A Transdisciplinary Evaluation of The Community Advisory Panels Model Of Community Responsiveness at St. Michael s Hospital, Toronto

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Daniela Briggs
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1 5 th International Conference on Urban Health Amsterdam, October 2006 A Transdisciplinary Evaluation of The Community Advisory Panels Model Of Community Responsiveness at St. Michael s Hospital, Toronto Jason Ramsay Jim O Neill Patricia O Campo Aileen Meagher Ross Smith Community Advisory Panels October

2 St. Michael s Hospital Mission Statement St. Michael's Hospital is a Catholic academic healthcare provider, fully affiliated with the University of Toronto and committed to innovative patient care, teaching and research. Established in 1892 by the Sisters of St. Joseph to care for the sick and poor, St. Michael's Hospital remains dedicated to treating all with respect, compassion and dignity. Community Advisory Panels October

economically diverse community The wealthiest and poorest in the province 40% of the city s lowest income tracts Largest

3 The People St. Michael s Serve The Hospital s local catchment area is home to 345,000 people, 8% of Toronto s population Ethnically, culturally and economically diverse community The wealthiest and poorest in the province 40% of the city s lowest income tracts Largest concentration of homeless in the city 12% of Emergency patients have no insurance High prevalence of mental illness and addictions High concentration of socially isolated seniors Our catchment area also includes many commuters Community Advisory Panels October

4 Inner City Health Program Mandate Reduce barriers to health for high-risk and priority populations Address social and economic determinants of health care that affect inner city populations Provide an integrated continuum of primary, secondary, and tertiary care, as well as community outreach Community Advisory Panels October

5 INNER CITY HEALTH PROGRAM Continuum of Life Determinants of Health Ambulatory Services Family Practice Community Outreach Emergency Obstetrics/Gynecology Pediatrics Mental Health Withdrawal Management Homeless / Underhoused HIV / AIDS Women at Risk Mentally Ill Addictions Inpatient Services General Internal Medicine Infectious Diseases / HIV Transitional Care & Regional Geriatric Program Level II NICU Obs/Gyn Mental Health Clinical Education Research Community Advisory Panels October

6 Community Advisory Panels (CAPs) Purpose Invite patients and community organizations as experts and partners Provide advice to Hospital and Inner City Health Program Ensure stakeholder input in planning, delivery, education, and evaluation of services Community Advisory Panels October

7 CAP Reporting Structure Community Advisory Committee (of Board) BOARD OF DIRECTORS EXECUTIVE TEAM Inner City Research Advisory Committee INNER CITY HEALTH PROGRAM Mental Health CAP Homeless & Underhoused CAP Women s & Children s Health CAP HIV/AIDS CAP Community Advisory Panels October

8 The Interests And Expectations Of CAPS Interests To improve quality of care and range of services for themselves/clients/community. To promote easy access to coordinated care. To provide and receive information. To understand hospital processes and decisions Expectations To be heard and respected as competent and knowledgeable. To provide input to processes, policies and decisions that affect them. To have timely, effective resolution of problems. To see results and have a sense of accomplishment Community Advisory Panels October

9 Select ICH Program And Community Advisory Panel Initiatives Homeless Out of the Cold Medical & Psychiatric Outreach to Hostels Patient Comfort Fund Rotary Transition Centre Clinical Care Homeless Pathway Dental Funding Support to Regent Park CHC Partners for Access and Identification Project (PAID) Community Economic Development Creating Access to Regulated Employment for Foreign Trained Nurses Project (CARE) Mentors for Foreign Trained Professionals Downtown East Community Development Collective (DECDC) HIV/AIDS Statement of Affirmation HIV Information Project HIV Psychiatry Research ICH Research Chair Arthur Sommer Rotenberg Chair in Suicide Studies Centre for Research in ICH (CRICH) SETO Projects Project to Explore the Development of Curriculum for Health Professionals Working with Homeless Women Community Advisory Panels October Mental Health CONTACT Mental Health Outreach Community Connections Case Management Crisis Team Mental Health Outreach Service Substance Abuse and Mental Illness Consultation Treatment Services (SAMI) Warm Line with Progress Place Advocacy for Mental Health Reform Women Survivors of Abuse Group Medical Director, Obs/Gyn, Pediatrics Pro-Bono Obstetrical Care Seniors Home Visit Program Young Parents No Fixed Address Parents for Better Beginnings Addictions Methadone Program Needle Exchange Seaton House Harm Reduction Withdrawal Management Services Psych Detox Beds Mental Health/Substance Use Disorders Beds Toronto Harm Reduction Task Force

