Authentic Partnerships: Prince Albert Integrated Human Services Practicum

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Authentic Partnerships Prince Albert
Integrated Human Services Practicum
We Are Not Alone Because We Are Community
Many the gifts for one community

• Linda Nosbush,
• Understanding the Early Years Community Research
  Coordinator
• Early Learning Consultant, Saskatchewan Rivers
  School Division
• Susan Fowler-Kerry
• Professor, Pediatric Nursing, College of Nursing,
  University of Saskatchewan

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Our Vision

• We want all children and youth to feel loved, be
  safe, be confident and be well
• We want our communities to promote the fullest
  health and enjoyment of childhood and youth
• We want our society to protect all the rights of
  children and youth in a sustainable environment
• - Canadian Institute of Child Health,
  2000

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Collaboration
An interprofessional process of communication and
decision making that enables the separate and
shared knowledge and skills of care providers to
synergistically influence the client/patient care
provided. - Way, Jones, et al. 2001
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Collaborator
Effectively consult with other physicians
health care professionals implying the
development of management plans in partnership
with patient and care providers. The
specialists recognizes the roles and expertise
of the other individuals involved and explicitly
integrates the opinions of the patient and
caregivers into management plans -
Royal College of Physicians and Surgeons of
Canada 2000
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The Infrastructure

• Faculty of Nursing
• Understanding the Early Years
• Regional Intersectoral Committee

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Prince Albert and Area

Regional Intersectoral Committee

• The Mandate
• Work collectively to foster and support an
  integrated approach to the planning and delivery
  of programs, policy and projects across sectors
  in response to the needs of children, youth and
  their families
• Works to establish authentic partnerships by
  enabling relationships between sectors,
  community, and clients in order to meet the
  complex demands of life
• Develop the capacity to collaboratively meet
  complex challenges that confront our community

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What is Service Integration?

• Joining of forces, knowledge and means
• To understand and solve complex issues
• Whose solutions lie outside the capacity and
  responsibility of a single sector

Federal/Provincial/Territorial Advisory Committee
on Population Health Intersectoral Action Towards
Population Health, 1999
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Role in the Nursing Program

• Clinical Practicum Experience

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• Working to Establish..
• A holistic approach to health care
• Challenging boundaries within the health care
  sector with the primary purpose of improving
  health for all
• Advocate for multidisciplinary/interdisciplinary
  approaches to health problems
• Become part of a Community Development Program
• Encouraged to participate with community
  programs where student nurses would typically not
  be sent
• Develop a new understanding of primary health
  care and the determinants of health

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Nursing(16 nurses graduated to date, 4 terms)

• Child and Family Health Focus
• Developmental Issues and Outcomes
• Intergenerational Impact
• Determinants of Health
• Primary Health Care
• Role of Prevention and Intervention
• Continuum of Care
• Understanding of Complex Nature of Health
• Circle of Care and,
• Interprofessional Collaboration

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Creating Awareness of Primary Health Care

• The Social Safety Net
• The Kinds of Placements that Create Awareness

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Community Mental Health

• Continuity of care - HUGE
• Create supportive environments by utilizing
  various resources and programs (e.g. Share, Nest)
• Building rapport and trusting relationship with
  clients
• Therapeutic communication skills paramount

Childrens Advocate Report suggests 90 of
Childrens Mental Health Needs are not being met.
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Prince Albert Housing Authority

• Rental housing aimed for moderate to low income
  families
• Developed owned by three levels of government
• Four cornerstones of Assisted Living Services
• Independence
• Dignity
• Choice
• Community

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Intertribal Health Authority Sturgeon Lake

• Community development
• Continuity of care
• Health teaching
• Integration of Western Traditional medicine
• Spiritual development

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• Prince Albert Police Service
• Systemic Causes of Issues Police Encounters

• Addictions, Drugs, Substance Abuse
• Over 2000 intoxicated persons picked up by the
  Police Service in Prince Albert in 2004 (43 of
  Cell stays were intoxicated people one man had
  76 nights in cells)
• Family History/Intergenerational Dysfunction
• Violence, Abuse, Neglect, Addictions,
  Criminogenic Behaviour

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Prince Albert Police Service Solutions/Responses

• Target Program
• Structure for Success
• Victim Services
• Ridealongs for Integrated Nursing Practicum
• Balanced Score Card
• Benefit of Participation in Integrated Nursing
  Program Working Together to Form Relationships
  so We Can Serve Our Clients More Effectively

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Many talents and many skills are required to
ensure the safety and protection of a community.
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Physical Aggression
Human Learn to Regulate Physical Aggression
During the Preschool YearsTremblay et. al,
2004. Centre of Excellence for Early Child
Development,University of Montreal
Children who are at highest risk for not learning
to regulate aggression in Early Childhood are

