Equitable services improve outcomes
Producing equitable services improves outcomes.
Inequities are commonly a marker of poor health system quality and performance. In addition, clients' assessments of the care services they received are often based on their interactions and recovery outcomes (Bathija & Reynolds, 2019).
Featured resource: Age Friendly Health Systems
The Age Friendly Health Systems movement is a good example for a collaborative, equitably driven approach to improve outcomes and patient satisfaction, and reduce cost. The initiative uses the 4Ms Framework – What Matters, Medication, Mentation and Mobility. There were measurable improvements in patient experiences, patient outcomes and reduced costs per patient as a result of this initiative.
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Equitable services improve satisfaction.
Producing equitable services improves client satisfaction.
Equitable client experiences promote satisfaction and lead to better outcomes and lower costs. Improving the equity of client experiences starts at the top where leaders need to act as champions to promote equity. At the individual level, staff must acknowledge the variety of needs for each client, and how biases and perceptions could impact their trust relationship with clients and the formulation of conflicting cultural beliefs.
This is why staff cross-cultural and health equity training is critical, along with providing essential services, such as professional medical interpreter services (Bathija & Reynolds, 2019).
Practice from the field: Mosaic Refugee Health Clinic, Calgary, Alberta
This organization is improving client satisfaction.
Text by Dr. Annalee Coakley, Medical Director, Mosaic Refugee Health Clinic
The Mosaic Refugee Health Clinic provides comprehensive primary care to refugees for their first two years in Calgary. Health services are provided by a diverse interdisciplinary team. To create a safe space for newly arrived refugees, our team is comprised of service providers and staff who themselves were refugees when they first resettled in Canada. In this way, our team represents the community we serve.
During their two years at the Mosaic Refugee Health Clinic, our program strives to identify and manage acute and chronic diseases, engage patients in preventive healthcare, address mental health concerns, and teach them to be independent navigators of the health system.
After two years with our program, patients are connected to their permanent medical home. Our goal is to transition our patients to a medical home that best meets their needs.
One example of achieving equity in practice is the changes that we made to our Transition Program in response to patient feedback. At the Mosaic Refugee Health Clinic, we have engaged with patients through a “Patient Advisory Committee”, which consists of former and current patients of the Mosaic Refugee Health Clinic. The Patient Advisory Committee (PAC) provides feedback on the services offered by the Clinic in addition to contributing to our research agenda. The PAC is managed by an organization separate from the Clinic called Refugee Health YYC, a research and educational program at the University of Calgary. Because the PAC provides feedback to an external group that is not directly involved in their clinical care, we have reduced the power differential and bias that would likely be present if the patients were speaking directly to their own healthcare providers.
Valuable feedback on our Transition Program was provided by the Patient Advisory Committee (PAC). The PAC reported that the Transition Program was too abrupt. When they received the call from our Clinic stating that they would be transitioned to a new medical home within the next month, the patients felt surprised and anxious since they were not adequately prepared about the transition process and were taken aback. They recommended that we engage with patients from their first appointment to ensure that they were aware that the Mosaic Refugee Health Clinic was a temporary medical home and that they would be transitioned to their permanent medical home after two years. The PAC also recommended starting the transition process much earlier around 18 months so that their departure from the Clinic did not feel abrupt and they had time to resolve any outstanding issues with their health providers at the Refugee Clinic prior to being attached to a new physician. In response to their feedback, we changed our Transition Program so that we explain from their first intake appointment that they will be transitioned in the future. We also start our transition planning at 18 months in collaboration with the patients so that they can have a comfortable and smooth transition to their new medical home. In this way, we changed our practice to meet the needs of the patients.
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