Enhancing Adaptive Capacity in the Primary Care System


In Fall 2021 the ISU undertook a Learning Cycle to better understand resilience in healthcare, motivated by seeing the increasing pressures facing both the primary care system and individual healthcare providers. Through an environmental scan and interviews with healthcare professionals we learned that:

  • The pandemic has exacerbated pre-existing challenges in primary care. People are tired and capacity is stretched. Finding the time to rest and build adaptive capacity is hard.
  • Teams are a protective factor that can enhance adaptive capacity. Investing in strategies that enhance relationships and trust to build a culture of Team Based Care is a priority.
  • Community-level coordination, planning and interventions are needed to identify needs and target supports to address backlogs in service provision.
  • The shift to team-based primary care must be supported by education resources for providers, teams, learners & the public.
  • Communication strategies are needed to ensure there is shared understanding of the goals and process of primary care transformation. Clear pathways will ensure that successes can be shared and common challenges can be identified and addressed.
  • All providers need to be included in systems-level planning. Policy and funding structures that enable equitable recognition of the value all providers bring to primary care is important.
  • Changing the system to embrace team based care and provide alternatives to fee-for-service funding is a generational shift that will require sustained effort and investment.

Current & Upcoming Projects

We are taking the learning from the initial learning cycle into a number of specific projects to support and enhance primary care system resilience. These next steps incorporate best practices from systems thinking and adaptive capacity. Projects include:

  1. Enhancing the Adaptive Capacity of Primary Care Teams Learning Cycle. The goal is to understand how to better support and enhance the adaptive capacity of primary care teams to protect against the risks of burnout and contribute to a more a resilient primary Health Care system.  By understanding what adaptive capacity supports and resources are currently being used by teams or are missing and needed within the system, the ISU can then work to develop appropriate tools and resources to support teams.
  2. Preceptor Resilience. In July of 2022 the ISU was successful in applying to the Strategic Investment Fund (UBC). This grant will be focused on the adaptation and refinement of tools to support preceptor resilience and teaching in team based care, in partnership with the Department of Family practice and the Team-based Primary Care Learning Centres project.
  3. Developing, Testing and Embedding an Adaptive Capacity Assessment for Teams.  Starting with a review of validated assessments and incorporating strengths assessment tools, as well as an assessment of resilience behaviours (e.g. recognition) for primary care clinicians, the goal is to further extend existing ISU supports (Team Mapping and PACC Mapping) by embedding an assessment tool and then support early adoption and scaling with partners through TBC Advisory.