Aboriginal Patient Navigator Program

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1 Aboriginal Patient Navigator Program An Integrated Approach to Healthcare Katie Dicker Terri Jean Murray

2 NL Population 514,000

3 4 Regional Health Authorities Labrador Grenfell Health Western Health Central Health Eastern Health

4 Eastern Health NL largest integrated health authority Regional population 290, 000 Full continuum of health and community services Tertiary health care for province

5 Aboriginal Groups Innu Nation Communities/Population Natuashish: 900 Sheshatshiu: 1, 700 Inuit Communities/Population 5 coastal communities: Nain to Rigolet Population: 7,000

6 NunatuKavut Community/Population Happy Valley-Goose Bay, southeast coast and interior waterways of Labrador: 6,000 Mi Kmaq Community/Population Miawpukek First Nation: Conne River, 900 (1, 900 off reserve) Qalipu Mi kmaq First Nation: Landless Band, 25,000

7 Aboriginal Health NL Research studies: Building Bridges (2002) Report on Cultural Sensitivity (2005) Needs Identified: Language interpretation services Dietary needs Signage Communication Patient education/orientation Follow-up care

8 Historical Context 2004: National Aboriginal Leaders and First Ministers established Aboriginal Health Transition Fund (AHTF) 2005/06: AHTF initiated million over 5 years 2008: Eastern Health (EH) submitted proposal to AHTF for Aboriginal Patient Navigator (APN) Program 2009: APN Program implemented in partnership with St. John s Native Friendship Center (SJNFC)

9 AHTF Intended Goals /Outcomes Improved integration of federal, provincial, territorial health services Improved access to health services Better suited health services to Aboriginal peoples Increased participation of Aboriginal peoples in the design, delivery, and evaluation of health programs and services

10 APN Program: Planning & Implementation Consulted Aboriginal Groups on program design Established Advisory Committee with Aboriginal Groups and other key stakeholders Recruited APN Developed training program for APN Established communication plan for APN program

11 APN Program Objectives Provide interpretative services Educate healthcare staff on Aboriginal issues and cultural sensitivity Minimize stress for Aboriginal patients travelling to urban centers Raise awareness of cultural differences, practices and traditions Enhance coordination of aftercare Implement a sustainable APN project

12 APN Program: Key Services Navigation to appointments Interpretative services Assistance with transportation and accommodations Discharge planning Liaising with internal/external agencies Education and information

13 Networks and Partnerships Health Care Professionals Shanawdithit Shelter SJNFC Youth Center Memorial University of Newfoundland Salvation Army Red Cross Innu Band Councils, Nunatsiavut Government, Miawpukek First Nation, Qalipu First Nation and NunatuKavut

14 APN Program: Initiatives Education/Orientation sessions for Eastern Health staff H1N1 Pandemic Planning Bell Canada for calling cards Medical Lexicon in partnership with MUN Aboriginal Diversity Awareness

15 Aboriginal Patient Navigator Program Client Experiences

16 Claudia Sheshatshiu, NL

17 Silpa Postville, NL

18 Nakummek ilitsinut suliakagitse tamane. Ikajugatse inukatinet. Pitsiagusuagitse. Thank you both for working here, because you are helping your people. Keep doing the best you can.

19 The APN would go to a lot of my Physio appointments and see the progress I was making, always light up and let me know how great I was doing. The APN also attended my doctor s appointments, to give my husband a break, she could see the toll this was having on him. She kept up with her visits at the hospital and doctor s appointments, there were days that I would wonder how she did it at all!

20 APN Evaluation Process Axis Consulting (2010) Literature Review/Web Search Initial Evaluation Consultation Session Key Informant Interviews Survey Patient Interviews

21 APN Program Outcomes Effective in achieving objectives 85.7% believed APN program minimized stress/anxiety 64% believed program enhanced coordination of aftercare 57% believed program raised awareness in cultural differences, practices and traditions Need for continuation of APN program

22 APN Program Recommendations Continue to focus on original objectives Improve accountability structure Enhance data tracking and reporting procedures Ensure privacy and confidentiality policies maintained Improve translation and interpretation services Develop formal agreements with Aboriginal communities and governments Enhance navigation services in the community Promote APN services

23 APN Program: Challenges Funding Geographic barriers Staff changes

24 APN Program: Sustainability One year pilot program funded by AHTF Currently funded on a contractual basis by DOHCS Sustainability plan in place pending funding Assisted approximately 1500 Aboriginal patients Priority for all stakeholders: EH, DOHCS, Aboriginal Governments and SJNFC

25 Thank you Questions Comments Discussion

Making an Official Referral/Report in Newfoundland and Labrador

Appendix 2 Making an Official Referral/Report in Newfoundland and Labrador What s In This Chapter: This appendix provides contact info to: Assist an Abused Senior to Obtain Services from their Regional