Community Adaptiveness & Social Accountability

Patient’s Medical Home

In the Patient’s Medical Home Model, the pillar of Community Adaptiveness and Social Accountability means: “A Patient’s Medical Home (PMH) is accountable to its community, and meets their needs through interventions at the patient, practice, community, and policy level.”

This includes the following goals:

  1. PMHs strive to assess and address the social determinants of health (e.g., income, education, housing, immigration status) as relevant for the individual, community, and policy levels.
  2. Panel size will consider the community’s needs and patients’ safety.
  3. PMHs use data about marginalized/at-risk populations to tailor their care, programming, and advocacy to meet unique community needs.
  4. Family doctors in the PMH act as health advocates at the individual, community, and policy levels, using the CanMEDs–Family Medicine (CanMEDS-FM) Framework as a guide to advocacy and are supported in doing so.
  5. Family doctors and team members within the PMH provide care that is anti-oppressive and culturally safe, seeking to mitigate the experiences of discrimination faced by many patients based on their age, gender, race, class, sexual orientation, gender identity, ability, etc.

Mosaic PCNs 2019-20 Annual Report

Here are some highlights from Mosaic PCNs 2019-20 Annual Report items reported to Alberta Health:

  • 94% of patients who completed a patient experience survey rated the care they received as “Excellent” or “Very Good”
  • 64% of proactive screenings had been completed as recommended in the Alberta Screening and Prevention (ASaP) initiative guidelines, aggregated across all MPCN physician member clinics
  • 49% of Mosaic PCN member physicians who provide scheduled services measured Time to Third Next Available Appointment 
  • The College of Family Physicians of Canada, in partnership with its provincial Chapters, released The Patient’s Medical Home—Provincial Report Card 2019.

This report summarizes and grades the development of each of the 10 current PMH pillars in Canada’s 10 provinces.