Indigenous people in Canada face many barriers to accessing primary health-care services, and a lack of cultural competency by health-care providers may be one of the reasons why. Chelsea Crowshoe, a senior advisor with Alberta Health Services and member of the Piikani First Nation, is hoping to break this barrier by promoting the importance of cultural knowledge and respect to health-care providers Alberta-wide. "My role is developing educational opportunities for health-care providers, and we've started within the awareness and sensitivity level of information," she says. "We believe the program is a two-way street, so not only are we supporting the providers but looking at the way other programs develop their resources and how different health-care policies and guidelines could support traditional ceremonies, like smudging for example."
For over two decades, capacity issues within Edmonton hospitals have existed. Crowded emergency departments with numerous patients waiting for admission into inpatient beds has made patient flow a topic at all administrative levels for all services. From a systems perspective, most strategies have simply displaced the problem from one part of the system to another. If we are going to make a true difference, a "big picture" systems approach is required and traditional ways of doing business need to be challenged. Like any discussion around flow, inputs and outputs must have a level of equilibrium and equality, or bottlenecks will occur. Although patient flow has been a huge focus across the continuum of care, discharge planning traditionally has remained with the provider where the patient currently is, as opposed to where the team feels the patient's end destination will be.
