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Alliance Statement on Racism in the 2019 Federal Election

Date:

Tuesday, September 24, 2019

The Alliance for Healthier Communities strongly condemns the racist and anti-immigrant sentiment characterizing the 2019 federal election.

The Alliance represents over 100 community-led organizations across the province that work with people and communities facing multiple social injustices and health disparities. We know that racism impacts how people move through the world in tangible ways. We recognize race as an important determinant of health. In addition to causing trauma, racism diminishes health and wellbeing. Racism’s impact is felt in policies that reinforce inequitable access to health care and make socio-economic deprivations and inequities possible. Failure to name and openly speak about racism reinforces harm and upholds white supremacy and settler dominance in Canada. We must urgently resist and call out racism and anti-immigrant sentiment as they seep into public discussions.

The Alliance reaffirms its commitment to social justice and health equity. We urge our members to do the same. Here are steps organizations can take:

Recognize, name and speak out against racist and anti-immigrant views in the election.
Call on government representatives to support steps and policy actions to eliminate structures that enable racism.
Advance health equity to address deprivations experienced by Indigenous, Black and other racialized communities across the province.
Endorse the Health Equity Charter, offer inclusive leadership training for your governing body and offer the Ontario Indigenous Cultural Safety Training to providers in your organization.

We encourage you to review these resources on racism, whilst considering actions your organization can take:

Racism & Public Health- CPHA
Policy and Guidelines on Racism and Racial Discrimination- Ontario Human Rights Commission
Key Public Health Resources for Anti-Racism Action: A Curated List- NCCDH
A Better Way Forward: Ontario’s 3-Year Anti-Racism Strategic Plan- Government of Ontario

Second report from the Premier’s Council on Improving Healthcare and Ending Hallway Medicine lays a strong foundation for a digital health strategy but lacks a health equity lens

Date:

Tuesday, June 25, 2019

The Alliance for Healthier Communities welcomes A Healthy Ontario: Building a Sustainable Health Care System, the second report from the Premier’s Council on Improving Healthcare and Ending Hallway Medicine.

A coalition of over 100 Community Health Centres, Nurse Practitioner-Led Clinics, Aboriginal Health Access Centres and Community-Governed Family Health Teams, we are Ontario’s voice for health equity through comprehensive, community-governed primary health care.

“We are pleased to see the report emphasize prevention and wellbeing, putting patients at the centre, strengthening partnerships between health and social services to address determinants of health, and ensuring primary care is the foundation of an integrated health care system,” said Adrianna Tetley, CEO of the Alliance for Healthier Communities. “With the majority of recommended actions and leading practice examples focusing on digital innovations, the report lays a strong foundation for a provincial digital health strategy. This highly-anticipated digital strategy, however, is only part of the solution to building a more sustainable health system that works for everyone, especially those communities currently facing barriers to healthcare and better health.”

In addition to the digital health strategy, there are a number of other recommendations presented in the report that are of particular interest to the Alliance: Support patients and providers at every step of a health care journey by ensuring effective primary care is the foundation of an integrated health care system. The Alliance for Healthier Communities believes a strong health system needs to leverage people’s lifelong relationships with primary care and agree with the report’s recommendation that people, especially those with complex needs, have to be “well-connected to a comprehensive range of health services in the community.” This work is already underway in more than 40 communities across Ontario where Alliance members connect non-team primary care physicians with interprofessional teams and make comprehensive primary health care supports available to those who need them most. One of these projects – Team Care Centre led by Windsor Family Health Team, City Centre Community Health Centre and Canadian Mental Health Association Windsor – is highlighted in the report as an example of innovation in action.

Modernize the home care sector and provide better alternatives in the community for patients who require a flexible mix of health care and other supports. We agree that changes are required allowing “Ontario Health Teams and their partner organizations to provide all services and perform all home and community care functions, including all aspects of care coordination” and “enabling care coordination and navigation throughout the full continuum of care.” Alliance members are ready to incorporate care coordination and social prescribing into primary care, enabling warm and efficient transitions with appropriate technologies, in order to support people throughout their interactions with the health and social systems.

