6.4 Blackbelt

Why is collaboration needed?6-4

  • According to the World Health Organization (WHO 2009), a global health human resources crisis predicting shortages across all health provider groups is looming
  • Evidence further indicates that lack of communication and collaboration between health providers can seriously harm patients
  • To solve these issues, we need to change how health services are delivered and how providers interact with each other

Reference: Esther Suter and Siegrid Deutschlander HEALTH HUMAN RESOURCES SOLUTIONS? March 2010.  http://www.wcihc.ca/__shared/assets/Final_Synthesis_Report_March_20103499.pdf

Medical Educator Perspective

Douglas Archibald Script:

Hi. My name is Doug Archibald and I’m the medical education research scientist with the University of Ottawa’s Department of Family Medicine. Working together as an effective health care team is critical to ensure recent immigrants and refugees in Canada have access to and receive good health care. Embracing the competencies of Interprofessional Care is a good framework to adopt.

First, is to communicate effectively in a respectful and responsive manner with others.

Second, is to establish collaborative working relationships with other providers, patients and families, around planning and providing patient care, promoting the integration of information and perspectives from others, and ensuring that appropriate information is shared with other providers.

It is also important to recognize one’s own roles and responsibilities as related to patient and family care; and to demonstrate an understanding of the roles, responsibilities and relationships of others within the team.

Furthermore it is paramount to apply patient-centred principles through interprofessional collaboration. Seek input from patient and family in a respectful manner. Integrate patient’s and family’s life circumstances, cultural preferences, values, expressed needs, and health beliefs into a healthcare plan. And be an advocate for patients and families as partners in the decision-making process.

Inevitably, you will need to work toward preventing and even dealing with conflict between and with other providers, the patient and family. Remember to demonstrate active listening and be respectful of different perspectives and opinions and work to to prevent and deal effectively with conflict.

Finally, support effective team functioning to continually improve collaboration and quality of care. Continually evaluate your team’s team function and dynamics and share leadership roles within the health care team.

For more information be sure to check out the resources at the end of this module.

Why is interprofessional collaboration important?1

  • Interprofessional collaboration is promoted to enhance the quality of care and create health human resources efficiencies
  • Collaboration between various health professionals will enhance the available support for older immigrants and refugees, who are often at risk for presenting with multi-morbidities
  • Interprofessional interventions are designed to teach students and practitioners how to work effectively across professions to enhance the quality of care
  • There is a need to study how interprofessional interventions can solve current health and human resources issues

Video Discussion

Family Physician

Dr. Doug Gruner
Associate Professor, University of Ottawa
Chair, Champlain Immigrant Health Network

Read the transcript

Hello, as a family physician who works with newly-arriving refugees my interest is to ensure that this family receives timely and high-quality primary care.

The first thing that comes to mind is the need for communication support, such as an interpreter, and to take time to make sure Mr Jemi and his wife have a basic understanding of how the Canadian primary care teams work and the clinics function.

My principal role would be to address any urgent health issues and then to ensure the entire family receives evidence-based preventive care in terms of vaccinations, screening and counselling. A smile and gentle approach that communicates a commitment to the family can provide a great start to our relationship, a relationship which I know will develop over the next several preventive care visits.


Duration: 48 seconds

Nurse

Heather Thomson
Nurse Practitioner
University of Ottawa

Read the transcript

Hi, my name is Heather Thomson and I am a nurse practitioner who has completed several humanitarian missions with MSF.

The Congo is a place very close to my heart and I empathize with the many challenges the Jemi family have faced up until this point. I also appreciate the importance of building a trusting relationship in order to enable effective primary care for this family. Many prevention and health counseling ideas spring to mind, but my focus will be on going slow, assessing the needs of this family and developing rapport that will enable educational counseling.


Duration: 31 seconds

Social Worker

Antoine Rousel
Social Worker
Bruyère Family Medicine Centre

Read the transcript

Bonjour. My name is Antoine Roussel and I am a social worker at the Bruyère Family Health Team and we care for many newly arriving refugees.

My reaction to this scenario is how it highlights the importance of ensuring interpreters are found to support communication, in particular for Mrs. Jemi who as a refugee woman without proficiency in English or French continues to be a vulnerable member of this family. I am also thinking that it will be important to work with my settlement colleagues to ensure that this family has provincial health cards, as well as finding appropriate housing, and that the children are integrated as soon as possible into school.


Duration: 43 seconds

Clinical Pharmacist

Roland Halil
Clinical Pharmacist
Bruyère Family Medicine Centre

Read the transcript

Hello, my name is Roland Halil and I am a clinical pharmacist and the deputy director of the Global Health Elective to Panama.

Along with the supporting various vaccinations (Hepatitis B, varicella, MMR, DTPP), I will be interested to ensure this family has access to essential medications.

In Canada, prescription medication for newly arriving refugees is funded by the Interim Federal Health Program, but there are medications that may fall outside the usual list of prescription drugs for this family. For example, I would be ready to support access to medications for tropical parasites such as strongyloidiasis and schistosomiasis.


Duration: 33 seconds

Director of Global Health

Dr. Anne McCarthy
Associate Professor, Infectious Diseases
Director, Tropical Medicine Clinic

Read the transcript

Hello, my name is Anne McCarthy and I am an infectious disease and tropical medicine physician at the Ottawa Hospital and the director of the office of Global Health at the University of Ottawa.

My role in refugee care includes the medical management of migrants who are acutely ill as well as supporting the primary care teams, particularly related to infectious diseases and tropical medicine. In the context of this family, recently arrived from Africa, it is very important to watch for fever as the as the family could be at risk for developing malaria especially over the next few months. I would also want to ensure testing and treatment for infections such as HIV, hepatitis B and C, latent tuberculosis and intestinal parasites. These are important considerations as part of the preventive strategy for this family.


Duration: 56 seconds

Developing a Refugee Health Network

A group of children.

Pre-Network

Problem: Poor access to health care system for newly arriving refugees.
Identify key players: Team

  • Research potential funders for program
  • Engage recent/past refugees
  • Investigate best practices (i.e. Minnesota Refugee Program)
  • Brainstorm and devise plan for how the network will function, develop structure, and practitioner base

The CCIRH Logo

Network

  • Create governance structure
  • Communication structure within Network (using open access web-based EMRs)

Key components of network:

  • HARP (Medical student program to interview recent arriving refugees at Reception House shelter)
  • Preventive screening clinic at Reception House shelter (using the new CCIRH guidelines)
  • Provider Network: Health centers to provide ongoing care for the most vulnerable

A group of women sitting in a circle.

Evaluation and Assessment

  • Regular meetings of network committee (representatives from settlement, primary care providers, social workers, regional health authorities, public helath)
  • Conferences and Continuing Education
  • Feedback from refugee communities

[Photo Credits; Bruyère Immigrant Health Program]


Example of a Refugee Health Network

A graph showing an example of a Health Refugee Network. Health Settlement Workers are comprised of 4 main types of workers: 1. Patient representatives (User's consituency), 2. Social and Settlemenet Workers (Settlement and social workers' consituency), 3. Multicultural Health Brokers - Community Health Centers (Immigrant Community champion constituency), 4. Health Professionals, Public Health (public health and health worker's consituency). These workers are within a steering committee and advisory board, which is comprised of: community settlement, organizations, regional health department, private sector, media.

 


Example of Collaborators for Elderly 6-4Immigrant Care

  1. Occupational therapists
  2. Recreational coordinators at nursing home
  3. Social workers
  4. Pharmacists
  5. Psychologists
  6. Physical therapists
  7. Dieticians
  8. Geriatricians
  9. Palliative care specialists