Background: The Seamless Care Optimizing the Patient Experience (SCOPE) project was initiated to increase linkages between primary care physicians (PCPs), hospitals and community resources to improve care for patients with complex chronic disease. This thesis examines the key steps and influencing factors associated with PCPs' engagement in SCOPE.
Methods: A case study design was employed to collect interview data from PCPs identified as 'early', 'mid', or 'later' adopters based on engagement during the first 14 months of SCOPE.
Results: Twenty two of 30 eligible PCPs participated. Several engagement factors and differences between adopter groups were identified. Contextual elements such as strained inter-provider relations; feelings of responsibility, isolation and burnout; and the provision of support in a trusting, collaborative manner further influenced PCPs' engagement.
Conclusion: A framework of contextual elements relevant to the engagement process of PCPs in care coordination models, and potentially other practice change initiatives, is presented .