Ensure Ontarians receive coordinated support by strengthening partnerships between health and social services, which are known to impact determinants of health. Addressing determinants of health through integration of health and social services is embedded in the model of care delivered by Alliance members. Majority of Alliance members offer a wide range of comprehensive primary health care services, including housing supports, food security programs, settlement services for new immigrants, employment and education supports. This allows them to see firsthand how these services help improve health outcomes for the people they serve. We support the Council’s push for stronger health and social services integration both at the point-of-care through Ontario Health Teams and at the system level.

While we welcome the report’s acknowledgment of the important role of wrap-around, community-based primary care, we are concerned about the absence of the health equity lens. The report outlines some of the specific barriers faced by Indigenous, Francophone, racialized and Northern communities, but the need to address these challenges is not reflected in the recommendations.

“The Alliance for Healthier Communities will continue engaging the government as it implements the Council’s recommendations to ensure health equity guides the health system transformation in Ontario. We, in particular, would like to see the requirement to collect socio-demographic and race-based data,” said Tetley. “Only by looking at the segmented data for different populations we can better understand and address the specific needs of various communities across the province. This, in turn, will help achieve better health outcomes for everyone living in Ontario and build a more sustainable health system.”

Media inquiries: Oleksandra Budna 647-278-7926; oleksandra.budna@allianceON.org

Alliance Statement on National Inquiry Report into Missing and Murdered Indigenous Women, Girls and 2SLGBTQQIA people

Date:

Thursday, June 20, 2019

The Alliance for Healthier Communities calls for the immediate implementation of recommendations put forward in the National Inquiry Report into Missing and Murdered Indigenous Women, Girls and 2SLGBTQQIA people, (Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls).

Launched in 2016, the inquiry heard testimony from 2386 people from coast to coast. It centered the voices of Indigenous families who have lost loved ones. It refused to reduce missing and murdered women, girls and 2SLGBTQQIA people to statistics on a page. Instead, the inquiry prioritized the expertise of Indigenous peoples and rigorously examined historic and contemporary contributors to the ongoing crisis. It found that Indigenous women and girls are 12 times more likely to experience violence than their non-Indigenous counterparts. Systemic dehumanization, racism and colonization are behind these disparities. The inquiry concluded that violence against Indigenous women, girls and 2SLGBTQQIA people amounts to genocide. The Alliance supports these findings.

The inquiry report established links between systems, structures and the everyday lived experience of Indigenous women, girls and 2SLGBTQQIA people. It is impossible to talk about the ongoing crisis without talking about access to equitable health services for Indigenous peoples. The inquiry report showed that socioeconomic marginalization compromised the physical, mental, emotional and spiritual health of Indigenous peoples, leading to disparate health outcomes, (including worse mental health outcomes, disproportionate devastation caused by the opioid crisis and heightened exposure to violence).

The national inquiry put forward several health and wellness calls to action, summarized here:

We call upon all governments to ensure that the rights to health and wellness of Indigenous Peoples, and specifically of Indigenous women, girls, and 2SLGBTQQIA people, are recognized and protected on an equitable basis.
We call upon all governments to provide adequate, stable, equitable, and ongoing funding for Indigenous-centred and community-based health and wellness services that are accessible and culturally appropriate, and meet the health and wellness needs of Indigenous women, girls, and 2SLGBTQQIA people.
We call upon all governments to fully support First Nations, Inuit, and Métis communities to call on Elders, Grandmothers, and other Knowledge Keepers to establish community-based trauma-informed programs for survivors of trauma and violence.
We call upon all governments to ensure that all Indigenous communities receive immediate and necessary resources, including funding and support, for the establishment of sustainable, permanent, no-barrier, preventative, accessible, holistic, wraparound services, including mobile trauma and addictions recovery teams.
We call upon all governments to establish culturally competent and responsive crisis response teams in all communities and regions.
We call upon all governments to ensure substantive equality in the funding of services for Indigenous women, girls, and 2SLGBTQQIA people, as well as substantive equality for Indigenous-run health services.
We call upon all governments to provide continual and accessible healing programs and support for all children of missing and murdered Indigenous women, girls, and 2SLGBTQQIA people and their family members.