10 Program Evaluation of the CAPs: Objectives Undertake an evaluation of the CAPs that is: Inclusive and Collaborative Transdisciplinary Methodologically sound Ethically sound Transparent Of use to the CAPs and St. Michael s Hospital Useful to other hospitals Generates research on CAPs model Community Advisory Panels October

11 Sources of Data Information was collected using: Primary Data One questionnaire survey In-depth interviews Secondary Data Document review Community Advisory Panels October

12 Group Type N % familiar with CAPs CAP Affiliated Includes CAP chairs, committee members, former committee members and consumer representatives on CAP committees % SMH Affiliated Includes staff, physicians and members of the board of directors at SMH Other Includes clients of SMH, and clients and employees of community agencies 94 33% 18 50% Community Advisory Panels October Total (all respondents) %

13 Emergent Themes The three major themes were: 1. Building Relationships 2. Visibility/Participation 3. Roles Community Advisory Panels October

14 Building and Maintaining Relationships I think the most important thing that the CAP does is that its a structure that reports at a very high level in the Hospital, it reports to a committee of the Board; that says a lot about how seriously it s taken. And so its, it s a structure, it s a vehicle for people s voice to come through. (Participant 5, p.15) Community Advisory Panels October

15 Theme 2: CAP Visibility/Participation I do not think CAPs are well known outside of the hospital by those other than community agency members. (survey respondent) Smaller community orgs have limited resources and may not be able to fully participate (survey respondent) one of the difficulties has been when you have women with young children it s just, the stress of you re getting out to meetings, right? (Participant from in-depth interview) Community Advisory Panels October

16 Theme 3: CAPs Roles I see them as a tremendous conduit for information from people we serve, to the people who are making policy and administrative and care decisions. (Interview Participant) I feel the CAPS were designed as forums for community members to meet with hospital staff to discuss mutual issues (Survey Respondent) Community Advisory Panels October

17 Select ICH Program And Community Advisory Panel Initiatives Homeless Out of the Cold Medical & Psychiatric Outreach to Hostels Patient Comfort Fund Rotary Transition Centre Clinical Care Homeless Pathway Dental Funding Support to Regent Park CHC Partners for Access and Identification Project (PAID) Community Economic Development Creating Access to Regulated Employment for Foreign Trained Nurses Project (CARE) Mentors for Foreign Trained Professionals Downtown East Community Development Collective (DECDC) HIV/AIDS Statement of Affirmation HIV Information Project HIV Psychiatry Research ICH Research Chair Arthur Sommer Rotenberg Chair in Suicide Studies Centre for Research in ICH (CRICH) SETO Projects Project to Explore the Development of Curriculum for Health Professionals Working with Homeless Women Community Advisory Panels October Mental Health CONTACT Mental Health Outreach Community Connections Case Management Crisis Team Mental Health Outreach Service Substance Abuse and Mental Illness Consultation Treatment Services (SAMI) Warm Line with Progress Place Advocacy for Mental Health Reform Women Survivors of Abuse Group Medical Director, Obs/Gyn, Pediatrics Pro-Bono Obstetrical Care Seniors Home Visit Program Young Parents No Fixed Address Parents for Better Beginnings Addictions Methadone Program Needle Exchange Seaton House Harm Reduction Withdrawal Management Services Psych Detox Beds Mental Health/Substance Use Disorders Beds Toronto Harm Reduction Task Force

18 Conclusion The CAPs have been a groundbreaking, successful program for SMH and the St. Michael s Community and consumers/patients. Those who are familiar with the program support it and see it as very valuable. More visibility in the catchment area needed. CAPs may want to evaluate ways of reducing reported barriers to participation. Community Advisory Panels October

19 ST. MICHAEL S HOSPITAL Statement of Affirmation Regarding Accessible, Welcoming, and Equitable Health Care for All To acknowledge the needs of the communities we serve, St. Michael s Hospital reiterates our longstanding commitment to affirm and protect the right to sensitive, secure, respectful health care for all patients, including people living with HIV/AIDS, lesbians and gay men, their partners and families, the poor, and homeless and people living with severe mental illnesses. It is the mission, values, and tradition of St. Michael s Hospital and those associated with the hospital to provide compassionate care in a welcoming environment, embracing all races, cultures, classes, beliefs, ages, gender, and sexual orientations. Board Approved 1998 Community Advisory Panels October

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