Models of Care Toolkit

How to use this toolkit

The Models of Care Toolkit is a practical resource for health system leaders and policy and program developers. It provides detailed information on innovative, evidence-informed models of care, with examples of care models used in Canada and internationally. To access details on models of care, view the five different topic areas: First Nations, Inuit and Métis, coordination with primary care, optimizing scope of practice, cancer care networks and virtual care and patient navigation.

Innovative models for the cancer system

The Canadian Strategy for Cancer Control was refreshed in 2019 and calls for action to improve cancer care, including in the diagnostic, survivorship and palliative care phases.

Meanwhile, the growing burden of cancer in the population, along with increasing expectations for person-centred care closer to home, continue to place more pressure on cancer care provider capacity.

The COVID-19 pandemic has further exacerbated these challenges and widened inequities of care. These factors reinforce the importance of exploring innovative models of care that optimize resources and enhance the delivery of person-centred care.

Innovative models of care have the potential to improve the efficiency of care delivery (thereby increasing system capacity and sustainability) and help achieve equity in access and outcomes for populations including First Nations, Inuit, Métis, people with low income, those who are part of a racialized community or those who live in rural and remote areas.

Advances in virtual care delivery and patient navigation have the potential to enhance person-centred care delivery, access to specialist services and delivery of care in line with people’s beliefs and values.

Supporting the efficient delivery of cancer services

This toolkit is a resource to assist health system leaders, and policy and program developers in implementing innovative models of care that will support the efficient delivery of cancer services and help address inequities in cancer care. Developed in response to challenges identified by cancer programs, it includes examples from cancer systems within Canada and around the world that can be scaled and spread to local, regional, provincial and territorial cancer programs. The models can help optimize health human resources and improve access and outcomes for underserved populations including First Nations, Inuit, and Métis.

The toolkit is intended to support the uptake of efficient and equity-focused models of care in following areas:

  1. Improve the coordination between the cancer system and primary care at key points in a person’s cancer journey to better support patients
  2. Optimize the scope of practice of cancer team members to enhance access to excellent cancer care closer to home and improve staff resiliency and satisfaction
  3. Leverage cancer networks and network models to support collaborative, person-centred care, especially in rural and remote communities

Innovations in virtual and digital health and navigation can also enhance the benefit of innovative models of care within these three areas and have been highlighted throughout the toolkit.

The priorities addressed in the toolkit were informed by input from cancer system leadership, clinicians, nurses and allied health professionals, First Nations, Inuit and Métis leaders and patients.

Collaborative partnership

The Canadian Partnership Against Cancer and the Canadian Association of Provincial Cancer Agencies jointly launched the Models of Care initiative in 2019. This collaboration yielded this toolkit along with initiatives that will support the implementation and evaluation of models of care within jurisdictions. The co-lead approach ensures solutions proposed in the toolkit reflect regional specificities and address the practical needs of provincial cancer programs and their patients.

Models of Care Working Group

The Partnership and CAPCA would like to thank and acknowledge the members of the Models of Care Working Group who provided strategic guidance and expertise to the development of this toolkit.

Dr. Marianne Taylor – BC Cancer, British Columbia

Dr. Cathy Clelland – BC Cancer, British Columbia

Dr. Shaun Loewen, CancerCare Alberta, Alberta

Dr. Desiree Hao, CancerCare Alberta, Alberta

Deb Bulych, CAPCA Lead, Saskatchewan Cancer Agency, Saskatchewan

Kathy Brooks, CPAC Patient and Family Advisor, Manitoba

Dr. Angel Arnaout, CPAC Expert Advisor, The Ottawa Hospital, Ontario

Dr. Andrea Corvelli, University Health Network, Ontario

Dr. Robin Urquhart, Dalhousie University, Nova Scotia

Critical success factors

Planning and implementing new models of care require careful administrative, operational and cultural consideration. Organizations should consider the following in the planning phase:

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1. Health and human resources
Assess current and projected staffing levels, scope of practice legislation, training opportunities and population needs to understand opportunities and limitations of proposed models of care.

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2. Remuneration
Consider how remuneration policies may impose challenges or incentivize participation when introducing connected care models or multidisciplinary clinics.

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3. Change management
Implement a concurrent change management strategy that considers workplace culture, team dynamics and workforce resiliency to facilitate real change

Implementation with a view towards pandemic recovery

The COVID-19 pandemic has magnified the importance of equity in health care. If we are to collectively eliminate barriers to high-quality care for all, we must focus on the most underserved populations and prioritize the health and well-being of our healthcare workers.

The pandemic has placed incredible pressure on Canada’s health workforce, and burnout, resignations and early retirements are impacting service delivery, especially in nursing. While staff recruitment is critical, innovative models of care can help optimize existing workforce capacity.

The models of care in this toolkit, together with funding to support model of care implementation and evaluation, will help support equitable access to care across the country, ease pressures on health care workers and support jurisdictions as Canada shifts from pandemic response to pandemic recovery.

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Deb Bulych headshot

“The burden of cancer is increasing, and we are always looking for ways to provide great cancer care for patients and their families. Canada’s cancer system is a small, tight knit community, and it is tremendously valuable to look at what other jurisdictions are doing well and find ways to adopt their best practices. This will allow Canada to remain at the forefront of cancer service delivery.”

Deb Bulych, Vice President Clinical Services, Saskatchewan Cancer Agency, Chair, CPAC Models of Care Working Group

To ensure this toolkit continues to provide value to those who use it, we’d love to hear from you.  Are there new models available? Should we focus on another priority area?