Social accountability in practice: Breathing and weaving together to build relationships and transform rural health services
Social Innovations Journal
Authors: Ray Markham, Scott Graham, Megan Hunt, Georgia Betkus, Bob Woollard, David Snadden, Daniel Harper, Kim Williams
Publication Date: August 2022
Rural and First Nations populations bring valuable lived experiences and perspectives to health reform efforts that serve as a powerful form of specialized insight and grassroots knowledge. To address the issue of inadequate and inconsistent inclusion of these populations in health reform planning and decision-making processes in British Columbia, Canada, the Rural Coordination Centre of BC (RCCbc) has adopted Boelen’s (World Health Organization 2000) Partnership Pentagram model for socially accountable health systems. This article illustrates Markham and colleagues’ (2021)innovative adaptation of the model—the Partnership Pentagram Plus (PP+)—in practice, through the design and delivery of a provincial-level dialogue and deliberation gathering that centered rural and First Nations voices for health system change. In doing so, it highlights four key features: Co-creation, Honouring Indigenous Ways of Knowing and Being, Appreciative Inquiry, and ‘Breathing and Weaving’. It also reports on the key outcomes of the meeting: relationship formation and long-term commitments to change.
Physician wellness: Doctors taking care of doctors
BC Medical Journal
Authors: Ahmer Karimuddin, Alan Ruddiman
Publication Date: December 2021
The four Joint Collaborative Committees (JCCs), a partnership of Doctors of BC and the BC government, work collaboratively to lead system change. The committees—General Practice Services Committee, Specialist Services Committee, Shared Care Committee, and the Joint Standing Committee on Rural Issues—are unique partnerships in Canada. Physicians partner with government and work closely with health authorities to make system change while strengthening the role of physicians as leaders in innovation at provincial, regional, and community levels … Through the JCCs, physicians continue to lead a spectrum of quality improvement initiatives to energize and stimulate better practice environments for other physicians.
Addressing rural and Indigenous health inequities in Canada through socially accountable health partnerships
BMJ Open
Authors: Ray Markham, Megan Hunt, Robert Woollard, Nelly Oelke, David Snadden, Roger Strasser, Georgia Betkus, Scott Graham
Publication Date: November 2021
There are few examples of the practical application of the concepts of social accountability, as defined by the World Bank and World Health Organization, to health system change. This paper describes a robust approach led by First Nations Health Authority and the Rural Coordination Centre of British Columbia … Our innovative approach uses social accountability engagement to counteract persistent health inequities. This involves an adaptation of the Boelen Health Partnership model (policymakers, health administrators, health professionals, academics and community members) extended by addition of linked sectors (e.g., industry and not-for-profits) to the ‘Partnership Pentagram Plus’. We used appreciative inquiry and deliberative dialogue focused on the rural scale and integrating Indigenous ways of knowing along with western scientific traditions (‘two-eyed seeing’) … to bring about practical and positive change to rural and Indigenous communities.
Building point-of-care ultrasound capacity in rural emergency departments: An educational innovation
Canadian Journal of Rural Medicine
Authors: Kathryn Young, Nicole Moon, Tandi Wilkinson
Publication Date: October 2021
Point-of-care ultrasound (POCUS) use is the standard of care in emergency medicine (EM), but rural physicians face barriers to obtaining and retaining this skill and cite low confidence in their use of POCUS. Without access to high-quality educational opportunities, this important clinical tool may not be used to its full potential in rural hospitals. The Hands-On Ultrasound Education (HOUSE) programme, launched in 2015 by the University of British Columbia’s (BC) Division of Rural Continuing Professional Development, is a rurally focused POCUS training and education programme that travels to rural and remote communities and aims to build a rural POCUS community of practice within BC. This study presents and evaluates the HOUSE programme.
How can rural community-engaged health services planning achieve sustainable healthcare system changes?
BMJ Open
Authors: Campbell Stuart Johnston, Erika Belanger, Krystal Wong, David Snadden
Publication date: October 2021
The objectives of the Rural Site Visit Project (SV Project) were to develop a successful model for engaging all 201 communities in rural British Columbia, Canada, build relationships and gather data about community healthcare issues to help modify existing rural healthcare programs and inform government rural healthcare policy … The SV Project appears to be unique in that it is physician led, prioritises relationships, engages all of the healthcare partners singly and jointly in each community, is ongoing, provides feedback to both the policy makers and all interviewees on a 6-monthly basis and, by virtue of its large scope, has the ability to produce interim reports that have helped inform system change.
Exploring health coaching and mindfulness as levers for transformation in health: stakeholder perspectives
Family Practice
Authors: Rahul K Gupta, Maureen Mayhew, Robert Woollard, Karen Gelb
Publication date: September 2021
Health coaching (HC) and mindfulness (MFN) are proven patient-centered interventions for mobilizing patients’ inner resources and changing the trajectories of many chronic physical and psychological conditions. However, though widely available in the private sector, they have been slow to find their way into public primary care in Canada. Since 2015, a rural medical community in British Columbia, Canada, has integrated physician-led HC and MFN-based programs into primary care. This exploratory study aimed to understand how these programs are working to help both patients and clinicians, providing insights that other communities might use.
Evaluating delays for emergent CT scans from a rural British Columbia hospital
Canadian Journal for Emergency Medicine
Authors: Adam Watchorn, Jason Curran, Zoe Evans, Vanessa Wong
Publication date: September 2021
Timely access to a CT scan is critical to diagnose and triage patients with life-threatening illnesses. In British Columbia, only 3 percent of rural hospitals have access to a local CT scanner, and patients in these communities must often be transferred hundreds of kilometres away for emergent imaging. This prospective cohort study investigates how many transfers from Golden and District Hospital were for CT scans over a one-year time period, and describes the time delays to emergent CT imaging.
