The IMPACT clinic: Innovative model of interprofessional primary care for elderly patients with complex health care needs

Sunnybrook Health Sciences Centre, Primary Care Research Unit, 2075 Bayview Ave, Room E3-49, Toronto, ON M4N 3M5. .
Canadian family physician Medecin de famille canadien (Impact Factor: 1.34). 03/2013; 59(3):e148-55.
Source: PubMed


The growing number of elderly patients with multiple chronic conditions presents an urgent challenge in primary care. Current practice models are not well suited to addressing the complex health care needs of this patient population.
The primary objective of the IMPACT (Interprofessional Model of Practice for Aging and Complex Treatments) clinic was to design and evaluate a new interprofessional model of care for community-dwelling seniors with complex health care needs. A secondary objective was to explore the potential of this new model as an interprofessional training opportunity.
The IMPACT clinic is an innovative new model of interprofessional primary care for elderly patients with complex health care needs. The comprehensive team comprises family physicians, a community nurse, a pharmacist, a physiotherapist, an occupational therapist, a dietitian, and a community social worker. The model is designed to accommodate trainees from each discipline. Patient appointments are 1.5 to 2 hours in length, during which time a diverse range of medical, functional, and psychosocial issues are investigated by the full interprofessional team.
The IMPACT model is congruent with ongoing policy initiatives in primary care reform and enhanced community-based care for seniors. The clinic has been pilot-tested in 1 family practice unit and modeled at 3 other sites with positive feedback from patients and families, clinicians, and trainees. Evaluation data indicate that interprofessional primary care models hold great promise for the growing challenge of managing complex chronic disease.

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Available from: Ross Upshur, Apr 11, 2014
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    • "Notably, these practices can foster consistent stakeholder communication and input into health care processes. Such models have increasingly shown their potential to: a) reduce gaps in patient health care (e.g., linking patients to health care providers and services ), particularly for populations who face disproportionate barriers to health care; b) reduce duplication in patient health care provision; and c) facilitate health care communication and support for multiple stakeholders47484950. In this, integrated care models can help reduce some of the multi-level barriers to Telehomecare implementation and adoption seen in this study and beyond, including a lack of stakeholder buy-in and capacity, and, at the patient level specifically, barriers to health care access . "
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    • "Resources to support research in the development and evaluation of techniques are needed to foster goal explication and alignment. Innovative approaches to primary care delivery for patients with multi-morbidities such as the Inter-professional Model of Aging and Complex Treatments (IMPACT) [22], and other team based and multi-disciplinary approaches to treatment and care may be appropriate venues for implementing and testing goal setting strategies for individuals with complex health issues that move beyond the traditional patient-physician consultation. "
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