Systemic discrimination has made race-based and gendered violence towards Indigenous people possible. This is a Canadian crisis and addressing it requires participation from all of us. The Alliance encourages its members to engage deeply with the inquiry findings, recognize the expertise of First Nations, Inuit and Métis people in defining the scope of the crisis and support Indigenous-led solutions. Additionally, the Alliance encourages its members to work towards a paradigm shift that dismantles systemic and structural factors driving inequity experienced by Indigenous people.

The Alliance supports the position that Indigenous health care be planned, designed, developed, delivered and evaluated by Indigenous governed organizations, and urges member centres to work in a manner that honours and respects Indigenous voice, leadership and governance frameworks, and that exemplifies authentic allied relationships.

The Alliance for Healthier Communities is the voice of community-governed primary health care in Ontario. Our members include Community Health Centres, Aboriginal Health Access Centres, Community Family Health Teams and Nurse Practitioner-Led Clinics who together serve approximately 5% of the Ontario population.

Health Centres keen to help deliver new Dental Program for Low-Income Seniors

Date:

Thursday, April 11, 2019

Toronto, April 11, 2019 - The Alliance for Healthier Communities is pleased to see the commitment in the Ontario budget to bring in a dental program for low-income seniors.

“In Ontario, one in five people do not visit a dentist because they cannot afford it. And we know you cannot be truly healthy if you have diseased teeth and gums,” said Adrianna Tetley, CEO of the Alliance for Healthier Communities. “So we welcome this new government dental program for seniors living on low incomes. It’s an important step forward in ensuring access to dental care for all.”

“We are pleased that our advocacy in partnership with the Ontario Oral Health Alliance has helped get oral health care on the government’s health agenda”.

Within the membership of the Alliance for Healthier Communities, 25 Community Health Centres and three Aboriginal Health Access Centres have full treatment dental clinics. Many others are interested in installing a dental suite to serve vulnerable people in their communities.

“Our member Community Health Centres and Aboriginal Health Access Centres are ready and willing, with additional funding, to help deliver the new dental program for seniors. Because Alliance members offer comprehensive primary health care, they can also provide wrap-around services to ensure low income seniors get the care they need – help with transportation, interpretation and connecting them to other health and social services all under one roof,” says Tetley.

Public dental clinics deliver cost-effective services with salaried dental staff working within defined budgets. Over the past four years, four Community Health Centres in eastern Ontario have been providing dental services to adults and seniors on low incomes with funding from the Local Health Integration Network. Evaluation shows a return on investment of 178% as they provide preventive care and treat people who would have otherwise gone to a hospital emergency room.

Budget documents indicate that this new investment in public dental programs for seniors will reduce dental visits to hospital emergency rooms, saving the healthcare system over $38 million annually.

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For further info contact:

Oleksandra Budna

oleksandra.budna@allianceON.org

647-278-7926

Submission to the Standing Committee on Social Policy regarding Bill 74, The People’s Health Care Act

Date:

Tuesday, April 2, 2019

The Alliance for Healthier Communities is the voice of community-governed primary health care in Ontario. Our vision is the best possible health and wellbeing for everyone. Members of the Alliance for Healthier Communities provide team-based health and social services, under one roof and close to home, for Ontario’s most vulnerable residents. Our 106 members include Community Health Centres, Aboriginal Health Access Centres, Community Family Health Teams and Nurse Practitioner-Led Clinics who together serve approximately 5 per cent of the Ontario population.

The Alliance for Healthier Communities shares the government’s interest in strengthening Ontario's health care system and promoting a patient-centred approach. We propose a number of amendments to Bill 74, The People’s Health Care Act, which would help advance a health system that recognizes the myriad of factors that promote health and wellbeing beyond care and treatment.

Read the Alliance's submission to the Standing Committee on Social Policy regarding Bill 74, The People’s Health Care Act

Letter to Minister Elliott regarding decision on consumption treatment services

Date:

Monday, April 1, 2019

April 1, 2019

Hon. Christine ElliottMinister of Health and Long-Term Care10th Floor, Hepburn Block 80 Grosvenor StToronto, ON M7A 1E9

Re: Decision on Consumption Treatment Services

Dear Minister Elliott,

We appreciate the commitment of the provincial government to approve 15 sites to operate Consumption and Treatment Services. However, we are deeply concerned that the government has, without notice or transition plans in place, decided to close several of the 19 currently operating overdose prevention services in the province. Minister, we know you have an expressed commitment to seamless transitions and ensuring no one falls through the cracks. We are calling on you to provide a three-month extension of funding support to allow these sites to develop and implement a transition plan.

