Primary Health Care Providers’ Perspectives: Facilitating Older Patients’ Access to Community Support Services

Abstract

The purpose of this paper is to understand how non-physician health care professionals working in Canadian primary health care settings facilitate older persons' access to community support services (CSSs). The use of CSSs has positive impacts for clients, yet they are underused due to lack of awareness. Using a qualitative description approach, 20 health care professionals from various disciplines and primary health care models were interviewed about the processes they use to link older patients to CSSs. Participants collaborated extensively with their interprofessional colleagues within and outside their organizations to find relevant CSSs. They actively engaged patients and families in making these linkages and ensured follow-up. It was troubling to find that they relied on out-of-date resources and inefficient search strategies to find CSSs. Our findings can be used to develop resources and approaches to better support primary health care providers in linking older adults to relevant CSSs.5

Health TAPESTRY: Exploring the Potential of a Nursing Student Placement Within a Primary Care Intervention for Community-Dwelling Older Adults

“…Some nursing students brought community health and social service information to the huddle, but uptake was low. This finding is supported in the literature ( Ploeg et al., 2016 ). These implementation challenges demonstrate how complicated it is to execute experiential placements that cross boundaries among primary care, community-based care, and older adult care.…”

“…The precise nature of this complexity is a component of what we thought would be valuable for students to participate in this placement. Research has shown that primary care physicians rely on consults with the health-care team to create community linkages, family members to make connections, and patient self-referrals ( Ploeg et al., 2017 ). Strategies that may improve communication and trust between community-based health and social care sectors include obtaining endorsements from patients on community services, relying on staff with previous community experiences, sharing consultation notes, and delegating a team member for community outreach.…”

Disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study

“…Physicians tend to link with HSS by providing patients with community information, initiating linkages for those in need, and encouraging families to access services for their loved ones [34]. Our results identified strategies for primary care and CBHSS to build bridges to address the need-service gap for older adults including: a) using a person-focused approach; b) applying effective case coordination; c) adapting services to address access barriers or filling gaps; d) employing effective communication strategies between sectors; e) building trust and rapport between them; and (f) advocating for improved program access.…”

“…Others have found that physicians often relied on team members' knowledge and expertise, especially if they had delegated responsibility to link to outside resources [4]. In addition, primary care physicians experience challenges, such as insufficient time and staffing to link individuals with social services [38,39]. Interprofessional teams, practice nurses, and case managers have been shown to facilitate primary care and community linkages for older adults and others with long-term conditions, such as social isolation [2,3,34,39,40].…”

Implementation of Community-Based Resource Referrals for Cardiovascular Disease Self-Management

“…22,23 Although there is a growing body of evidence about clinic-based interventions to facilitate community resource referrals for disease self-management and selfcare, [24][25][26] and large health systems are rapidly adopting community resource referral technologies, 27 little is known about small primary care practices' implementation of community resource referral strategies. 28,29 To address this gap, this study applies the Consolidated Framework for Implementation Research (CFIR) 30 to investigate practice facilitator perceptions and observations about CommunityRx-H3 implementation.…”