Document Type

Thesis

Degree Name

Master of Arts (MA)

Department

Psychology

Program Name/Specialization

Community Psychology

Faculty/School

Faculty of Arts

First Advisor

Dr. Maritt Kirst

Advisor Role

Supervisor

Second Advisor

Melody Morton Ninomiya

Advisor Role

Internal committee member

Third Advisor

Ketan Shankardass

Advisor Role

Internal committee member

Abstract

Introduction: Approaches to health care have shifted from individual treatment delivered by one health care provider, to an integrated care approach across health and social sectors involving multiple health care providers who are collaborating across sectors. A main focus of this research was to investigate the planning and development of the Cambridge-North Dumfries Ontario Health Team (CND-OHT). The CND-OHT is currently one of 42 Ontario Health Teams that are being implemented in the province according to integrated care (IC) principles.

The exploratory evaluation addressed a gap related to exploring initial planning and development of the CND-OHT IC team. In addition, contextual factors and mechanisms for successful integrated care efforts were explored within the evaluation. The exploratory evaluation answered three research questions. Specifically, how are members engaging in planning and decision making within the CND-OHT? How is the CND-OHT establishing a shared vision between members? And, what are the key components of successful planning and development of the CND-OHT? The exploratory evaluation drew upon realist methods, which provided a lens to understanding facilitators and barriers to IC planning.

Methods/Research Design: Research methods involved an exploratory evaluation of CND-OHT planning processes and an evaluability assessment (EA), which is a form of exploratory evaluation. A purposive sample of N=18 was recruited from CND-OHT members, where members participated in focus groups and interviews. Thematic analysis was used to determine overarching themes across the dataset.

Results: Five foundational partnership characteristics that foster transformational planning and integration were identified. Specifically, accountability, appreciation and value of members, optimism and hope, commitment to integration, and a “no ego” mindset. As well as, three components that support the CND-OHT common vision, and three components that hinder the CND-OHT common vision. Components that support the CND-OHT common vision include collaboration, support, and trust. Components that hinder the CND-OHT common vision include, fear and uncertainty to integration, lasting impacts of silos, and a disconnect between the provincial government and the CND-OHT. Finally, four additional components were suggested to support planning and service integration. The additional components that support planning and service integration include goals, incentives, opportunities for member engagement, and shared power.

Discussion and Conclusions: The exploratory evaluation provides useful information for the CND-OHT, and other integrated health care teams regarding planning and decision-making processes, and addresses an important gap in the literature in this area. A richer understanding of service integration and planning may encourage IC teams to dedicate time and resources to initial stages of integration that are necessary for success. The study also provides a rationale and context for why IC teams should consider prioritizing the importance of trusting relationships, commitment and a shared common vision.

Convocation Year

2021

Convocation Season

Fall

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