Centre of Research Excellence :Innovative Models Promoting Access-to-Care Transformation (IMPACT)



Chief Investigator: Professor Grant Russell, email: Grant.Russell@monash.edu

CRE Manager / co-ordinator: Dr Phil Thompson, email: phil.thompson@monash.edu


Recent and widespread reforms in primary health care (PHC) in western countries reflect a growing concern that health systems should become more affordable, inclusive and fair. In Australia and Canada PHC reforms have prioritised access to effective and high-quality health services, with equity being at the heart of that system.

Despite these reforms, meaningful gaps in equitable access to Community-based Primary Health Care (CBPHC) remain. These gaps particularly affect vulnerable groups, such as the poor, refugees and indigenous communities. These problems translate into unmet needs for care, delayed or inappropriate treatments and avoidable emergency department consultations and hospitalisations. Many of the myriad PHC innovations and pilot projects have been limited in their ability to generate transformative change throughout health care systems.

Innovative Models Promoting Access and Coverage Team (IMPACT) program aims to generate organisational innovations to promote access to PHC for vulnerable populations, more specifically the poor, refugees and people from indigenous communities. Activities will be conducted through a learning network of administrative regions within three Canadian provinces and three Australian states.

Like many, these regions are grappling with the challenges of optimising access for vulnerable populations to quality CBPHC. In partnership, the multidisciplinary team (including care providers and community representatives) will work with the regions to identify and perform an in-depth and rigorous assessment of existing system-level organisational innovations that address access to vulnerable populations. Then, informed by state of the art evidence on these potential interventions, teams will select, adapt, and implement/evaluate approaches that best address their needs and context.

Research aim & objectives

The aim is to transform the PHC organisational structure to improve access to appropriate care for vulnerable populations resulting in reduced unmet need, avoidable emergency department visits and avoidable hospitalisations for vulnerable populations.

The program’s three main objectives are to:

  1. develop a network of partnerships between decision makers, researchers and community members to support the improvement of access to PHC for vulnerable populations
  2. identify organisational, system level CBPHC innovations designed to improve access to appropriate care for vulnerable populations, and establish the effectiveness and scalability of the most promising innovations
  3. support the selection, adaptation and implementation of innovations that align with the regional partners local populations’ needs and priorities and evaluate the effectiveness and efficiency and further scalability of these innovations.

Expected outcomes & impact

The five-year program will empower vulnerable health consumers and develop capacity among academics, clinicians and decision-makers about research on and implementation of organisational innovations in CBPHC.

The research will address important challenges or barriers in the delivery of CBPHC. The program is centred on producing evidence to support decision makers in addressing the CBPHC access gaps facing their region, and to support policy makers in creating the environment to help this occur.

The research will provide new policy and program options for improving access to care by vulnerable population groups through interventions in and with CBPHC. Options for policy and practice will be communicated through various means to managers and policy makers for more widespread implementation.

Research activities

Description of projects

Establishing a learning

network of Local

Innovation Partnerships


Identification of needs and access gaps in


  • Understand local organisational context and emergent innovations
  • Select potential Innovations for scoping, knowledge syntheses and implementation
  • Adapt and implement intervention model in the LIPs
  • Assess benefits of innovations for the LIPs and broader health systems

Stream one:

Identifying and understanding access-related

organisational CBPHC innovations

Project 1 Scoping the innovations: A review of

academic and grey literature relating to organisational innovations to improve CBPHC access


Project 2 Effectiveness and scalability: Syntheses of factors related to the implementation and effectiveness of innovations to improve access for vulnerable populations


Project 3 Mixed-method analysis of currently existing population based surveys

Stream two:

Adapting, implementing and evaluating promising organisational CBPHC innovations

Project 4 A mixed-method evaluation of the impact of organisational innovations to improve access for vulnerable populations


Updated:  24 February 2017/Responsible Officer:  Director, APHCRI/Page Contact:  Web Admin, APHCRI