Each year, staff at Health Quality Ontario read the Quality Improvement Plans (QIPs) submitted by Ontario hospitals, primary care organizations, long-term care homes, and local health integration networks (which administer home care). We identified some stand-out examples from the 2017/18 QIPs showcasing what some organizations have done to address health equity in the populations they serve, and reached out to the people involved to find out more about their experiences.
Here, we spoke with Taralea McLean, Executive Director, Ashley Chiarello, Health Promoter, and Lori Kleinsmith, Health Promoter at Bridges Community Health Centre (CHC), which described the creation of a quality improvement initiative to support an inclusive, welcoming environment for everyone who walks through the doors.
Can you tell us a bit about your CHC’s work with the LGBTQ2S community?
During the 2016/17 fiscal year, Bridges CHC staff attended training related to serving our LGBTQ2S community in a better way. At that training we realized that, as a health service provider, there was more that we could be doing to support these patients. With the support and participation of members of the local LGBTQ community, we launched a quality improvement initiative to investigate ways in which our CHC could improve the quality of supports and programming for this community. The Senior Pride Network of Niagara’s LGBTQ Welcoming and Inclusive Services Checklist (see attachment) was used to examine our CHC’s practices, processes, forms, environment, and general knowledge of staff.
What were your results?
We were able to:
- Create an internal staff committee to spearhead the initiative and conduct ongoing research on best practices to assist the CHC interprofessional team in their own practice and provision of services to the LGBTQ community;
- Revise forms to be more inclusive of how the LGBTQ community self-identifies, by allowing individuals to identify their gender identity in terms other than "male" or "female";
- Establish a LGBTQ Coffee Club – once a month, Bridges CHC provides the safe space in which the group meets;
- Review and update our CHC’s anti-discrimination policy;
- Join a Regional Committee Advocating With and For Older LGBTQ2S Citizens;
- Provide visible support for the LGBTQ population such as displaying posters and articles in support of the LGBTQ community in waiting rooms and providing staff “allies” with pins to wear and posters to clearly display in their offices/exam rooms.
What other work have you been doing regarding health equity?
Bridges CHC also provides leadership within the Niagara Poverty Reduction Network (NPRN), where we are working collectively to wipe out poverty in Niagara region through education, collaboration, and advocacy to address poverty’s root causes.
Lori leads the NPRN’s Work & Wages Workgroup. The Network has released two new reports, ‘Calculating the Cost of Living in Niagara Region, 2017’ and ‘Calculating the Living Wage for Niagara Region, 2017’. The reports are available at www.wipeoutpoverty.ca.
Ashley and Lori are members of the NPRN’s Health Equity Task Group, which has been working collaboratively with medical students on recommendations highlighted in a recent report, Healthcare First: Improving access to healthcare for the homeless and vulnerably housed in Niagara, released by the Health Equity through Advocacy, Research and Theatre (HEART) Project. The group is advocating for interventions that can be built into policy around improving the emergency department visits for patients experiencing homeless and mental health issues.
What enables your organization to do this work?
At Bridges CHC, our health promotion activities support comprehensive social and political process directed towards changing social, environmental, and economic conditions to ease their impact on public and individual health. We focus on empowering people to increase control over the determinants of health, which ultimately improves their health.
Working on the social determinants of health with and for our community requires going beyond some of the more measurable accountability activities of a CHC. Bridges CHC has designated staff time for the health promoters to work on improving the social determinants of health and related poverty reduction campaigns, going well beyond the medical model of care. Commitment from leadership has allowed this time to be built into our workplans.
You may also be interested in:
Quorum’s Indicators & Change Ideas page. Find more information about QIP indicators and related change ideas.