Descriptive and process evaluation of a shared primary care program

Purpose: This study involved the conduct of a descriptive and process evaluation to examine the implementation and maintenance of an existing local shared care program: The Hamilton Health Service Organization Mental Health and Nutrition Program located in Hamilton, Ontario, Canada. The program was organized to strengthen links between mental health, nutrition, and primary care services, to improve access to mental health and nutrition care, and to realize the benefits of improved communication, collaboration and mutual support among multiple practitioners, increased continuity of care, and increased family physicians’ comfort and skill in handling more complex problems. Method: A mixed-method, multi-measures evaluation design was used. Data were gathered from the program’s central patient database and by conducting focus groups. Results: Teams of practitioners provide comprehensive primary mental health and nutrition care. Collaboration and education opportunities are extensive although time constraints are an issue. Patients with a range of problems were assessed, treated, and referred among team members. There appears to be a decreased burden on external services. Conclusions & Discussion: This evaluation suggests that implementation and maintenance of shared care programs are possible within community practices.