The Brant Community Healthcare System is doing something unexpected with people in the rural communities of its catchment area. In the words of Bev Aikenhead, the community developer spearheading the project, “We are going out beyond the buildings with arms extended and opening a rural dialogue.”
In Brant County with a population of 119,000, approximately 18 per cent are rural. In many cases, people in rural communities often feel isolated when it comes to health services. Because of problems with distance or communication, these people, especially women and the elderly, often don’t get information about services that may be available to help them.
In 1999, the two hospitals, The Brantford General and The Willett, came together to provide an integrated system of services. Being a smaller hospital located in the beautiful hamlet of Paris, Ontario, The Willett has long championed the health-care needs of the rural population. So much so, that when the Heath Services Restructuring Commission laid out its directives for Brant County, The Willett was left to pursue, “its unique approach to alternative healthcare.”
Very soon after the creation of The Brant Community Healthcare System, the joint Coordinating Council of the two hospitals created a senior V.P. position responsible for Community Integration. A Community Health Services Team was struck and Aikenhead says, “It was a sign to the entire rural community that the Healthcare System meant business.”
Based on previous work done by The Willett, funding was obtained through the federal government and four communities were selected to have Well-Being Teams set up. The Paris team, in existence for about nine years, supported the vision and was used as a template for the other communities. The communities chosen for the pilot project were Burford, St. George, Oakland-Scotland and Princeton.
The first task for organizers was to open a dialogue by asking the right questions and finding the right answers. “Often we think we have a good sense of what’s needed but each community has different values,” points out Dilys Haughton, Director of Community Health Services.
In each community, the listening process begins with a “needs and assets report.” A group of students from McMaster University and the University of Western complete a community health report, which forms the basis for a forum when the findings are presented back to the community.
These “Community Forums” generated plenty of interest with comments such as “Why didn’t I know these services were available?” and, “It’s really neat that the hospital is having this dialogue with our community.”
Haughton says it is important not to apply a general formula to rural areas. “For instance, in the community of Burford, child care and parenting were the burning issues. In St. George, senior’s issues were the matter of concern. Different community, totally different concerns.”
Besides learning about the concerns in their own community, so far, the teams have sponsored an eight-week parenting course, a farm stress forum, a falls clinic for seniors and a local drop off for well water testing.
Recently the Diabetic Education Centre based at The Brantford General Site created an outreach component that increases accessibility to assessment, education and support for clients from rural locations. Betty Poole, RN, CDE, says physicians in the local communities are, “eager and looking forward to this kind of outreach with their community.”
Currently, the Diabetes Outreach Program operates out of The Willett, but Poole is approaching each well-being team to find locations for the program in their community. Says Poole, “The hospital and the Well-Being Teams are a good mesh. The Teams get people involved and they can get others out to the program.”
The Well-Being Teams and the Community Health Services Team are garnering quite a bit of attention for the pioneering work they are accomplishing. A number of other hospitals are eagerly watching the program develop and The University of Toronto is using the Community Health Services team of the Brant Community Healthcare System as a research project to set benchmarks and national accreditation standards.
By November of 2002, the first phase will be complete when all four Well-Being Teams are up and running on their own. Haughton, however, is cautious of putting a time line on the process, stressing that, “It is not a quick fix and it won’t happen overnight.”
As the Teams enter their next phase, exciting plans are in progress to further develop and fine-tune the concept. It is all about empowering people to improve health in their own communities and that is “wonderful,” says Haughton. “The teams will continue, partnerships will grow and we will continue to offer each other support.”