Bruyère Academic FHT is part of a multi-sector organization comprised of acute care, primary care and long-term care services across three geographic locations. The FHT is located at two sites with 13,500 enrolled patients.
Bruyère’s focus has always been to meet the needs of the most vulnerable in their community by looking for gaps in health services and filling those gaps accordingly.
To gain a better understanding of how they were able to respond to the Syrian refugee crisis in 2016, Health Quality Ontario had a chance to catch up with Medical Chief of Family Medicine and Medical Director Dr. Jay Mercer, Co-Chair of Social Accountability Committee Dr. David Ponka, Co-Chair of Social Accountability Committee Manon Bouchard, and Executive Director Vela Tadic.
Can you share your approach to addressing the needs of vulnerable populations in your community?
At Bruyère Academic FHT, we view the provision of health services through micro, meso and macro lenses. At the micro level, we try to meet all our patients’ unmet needs here and now. At the meso level, we provide access to services through outreach and home visits.We bring research and knowledge translation from the macro level into practice to further close health care inequities.
In 2016, nearby colleagues at the University of Ottawa brought forward the pressing needs of the Syrian population to the FHT.
The crisis became a rallying cry for our clinic. It helped us realize that there are many unmet needs in this population that require our attention. It became a big advocacy issue for our nurses and doctors interested in immigrant health.
How did your FHT respond to the Syrian refugee crisis?
Bruyère Academic FHT acted as an initial health system touch point for this population.Many refugees had not received the standard of care we are accustomed to in Ontario until they arrived in the community Bruyère serves.
Basic labs, physical assessments, vaccinations and cancer screening were completed and the FHT then worked to connect refugees to health services in their new neighbourhoods.
What were the challenges you faced working with this population?
Bruyère had already been tackling social and health issues of vulnerable populations for many years.
However, following the successful integration of 240 Syrian refugees into our patient population, we acknowledged that we had limited understanding of the issues facing some of the refugees.
This spurred the establishment of a Social Accountability Committee (SAC) to intentionally focus on ways to respond to this populations’ needs. The committee has been meeting for over a year. Our initial goals have been to:
- Encourage our providers to ask a question about whether patients have difficulty making ends meet at the end of the month and referring patients for assistance
- Insert a template into the electronic medical record to document social determinants of health concerns of patients
- Advertise free food and meals available in the region and the 211 service through our patient newsletter and around our clinics
- Host lunch and learns for staff about social determinants of health
- Ask for holiday donations of meal supplements to have a supply available in the clinics
- Collaborate with the University of Ottawa Faculty of Medicine in a new student clinic to link patients with community resources
- Investigate a potential collaboration with an outside agency to develop a pool of loaned medical equipment
This multipronged approach connects the micro, meso, macro levels of service implementation and embeds it in practical advocacy.
At the micro focus, social determinants of health are captured in the patient charts with a stamp in the electronic medical record allowing clinicians to assess for unmet needs and develop a meaningful action plan.Connecting patients to appropriate local services to fill the gaps represents the meso level.The macro level of knowledge translation comes to life in evidenced-based questions during health assessments such as, “Do you have trouble making ends meets at the end of the month?”.
The scope of the SAC is not yet finalized, but as our group grows and matures, our collective contributions and expertise will help determine our way forward.
What has been the key to successfully operating your Social Accountability Committee (SAC)?
Initially designed as a voluntary, interest-based forum to address the social determinants of health for patients, the SAC has become more formalized with open membership to interested staff members meeting monthly.
A key to the success of this committee is having leadership at the table. Our plans become much more actionable when you have leadership behind you.
What advice would you give to other organizations looking to collaborate on important health care issues?
Bruyère FHT is passionate about the power of our Quality Improvement Plan (QIP). Our advice would be to bring your team to the table and have a meaningful planning process for developing your QIP.
Our QIP is a living document, not just an administrative exercise. It is an important document that drives our work. It helps us be more efficient, figure out what to do and what not to do especially when resources are limited. The QIP helps us achieve our mission and foster advocacy for vulnerable populations.
Resources, education, approaches and strategies all align with the QIP and the benefits are seen beyond patient outcomes.
For more specific information on this initiative please contact Manon
Bouchard NPPHC via email MBouchard@bruyere.org.
You may also be interested in:
Quorum’s Indicators & Change Ideas page. Find more information on QIP indicators and related change ideas.