In Quebec: Improving timely access one clinic at a time

In this episode, we take you to Saint-Hyacinthe to see how a team in Quebec is transforming timely access to primary care. Quebec has more interprofessional primary care teams than anywhere else in Canada — yet it remains one of the provinces struggling most with access. So how do you turn a team into one that actually works? Dr. Kiran sits down with Dr. Isabelle Gaboury, a researcher and QI leader who, alongside colleague Mylaine Breton, has modernized the “advanced access” model for today’s interprofessional clinics. Together, they’ve coached more than 40 practices to redesign workflows, clarify roles, and use data to constantly iterate. Then I take you inside GMFU Richelieu-Yamaska, where waits dropped from 14–16 days to just 3. You’ll hear how receptionists learned to triage using a symptom-based algorithm, how nurses and social workers took on new responsibilities, and how the whole clinic shifted from working harder to working differently. It’s a story about change management, team-based care, and what it really takes to deliver timely, patient-centred access — in Quebec and across Canada.Resources mentioned in the episode:An article on why it’s so hard to find a family doctor in QuebecIsabelle and Mylaine’s contemporary advanced access modelHow Canada compares to peer countries when it comes to timely careAn older commentary from Tara that delves into why timely access is such a problem in CanadaA summary of Quebec’s data from the OurCare surveyExplore Quebec data from the 2022 OurCare National Survey at data.ourcare.ca or read this articleVisit the website for GMFU Richlieu-YamaskaListen to our 4-part series on The Netherlands (mentioned in this episode when discussing training for primary care nursesMAINPRO CREDITS: Family doctors can claim Mainpro Credits by completing a linking learning exercise. More about Primary Focus:Subscribe to our Substack newsletterVisit our website at primaryfocus.caLearn about the OurCare StandardDo you have an idea for an episode? Email [email protected] Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ Primary Focus is supported by the MAP Centre for Urban Health Solutions, St. Michael’s Foundation and the Max Bell Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit primaryfocus.substack.com