Client Assistance

Description

Staff members at the Health and Wellness Centre are often the ‘first contact’ for community members who need to use Health and Wellness Centre services.
Their goal is to provide community members with the help they need in a caring, warm and supportive way. As professionals, they are trained to respect the need for confidentiality, both inside and outside the building.

Challenges and Priorities

The Health and Wellness Centre has been going through an almost continuous period of growth and change for the past 10 years. This has placed pressure on staff to maintain a client-centered focus while still dealing constructively with all of the changes and their effects.
The main challenge is to continue to provide outstanding service to our clients while those changes are happening in the background.
As a result, a top priority is to listen carefully to Health and Wellness Centre clients and to ask for their feedback in a systematic, anonymous and objective way.

Range of Services

• Medical transportation
• NIHB forms
• Client advocacy
• Bulletin boards
• Client reception
• Appointment scheduling
• Medical referrals
• Facility tours

Cultural Spritituality

Challenges and Priorities

The challenge in this area is suiting the services to community needs. Traditions provide one route to healing and health, but not everyone is willing or ready to use this path, and for some it is not relevant.
We must be sensitive to what community members are saying to us about this. Traditional culture and spirituality are a gift for healing. Our priorities in this area are to remain open and to listen well.

Description

The Medicine Wheel teaches that all aspects of our lives and our community must be in balance in order for us to be healthy. The Health and Wellness Centre is committed to restoring a healthy balance in Elsipogtog.
The spiritual aspect of health is central. Individual spirituality and our connection to the Creator are celebrated and explored through teachings, ceremonies, traditional medicines, language and history.
This effort has received guidance from the Wellness Committee. This group is building a framework that will have many community-based programs working together to improve the social and cultural conditions that affect health.

Range of Services

Developmental Services

Description

Developmental Services is a term that has been given to a series of efforts to provide cohesion to community development and program development efforts that have the potential to have a dramatic impact on the health of the community.
The health needs of First Nations communities are more complex and, at times, fundamentally different than those of non-native communities. The Provincial health care system is focused on high-level prevention and intervention for individuals who are physically unhealthy. First Nations communities must first deal with collective and social health issues before they can make major inroads into physical health problems.
Additionally, First Nations have, and need, a much more wholistic approach which deals actively with spiritual, emotional and mental health problems and seeks to restore a balance among them. As well, families, friends and neighbours are an important part of the wellness and healing processes, much more so than in the rest of Canadian society.
Since the health care system does not see these needs as priorities, First Nations must develop their own, more meaningful services if they are to deal effectively with these needs. This can, and often does, include adapting mainstream services to reflect the cultural and social realities in First Nations communities.
Developmental Services is attempting to address this situation by developing and coordinating innovative, evidence-based programs and services that will work well for First Nations. To date, it has included pioneering efforts in:

• healing from past, historical losses and abuses
• restorative justice, victim’s assistance and preventative community policing
• youth mental health
• addictions treatment and recovery
• involvement of elders, families and others in treatment, and
• adaptation of mainstream services to include culturally meaningful aspects such as traditional approaches to health and healing.

It is important to note that none of these efforts current has sustainable funding. They are not part of the core services from the HSTA (although some discretionary resources can be used in an emergency). Instead, they have been developed over the years since the beginning of the suicide crisis in 1992 by applying for non-renewable term project dollars over and over again. Gradually, these projects have led to a coordinated and cohesive group of programs which are continuing to address some of the root causes of illness in Elsipogtog.
The cycle of non-sustained funding has taken its toll on staff and those who depend on the services which are being offered, but much ground has been gained and many skeptics have been won over. Even those who have fought this battle from the beginning are optimistic about the future and energized by recent developments.

Administrative and Support Services

Administrative Support

Description

This program area emphasizes communication and helping staff members to do their work efficiently. It provides overall Health and Wellness Centre support by managing several areas of operations:

• coordination of staff activities
• accountability
• facility management
• logistics for special events
• information gathering and use
• negotiations for resources and support
• liaisons with Chief and Council, Agencies, partners and Governments
• communication with community members, and
• reporting.

