Primary health care in practice

October 2015   Comments

In the June issue of CNA Now, we presented a primer on the differences between primary care and primary health care. For this issue, we invited Lisa Ashley, one of CNA’s senior nurse advisors, to speak about integrating the core principles of primary health care into nursing practice. Ashley has worked in acute care settings and has held nursing leadership positions as a home health and public health professional. As part of her work at CNA, she advocates for healthy public policy.


For many RNs and NPs, the initial discussions about primary health care will have occurred in undergraduate nursing school during a community health course. That was certainly my experience. Once I entered the workforce, I did not hear the term again until I moved from working in an acute care orthopaedic hospital into public health nursing. But as I think back, the head nurse at that hospital encouraged me to adopt a primary health care approach. She would ensure that the care plans we developed were centred on patients and families. What will the 80-year-old woman having a hip replacement after falling at home be going back to? With no family, will she be able to afford her medications and to hire someone to look after her? Who will assist her in looking into other supports in the community?

The head nurse empowered me to ask questions and advocate for resources to support this patient and others like her in making the best decisions for their health. I realize now that she was asking me to challenge the system and to bring my ideas forward to improve the way we delivered care in our hospital. She also carved out time in busy schedules for me to participate on a committee that was working with community citizens on modernizing our wards. The committee’s mandate encompassed four of the principles of primary health care: active public participation, accessible care delivery, innovation and the use of appropriate technology.

In my role at CNA, I learn about nurses’ involvement in primary health care in a variety of settings to create systems that support the health of individuals, families, groups, communities and populations. Here are just a few examples:

  • an NP-led surgical spine consultation clinic that is improving wait times in southern Ontario
  • 24/7 RN telephone advice and health information services, operating across Canada, that offer alternatives to emergency department visits
  • collaboration on inpatient room design and facility planning for hospitals in Alberta and Manitoba
  • an RN “flow” position that facilitates the efficient navigation and coordination of patients at an Ontario hospital
  • development of a comprehensive model for outreach services in northern British Columbia
  • a nurse-led heart health clinic in Quebec that focuses on prevention and early treatment for women
  • the shift to a patient-centred approach in a dementia care facility in P.E.I.

So what can you do? You too can get involved in the development of programs that reduce exclusion and social disparities in health, organize health services around people’s needs, integrate health into all sectors and increase stakeholder participation.

Read more about primary health care.

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