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

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

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

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

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

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!