Project Overview

The project builds on work begun in the CIHR-funded Planning and Dissemination Project, in which the PI collaborated with Leslie Bryant, the Regional Practice Leader, Research and Indigenous Engagement at Interior Health and Provincial Lead for the Strategy for Patient-Oriented Research, and Shuswap Nation Elders, at meetings at the Shuswap Nation Tribal Council in May 2018 and the Qwemstin Health Society in February 2019. Information was shared on a related CIHR funded Developing Elders’ Support for Trauma Informed Emergency Departments (DESTINED) Project, which was led by the PI, and Elders expressed interest in expanding the project to share the educational recommendations with Interior Health.

The main objective of the research is to implement the findings and recommendations emerging from the DESTINED project, original research led by the PI and Indigenous and health authority collaborators, and conducted with Elders in Indigenous communities, by developing a more trauma-informed approach to the care of Elders in Interior Health Authority hospital Emergency Departments. Originally, the project was planned to be conducted in person by the project team, in 16 hospital Emergency Departments over the course of two years (8 per year). This would be an educational intervention, which would include a better understanding of frailty in Indigenous Elders, trauma informed care and discharge processes, ensuring that Elders receive health promotion of individual behaviour change to increase adoption of healthy life-style practices shown to prevent or mitigate morbidity and frailty, and a dialogue session between the project team and hospital staff to ensure the necessary level of understanding and commitment to culturally safe and trauma-informed care. Appropriate community level outcomes monitoring would be conducted in First Nations communities using talking circles facilitated by Elders, with the evaluator present to collect data. A process for determining and measuring appropriate individual level outcomes would be developed by Interior Health Authority during the project, based on the outcomes of the community evaluation.

The grant application was successful, but the global COVID-19 pandemic was declared by the World Health Organization prior to the beginning of the project. During the interim period, the funder approved plans for the project to proceed virtually. However, the pandemic had an unanticipated and profoundly negative impact on the Interior community, consequently, hospital Emergency Departments were stretched beyond capacity, and Interior Health Authority halted all non-COVID related research. Given the circumstances, the Canadian Frailty Network approved an indefinite pause to the project, in recognition of the significant impact of COVID on the Interior community and project team, with permission to resume when ready and able. During the period, project partners continued to engage with the community and update plans according to the changes affecting the health authority and Interior communities.

The project resumed in 2023, in partnership with the Cultural Safety Education Team that was established in Interior Health, led by Shawna Duncan. The project team engaged with Elders and Indigenous contractors, as well a policy collaborators at the Minstry of Health, and built on new cultural safety curricula developed in Interior Health, in response to the In Plain Sight Report. The focus on the project developed into virtual training for Emergency Departments, specialized in supporting Indigneous Elders in Emergency Departments. This training will be offered to all Interior Health staff, and is specifically intended for Emergency Department staff working in hospitals.