PT  - JOURNAL ARTICLE
AU  - Thorpe, Cathy
AU  - Brown, Judith
AU  - Terry, Amanda
AU  - Hameed, Saadia
AU  - George, Catherine
AU  - Ryan, Bridget
AU  - Clark, Rebecca
TI  - Measuring Meaningful Involvement of Family Physicians in Health System Design and Implementation
AID  - 10.1370/afm.22.s1.5268
DP  - 2023 Nov 01
TA  - The Annals of Family Medicine
PG  - 5268
VI  - 21
IP  - Supplement 3
4099  - http://www.annfammed.org/content/21/Supplement_3/5268.short
4100  - http://www.annfammed.org/content/21/Supplement_3/5268.full
SO  - Ann Fam Med2023 Nov 01; 21
AB  - Context: Family physician participation is increasing in health system design and implementation in Ontario. Therefore, it is important to determine a definition of meaningful involvement and explore the activities and processes that constitute meaningful involvement.Objective: The purpose of the study was to elicit primary healthcare leaders’ definition of meaningful involvement in the conception, design and delivery of integrated care planning and implementation as well as to identify various means to measure meaningful involvement.Study Design and Analysis: Grounded theory study using in-depth interviews via Zoom, with individual and team analysis.Setting: Ontario, Canada.Population Studied: twenty-two primary healthcare leaders (family physicians and decision-makers) affiliated with Ontario Health Teams (OHTs).Results: Participants found it challenging to provide a clear definition of ‘meaningful involvement’. However, a few participants did offer definitions that consisted of different levels of involvement. These ranged from being aware/informed; to participating in some activities; to more active involvement, including leading activities/being at the decision-making table; and some participants highlighted another level of involvement -- using the clinical services/being integrated into the clinical pathway within the OHT. All participants offered ideas about how to measure/assess meaningful involvement of family physicians while recognizing the challenges inherent in creating appropriate measures. Their suggestions ranged from relatively easy items to measure, such as attendance at meetings and counting opened emails to a more comprehensive set of activities such as involvement in the co-design/evaluation of programs. Participants believed that involving family physicians in the co-design of program implementation activities fosters ownership and empowerment, leading to improved health care delivery in Ontario. Participants articulated that the foundation for meaningful involvement of family physicians in health system change is relationship building: trust and respect are paramount.Conclusions: This study illuminates the challenges in defining and measuring meaningful involvement of family physicians in health system design and implementation. These findings are assisting the Ontario Ministry of Health as they continue to support family physicians’ involvement in the conception, design and delivery of program implementation activities.