Ontario remains gripped in a public health crisis, with an average of 3 people dying every day from drug overdoses and a poisoned drug supply that is not going away. Closing low-barrier health services that support very marginalized populations is extremely disappointing and the implications are alarming given that many people rely on these safe consumption services as part of their strategy to stay alive.Without any transition plan in place, the 15 sites that were approved to continue operating do not have the immediate capacity and/or geographic proximity to the closed sites to take on the influx of clients that will no longer be able to access harm reduction services.The most recent statistics show that over 600 Ontarians died from opioid overdoses in the first six months of 2018. Across the province there is already more demand for supervised consumption services than capacity. We are concerned that other agencies that had planned to open Consumption and Treatment Service (CTS) in communities hard hit by the opioid crisis will not be able to bring these lifesaving services to people dealing with substance use. Minister, we appeal to you to reconsider your decision and approve all existing sites. If you will not allow them to operate, we ask that you support a three-month transition phase. The Province would continue to fund the sites during this period to allow implementation of a transition plan to support a community of clients who have come to rely on these harm reduction services. During this overdose crisis, Ontario needs more services that meet people’s needs in the most low-barrier approach possible, not cuts to services. There are two issues at stake: long-term systems planning to support people dealing with substance use, and saving lives during the immediate public health emergency. We will continue to advocate on both fronts as we provide the supervised consumption and treatment services that we know save lives, connect people to services, improve community safety and save public spending on emergency services.

Yours sincerely,

Mark Aston, Executive Director, Fred Victor Centre, Toronto
Mike Bell, Chief Executive Officer, Kingston Community Health Centres
Denise Brooks, Executive Director, Hamilton Urban Core Community Health Centre
Naini Cloutier, Executive Director, Somerset West Community Health Centre, Ottawa
Dr. Eileen de Villa, Medical Officer of Health, Toronto Public Health
Raechelle Devereaux, Executive Director, Guelph Community Health Centre
Paulos Gebreyesus, Executive Director, Regent Park Community Health Centre, Toronto
David B. Gibson, Executive Director, Sandy Hill Community Health Centre, Ottawa
Juanita Lawson, Chief Executive Officer, NorWest Community Health Centres
Wendy Muckle, Executive Director, Ottawa Inner City Health, Inc.
Kapri Rabin, Executive Director, Street Health, Toronto
Brian Lester, Executive Director, London Regional HIV/AIDS Connection
Lynne Raskin, Chief Executive Officer, South Riverdale Community Health Centre, Toronto
Angela Robertson, Executive Director, Parkdale Queen West Community Health Centre
Bill Sinclair, Executive Director, St. Stephen's Community House, Toronto
Glen Walker, Executive Director, Positive Living Niagara

cc. Bhutila Karpoche, MPP. NDP Critic for Mental Health and Addictions John Fraser, MPP. Liberal Health Critic

Premier rapport du Conseil du premier ministre sur l’amélioration des soins de santé et l’élimination de la médecine de couloir

Date:

Thursday, January 31, 2019

L’Alliance pour des communautés en santé accueille avec satisfaction le premier rapport du Conseil du premier ministre sur l’amélioration des soins de santé et l’élimination de la médecine de couloir.

Une coalition regroupant une centaine de centres de santé communautaires, de cliniques dirigées par du personnel infirmier praticien, de centres d’accès aux services de santé pour les Autochtones et d’équipes de santé familiale régies par la communauté, nous sommes la voix de l’Ontario en faveur de l’équité en santé grâce à des soins primaires complets régis par la communauté.