Challenges and Priorities

The main challenge for Administration is to coordinate staff activities to maximize efficiency, without taking away from creativity or the accountability of the EHWC to community members. The priority will be to continue to make administrative decisions that are focused on the needs of community members (i.e., not taking an administratively “easy way out”).

Range of Services

Community Relations

Description

Community Relations is a series of organized efforts to develop a common sense of vision, trust, awareness and support for the Health and Wellness Centre’s activities among community members.
In a similar way, these efforts are designed to develop a strong sense of awareness, sensitivity and commitment by the health staff to the needs and wishes of community members.

Challenges and Priorities

The Health and Wellness Centre is focused on and driven by community needs. Relations with the community must be mutually honest, respectful and open if Health and Wellness services are to be effective.
The challenge is to convince community members, many of whom are skeptical, wounded or detached, that the Health and Wellness Centre is sensitive and responsive to their needs.
The priority must always be to have transparent, open operations and a real commitment to two-way communication.

Range of Services

Every program area and health service is tied to building positive community relations. However, some are especially aimed at this area. These include:
• community surveys
• Open House
• staff participation in community events
• newspaper articles and calendar
• bulletin board
• public forums and workshops
• reporting

Every program area and health service is tied to building positive community relations. However, some are especially aimed at this area. These include:
• community surveys
• Open House
• staff participation in community events
• newspaper articles and calendar
• bulletin board
• public forums and workshops
• reporting

Staff Support

Description

This area provides support, guidance and development opportunities to members of the health staff. Managers and supervisors ensure that staff members have the skills, tools and guidance which they need to perform at their very best. This is done through planning, training, and team building.
Policies and procedures provide a framework that shows how the EHWC should work. Activities are guided by the Community Health Plan. Knowledge Management provides staff with important and meaningful program knowledge when they need it.
Each staff member develops annual workplans that are used to keep everyone on track. Staff meetings and social activities build team spirit and morale and also provide a way to share important information.
Staff wellness activities ensure that staff are energized, productive and able to handle the demands of their jobs. Morale is kept up through respect, support and recognition of staff members.
Personal and professional development are assisted through training plans, workshops and regular performance evaluations.

Challenges and Priorities

The Health and Wellness Centre has been going through an almost continuous period of growth and change for the past 10 years. This has placed a great demand on staff to develop new knowledge and skills, as well as personal strengths to deal constructively with all of the changes and their effects.
The main challenge in this area is to remain aware of, and responsive to, the personal and professional needs of staff members.
As a result, a priority must be to maintain and enhance the wellness of the front line staff who provide the first contact with Health and Wellness clients, as well as the support staff who assist them in their work. Supervisors and coordinators will be provided with the training to develop the attitudes, skills, knowledge and tools to do this effectively.

Range of Services

Partnerships

Description

Administrative staff are involved in the development and use of partnerships. This is an area that does not receive a lot of exposure, but it is very important to the success of the Health and Wellness Centre. Partnerships, if used properly, provide extra “leverage.” By being able to share the tools and expertise of the partners, the Health and Wellness Centre is then able to do more than it could without them. Partners come from both inside Elsipogtog and from outside. By looking at the lists on this page, the reader can see how much care has been taken to build useful and lasting relationships with partners.

Challenges and Priorities

The Elsipogtog Health and Wellness Centre must try to understand the needs, capacities and limits of potential partners, and how they can benefit the community.
In the current business and political climates there are tremendous opportunities for leveraged help from alliances. However, these need to be approached carefully and in the knowledge that advances in community health will need many years of good, mutually-beneficial partnerships.
The priority will have to be on establishing partnerships with institutions, governments and agencies which understand and are supportive of the long-term health needs of the community.

Range of Partnerships

Primary Health Care Integration

Description

The Integrated Primary Health Care Project (IPHCP) was a pilot project that built upon a highly successful Transition Fund project. This was the Eskasoni primary care project, with its four-party collaboration among a large First Nation community, the province, FNIH and a university medical facility.
The Elsipogtog approach is based on a collaborative, inter-professional team of primary health care professionals that integrates primary medical care (i.e. care provided mainly by physicians) with community health programs (such as public health, home care, prenatal care and diabetes care services). This involves the recruitment of a team of professionals who are committed to collaborative practice (eg. physicians, nurses, health educators, nutritionists and pharmacists, etc.) to provide comprehensive and cohesive services with an emphasis on mental health, health promotion and disease prevention.

