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Community engagement key to IT healthcare delivery

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An ongoing project to ensure First Nation community residents in Alberta receive timely client assessments has had a surprising spin-off: better data.

Every Albertan seeking placement in a provincial supportive living or long-term care facility requires an InterRAI placement assessment, but delays with some aspects of implementation meant Home Care clients on-reserve were experiencing wait times of up to 18 months while most Albertans have a significantly shorter wait time.

Health Canada’s First Nations and Inuit Health Branch – Alberta Region (FNIHB-AB) became aware of the significant delays in 2007 on the heels of InterRAI becoming the provincial standard. First Nations community health centres were not using the InterRAI system, while Alberta Health Services nurses were required to travel to remote First Nations communities to perform assessments. The co-ordination between the two health authorities would take weeks, sometimes months, which meant there was a clear inequity in terms of access to health services.

“We knew there had to be some other option,” said Lorene Weigelt, senior officer with Health Canada. The obvious solution was to implement the InterRAI system and tools in the health centres on reserves so that community nurses could complete the assessments on site, share the results with the provincial facility, and reduce wait times overall.

The project was very much a partnership, as First Nation communities in Alberta took a lead role in moving it forward. FNIHB-AB played the coordinating role and sought out communities that would be willing to participate in the pilot project.

The first step was to assess the process needed to work with the provincial system, with the ultimate goal of achieving seamless service delivery on and off reserve. “We had to have their engagement,” Weigelt said. “It needed to be community led.”

Beyond improving assessment access for First Nation community residents, Weigelt said there were some other broader goals, including improved co-ordination of care and more consistent documentation, as well as compatibility with the overall health care system to allow for a seamless client transition between home and healthcare facility.

“From an actual logistics and technological perspective, the biggest challenge was getting nurses working in real time in client homes in remote, isolated communities,” said Weigelt. “The answer was software that could support an asynchronous connection. Assessments are done on a laptop in the home and the information gathered can be synched at a later date.

For the 24 of 46 communities that have been completed, the solution has drastically reduced the time for assessment to care.    The success of the project speaks to the power of collaboration and partnership, ” noted Weigelt.