Grant: Team Grant: THINC Implem. Science - Health Services and Policy pool

The World Health Organization defines health as "a state of complete physical, mental and social well-being", but more than 26% of Canadians suffer from multimorbidity and 18% of people in primary healthcare face multiple interacting challenges among these three health dimensions, having the most complex needs. Case management (CM) is one of the most studied and recommended models of integrated care to facilitate the appropriate delivery of healthcare services for people with complex needs. Our team has conducted many studies over the last decade to evaluate CM from different perspectives. Following promising small-scale implementation studies, research is now needed to inform the implementation of this integrated care intervention on a larger scale. The goal of this study is to scale up case CM in primary care settings for people with complex needs and generate new evidence to inform policies and healthcare system transformation towards increased integrated care with a mid and long-term goal of benefiting all Canadians. A scale-up committee in each participating province (Quebec, New-Brunswick, and Nova Scotia), composed of decision-makers, members of the research team, managers, providers, and patient partners, will oversee the scale-up. We will then conduct a realist evaluation in ten regions. Each primary care clinic of these ten regions will recruit at least 30 adult patients with the most complex needs who frequently use healthcare services to participate in CM for a year. Qualitative and quantitative date will be collected. This proposal will advance the field of implementation science. The new scientific knowledge will inform healthcare transformation. People with complex needs in three provinces will benefit from an innovation building interdisciplinary, multisectoral collaborations, partnerships and providing a nurturing environment to sparking collaborations, and building human and organizational capacity.