support, one of whom is the team captain. The practice has administration staff such as a human resource manager and executive assistants, and a pharmacist and optometrist in the building. Medical teams coordinate the various services each day to best utilize resources. Dr. Reynolds works in a dyad leadership model with an executive director, co-managing the clinic.

Change requires “shifting mental models” that may be rooted in the traditional ways of practicing medicine, she said. Physicians used to say every Canadian should have a family physician, but the thought is changing to every Canadian should have access to providers on a health care team who may be better suited to provide the care people need.

Developing the team-based care model at CVFP has taken several years, through several changes in the Alberta health system structure, and with more progress made in some areas than others. However, she urged physicians and clinic staff to persevere and do what they can, when they can.

“Don’t let perfection get in the way of progress.”