« Il est judicieux de mettre l’accent non plus sur les hôpitaux et les établissements, mais bien sur les patients et les communautés », a déclaré Adrianna Tetley, PDG de l’Alliance pour des communautés en santé. « Nous sommes heureux d’appuyer le mouvement énoncé dans ce rapport vers un accès équitable aux soins de santé dans diverses communautés; l’accent mis sur la santé mentale, la promotion de la santé, la prévention et les déterminants de la santé; ainsi que les ressources locales globales et les transitions harmonieuses qui donnent la priorité aux patients. »

Dans son premier rapport, le Conseil soutient en particulier les orientations suivantes :

Soins primaires dans la communauté : Les données corroborent la conclusion du Conseil selon laquelle « trop de patients se rendent à l’hôpital pour des pathologies qui pourraient être traitées dans des établissements de soins primaires ou communautaires, ou même faire l’objet d’une prévention. » S’éloigner des couloirs des hôpitaux pour se tourner vers la communauté fournit le type de soins de santé que le rapport du Conseil appelle « recentrés sur la qualité, au lieu de sur les coûts élevés ».

Accès équitable aux soins de santé : Les résultats en santé et en mortalité des Ontariens varient en fonction de facteurs comme la géographie, l’identité de genre, l’orientation sexuelle, la racialisation, la langue et le statut socioéconomique. Nous sommes heureux de constater que le rapport du Conseil reconnaît la nécessité de cibler directement les solutions selon chaque communauté et « tiendra compte des besoins de soins particuliers et des différences culturelles des diverses populations de la province, y compris des Autochtones et des francophones. » Nous continuerons d’insister sur l’importance de prendre des mesures pour répondre aux besoins intersectoriels en matière de santé et de services sociaux des personnes et des communautés racialisées, LGBTQ et des nouveaux arrivants.

Santé mentale, promotion de la santé, prévention et déterminants de la santé : Les professionnels de la santé communautaire conviennent que les soins complets, globaux et axés sur le patient, devraient prendre en compte la santé mentale et « tenir compte de l’incidence des déterminants sociaux de la santé et offrir des interventions en santé plus proactives. »

Coordination des soins : Nous partageons la frustration du Conseil face à « la séparation entre le rôle de coordinateur et les soins de première ligne. » Les membres de l’Alliance sont prêts à intégrer la coordination des soins et la prescription sociale dans les soins primaires, et à favoriser des transitions bienveillantes et efficaces avec des technologies appropriées, afin de soutenir les personnes tout au long de leurs interactions avec les systèmes de services de santé et les services sociaux.

Prestation de services de santé intégrés : Grâce à des partenariats locaux novateurs tels que « Améliorer l’accès aux soins en équipe » (liens entre les médecins non-membres d’une équipe et les équipes interprofessionnelles de soins primaires) pour les clients aux besoins les plus complexes, en particulier en matière de soins de santé mentale et de lutte contre les dépendances – et la prescription sociale (mettre en contact les patients avec des services autres que des services de santé qui favorisent la santé et le bien-être tout en réduisant le recours au système de santé), l’Alliance pour des communautés en santé ouvre la voie à ce que le rapport du Conseil appelle des « exemples d’innovation » et la « collaboration harmonieuse entre équipes pour offrir des services globaux à des patients aux besoins complexes. »

Alors que le Conseil aborde son deuxième rapport et formule des recommandations concernant l’avenir du système de santé de l’Ontario, voici deux principes essentiels à prendre en compte :

La capacité communautaire actuelle est à la fois forte et flexible : Les soins primaires, la santé mentale et les dépendances et les services communautaires ont déjà la capacité de jouer un rôle accru dans les services communautaires, les soins primaires, la prévention et les déterminants de la santé dans la gamme de services de santé de l’Ontario. Des investissements modestes ciblant les résidents de l’Ontario qui se heurtent aux plus grands obstacles à la santé et au bien-être peuvent étayer ce changement nécessaire dans notre environnement de santé publique existant.

La planification basée sur les besoins de la population et la reddition de comptes doivent faire passer les services et les résultats en santé avant la structure et la rationalisation : Partout au Canada, les efforts déployés par d’autres provinces pour régionaliser les systèmes de santé sans intégrer les services au préalable ont échoué. C’est pourquoi l’intégration des services doit précéder l’intégration de la gouvernance afin de garantir que toute consolidation ait lieu dans une direction appropriée et adaptée au contexte local. L’Ontario doit miser sur la bonne volonté et l’énergie des professionnels de la santé de première ligne pour développer les partenariats locaux qui donnent la priorité à la reddition de comptes en ce qui concerne les résultats en santé des patients et de communautés entières – et non d’établissements, de professionnels ou de maladies uniques.

