First Nations and Inuit Home and Community Care Program - National
Evaluation Update - Winter 2004/2005
Her Majesty the Queen
in Right of Canada
2004
ISSN 1710-3878 (Print)
1710-3886 (Online)
HC. Pub. No.: 9040
Help on accessing alternative formats, such
as PDF, MP3 and WAV files, can be obtained in the alternate
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Table of Contents
Introduction
National Evaluation, Current Status
Other Evaluation Activities
Pilot to test alternative access to home care medical supplies
Manitoba pilot of remote education and support for health care providers
Health Human Resources Study
For further information
The First Nations and Inuit Home and Community Care Program (FNIHCC) has developed an evaluation strategy to see if the program is meeting the needs of the communities and is costeffective. This newsletter gives you an update on the status of current national program evaluation studies and other evaluation activities.
A summary of Study 1, "Implementation: foundations for success," was provided in a previous edition of the newsletter. The full report of Study 1 has been published and distributed to communities. The full report is also available on our website.
Study 2 is now being done to examine how the program addresses the need for home care in First Nations and Inuit communities. Many of you have already participated in interviews or focus groups, answered a survey or hosted a community visit. We appreciate the effort everyone is putting into this valuable work. A summary of the findings will be published in the next newsletter, with a full report to follow.
One of the things we learned in Study 1 is that many communities would like to have specific tools to help manage their programs. An important part of Study 2 is the development of a needs reassessment tool that communities can use for their own management purposes. This tool is being developed collaboratively with community participants. Your input during interviews and on the brainstorming survey will help to develop this important tool.
Several other pilot projects and studies are currently ongoing.
In most FNIHCC community programs, supplies needed for clients (such as dressing supplies, syringes and needles) are ordered through a physician's prescription, and obtained through providers such as local pharmacies.
In early 2004, communities in two regions ( Alberta and Atlantic ) participated in a pilot project to test a possible alternative process to access medical supplies for FNIHCC clients. In the pilot, one FNIHCC Registered Nurse per community was assigned a prescriber number to order supplies for client
care directly from Drug Distribution Centres (DDC), through Non-Insured Health Benefits (NIHB).
It was hoped that the pilot process would lead to:
- easier and more timely access to supplies for clients;
- enhanced use of nursing assessment skills; and
- more effective use of resources.
In the pilot, the nurse assigned the prescriber number was provided with a list of allowable supplies covered by NIHB. This nurse was responsible for ordering all supplies required by clients. If supplies were needed that were not on this list, they were obtained through other providers.
Non-Insured Health Benefits (NIHB) is a client-based system, so supplies were ordered and paid for according to what was needed for each client. For efficiency, nurses submitted orders to the NIHB regional office each month. The nurse kept track of what was used for each client, and the DDC billed NIHB on that basis.
In the pilot, the nurses have a stocked cupboard so they have supplies needed for each client. Nurses would constantly replace what they had used to maintain the necessary level of supplies. The nurse kept track of what was used by that client and returned any unused supplies to the supply cupboard. The nurse also monitored levels of supplies and ordered what was needed to keep the cupboard stocked. This is common inventory management practice with home care programs.
An evaluation of this pilot is underway now and a phase 2 will be considered based on these results.
Obtaining access to affordable, ongoing clinical support, education and communication is a challenge to busy health care providers and managers everywhere. Barriers such as geography, climate, distance and staff shortage greatly add to those challenges for providers working in rural and remote First Nations and Inuit communities. Adequate education and communication are essential to maintaining competency, quality of patient care, job satisfaction and corresponding recruitment and retention. .
To help address these challenges, the FNIHB Manitoba regional office and its partners initiated an e-learning demonstration project for health care providers in 35 Manitoba First Nations communities. The National FNIHCC program funded an evaluation of the pilot so that this resource might be considered on broader scale. The focus of the project was an interactive, web-based e-learning application developed by Saint Elizabeth Health Care known as @YourSide Colleague"! (@YSC).
This application provides remote access to clinical and program management content, an online exchange to enhance dialogue and discussion among colleagues, and access to specialists at Saint Elizabeth Health Care. There is also access to resources such as an online library. Participants can access these resources and supports from any Internetconnected computer -- anytime, anyplace. The purpose of the project was to demonstrate the value of remote, dynamic access to knowledge and health human resources to First Nations communities, their health programs and services, and their health teams.
Of 130 participants given access to @YSC, 60% went on to use it. Those who did not cited barriers such as infrastructure limitations, including unreliable connectivity, computer access and computer skills. The evaluation revealed that most participants had a very satisfactory learning experience and benefited from using @YSC.
Participants identified these benefits:
- rapid, 24/7 availability of information and resources for clinical and program management;
- ongoing, convenient access to up-todate information on best practices in health care;
- better communication for staff and managers/administrators; and
- significant knowledge gains for participants in areas such as diabetes care, wound management, and quality and risk management.
The FNIHCC program will be exploring options for possible future expansion of this system.
The FNIHCC program is currently funding a study of the Health Human Resources needs of the FNIHC program, including the needs of family caregivers. This study is intended to inform implementation of the Aboriginal Health Human Resources Strategy, as announced in the 2004 First Ministers Meeting (FMM) Accord.
The study will examine how the needs in First Nations and Inuit communities compare to those indicated in the  Canadian Home Care Human Resources Study. This study will look at both recruitment and retention issues, as well as how educational program curricula might be adapted to provide a more culturally relevant focus.
The study will be conducted by an Aboriginal firm (Aboriginal Research Institute) with experience in health and First Nations and Inuit communities. The study will include health managers, service providers, family caregivers, community leaders and students. We expect to be distributing surveys for both health managers and service provider staff during early spring. We appreciate your help in carrying out this important work.
Contact the National Coordinator, First Nations and Inuit Home and Community Care Program (FNIHCC) program at (613) 941-3465 or visit us online.
You can also request more information about the evaluation from your FNIHB regional office.
Pacific
6th Floor, Sinclair Centre - Federal Tower
757 West Hastings Street
Vancouver , BC V6C 3E6
(604) 666-0737
Alberta
Canada Place , 7th Floor, Suite 730
9700 Jasper Avenue
Edmonton AB T5J 4C3
(780) 495-2703
Saskatchewan
18th Floor, 1920 Broad Street
Regina SK S4P 3V2
(306) 780-5449
Manitoba
300 - 391 York Avenue
Winnipeg MB R3C 4W1
(204) 983-4199
Ontario
1547 Merivale Road, 3rd Floor
Nepean ON K1A 0L3
(613) 952-0088
Quebec
Guy-Favreau Complex
East Tower , 2nd Floor,
200 René-Lévesque Blvd. West
Montréal QC H2Z 1X4
(514) 283-4256
Atlantic
18th Floor, Maritime Centre
1505 Barrington Street
Halifax NS B3J 3Y6
(902) 426-6637
Northern Secretariat ( Yukon , NWT, Nunavut )
14th Floor, PL3914 A
60 Queen Street
Ottawa ON K1A 0K9
(613) 946-8102
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