Don't tinker, transform: launching a primary healthcare revolution.

F or years, efforts to reform primary healthcare in Canada have focused on fixing bits and pieces, rather than on a wholesale transformation of how care is delivered. Exciting, effective changes flourish in pockets but rarely manage to spread. " So much innovation, so little change, " laments Dr. Brian Hutchison, co-chair of Picking up the Pace – How to Accelerate Change in Primary Healthcare, a conference hosted by the says, is " the reigning champion of pilot projects. " But, he adds, the conference offered proof that primary healthcare innovation in Canada is gaining speed and force. Picking Up the Pace brought together more than 300 clinical leaders, health system managers and policy makers to hear about 47 innovative solutions to primary healthcare challenges and to share their own experiences and strategies for reforming primary care. Over two days, participants communicated ideas on ways to create an effective, sustainable primary care system flexible enough to serve the varied needs and realities of communities and people across Canada. The conference opened with an inspiring presentation by keynote speaker Doug Eby, vice-president of medical services at Alaska's Southcentral Foundation. Southcentral's revolution began 12 years ago when control of the organization passed to the Alaska Native People it served. It was, says Dr. Eby, the beginning of an extraordinary adventure, moving from giving care to recognizing that healthcare's role is to support individuals , who ultimately control their own health outcomes. Southcentral's goal was no less than " transforming this thing called medical care to a lifetime journey through health. " That message – that primary care reform demands a shift away from the medical model and an accompanying ascendance of teamwork – resonated throughout the conference as speakers challenged each other to stop thinking in terms of medical care. Although Southcentral has up to 75 quality improvement projects going at any one time, and a staff of 20 supporting them, these projects are no longer how Southcentral judges the work it does. There are always technical improvements that can and should be made. But success depends on creating a system based on relationships with individuals, recognizing them as the leaders of their own care. " We went from project-based fixes to whole-system transformation. That's the part to take home, " Dr. Eby asserts. How to take innovations from the project level to system transformation was a recurring theme of the 23 …