Ontario Health Teams: Negotiating Social Work Values in an Emerging Integrated Care System

Abstract

Ontario Health Teams (OHTs) represent Ontario's most recent shift towards integrated care. OHTs are underpinned by a common value framework, the "Quintuple Aim." The present study investigates how the Quintuple Aim enables and constrains the work of value-driven professionals, in this case social workers, working within the OHT system. An institutional ethnography was conducted at a Community Health Centre in a metropolitan OHT. Data was collected during six in-depth interviews with both social workers and management staff. Thematic analyses were performed from which four themes emerged: 1) participants' commitment to health equity, 2) issues with provincial leadership & neoliberalism within OHTs, 3) social workers’ disengagement from OHTs, and 4) an on-going need for service integration. Findings suggest misalignment between the values espoused in the Quintuple Aim and providers’ testimonies, most notably in the domains of health equity and provider experiences. Findings are interpreted through a critical neoliberal lens and particular attention is paid to how performance evaluation targets constitute an unspoken set of values within OHTs. Implications are discussed for social work practice and integrated care practices within OHTs.