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Ď_IC\j00HkbfbBv1  讉2zK+(`mRȃU GT55v.5dަ`)'Fy uEo 43MV wqL8ܾT׮6q-`|*%TE]7vqT!b)QiaVY#(I L ϷXbz-ZQdV밧*cr\_gyO?:ɂ endstream endobj 33 0 obj << /F18 120 0 R >> endobj 34 0 obj << /Length 791 /Filter /FlateDecode >> stream xUO1 +8&ڱKBHmLbTSQ`\Yh[OsC S ~Ǩ#t<4黱Z\5_?6wb'u$PI7X̚ c3ho~C5j5S%\vt6GF}.TexEuiU{!j{GEVPx6fl`5HL5襫ۖ_2TH*tiNnB'KΞd.Ά1;yq%;38ۡe|z+ n 3H -J,d4@lHa[@L,;KѺ1E`zۦÉ}h >&GI*Ѭk┿Mz`KjՊFvHTڦq-zƪJVM[f].sESبɟߞ/D,#+ﴏ&Zz'~UЪ >߱<-Oy&R6$[~zHys`bLM :yg@+w=M<`IC*cMyQK-6m b8.wH؀ݒDU8#CL9MK5Qv34{b-gdqu4)³ #&?7$1ɑC%E^EZgj$E\4ehM2XcJtcqtۺ1j> endobj 36 0 obj << /Type /StructElem /S /Part /P 9 0 R /Pg 8 0 R /K [52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R] >> endobj 37 0 obj << /Type /StructElem /S /Figure /P 35 0 R /Pg 7 0 R /K [0] >> endobj 38 0 obj << /Type /StructElem /S /Figure /P 35 0 R /Pg 7 0 R /K [13] >> endobj 39 0 obj << /Type /StructElem /S /H1 /T (The Importance of Primary Care Network \(PCN\) Leadership for Ontario Health Teams \(OHTs\) ) /E (The Importance of Primary Care Network \(PCN\) Leadership for Ontario Health Teams \(OHTs\) ) /Pg 7 0 R /K [6] >> endobj 40 0 obj << /Type /StructElem /S /H2 /T (A Summary for PCN and OHT Leaders ) /E (A Summary for PCN and OHT Leaders ) /Pg 7 0 R /K [7] >> endobj 41 0 obj << /Type /StructElem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g 7 0 R /K [8] >> endobj 42 0 obj << /Type /StructElem /S /H3 /T (This briefing note explains why leadership structures and processes are foundational elements for all PCNs and outlines some key considerations for PCNs and OHTs as they co-evolve their relationships.) /E (This briefing note explains why leadership structures and processes are foundational elements for all PCNs and outlines some key considerations for PCNs and OHTs as they co-evolve their relationships.) /Pg 7 0 R /K [9] >> endobj 43 0 obj << /Type /StructElem /S /H2 /T (The Role of PCNs ) /E (The Role of PCNs ) /Pg 7 0 R /K [1] >> endobj 44 0 obj << /Type /StructElem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g 7 0 R /K [2] >> endobj 45 0 obj << /Type /StructElem /S /P /E (PCNs are organizational entities with their own leadership structures, decision-making processes, and strategic priorities. To enable integrated care to advance in Ontario, PCNs need to \(1\) engage and represent local primary care in their OHTs and \(2\) mobilize primary care providers in connecting with other providers) /Pg 7 0 R /K [3] >> endobj 46 0 obj << /Type /StructElem /S /P /E (in OHTs to achieve system priorities. This requires strong leadership within the PCN and the capacity) /Pg 7 0 R /K [4] >> endobj 47 0 obj << /Type /StructElem /S /P /E (to work effectively with OHT leadership structures. These dual roles require specific competencies in network leadership, boundary spanning, and balancing dual accountabilities. PCN leadership also requires system thinking and a collaborative mindset.) /Pg 7 0 R /K [5] >> endobj 48 0 obj << /Type /StructElem /S /H2 /T (Leadership and Governance are Foundational ) /E (Leadership and Governance are Foundational ) /Pg 7 0 R /K [10] >> endobj 49 0 obj << /Type /StructElem /S /P /E (PCN leadership and strategic orientation differs substantially from traditional clinical leadership. Questions about membership \(who is included in primary care?\), leader selection \(how are leaders chosen?\), decision-making \(how do diverse providers engage in collective decision-making?\), and authority \(what power does the PCN have within the OHT?\) highlight unique issues. 