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June 2023 - Everything You Ever Wanted to Know About Primary Care Governance, and More!

To influence a system, it's critical to first understand it. What was the origin of the Primary Care Network approach? How do the zones operate? How are decisions made about the future of primary care? Michelle Tobias-Pawl (AMA ACTT) walks us through Primary Care Governance and prompts some insightful conversation.

Session Summary

Session Host: Michelle Tobias-Pawl   

Session Objectives: 

At the end of this webinar, you will be able to:

  • Describe the concept of governance and how it applies in the Alberta primary care context.  
  • Explain how decisions are made about primary care in Alberta. 

 

Recommended Resources: 

Session Highlights & Themes:

  • Governance helps you to always act in the best interests of the business. More specifically, it can improve the performance of your business, help it become more stable and productive, and unlock new opportunities. It can reduce risks and enable faster and safer growth. It can also improve reputation and foster trust. 
  • Governance is defined as, “the way in which society and groups organize to make good decisions. Decision making in ‘good governance’ must be legitimate. It must be based on a solid strategic direction. There must be clear plans and expectations that allow the execution of those plans so that everyone is accountable to ensure that the organization’s goals, objectives, and values are demonstrated through consistent action. It must perform effectively, be transparent, accountable, inclusive, and equitable. (The Institute of Governance www.iog.ca)
  • The Physician Leads Executive statement:  We believe PCNs collectively advance the transformation of primary care by improving patient care delivery and health outcomes, because we:
    • Support members/clinics to implement Patient's Medical Home
    • Are the platform to support change for new initiatives and direction
    • Provide interdisciplinary team-based care programs and services
    • Strive to have a direct connection to member physicians 
  • It is important to note that each PCN retains its own governance and aligns priorities to the Zone PCN Service Plan.  
  • It is also important to note the bi-directional information flow, that each PCN continues with its own business plan and initiatives but in addition each PCN is able to take their issues to the Zone PCN Committees and the Zone PCN Committees can take initiatives and communications to each PCN.  
  • The five Zone PCN Committees are required sub-committees of the Provincial PCN Committee, and their membership includes representatives from PCNs and AHS. The main deliverable of Zone PCN Committees identified in the Provincial PCN Committee Terms of Reference is the creation and implementation of population-focused Zone PCN Service Plans. The zone PCN committee takes the priorities of the Provincial PCN Committee and prioritizes them for implementation at the level of the zone. Each Zone PCN Committee represents the PCNs in their zone. The number of PCNs in each zone varies as does how the committee choses to represent each PCN so we do see some variation in structure and membership across the zones. In addition to representation the structures beneath the Zone PCN Committees also vary depending on the priority areas for a Zone. The Zones have a number of task groups, also referred to as subcommittees or working groups, that report to them. These groups are the operational arm that determine how the priorities of the Provincial PCN Committee will eventually be implemented. One important deliverable of a Zone PCN committee is to develop a Zone PCN Service Plan. The PCNs in each zone gather to develop this important document. 
  • The duties of a Board are fiduciary and include the specific duties of loyalty, obedience and care. 
  • PCN Board governance includes how the Board, on behalf of its membership and working in alignment with the organization’s values, needs and aspirations: 
    1. determines the strategic direction 
    2. engages and directs its senior management (ED/MD) 
    3. monitors results 
  • Clinic governance hygiene includes: 
    • Practice agreements
    • Decision making
    • HR, resourcing, compensation, roles and responsibilities 
    • Recruitment, Performance Reviews, Termination 
    • Employee Handbook
    • Policies and Procedures 
    • Labour Law Standards
    • EMR 
    • Budget Management
    • Risk Management 
    • Succession planning