Using positive deviance to improve timely access in primary care.

Background: Improving timely access in primary care is a continued challenge in many countries. We used positive deviance to try and identify best practices for achieving timely access in our primary care organisation in Toronto, Canada.

Methods: Semistructured interviews were used to identify practice strategies used by physicians who successfully maintained a low third next available appointment (TNA) (positive deviants, n=6).

Understanding disparities in primary care patient experience.

Objective: To understand disparities in primary care patient experience.

Design: A serial cross-sectional study was conducted to understand disparities in patient experience at 2 time points (2014 and 2016). Disparities related to age, gender, neighbourhood income, and self-rated health were explored using 3 analytic approaches: stratification, logistic regression, and relative comparison across multiple demographic variables.

Partnering with patients to improve access to primary care.

Continuity and timely access are hallmarks of high-quality primary care and are important considerations for urgent concerns that present both during the day and after-hours. It can be especially difficult to ensure continuity of primary care after-hours in urban settings where walk-in clinics offer patients easy and convenient access. Patients of our large, multisite primary care practice in inner-city Toronto, Canada were reporting that they were not easily able to access after-hours care from their team without having to use outside services.

Cancer screening rates among transgender adults: Cross-sectional analysis of primary care data.

Objective: To compare rates of cervical, breast, and colorectal cancer screening between patients who are transgender and those who are cisgender (ie, nontransgender).

Design: Cross-sectional study.

Setting: A multisite academic family health team in Toronto, Ont, serving more than 45 000 enrolled patients.

Mailed Letter Versus Phone Call to Increase Uptake of Cancer Screening: A Pragmatic, Randomized Trial.

Background: There is good evidence that cancer-specific patient outreach improves rates of cervical, breast, and colorectal cancer screening. However, it is unclear how primary care practices should implement integrated outreach for all 3 types of cancer screening. We aimed to understand whether integrated outreach using mailed letters or phone calls were more effective at increasing screening uptake in a primary care organization.

Measuring and improving cervical, breast, and colorectal cancer screening rates in a multi-site urban practice in Toronto, Canada.

Our Family Health Team is located in Toronto, Canada and provides care to over 35 000 patients. Like many practices in Canada, we took an opportunistic approach to cervical, breast, and colorectal cancer screening. We wanted to shift to a proactive, population-based approach but were unable to systematically identify patients overdue for screening or calculate baseline screening rates.