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Introduction: Growing evidence supports patient engagement (PE) in health implementation research to improve the quality, relevance and uptake of research. However, more guidance is needed to plan and operationalize PE before and throughout the research process. The aim of the study was to develop a logic model illustrating the causal links between context, resources, activities, outcomes and impact of PE in an implementation research programme. Methods: The Patient Engagement in Health Implementation Research Logic Model (hereafter the Logic Model) was developed using a descriptive qualitative design with a participatory approach, in the context of the PriCARE programme. This programme aims to implement and evaluate case management for individuals who frequently use healthcare services in primary care clinics across five Canadian provinces. Participant observation of team meetings was performed by all team members involved in the programme and in‐depth interviews were conducted by two external research assistants with team members (n = 22). A deductive thematic analysis using components of logic models as coding categories was conducted. Data were pooled in the first version of the Logic Model, which was refined in research team meetings with patient partners. The final version was validated by all team members. Results: The Logic Model highlights the importance of integrating PE into the project before its commencement, with appropriate support in terms of funding and time allocation. The governance structure and leadership of both principal investigators and patient partners have significant effects on PE activities and outcomes. As an empirical and standardized illustration that facilitates a shared understanding, the Logic Model provides guidance for maximizing the impact of patient partnership in various contexts for research, patients, providers and health care. Conclusion: The Logic Model will help academic researchers, decision makers and patient partners plan, operationalize, and assess PE in implementation research for optimal outcomes. Patient or Public Contribution: Patient partners from the PriCARE research programme contributed to developing the research objectives and designing, developing and validating data collection tools, producing data, developing and validating the Logic Model and reviewing the manuscript. [ABSTRACT FROM AUTHOR]

Introduction Some people frequently use healthcare services due to complex healthcare needs and are more at risk of incapacity and mortality. Literature supports case management (CM) to improve integrated care, patient experience, and patient-reported outcomes for this clientele. However, challenges remain in the interaction between hospitals and primary care clinics. The aim of the study was to implement and evaluate an intervention where case managers in hospital work closely with primary care nurses to improve integrated care of frequent users of healthcare services. Methods: Study Design Multiple embedded case study. Setting Four hospitals and four primary care clinics in the region of Saguenay-Lac-Saint-Jean, Quebec, Canada. Each clinic was considered as a case. Frequent use was defined as = 4 emergency department (ED) visits and/or = 3 hospitalizations in the previous year. Intervention: Case managers identified frequent users in each clinic within the computerized platform of the hospitals. Primary care nurses worked in close collaboration with case managers to develop an individualized service plan and ensure coordination and self-management support during 6 months. Data collection and analysis The mixed data collection included, at baseline and 6 months: 1) Semi-structured interviews with case managers (n=3), primary care nurses (n=11), programs managers (n=4), and patients (n=19), and focus groups with family physicians (n=36) and other professionals (n=26) to evaluate implementation and outcomes (care access and satisfaction, self-management, well-being and hospital services use); 2) Fieldnotes to complete and validate the qualitative data; 3) Selfadministered questionnaires for sociodemographic characteristics (age, sex, marital status, education, occupation, family income and perception of the economic situation, health literacy, and multimorbidity) and quantitative outcomes (patient experience of integrated care and selfmanagement of health) completed by frequent users who received the intervention (n=33); and 4) Services use (ED visits, hospitalizations and primary care utilization) measured in the electronic medical record. For each case, qualitative and quantitative data were first analysed separately, then combined into case stories that were compared. A patient partner was involved in data collection and analysis. Results Implementation of the intervention varied among the 4 clinics, from almost no implementation (the family physician in charge of the clinic decided to stop the implementation) to full implementation (strong leadership and collaboration among all stakeholders - case managers, primary care nurses, family physicians and managers). Qualitative and quantitative outcomes were proportional to the stage of implementation. Discussion This study adds to the literature on CM to improve integrated care by proposing the concept of integrated CM between hospitals and primary care clinics. Conclusions: Integrated CM may have positive impacts on frequent users and services use if all stakeholders engage in practice change. Lessons learned Adressing change management and mobilizing all stakeholders at the onset are mandatory when implementing such complex interventions targeting practices changes. Limitations The study lacked of power for analysis by clinic for outcomes such as self-management and services use. Results are transferable to similar contexts (to be described in the presentation). Suggestions Future research could replicate this study on a larger scale with economic analysis. [ABSTRACT FROM AUTHOR]