• Mothers with a history of antisocial behaviour
  during their school years
• Mothers who start childbearing early
• Mothers who smoke during pregnancy
• Parents who have low income
• Parents who have serious problems living together

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Prince Albert and Area Crime Reduction Strategy

• Work together differently to make a difference
• Enhance public safety by engaging community
  supports
• Create partnerships with stakeholders to develop
  a plan to reduce and prevent crime in Prince
  Albert and Area

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Prince Albert and Areas Addictions and
Detoxification Strategy

• Infrastructure
• Regional Intersectoral Committee
• City of Prince Albert
• Involvement of the Whole Community vehicle is
  collaboration and coordination
• Framework
• Prevention
• Treatment (Inpatient and Outpatient)
• Integration
• Supply Reduction

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There is only one female correctional centre in
the Province of Saskatchewan.

• Our Client Profile
• Low Education (below eighth grade level)
• Low Employment
• Mothers without Resources
• Personal
• Community
• Basic Know-how to Access the Resources that Exist

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• Issues
• Addictions
• Employment
• Peer Pressures
• Sexual Exploitation
• Solutions/Responses
• Provide Support Systems
• Appreciation/Understanding of Needs of Women in
  conflict with the law
• Core Acute Care Placement in The Integrated
  Nursing Program Our Contribution

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Role Of School
SchoolPLUS

• Educating the Whole Person
• Supporting the Family
• Planning for Student Success (responsive
  planning)
• Connecting Students to the School
• Ensuring the Opportunity to Develop Personal
  Competencies
• Support Service Delivery
• To serve as a centre at the community level for
  the delivery of social, health, recreation,
  justice and other services for children and their
  families

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Wesmor Community High School
Student Background/Profile
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• Riverside Community School
• Pre-Kindergarten Grade 9
• The whole gamut of economic levels
• Diabetes Project
• Community participation and learning

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Aboriginal Education

• Honouring and Respecting Differences in Family
• Values
• Different ways of being family
• Dynamics
• Moving Toward Solutions
• Become more family and child-centered
• Increasing awareness of our interdependence

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What Authentic Partnerships Mean to Us

• Knowing that youre not solely responsible for
  children in the community
• There is a community response to keeping
  children safe
• Others are involved in improving the lives of
  children and families
• Listening as you work with others
• Gives insight
• Enables you to consider other options to
  increase the quality of life for children and
  families

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• Develop knowledge of how childhood experiences
  shape learning, health and well-being
• Track how well children are doing and
• Build the communitys capacity to improve child
  development through policy, program and resource
  development.
• Knowledge Exchange and Pay It Forward
• The development of an Integrated Human Services
  Practicum will build strong bonds between the
  Human Services and will enable better response
  systems to childrens and familys complex needs.

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Prince Alberts Social Index Challenges Faced
By Neighbourhoods
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The Distant Early Warning SystemThe Early
Development Instrument

• Indicates how well development has proceeded
• in the first six years of life in five
  domains
• Physical Health and Well-Being
• Social Competence
• Emotional Maturity
• Language and Cognitive Development
• Communication Skills and General Knowledge
• Available at the community and neighbourhood
  level
• Two types of Analysis
• Prospective Analysis These are our children,
  how can we support their future development?
• Helps to construct support systems for the
  present age cohort
• Retrospective Analysis How can we change things
  so that future age cohorts develop more
  positively?
• Helps to change the playing field for all
  subsequent age cohorts

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Childrens Readiness to Learn at School 2004
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Readiness to Learn Factors2004(Age cohort of
642 Kindergarten Children)
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Prince Albert Parkland Health Region

• Maternal Child
• Obstetrics
• Pediatrics
• Family Medicine
• Mental Health, Addictions Community Development
• Community and Mental Health
• Addiction Services
• PACADA
• Primary and Community Care
• Sexually Transmitted Disease Centre
• Public Health
• Critical Care
• Emergency
• Family Medicine

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• Working with vulnerable families to provide
• Universal Screening at Birth
• Indepth Assessment for those in Targeted Areas
• Home Visiting
• Early Learning and Care
• Addictions and Mental Health Support

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Emergency Medical Services

• Point of need to Medical Centre
• The process
• The support medical and psycho-social
• The collaboration with other emergency services
• The continuum of care
• Responding to patient needs
• Resources for other family members especially
  children
• Prevention Services

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Emergency Medical Services

• On the front line
• At the scene providing initial emergency care
• Dealing with the family
• Responding to the needs
• of the patient

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Emergency Medical Services

• On the front line
• Deals only with the urgent and present situation
• Does make a difference through the smile and eyes
  of the children

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Emergency Medical Services

• Working as a Team
• With agencies such as Mobile Crisis and Prince
  Albert City Police
• Transporting the children if needed to the
  hospital
• Waiting for family or crisis workers to attend
• With emergency room nurses to continue care

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Prince Albert Grand Council Urban Services
Linking On and Off Reserve Services Supports

• Support of First Nations Peoples as they make
  their transition to Urban Life
• Urban Sport Culture and Recreation Program
• FASD moving from diagnosis to treatment
• Housing Transition Housing
• Working with other sectors, agencies,
  community-based organizations to ensure ease of
  transition to urban life
• Post-secondary support, training and employment
• Youth Justice Project
• Job Skills Coach (Carlton, St. Marys, Wesmor)

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Reaching Out to Other Health Care Professions

• College of Pharmacy and Nutrition

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Pharmacy
Choice of Focus

• Addictions with a Developmental Focus
• Chronic Disease Management Diabetes
• Elderly Palliative Complex Health Needs

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• Working Together Differently to Make
  a Difference
• A practicum designed to enable us to
• -realize our full potential
• -respond to our needs and interests
• -build our competence as a
• health care professional in an
• intersectoral context

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Pharmacy Experience

• Safeway, Shoppers, Pharmasave, CO-OP, Victoria
  Square, Victoria Hospital Pharmacy
• Concept of interdisciplinary collaboration
• Methadone Program
• Support network available
• Knowledgeable resource

Fall 2005 Police in Pharmacies on a regular
rotating basis
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Pharmacy
(1 Term 3 Pharmacy Students)
Three Emphases

• Youth/Addictions
• Chronic Disease Type II Diabetes
• Elderly Palliative

How?

• 5 weeks Hospital Pharmacy
• 5 weeks Community Pharmacy
• 5 weeks Community Social Safety Net

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Creating a Model for Teaching and Learning

• Growing in the Shelter of Each Other

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Breaking the Cycle A Balanced Approach

• Identify the root causes
• Problem solve common issues
• Move toward early identification
• Intervention
• Acute Services
• Collaborate to create joint solutions
• Communication Strategy
• Engaging the stakeholders
• Engaging the whole community

Increasingly more expensive but easier to measure
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Our ModelStrong Children grow up in Strong
Families, Strong Neighbourhoods, Strong Peer
Groups, and Strong Nations
Vision Leadership Structural Change

• Four Worlds of Childhood(SchoolPLUS)
• Family
• Peer Group
• School
• Neighbourhood and Community

Acute Care
Education and Awareness
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The Circle of Care

• Creating a new Social Safety Net and Redefining
  how we work together to enhance
• The health, well-being and competence of our
  children, youth and their families.
• Our individual and collective capacity to make a
  positive difference.

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Integrated Nursing Practicum Students Comment
about Their Experiences

• Allowed me to move from thinking outside the box
  to practicing outside the box
• Getting to see many aspects of the community and
  how they all work together
• The community affects a persons health and
  their health affects the community

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Social Justice and the Social Determinants of
Health, Well-being and Competence
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• Wholeness. All things are interrelated.
  Everything in the universe is part of a single
  whole. Everything is connected in some way to
  everything elseit is therefore possible to
  understand something only if we can understand
  how it is connected to everything else.

Bopp, J., Bopp, M., Brown, L. Lane, P. (1989).
The sacred tree Reflections on Native
American spirituality (3rd ed.). Twin Lakes, WI
Lotus Light.
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Conceptualizing the Common Humanity in Human
Services
A Tapestry of Support - Realize Our Collective
Promise
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Adding Partners

• Inviting Other Professional Partners into
  Interprofessional Collaborative Experiences

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Family Medicine Residency

• Emergency/Internal Medicine
• Police and Ambulance Ride alongs, Victim Services
• Obstetrics and Gynecology
• Maternity Home Visits
• Pediatrics
• Public Health, Kids First, Understanding the
  Early Years, Family Futures, Saskatchewan Rivers
  School Division
• Psychiatry
• Community and Mental Health, Youth Addictions
• Family Medicine
• Sexually Transmitted Infection Clinic, Pine Grove
  Correctional Centre, Prince Albert Housing
  Authority

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Continuing to Round the Circle

• Social Work
• Education SUNTEP
• Other Members of the Health Sciences Deans
  Committee
• Human Services Professionals in the Community

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So Why Does It Matter? Initial Phases of these
Kinds of Endeavors are

• Energy Intensive
• Require Thinking and Working Outside the Box
• Redefinition of Professional Scopes of Practice
• Trust, Willingness to Risk
• Forging New Professional and Interprofessional
  Relationships

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The Virtuous Circle
Prosperous Society
Social Stability
Innovation and Competitive Workforce
Resources to Fund Programs that Foster Healthy
Child Development
Healthy Children and Adolescents
Healthy Child Development
Doherty Offord
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We live, love, learn, and develop our human-being
in the shelter of each other.
Can we each go forth to make Prince Albert and
area a place where all can, not only survive, but
thrive?
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Alone we go fast, Together we
go far.
Join us in going far together.to change the
quality of care for our children, families,
communities and each other..