INSPIRE PHC - Primary Health CAre Program:INnovations Strengthening PrImary Healthcare REsearch
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Research Leads

Dr. Lisa Dolovich
Co-Lead
Credentials:
Research Director and Professor, Department of Family Medicine, McMaster University
   
Dr. Gina Agarwal
Co-Lead
Credentials:
Associate Professor, Department of Family Medicine, McMaster University
   
   
Co-Investigators:
Ron Goeree, Lori Letts, Clare Liddy, Jenny Ploeg, Graham Reid, Julie Richardson, Bridget Ryan, Ruta Valaitis
   

Staff:
Jennifer Longaphy
Research Assistant longaj@mcmaster.ca

Ernie Avilla
Program Manager
avillae@mcmaster.ca

   
Research Project Links

PC Reform
Optimizing quality, access, integration and equity in Ontario primary care

Care in the Home (TAPESTRY)
Primary health care linking with community (TAPESTRY-CM)

Community Linkage - SCOPE
Enhancing PHC linkages with home care and hospitals (SCOPE)

Specialist Linkage -eConsult
Creating new PHC linkages with specialists

Knowledge Translation Exchange (KTE)

Sex and Gender Analysis

Research Projects...


Care in the Home: Primary health care linking with community
(TAPESTRY-CM)

Teams Advancing Patient Experience: Strengthening Quality for people with cardiovascular and metabolic disease (TAPESTERY-CM)

 


 

Click here for more information on TAPESTRY

Acknowledgment of Support for TAPESTRY:
Funding provided by Health Canada with additional support by the Government of Ontario (MOHLTC) through the INSPIREphc Program , LaBarge Optimal Aging Initiative, and McMaster Family Health Organization

TAPESTRY Program Department of Family Medicine Faculty of Health Sciences, McMaster University Hamilton, Ontario
Website: www.healthtapestry.ca

TAPESTRY Co-Leads:
Drs. Lisa Dolovich, Doug Oliver, David Price

For more information:
Lisa Dolovich ( ldolovic@mcmaster.ca )
Ernie Avilla, Program Manager ( avillae@mcmaster.ca )
Website: www.healthtapestry.ca

What is TAPESTRY?
TAPESTRY (Teams Advancing Patient Experience: Strengthening Quality) is an 8.7 million dollar primary healthcare development and research program that is part of the Faculty of Health Sciences, McMaster University. It is being coordinated by the Department of Family Medicine in collaboration with the McMaster Family Health Team and other Program Partner sites across Canada. Funding has been provided by Health Canada with additional support by the Government of Ontario (MOHLTC) through the INSPIREphc Program, LaBarge Optimal Aging Initiative, McMaster Family Health Organization, and the Department of Family Medicine at McMaster University.

Older adults are a growing population. The primary health care system must evolve towards responding to the needs of older adults with multiple conditions, when needed. To best meet the needs of older adults living in our communities, it is essential that health care delivery evolve from being disease-focused to being more patient- and wellness-focused.

The objective of TAPESTRY is to foster optimal aging for older adults living at home using an interprofessional primary health care team delivery approach that centres on meeting a person's health goals with the support of trained community volunteers, system navigation, community engagement, and use of technology. Early identification of problems such as nutritional deficiencies, inactivity, polypharmacy and social isolation will emphasize an informed and proactive approach to care and one that allows patients, their families and their health care providers better access to health care so as to make changes before a crisis arises.

Person-Centred Approach:
Patients are at the core of TAPESTRY. TAPESTRY incorporates the health care needs and preferences of patients into every step of the interprofessional primary health care team delivery approach so that their care is appropriate, timely and cost effective. The definition of team is broad. It includes anyone contributing to a person's health care within the formal health care setting, a community organization or informal care network. TAPESTRY promotes better connection between health care providers and patients, and the provision of support to enhance patient self - management and empowerment to achieve health goals.

The Tapestry Approach:
The TAPESTRY intervention is an integrated multicomponent intervention that centres on meeting a person's health goals with the support of four main elements:

  • Using trained community volunteers who will visit patients in the home, build a social connection and collect relevant information through a tablet computer application on personal health goals and on key themes around healthy aging, such as nutritional status, fitness levels, functional independence and social connectedness

  • Integration of a personal health record including specialized TAPESTRY Application s (eg. life and health goals, diabetes, exercise, sleep, hypertension) into patients' personal healthcare management

  • Adapted roles, activities and communication of the interprofessional primary healthcare team

  • Improved navigation of the health care system including improved linkages between primary health care, acute care and social services as well as improved engagement and mobilization of other relevant community organizations

Population:
TAPESTRY identifies patients at-risk prior to an event or crisis (when they need intensive, and often costly, intervention(s) such as admission to hospital) and puts a focus on activities across the health promotion disease management spectrum. By engaging patients and creating a community around them, TAPESTRY expects to positively impact their health and help keep them out of hospital and at home, living independently longer with resultant cost savings to the system.

  • Seniors (70 ≥years old) considered at risk (as they are more likely to present with one or more chronic conditions, are the most frequent users of the health care system, and are likely to benefit from the types of interventions proposed in the TAPESTRY approach)
  • TAPESTRY cardio and metabolic (p eople with diabetes and hypertension ) funded by the Government of Ontario through the INSPIREphc program
  • Other target populations: complex medical needs, maternity care, depression and those recently discharged from hospital

Th e value of the TAPESTRY intervention comes with weaving of all the components together to act synergistically to produce a new integrated health care delivery and management approach.

Development of the intervention involved a developmental evaluation ap proach, including co - development by key stakeholder groups (patient, volunteers, community agencies, and the interprofessional health care team). Pilot work has been completed to better understand how all facets of the intervention work.

Research Question:
How does a technology-enabled, community organization and primary health care connected program for people with cardiovascular and metabolic and other chronic conditions affect patient enablement, use of community programs, and access to primary healthcare compared with people receiving usual care?


 

Click here for more information on TAPESTRY

Acknowledgment of Support for TAPESTRY:
Funding provided by Health Canada with additional support by the Government of Ontario (MOHLTC) through the INSPIREphc Program , LaBarge Optimal Aging Initiative, and McMaster Family Health Organization

TAPESTRY Program
Department of Family Medicine
Faculty of Health Sciences, McMaster University
Hamilton, Ontario

Website: www.healthtapestry.ca