Ontario Health Teams: Negotiating Social Work Values in an Emerging Integrated Care System
Bibliographic record
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.028 | 0.019 |
| Scholarly communication | 0.008 | 0.002 |
| Open science | 0.002 | 0.009 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".