Primary care collaboratives: Stepping up to the plate during a pandemic

Context: Several months before the arrival of COVID-19, the province of Ontario began to roll out a new structure of integrated health care delivery. In response, after decades of lacking a cohesive structure, family physicians began to spontaneously form grassroots organizations in order to be engaged in the process of reform. Objective: This study describes the formation and structure of these organizations, and the impact of the COVID-19 pandemic on their development. Study Design: In accordance with Grounded Theory methodology, individual interviews were analyzed, including a constant comparative approach. Setting: Regional health care organizations in Ontario, Canada. Population Studied: A purposive sample of twenty primary care leaders engaged in health system change from across Ontario. Results: While these grassroots organizations assumed different names (e.g., alliance, coalition, collaborative), and varied in their structure (e.g. high/low governance), they shared a common vision of having a strong and unified voice in health system change. Prior to the pandemic, these organizations served as a vehicle to d iscuss shared “pain points” and seek common solutions to local challenges. The declaration of the pandemic mobilized these organizations to respond in several ways. The most important feature was their capacity to rapidly respond at a local level to the pandemic crisis. With lines of communication already established and a foundation of trusting relationships, these organizations acted on requests for PPE, staffing of assessment centres, and created respiratory assessment centres. Participants often noted how the pandemic was a galvanizing agent in the development and engagement of the membership within their organization. Conclusion: Study findings suggest that, while these family medicine organizations came together in response to health care reform in order to create a common voice, the pandemic accelerated not only their value but also the importance of remaining grounded in the needs of their local communities.