1. Community Health Centre Socio-demographic Data
EMBEDDING EQUITY INTO QUALITY HEALTH CARE
SYMPOSIUM
May 13, 2014

2. Pilot project LHIN Engagement
Five centres (South Riverdale, PPT, Parkdale, Access Alliance, Central Toronto)
Training
EMR modifications
Pilot (and evaluation) ongoing…
LHIN approached CHC sector reps to participate in this project
Recruited five centres
All have reeived training - 2 have not begun pilot testing until EMR transition complete
EMR workaround completed to capture the data electronically
Pilot ongoing for 3 centres and will begin shortly for other two
Preliminary evaluation outcomes being discussed here now

3. Minimum Mandatory data: File number, Last name, Gender, Data of birth, Insurance Status, Postal Code
Core Questions
Answer Option
CHC Evaln Framework
*What language do you feel most comfortable speaking in with your healthcare provider?
34 choices
Includes American Sign Language
PLUS “Other (Please Specify)” option
“Preferred Language of Service”
>70 languages
Were you born in Canada?
Yes/No options
If no, what year did you arrive in Canada?
Country of Origin and if not Canada, the year of arrival
*Which of the following would best describe your racial or ethnic group?
16 choices PLUS “Mixed Heritage (Please specify)” PLUS “Other (Please Specify)”
Cultural background
*Do you have any of the following ?
8 options
NEW QUESTION
*What is your gender?
5 options PLUS “Other (Please Specify)”
3 options
*What is your sexual orientation?
6 options
*What was your total family income before taxes last year?
Categories of income ranges high relative to CHC client incomes
Use term “household”, not “family”
Income ranges lower and smaller
*How many people does your income support?
Open field for numeric data
Same
Purpose of this slide is to show that while there are identical questions, a few are slightly different and two are new.
Unexpected difficulty with handling the subtle changes with the questions both with respect to change management with the staff as well as technology

4. Pilot Results – Focus Groups
Training comments
Implementation
‘We want to recommend that it's done with the counsellor. Front desk is always busy.’
Training Comments:
- some individuals appreciated the role-playing while others felt that it was not really applicable to how they are currently asking the questions, but agreed the one on one discussion with the clients is the way to go. Currently they are handing the questions to clients to complete
Appreciated the videos for the learning about the importance of equity and hearing different individuals address this topic
Implementation comments
Difficulty explaining some of the questions when there is a language barrier, stressed importance of having translations completed. One site had peer workers assist with translation, which was important but then impacted the time and workload
Logistics of privacy – front desk reception is not ideal for asking these sensitive questions, when just handed out would sometimes get blank forms back
Overall suggestions
Translations
Training to include the way it is currently being done in CHC – sheet being handed out – to find a way to gather this data
Train all staff so they all understand the importance of equity and gathering this data, not just data collectors, everyone has a role in this

5. Pilot Results - Survey Adequate training
Appreciated material resources
Need translated materials
‘More privacy and time is needed for front desk to be able to properly connect with the client to gather some of this sensitive information’
‘Collecting the info was easier than I thought it would be. Would be great if there was a form for children/babies (would the sexual orientation apply to them???)
Respondents – combination of clinical leads, admin and data staff
Training – adequate and very well – re-preparation
Time – short time to administer, in some cases more than 15 minutes, data limitation is that this is very early and may want to continue to ask this after time has passed and learning curve declines
Comfrt level – most were comfortable or very comfortable asking the questions
Overall survey results represented results from focus groups, continue to monitor progress and address recommendations for improved implementation

6. Next Steps… Continue to work with pilot centres Evaluate
Implement pilot suggestions
EMR updates
Resources (translations)
Adapt training (train the trainer for internal capacity)
Roll out to LHIN, then…
To ENTIRE PROVINCE!