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12 Building stronger medical homes: implementing a sustainable team-based care model in primary care

bmjqir · 2025-12-01 · canonical JSON source

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Description Delivering sustainable, team-based care in publicly funded primary care systems requires more than clinical integration—it demands executive leadership, strategic infrastructure, and a culture of collaboration between central networks and community-based medical homes. The Edmonton O-day’min Primary Care Network’s (EOPCN) Resource in Clinic (RIC) Program provides a replicable model for how system-level leadership can drive scalable, high-impact quality improvement.This session explores the design, implementation, and evolution of the RIC Program, which places EOPCN-employed multidisciplinary staff—including nurses, specialist navigators, and practice facilitators—directly into member clinics. Resources are allocated based on transparent criteria tied to provider panel size and clinic readiness, supporting equity, accountability, and alignment with the Patient’s Medical Home model. With over two years of implementation, the program has demonstrated improvements in access, care coordination, and clinic efficiency.Led by the CEO of EOPCN, a credentialed evaluator and healthcare executive, this session provides actionable strategies for quality leaders and system executives seeking to advance multidisciplinary team-based care in resource-constrained, publicly funded settings.