« L’Alliance pour des communautés en santé continuera à interpeller ce gouvernement pour veiller à ce que l’équité en santé, la gouvernance communautaire et les soins primaires complets soient représentés dans les solutions proposées dans le prochain rapport », a déclaré Adrianna Tetley. « Nous devons tous travailler ensemble pour transformer notre système de santé en mettant à l’avant-plan les individus et les collectivités. »

Demandes de renseignements des médias : Oleksandra Budna 647-278-7926; oleksandra.budna@allianceON.org

First Report of the Premier’s Council on Improving Healthcare and Ending Hallway Medicine: Alliance for Healthier Communities welcomes emphasis on shifting to primary health care in community

Date:

Thursday, January 31, 2019

The Alliance for Healthier Communities welcomes the first report of the Premier’s Council on Improving Healthcare and Ending Hallway Medicine.

“Shifting the emphasis in health care from hospitals and institutions to people and communities is the right thing to do,” said Alliance for Healthier Communities CEO Adrianna Tetley. “We are pleased to support this report’s movement toward fair access to health care across diverse communities; a focus on mental health, health promotion, prevention and the determinants of health; and the local wraparound supports and seamless transitions that put people first.”

In particular, the Alliance supports the following directions in the Council’s first report:

Primary health care in community: The data supports the Council’s finding that “too many patients are going to hospitals for conditions that could be treated in primary or community care settings or prevented altogether.” A shift away from hospital hallways and into community provides the kind of health care that the Council report calls “high-value, instead of high-cost.”

Fair access to health care: People living across Ontario have different health and mortality outcomes based on factors including geography, gender identity, sexual orientation, racialization, language and socioeconomic status. We are pleased to see the Council’s report acknowledge the need to directly target solutions to each community, and “consider the unique health care needs and cultural considerations of distinct populations in the province, including, Indigenous people and French-speaking individuals.” We will continue to foreground the importance of action on the intersectional health and social needs of racialized, LGBTQ, and new immigrant individuals and communities.

Mental health, health promotion, prevention and the determinants of health: Community primary health care providers agree that team-based, patient-focused, wraparound care should consider mental health and “the impact of the social determinants of health, and providing more proactive health care interventions.”

Care coordination: We share the Council’s frustration at “the separation between the coordinator role and front-line care.” Alliance members are ready to incorporate care coordination and social prescribing into primary care, and to supporting warm and efficient transitions with appropriate technologies, in order to support people throughout their interactions with the health and social systems.

Integrated health care delivery: Through innovative local partnerships such as “Advancing Access to Team-Based Care" (connecting non-team physicians with interprofessional primary health care team support for their most complex clients, particularly in support of mental health and addictions care) and Social Prescribing (connecting people to non-health services that support their health and wellbeing while reducing health care utilization), the Alliance for Healthier Communities is leading the way on what the Council’s report calls “examples of innovation” and “teams that are working seamlessly together to provide wrap-around services for patients with complex needs.”

As the Council moves into its second report and makes recommendations regarding the future of Ontario’s health system, here are two vital principles for consideration:

Current community capacity is both strong and flexible: Primary care, mental health & addictions and community services already have the capacity to support an increased role for community, primary care, prevention and the determinants of health in Ontario’s health services mix. Modest investments targeted toward the Ontario residents facing the biggest barriers to health and wellbeing can support this necessary shift within our existing public health care environment.

Population needs-based planning and accountability must put service and health outcomes before structure and streamlining: Across Canada, efforts by other provinces to regionalize health systems without first integrating services have universally failed. That’s why service integration must precede governance integration to ensure any consolidation occurs in a locally appropriate and forward-moving direction. Ontario must leverage the good will and energy of front-line health service providers to help develop the local partnerships that put the accountability for health outcomes of whole patients and communities – not institutions, providers or single diseases – first.

“The Alliance for Healthier Communities will continue engaging with this government to ensure that health equity, community governance and comprehensive primary health care are represented in the solutions proposed in the next report,” said Tetley. “We need to all work together to transform our health care system with people and communities at the centre.”