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This collaborative governance model can be challenging for OHT partners, as it differs from traditional single-organization leadership. For primary care, moreover, this model can create additional tensions. As noted earlier, primary care is comprised of a diverse range of professionals working in different practice models, funding arrangements, and priorities. PCNs are meant to aggregate this diversity into a collective voice that can participate effectively in system planning; without them, the voice of primary care will be fragmented \(diluting its influence\) or a few outspoken voices will claim to represent the whole \(leading to a lack of legitimacy\). Hospitals, public health units, and even community-based organizations usually have established leadership structures and clear spokespersons, making speaking with a coherent voice easier. This is not always the case with primary care.) /Pg 8 0 R /K [2] >> endobj 57 0 obj << /Type /StructElem /S /H1 /T (Structural Inequality in Collaborative Systems ) /E (Structural Inequality in Collaborative Systems ) /Pg 8 0 R /K [8] >> endobj 58 0 obj << /Type /StructElem /S /P /E (Collaborative partnership is aspirational, but organizations and practitioners don't start from positions of equality. Hospitals and other health organizations usually have established governance structures, legal entities, dedicated administrative capacity, and clear funding. PCNs are newer, and and at various stages of maturity. For a collaborative partnership to be real rather than rhetorical, PCN leadership needs to be sufficiently mature to participate meaningfully.) /Pg 8 0 R /K [9] >> endobj 59 0 obj << /Type /StructElem /S /P /E (PCN leaders face a unique challenge. They must govern their own network \(maintaining accountability to primary care providers\) while also participating in OHT structures \(being accountable to the broader network\). Key questions reveal this tension: Can PCN leaders make commitments on behalf of their members? How can PCN leaders ensure alignment between primary care perspectives and OHT decisions?This requires sophisticated boundary-spanning leadership. If PCN leadership is weak or unclear, PCN representatives at the OHT table may end up only representing the system's interests back to primary care rather than also bringing primary care's voice to system decisions. PCN leadership must be strong enough to maintain primary care's distinct perspective and priorities while participating collaboratively in system-level decisions, particularly as the sector is striving to act on provincial priorities regarding primary care access and attachment.) /Pg 8 0 R /K [10] >> endobj 60 0 obj << /Type /StructElem /S /P /E (OHTs are networks of provider organizations that are coordinating and delivering care to local communities. Network leadership exists at the PCN level and at the OHT level, and these networks need to interlock and work effectively. 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(ALIGN's focus on collaborative leadership and strategy within integrated care systems cannot be complete without understanding how PCNs organize themselves and connect to the larger system and must explicitly address how to build and sustain the leadership capacity that makes authentic partnership possible across structurally different sectors.If you would like to learn more, please join ALIGN for its monthly PCN leadership and governance peer learning sessions.) /Pg 8 0 R /K [7] >> endobj 66 0 obj << /Type /StructElem /S /Figure /P 36 0 R /Pg 8 0 R /K [0] >> endobj 67 0 obj << /ca 1 /BM /Normal >> endobj 68 0 obj << /ca .44 /BM /Normal >> endobj 69 0 obj << /ca .4 /BM /Normal >> endobj 70 0 obj << /ca .9 /BM /Normal >> endobj 71 0 obj << /Type /ExtGState /ca 0.0 >> endobj 72 0 obj << /G3 67 0 R >> endobj 73 0 obj << /Type /Group /S /Transparency /I true >> endobj 74 0 obj << /G3 67 0 R >> endobj 75 0 obj << /Type /Group /S /Transparency /I true >> endobj 76 0 obj << /G3 67 0 R >> 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