Navigating health care, a complex journey
You have not been feeling well for several days and it worries you. Your chronic digestive problems are out of control. You have just celebrated your fiftieth birthday and feel that a medical check-up would be timely. Your teenage girl would like to get a prescription of contraceptives. You are pregnant and need follow-up. On which door are you going to knock?
Logically, you would turn to your family doctor. But if, like 20% of Quebecers, you do not have one (Dubé-Lintel et al., 2013), what are your alternatives? The walk-in clinic? The community center? The emergency room?
You finally managed to find your entry into the health care system? Congratulations! But it is only the beginning. You come out of your first visit with prescriptions for additional exams and follow-up with specialists. At each new reception desk, you are asked to fill in more or less the same form and, to each health care professional you meet, you answer similar questions. They do not seem to be aware of your case or have not received your file yet. As you navigate through various health care facilities – which all operate differently – you constantly wonder where to go and to whom address requests. In fact, the time between your initial visit and the follow-up has been so long that you do not even remember why you consulted in the first place. How stressful! What a waste of time for everyone!
Of course, this is a caricature. Still, for many, navigating the health care system that is, finding their way to the right place, the right person and at the right time is a challenge. But does it have to be so complex? Can we do better? And if so, how?
In this dossier, the collaborators of Hinnovic highlight the navigation issues many patients face across Canada. But they also underline various innovations that have been implemented to improve access and continuity of care.
In this dossier
Shalom Glouberman, President of the Patients’ Association of Canada, explains that the complexity of navigating the health care system is in part due to its design, which meets the needs of health care professionals rather than those of patients.
Mylaine Breton, Assistant Professor, Department of Community Health Sciences, University of Sherbrooke, provides an overview of the most promising organizational innovations to improve access to primary care services.
Karen Jackson, Consultant in Research and Evaluation, Alberta Health Services, and Nelly Oelke, Professor at the School of Nursing, University of British Columbia, identify three factors that make navigation particularly difficult and propose solutions to improve the coordination and continuity of care.
Juliana Alvarez, designer and co-founder of Ide3s, presents an ingenious tool to facilitate communication between patients and providers in emergency rooms in a multicultural context.
Hinnovic summarizes three innovative solutions identified by the Observatoire québécois des réseaux locaux de services that were developed in various regions of the province of Quebec to facilitate patients’ navigation through primary care.
Coming in August 2013
François Desmeules, Researcher at the Orthopedic Research Centre, Maisonneuve-Rosemont Hospital, will provide a post on an innovative project to improve the triage in hospital emergency rooms.
Roxanne Borges Da Silva, Researcher at the Direction de santé publique de Montréal and at the Institut national de santé publique du Québec, will provide a summary of a one-day symposium on primary care services that took place on June 13, 2013 at the University of Montreal.
Also relevant to this dossier
The TEDx conference by Lauren Tan Codesigning for dementia presents an innovation developed in the UK to improve continuity of care for people with Alzheimer.
|Author :||Myriam Hivon, Ph.D.
Dubé-Linteau A., Pineault R., Lévesque J-F., Lecours C., et Tremblay M-È. (2013). Enquête québécoise sur l’expérience de soins 2010-2011. Le médecin de famille et l’endroit habituel de soins : regard sur l’expérience vécue par les Québécois, Volume 2, Québec, Institut de la statistique du Québec, 73 p.