Media inquiries: Oleksandra Budna 647-278-7926; oleksandra.budna@allianceON.org

Spotlight on Healthier Community Builders: How gardens grow community at North Hamilton CHC

Thursday, December 20, 2018

Community Development Worker Andrew Sweetnam says his main job is giving people chances and opportunities to come together, to learn, and to be well.

Healthier Community Builders work in partnership and cooperation with others to create the conditions for everyone to achieve their best possible health and wellbeing. We put the spotlight on these local heroes to bring their work into wider discussions of what it means to build healthier communities. This week, the spotlight is on community gardening at North Hamilton CHC.

When you first enter a group meal and end-of-year celebration of the North Hamilton Community Health Centre gardening group, you might feel like an outsider – for about five seconds. Then someone offers you a plate, and some home-cooked stew, while someone else passes you the bread and butter, and the lady next to you fills your cup. You might be new to this group, but their first message is: you’re welcome here among us. Their second is: What kind of tomato do you like to grow?

Community Development Worker Andrew Sweetnam isn’t about to take credit for the familial atmosphere among the gardening crew he supports.

“My role is a facilitator,” he says. “We initiate the contact people have in groups, but then it’s sort of up to them where they want to go, and how they want to connect. That’s kind of how it should be.”

Many people in the group, he notes, might otherwise be quite isolated, but those who’ve been gardening for a few years have built some strong ties that are sustained beyond the growing season. So while there is some discussion about practicalities for the spring (chief among them the desire for a new wheelbarrow for moving soil and compost to gardeners’ plots), there’s much more discussion about who had the best tomatoes of the season, who has family coming into the city for the holidays, and when they might see each other next.

“We have heard that some of the gardeners who are alone over the holidays, a group of them come together to have a meal together, outside of the garden group and the CHC,” Sweetnam says. “A lot of them have become good friends from meeting and working together in the gardens. That’s the best outcome we could hope for.”

And in terms of outcomes, Sweetnam and other Community Health Workers across Ontario know that gardens are one of the best and most cost-efficient ways to get people thinking more deeply about their diets and health. In fact, research has shown that there may be "measurable impacts on BMI" over time, helping people to battle obesity, among other health and social benefits. Community gardening may also help reduce food insecurity as well as strengthen relationships, according to other research from the U.S.

In his work at North Hamilton CHC, Sweetnam is always looking for ways to enhance the experiences of participants in programs like the gardening group. One of his latest involved seniors getting together in the CHC’s greenhouse space for a mindfulness and growing workshop. A little different from community gardening, this program focused on getting people in touch with the food they eat. Getting the group to think about what they consume -- and supporting those efforts through workshops with dietitians, and mindfulness activities such as drying herbs and making tea with them -- puts people in a better position to take control of their diets, Sweetnam says. Through shared meals, too, people who were isolated have chances to connect and share their experiences of eating healthy (and its challenges) with those around them.

Taking control of diet and eating healthy are important factors for many of the CHC’s clients who are living with multiple chronic conditions. Groups and workshops like the ones that Sweetnam facilitates give people a chance to take control of their own health and achieve their best possible wellbeing. It’s the Model of Health and Wellbeing in action.

“It’s more than just sharing seeds and plants,” Sweetnam says. “It’s also sharing a healthy lifestyle, sharing stories, sharing meals. The number one reason people come out, though, isn’t for the food. They come out to be with others, to make friends, to find a place where they belong.”

Le Centre de santé communautaire de Sudbury-Est ouvre la voie aux centres francophones utilisant Purkinje dans la transition du DME vers TELUS PS Suite

Wednesday, December 12, 2018

Être le premier centre entièrement bilingue mis en ligne sur TELUS PS Suite est un exploit de taille. Pourtant, même s’il s’agit d’un centre de taille modeste, disposant de moins de ressources, le Centre de santé communautaire de Sudbury-Est (SECSC) était plus que prêt pour la transition. Le SECSC a également la distinction d’être le premier centre à passer de Purkinje à TELUS PS Suite. Nous nous entretenons avec le directeur général, Michel Mayer, de la mise en œuvre et des expériences de la mise en ligne dans son centre.

Commençant sur une note très positive, M. Mayer déclare sans ambages : « Le fournisseur [TELUS] était très impliqué et a investi pour aider le SECSC à réussir pendant tout le processus de migration et de mise en œuvre. Cependant, il y avait et il y a toujours des domaines importants qui nécessitent des améliorations. » Vous trouverez ci-dessous certaines des préoccupations et recommandations de M. Mayer.