By implementing a collaborative practice model we can address current service gaps and overlaps, improve access to primary health care services, and enhance the quality of care provided to our clients.
There is also another level to integration. Federally funded programs lack co-ordination and integration with primary health care services from the BRHA. Support is required to make the transition to a system where service providers (whether employed by the community or province) collaborate in the care of our high-needs population, with a special focus on mental health, health promotion and disease prevention.
This approach meets community priorities and lessens the burden on other health care services. A successful model of integration, with a particular emphasis on mental health, will be promoted to other Mi’kmaq communities in the Atlantic region and may serve as a model in other FN communities across the country.

Challenges and Priorities

A principal challenge in the project will be to ensure that all key personnel see “the big picture” and are comfortable with their respective roles in it. The priorities should be maintaining organizational effectiveness and basing decisions on evidence.

Range of Services

The IPHCP Legacy

The IPHCP re-examined the delivery of primary health care services, looking for ways to help to address alarmingly negative trends in health status indicators among First Nations. Its main focus was to look for approaches to align community-based and external services.
The Project revealed important barriers in terms of the ability of First Nations to:

• access culturally relevant data about their respective communities, and
• participate in a meaningful way within the health care delivery system.
This led to evidence-based findings and best practices (adapted for FN realities) in the areas of:
• service content, and
• service delivery.
These findings have led to strategic initiatives to prepare the EHWC for future developments. Specifically, work is being done in the areas of:
• organization development, and
• capacity building.

It is expected that this preparation will provide compelling evidence for partners, in a language that is meaningful to them, that will lead to enhanced sustainability for HIM and related processes.

EHWC Commitments from the IPHCP

A lasting result of the IPHCP is that the EHWC has committed itself to specific approaches, based on the evidence collected from the project and extensive vetting of the findings with staff and focus groups. These legacy commitments, and how they express themselves in operations, are outlined in the Table to the right.
In the context of Health Information Management, these commitments have laid an excellent foundation for IT integration and HIM best practices by increasing the EHWC’s capacity to use mainstream business processes in a culturally appropriate way.

Infrastructure

Description

The term ‘infrastructure’ refers to the more-or-less-permanent resources that the Health and Wellness Centre has available to it. These include:
• the Program’s core funding
• facilities, including the EHWC
• technologies (hardware and software) for computing and telecommunications
• human resources, including staff members and volunteers
• ‘staff capacity,’ or the collective skills and knowledge of the staff members, and
• partnerships, both internal and external
Infrastructure is often taken for granted as a support system, since its weaknesses only become evident during challenging times or periods of change. A strong and adaptable infrastructure is an important aspect of successful organizations. As a result, infrastructure planning is necessary when preparing for growth and expansion.

Selected Aspects of Infrastructure

Health Information Management

Description

Knowledge management (KM) refers to the way in which important information is gathered, examined and used. It is called KM to strengthen the message that the EHWC is constantly learning and making decisions, and needs to do this in a systematic and responsible way.
For the EHWC, KM consists of 7 key elements:
• assessing the needs, opinions and experiences of community members
• sharing and discussing this information as a group
• making decisions about how to use the information
• turning information into guides for action (plans, etc.)
• making decisions about when and how to act
• measuring the effectiveness of program activities, and
• reporting to the community, getting their reaction.

Challenges and Priorities

Information is critical to running effective programs. The types of information that are needed include:
• the needs and wishes of community members
• the reasons why some programs and services work well and others don’t, and
• technical information about health areas.
In order to manage this information, staff members need a good system. The EHWC’s information management system (IMS) has grown greatly over the past few years. Challenges and priorities include:
• enabling staff to access needed information
• encouraging staff to use the IMS effectively, and
• remaining current with information technologies.
In 2008 and beyond, these will be addressed systematically, thanks to the progress made during the recent Health Information Management (HIM) Project. EHWC expects to sign agreements with FNIH for projects in community health surveillance and the development of a client registry in 2008. Possible HIM projects with NBDoH are also under discussion.

Range of Services