Engagement and collaboration set foundation for proof-of-concept journey

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Having a solid foundation in place, including a passionate and cohesive CSC and a strong relationship with the health authority, was key to the Kootenay Boundary Division of Family Practice becoming a proof-of-concept community for the patient medical home model. The Division also had team-based care experience under its belt after piloting a program that had social workers working with GPs. But that was just the beginning. The CSC then engaged extensively with physicians, senior health authority staff, and local community leaders around proposals to expand teams. 

Before any funds were spent, it embarked on a collaborative, consensus-based process to have all partners agree on outcome targets, a QI framework, and team development processes. Now, with plans moving ahead, doctors are gearing up to start hiring nurses and social programs officers, while Interior Health is looking at realigning its services to eventually link together with the new teams.

Watch the full presentation.


“The physicians in the entire Kootenay Boundary were very interested in what we were doing and very quickly embraced this, and they all want it in their clinics now. Several clinics are looking at infrastructure reorganization in terms of moving to new facilities … trying to develop facilities that have space for group medical visits, and space for associated practitioners. The health authority partners are very keen on this and interested in helping and finding ways that they can reorganize and reorient their staff to work within what we’re trying to do.”
— Dr David Merry, Kootenay Boundary Division of Family Practice