Durée – Une mise en œuvre de près de 13 mois a maintenu le centre dans un état de mutation continue. Bien que les gens aient compris en général que cela était dû à la première migration d’un Centre de santé communautaire de Purkinje vers PS Suite, maintenir la concentration et l’engagement du personnel était un défi permanent. M. Mayer espère que les leçons tirées de la migration aideront le fournisseur à réduire la durée de l’exercice dans les autres centres qui possèdent Purkinje.

Migration de données – La complexité de la migration des données d’un DME à un autre a été rendue plus difficile par le manque de coopération du fournisseur précédent au tout début de la migration. Heureusement, cette situation a fini par s’améliorer. M. Mayer précise que le succès dépendait de la contribution des deux fournisseurs et recommande que les centres qui ont encore Purkinje insistent sur cette attente dès le début du processus.

Validation des données – Le SECSC continue de se débattre avec des problèmes de qualité des données dans le nouveau DME. Les valideurs de données ont fait face à de nombreux défis, notamment une compréhension insuffisante du nouveau système. Certaines données de Purkinje n’ont pas été facilement transférées vers PS Suite et le centre a dû lancer un processus de nettoyage des dossiers. Ils estiment que cela prendra environ neuf mois. Il est recommandé de commencer à travailler maintenant sur la correction des données dans le DME existant.

Hardware/Software and Internet InfrastructureInfrastructure matérielle/logicielle et Internet – Dans le cadre de la mise en œuvre de Nightingale on Demand, les centres devaient procéder à un inventaire complet et à l’analyse de leur infrastructure matérielle, logicielle et Internet. L’ancien DME de Purkinje était installé localement dans chaque centre et la modification vers la version nuagique (ASP) du DME de PSS était importante. Pour le SECSC, il s’agissait d’un tout nouveau processus. Comprendre les exigences matérielles et d’infrastructure Internet requises pour accéder au DME et s’assurer qu’il répondait aux normes optimales au chapitre de la bande passante, de la confidentialité et de la sécurité était essentiel à la réussite de l’entreprise. M. Mayer recommande aux centres de démarrer le processus d’infrastructure matérielle/logicielle et Internet le plus rapidement possible.

Gestion du changement – La gestion du changement était un sujet de préoccupation majeure. M. Mayer cite plusieurs domaines auxquels tous les centres devraient accorder une attention particulière :

Rôles – Comme le recommandait le CSC de South Riverdale, il était très important de définir clairement les rôles et responsabilités du personnel de l’équipe de mise en œuvre. Les petits centres disposant de moins de ressources pourraient se trouver débordés.
Flux de travail – Le centre n’a pas eu l’impression que suffisamment de temps a été consacré aux flux de travail et à aider les utilisateurs à comprendre comment leur flux de travail existant serait modifié ou disparaîtrait. Ils ont également estimé que le fournisseur ne comprenait pas bien les CSC et leur fonctionnement. De plus, le fournisseur n’a pas compris ni expliqué clairement le bien-fondé des modèles standardisés de l’Alliance et leur utilisation, ce qui a créé une certaine confusion après la mise en ligne.
Formation – La formation n’était pas axée sur les CSC et a donc omis plusieurs éléments clés. Le formateur n’a pas pu traiter de domaines importants des flux de travail, de l’utilisation de formulaires électroniques et d’autres fonctionnalités propres aux CSC. En l’absence de corrélation directe avec leur propre travail, certains membres du personnel n’ont pas été en mesure d’internaliser correctement la formation.
Soutien – Après la mise en ligne, le soutien, y compris les groupes d’apprentissage et les super utilisateurs, ont été des éléments très importants pour la capacité du personnel à effectuer son travail.

M. Mayer félicite le personnel du SECSC pour le travail effectué sur ce projet, affirmant sans équivoque que sans leur dévouement infatigable et déterminé, la mise en œuvre n’aurait jamais abouti. Nous tenons à exprimer notre sincère gratitude à tous les membres du Centre de santé communautaire de Sudbury-Est pour leur diligence, leur travail acharné et leur engagement à réussir cette transition.