William Osler Health System (Osler) serves one of the most diverse and fastest growing communities in Canada.  Diversity adds richness and value to communities whether it's race, ethnicity, language, religion, sexual orientation, gender, age, physical or mental health, educational background, socio-economic status, literacy or any of the other dimensions that make us unique and diverse.  However, in health care, national and international studies have shown that one's diversity can result in inequities, disparities, risks and barriers to safe and quality care, and negative health outcomes for vulnerable and disadvantaged patients.

Ethno-cultural and other minority populations endure stress due to external factors (such as settlement in a new country, language barriers, systematic barriers and racism) and recent immigrants from non-European countries are twice as likely as Canadian-born residents to report deterioration in their health over an eight year period. (Central West LHIN’s Health Equity Environmental Scan 2011 and Census 2006).

The neighbourhoods surrounding Osler's Brampton Civic Hospital (BCH) and Etobicoke General Hospital (EGH) have some of the highest proportions of newcomers, visible minorities, seniors, low-income individuals and people with limited English proficiency.  Factors such as these acts as barriers in accessing safe and quality care and can result in negative health outcomes.  Language/religious accommodation needs/cultural practices and a lower means of income can deter individuals from accessing preventive health care.

One of Health Equity & Inclusion at Osler's goals has been to introduce and leverage Clinical and Community Partnerships.  Formal partnerships with community organizations that serve newcomers, low-income populations, seniors, individuals with hearing or vision difficulties, offer language and culturally appropriate day programs for those with chronic disabilities, etc. have enabled Osler's Discharge Planners and Social Workers to facilitate discharges to more appropriate supports in the community.  Recreation and Occupational Therapists are able to provide language and culturally appropriate tools and resources including books and religious music.  Memoranda of Understanding have been developed collaboratively and in agreement with community partners.  Staff from these community partners have committed to setting aside time on a weekly basis to be on-site/accessible at BCH and EGH to provide a wide array of services to disadvantaged patients, families, staff and physicians.

Activities and services include:

• Supporting Staff Serving Newcomers via Settlement Workers: Settlement Staff from Brampton Multicultural Centre (BMC) and Polycultural Immigrant and Community Services (Polycultural) are on-site at BCH and EGH to provide support, advice and referrals to newcomer patients and families as well as staff.

• Linking Patients to Community Programs: India Rainbow Community Services of Peel (IRCS) provides on-site information once a week to individuals requiring their services. This organization offers unique language and culturally appropriate services such as Day Programs for South Asians with chronic disabilities and Alzheimer’s.

• Building Bridges with Community Health Centres: In 2015 and early 2016, Rexdale Community Health Centre (RCHC) and Bramalea Community Health Centre (BCHC) began offering on-site consultations and referrals to programs available through their respective organizations. Community Health Centres provide health services to refugees, newcomers, low income, insecurely housed and uninsured individuals in the community all of whom who may have difficulty navigating the Canadian health system. Community Health Centre staff are also available to provide guidance to newcomers who need to sign up for an OHIP card or to secure a family doctor.

• Post-Discharge Partnership for Isolated Seniors and Newcomers: This partnership is in collaboration with Polycultural and was launched in May 2016. It aims to fill the gaps in care for patients who may be ready for discharge and who are isolated seniors or newcomers to Canada with complex health needs and/or face language or cultural barriers.

The impacts of the partnerships have been substantial – regular tracking, monitoring and evaluation have shown faster discharges, reduced readmissions to the hospital and reduced unnecessary repeat Emergency Department visits.  The community partners have been able to provide more appropriate supports and services to patients upon discharge and for a longer period of time.

This has improved the patient experience and satisfaction, access and flow due to the reduction in unnecessary admissions/readmissions and better self-management of illness and disease. The partnerships have also resulted in improved staff satisfaction and a reduction in barriers to care for vulnerable populations.

Contact Information:

Title: Regional Director – Health Equity & Inclusion

Contact email: gurwinder.gill@williamoslerhs.ca

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