Navigating Ottawa Resources to Improve Health (NORTH)

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Rationale

As part of a shift towards greater emphasis on Social Accountability, the University of Ottawa Faculty of Medicine Undergraduate Medical Education program has established a student-run clinic focusing on social determinants of health. Our goals are to improve health equity for marginalized populations and to enrich the educational experience of future professionals in multiple disciplines. Based on the Health Leads program originating in Boston, the idea was that an interdisciplinary group of student volunteers would act as navigators for patients referred for social needs from primarily health care settings (these could be varied, from primary care medical clinics to legal/dental/nurse practitioner run clinics).

Governance

NORTH has an executive team composed of representatives from each discipline involved, currently Law and Medicine. There are a number of executive roles (scheduling, training, etc) that are shared equally between the two disciplines. This committee has drafted its own Terms of Reference, establishing how the clinic is organized and run. As well, each discipline has a faculty lead, allowing students to clarify how the clinic initiative fits into their program’s curriculum (i.e. as an elective, community service-learning project, course, etc.) and associated issues like evaluation, recruitment and insurance.

Model

Our pilot took place at the Bruyere Family Health Team from January to August 2018. In this location we accepted referrals from various members of the Health Care team, including medical staff, residents and nurses. We saw over 30 clients while learning how to run and manage a complex clinic.

We are now working through a model that has us based within the Somerset West Community Health Centre working with a refugee population seen and referred from the Ottawa Newcomers Health Centre. Our work began there in October 2019. Clinics run twice weekly, where pairs of students, supervised by community social workers, see refugees referred for social needs. A full-day training program was developed for our navigators, organized and run by the students. From the research perspective, we are both tracking all our results and outcomes, and will be doing a study on the impact of the clinic on our navigators (a Mixed-Methods Investigation of the Educational Impact of an Interdisciplinary Social Determinants of Health Clinic on Students). The clinic has the support of a research advisor from the Bruyere Research Institute, and a Social work Lead from our Community Team.

In Summary

This is an exciting initiative that allows us to focus a student run clinic solely on social determinants of health and social needs. We believe this is unique and the only one of its kind in Canada. In addition, the clinic has been interprofessional from the start with students from all disciplines involved taking on similar roles. We will also be evaluating the initiative using sound research methodologies that will allow us to document and publish our results.

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