Table 5 Results of SWOT analysis for the implementation of chronic disease prevention and management programs
Strengths to leverage | Weaknesses to address |
|---|---|
Stakeholders, partnerships, and knowledge transfer | Funding |
Having a “complete picture” and understanding [needs] of key stakeholders, including decision- makers and their willingness to support change | Length of project is too short to make a clinical or behavioural change in patients |
Strong government leadership (local, regional, and national) | Evaluation component is under financial and evaluation constraints bringing delays in patient interventions |
Clinicians and clinical teams | Lack of resource and funds (local, regional, and national) |
Motivated clinicians Immediate embracing of the program by some clinicians—willingness to go above and beyond what the pilot project was meant to implement | Funding required sites to commit to the longevity of programs before programs were proven to be effective |
Communication Lack of communication/marketing plan aimed at reaching target populations | |
The presence of complete clinical teams composed of various professionals allows clinicians to learn from one another | |
Strong clinical leadership in the diverse professions | Ineffective communication of teams in primary care and no systematic communication with referring doctors |
Program structure | Clinicians and clinical teams |
A common model of care between projects Ability of a program to integrate into existing structures. Projects need to be able to weave a place into what already exists | Have a tendency to use “champion clinicians”. There is a danger in counting on “champions” who are not always available |
Existing medical culture closed to the concept of interdisciplinary and preventative interventions | |
Nature of the programs is evidence-based | Recruitment and turnover of personnel is especially difficult in a perspective of trying to transform clinical roles |
Address diseases as well as their risk factors | Lack of participation from referring physicians |
Patient-centered approach compared to a typical silo approach | Program structure |
Touch on psychosocial factors as much as biological factors | Many tools available make the decision about choosing which one to use difficult |
Emphasis on interdisciplinary teams, and self-management | Not having clinical information systems |
Low number of referrals to the programs. May be due to lack of awareness of referral forms or clear referral procedures | |
Method of physician remuneration | |
Lack of continuity of care |
Opportunities to optimize | Threats to mitigate |
|---|---|
Funding | |
Seize public and private funding opportunities | Funding |
Capitalize on existing funding to add resources to Family Medicine Groups | Ensure continuation of funding |
Explore what currently exists in terms of remuneration models | Lack of resources and difficulty of resources management |
Stakeholders, partnerships, and knowledge transfer | Ensuring constant and continuous data collection |
Facilitate intra and inter-professional meetings for knowledge exchange and ensuring human contact between stakeholders | Stakeholders, partnerships, and knowledge transfer Integration of many organizations with different business models and cultures—brings challenges in terms of communication, authority, financing, etc |
Working with people and community networks who have a shared vision and philosophy Influence changes in university curriculum to put greater emphasis on interdisciplinarity | |
Roles and responsibilities described in the law do not necessarily translate into real power or influence | |
Continuously talk about chronic disease in its entirety to incite others to associate themselves with the cause | Lobby presence (ex. pharmaceutical, professional federations) Mobilization of primary care teams and all the financial factors involved—resource re-allocation |
Clinicians and clinical teams Make better use of clinical tools, stakeholders experience, and models which have already proven themselves—avoid reinventing the wheel | |
Will take effort to compile and disseminate the results of seven projects so that they can be used to guide decisions across the province | |
Capitalize on the synergy between research team and clinicians | Clinicians and clinical teams |
Strong evaluations and the guidance it can provide throughout the implementation process and for guiding future decisions | Potential resistance that arises during the evaluation of clinical practice Harmonizing the visions in the management of chronic disease (ex. expert clinician vs. the patient partner) |
Support the transformation of professional roles by exploring different types of training | |
Program structure | Learning to work in interdisciplinary teams |
Support integration of self-management into patient care | Lots of sudden changes can become tiresome |
Adoption of health information technologies to facilitate referrals, care delivery, access to medical information, and communication | Ensure that professionals are using their full potential, particularly in a context of the revision of roles |
Would be good to have access to a single tool that could facilitate work of the doctor and properly identify the patient’s needs and show where they are in their care path | Avoiding a doubling of services—make sure projects are not competing with existing services on a territory Physicians often lack a complete health profile of their clientele |
Restructure programs to better respond to personnel turnover | |
A large proportion of the population does not have a family physician and therefore no access to these projects | |
Conservative leadership of authorities—is the leadership sufficient to bring about the desired changes? | |