C1-c “Like an umbrella, protecting me from the rain until I get to my destination”: Evaluating the Implementation of a Tailored Primary Care Model for Urban Marginalized Populations

1. Expanding access to team-based care

  • Date: 2024-10-24
  • Concurrent Session: Concurrent Session C
  • Time: 4:45 – 5:15 pm
  • Room:
  • Style: Presentation (information provided to audience, with opportunity for audience to ask question)
  • Focus: Balance between both (e.g. Presentation of a best-practice guideline that combines research evidence, policy issues and practical steps for implementation)
  • Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.)    Clinical providers    Administrative staff    Representatives of stakeholder/partner organizations
     

Learning Objectives:

Participants will learn: 

  • Be  able to describe a program that serve marginalized and medically and socially complex individuals and families in their communities.
  • Gain knowledge to how to evaluation evaluate the implementation of a complex health care program.
  • Describe the development and implementation of a holistic, interprofessional program at a community health centre to address unmet needs of urban marginalized individuals who have historically encountered barriers to accessing quality health care.  

Summary/Abstract:

 Social accountability necessitates improving health equity and access to the highest possible standard of health care for all. A holistic, interprofessional program that aimed to target and serve marginalized and complex populations was iteratively developed at the Centretown Community Health Centre in Ottawa, Canada. We evaluated this Urban Health program using a validated implementation framework.     Methods:  Quantitative and qualitative data collection involved a health records extraction (n=570), a client complexity assessment tool (n=74), semi-structured interviews with clients and key stakeholders (n=41), and a structured client satisfaction survey (n=30). Data was analyzed using descriptive statistics and inductive thematic analysis.    Results:   Between November 1-30, 2021, 570 unique clients were seen. A third of clients (34%) did not have a provincial health card, and most (68%) were homeless or a resident of rooming houses. Most clients who reported their income (92%) were at or below Canada’s official poverty line. The total mean complexity score for clients seen over a one-month period (n=74) was 16.68 (SD 6.75) where a score of 13/33 is perceived to be a threshold for client biopsychosocial complexity. Clients (n=31) and key informants (n=10) highlighted the importance of building relationships with this population, providing wrap-around care, and providing low-barrier care as major strengths to the Urban Health program (UH). Clients reported high satisfaction with the program  (average total score of 18.50/20).    Conclusions:  The program appears to have successfully met its goals, as it serves marginalized and complex clients and appears to be well-received by the community.  

Presenter:

  • Alison Eyre, MDCM, CCFP, FCFP Centretown Community Health Centre, University of Ottawa Department of Family Medicine    
  • Soha Khorsand, BSc        University of Ottawa    
  • Carol Geller, MD, CCFP, FCFP, Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa,  2. Centretown Community Health Centre, 
  • Andrew Mclellan, PHC-NP, MScN, DN (Candidate)  Department of Family Medicine, Faculty of Medicine, University of Ottawa, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto,