C3 A BC First Nations Lens on Cultural Safety & Quality in Health Care - J. Gallagher
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C3 A BC First Nations Lens on Cultural Safety & Quality in Health Care - J. Gallagher






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C3 A BC First Nations Lens on Cultural Safety & Quality in Health Care - J. Gallagher C3 A BC First Nations Lens on Cultural Safety & Quality in Health Care - J. Gallagher Presentation Transcript

  • QUALITY FORUM 2012Applying a BC First Nations lens to quality in health care Presented by: Joe Gallagher, CEO March 8th , 2012: Four Seasons Hotel, Vancouver
  • British Columbia First Nations 26 Cultural Groups 32 Aboriginal Languages 203 Bands (or First Nations) 3 Provincial First Nations Organizations BC Assembly of First Nations First Nations Summit Union of BC Indian Chiefs
  • OUR POPULATION• First Nations population suffered a major collapse in the late 19th century.• PHO report estimates that the FN population of 250,000 in mid 1700’s was reduced to 23,000 by 1929.
  • OUR POPULATION• Aboriginal Population in BC is 197, 070• Registered status First Nations population is 127, 675• 60, 505 (47%) registered status First Nations people live on reserve
  • OUR POPULATION On and Off-Reserve Status Population by HA Region 50,000 45,000 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 0 Fraser Interior Northern Vancouver Coastal Vancouver Island Fraser Interior Northern Vancouver Coastal Vancouver IslandOff Reserve 3873 13678 28169 6254 15169On Reserve and on Crown Land 4,489 14,720 18,464 8,962 13,870
  • CURRENT FIRST NATIONS HEALTH SERVICE DELIVERY203 BC First Nationscommunities137 CommunityHealth Centres(Federal / FNs)Regional HealthAuthorities (Provincial)
  • A BRIEF HISTORY OF FIRST NATION HEALTH DEVELOPMENTS IN BC• 2005: Leadership Accord & New Relationship & Transformative Change Accord (TCA)• 2006: TCA: First Nations Health Plan• 2007: Tripartite First Nations Health Plan. FNHC established
  • A BRIEF HISTORY OF FIRST NATION HEALTH DEVELOPMENTS IN BC• 2008 - 2011: Gathering Wisdom for a Shared Journey• 2012: FN Health Society becomes interim First Nations Health Authority.• Transition phase to become the new FNHA 2013-2015
  • The health andwellbeing of mypeople depends onhow well I work witheach and every one ofyou in this room.
  • Gathering Wisdom 2011
  • 1- Community Driven, Nation Based
  • 2- Increase First Nations Decision-Makingand Control
  • 3- Improve Services
  • 4- Foster Meaningful Collaboration and Partnership
  • 5- Develop Human & Economic Capacity
  • 6- Be Without Prejudice to First NationsInterests
  • 7- Function at a High OperationalStandard
  • What does this all mean for `quality and safety` in First Nations patient care in BC?• Definitions must come from First Nations themselves…• We can and should create space for this dialogue to happen• Dialogue needs to occur between PROVIDERS of care and RECEIVERS of care on what quality and safety means
  • Example of Model of Care: South Central Foundation, Anchorage, AlaskaNUKA MODEL of CARE:• Relationships are key to health care• Patient care should be integrated• Same day access for primary care• CUSTOMER-OWNERS are partners in their own health care• Customers must have ample opportunity to offer advice and feedback
  • How SCF implements the Nuka Model• Create a culture where training and re-training is valued• Create a comprehensive induction process around the Nuka model• Have primary care teams that are without hierarchy – everyone on the team is equal• Have `talking rooms`- not consulting rooms• Customer-owners choose their team – and make changes if unhappy• Leaders share and constantly LIVE the vision
  • Creating the Space to talk about Quality• iFNHA / FNIH, BC Patient Safety and Quality Council and Province working together• Utilizing Regional Tables who partner with Regional Health Authorities• Working with First Nations Health Directors and their patients, clients and communities
  • PATIENT SAFETY & QUALITY COUNCIL QUALITY MATRIX Acceptability Appropriateness Accessibility Safety Effectiveness Geographic Equity ofPREVENTION Culturally Cultural factors (rural, Cultural outcome for acceptable appropriateness remote, on & safety for FN patientsTREATMENT services, res of health off reserve) FN clients who have pectful of professionals higher rates FN and FN Health Cultural of most values, tradi organizations Literacy safety for illnesses andLIVING WITH tions, teachi and the services (across workers & conditionsILLNESS OR ngs and they provide for jurisdictions) practition-DISABILITY cultural FNs ers The practices outcomes are not the sameCOPING if access andWITH END experience isOF LIFE not the same
  • Cultural Competency Factors‘Cultural Competency’ in health may been defined in two mainforms: – An individual focus on the COMPETENCY of PEOPLE: • Health professionals and practitioners, Nurses, Managers, Governors, Health Workers – An institutional focus on the COMPETENCY of ORGANIZATIONS including: • Policies, practices, strategies, plans, service delivery mechanisms, systems, processes, forms, partnership s and relationships, communications etc
  • Cultural Competency Factors A Culturally responsive health system Is a combination of Culturally competent staff / workforce + Culturally safe clients +Culturally appropriate systems & processes operated by institutions within the system
  • Cultural Competency at South Central Foundation• RAISE PROGRAM - opportunities for native youth 14 – 19 to get on-the-job work experience in the context of Alaska Native cultural values• TRADITIONAL HEALING CLINIC ON SITE – provide service and teach other health workers• FAMILY WELLNESS WARRIORS – promote wellness through cultural and traditional methods• ORIENTATION OF NEW STAFF – incorporates Nuka model, values, traditions and ongoing learning
  • TAKING RESPONSIBILITY / RECIPROCAL ACCOUNTABILITYEmbed cultural competency programs and initiatives within organizationsIndividual workers, employees and practitioners take responsibility for their own learning First Nations take responsibility for helping others to understand their perspectives in health Tripartite Partners can create the space for these dialogues to happen at all levels
  • In conclusion… The environment is right for partnership and collaboration at all levelsFirst Nations have been clear that they must define and govern their own health First Nations health leaders are committed to service improvement; to better health experiences for their community members and to better health outcomes THANK YOU