Canadian Government Executive - Volume 23 - Issue 09

Evaluating Innovation in Practice: 28 / Canadian Government Executive // December 2017 Evaluation The Backdrop: Advancing Health Care Throughout Canada, health care systems are challenged by population growth, ag- ing, and physician retirement and relo- cation. These, among other factors, have added demands to and limited the capac- ity of the health care system. Such challenges require a combina- tion of initiatives, including community- driven efforts to first understand and then respond to local and regional needs. In British Columbia, the Ministry of Health and Doctors of BC worked in partnership through the General Practice Services Committee (GPSC), to foster community action of this sort, through a three-year initiative named A GP for Me. Launched in 2013, A GP for Me had three goals: • Confirm and strengthen the continuous doctor and patient relationship, includ- A GP for Me ing better support for the needs of vul- nerable patients. • Increase the capacity of the primary health care system. • Enable patients who want a family doc- tor to find one. Funding for A GP for Me was provided in two ways: the creation of incentive fees to facilitate practice-level change with physicians; and investments in projects delivered by more than thirty Divisions of Family Practice, groups of family physi- cians in over 230 communities across Brit- ish Columbia. At the heart of it, A GP for Me was truly a community-driven, broad undertaking to foster innovation, quality and continuity in patient access and care. The Task: Undertaking a Provincial Evaluation of A GP for Me Evaluating an initiative like that of A GP for Me is complicated. A few of the twists and turns of this endeavour centred on the following. Relating Results: A GP for Me was one of many efforts in British Columbia to fur- ther health care system transformation. Additionally, divisions of family practice had been formed around the province, providing an alternative way for fam- ily physicians to collaborate with health authorities and other partners to identify and address local health care challenges. Over the course of A GP for Me, about 150 projects were started by divisions, each furthering its own form of innovation. This made the direct attribution and sum- mary of results to A GP for Me challeng- ing. Harnessing Efforts: The purpose of the provincial evaluation was to not only gain an understanding of the effectiveness of A GP for Me from the experiences of those involved, but also to share lessons learned from innovations that sought to enhance the quality of care. In addition to the provincial evaluation, divisions were also completing assess- Bill Reid Jasmina Fatic Petra LoliC ments of the effectiveness of supported projects, to inform their own learning and innovation. The provincial evaluation had to harness these local efforts to allow for an integration of findings, while also not obstructing the unique work that was pro- ceeding. Dealing with Unknowns: In 2015, a substantial Provincial Evaluation Plan was prepared for A GP for Me with the involvement of staff from the Doctors of BC and the Ministry of Health, a GPSC Evaluation Working Group, contracted specialists, a Divisions Reference Group, and evaluators hired by various divisions. Following the completion of this Pro- vincial Evaluation Plan, and by the time the provincial evaluation commenced, it became apparent that the awareness of stated outcomes and indicators of perfor- mance for A GP for Me had since dimin- ished such that partners were challeng- ing concepts, describing intentions and using measures in a variety of disparate ways. This complicated the ability to draw