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Poster Abstracts

Access and continuity of health and social services for refugees: implementation of an innovative intersectoral primary care intervention in Quebec

Authors:

Lara Maillet ,

National School of public administration (ENAP), Canada, CA
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Anna Goudet

National School of public administration (ENAP), Canada, CA
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Abstract

Introduction: In Quebec, the vulnerability of refugees is exacerbated by the lack of integration of the existing resources and the lack of access to care and continuity of services. An action-research project (Network 1, 2017-2018) on integrated first-line outreach interventions in a multicultural context in Quebec showed that it is a priority to set up an intersectoral outreach network for refugees that facilitates access to and continuity of care and services.

Aims: The objective is to establish and assess an intersectoral local network focused on the roles of registered nurses and primary healthcare nurse practitioners to ensure the continuity of care and service pathways for refugees in Quebec. We conduct a developmental evaluation with a mixed methods design in two multicultural neighborhoods in an urban city community of Quebec province. The qualitative component includes documentation (N=25), observations (n=20h) and semi-structured interviews with key actors and users/refugees (n=15 expected). The quantitative component comprises data sheets on interventions for refugees completed by nurses (n= 378), and data analysis of the clinical-administrative database since 2012.

Results: Preliminary results on the implementation of this intersectoral outreach network based on the extended role of nurses show promising effects, although slowed by the pandemic. In fact, this innovative intervention reaches the most vulnerable refugees (under 15, without employment and/or unattached to family physicians, not speaking French or English, etc.) and meet their needs in terms of navigating across the health system, follow-up and monitoring medication administration, and sexual and reproductive health prescription and education. In addition, collaboration between social workers and nurses particularly promotes the identification and appropriate follow-up of mental health issues. These beneficial effects extend beyond the refugee population and improve access to care and services for other disadvantaged population in these neighborhoods. However, a lack of fluidity in the information’s flow related to logistical access to patient records between all the actors of the network hinders the continuity of services.

Conclusions: The combination of an expanded role for nurses and an intersectoral outreach network is expected to contribute to improve accessibility, continuity of care and services delivered to refugees and other vulnerable population. Preliminary results indicate the need to sustain this pilot project and scale it up in the province.

 

Implication: Findings may contribute to influence policy and practice in primary care settings and to generate new theories for innovations in nursing care administration, in participative evaluative research and in the field of governance.

How to Cite: Maillet L, Goudet A. Access and continuity of health and social services for refugees: implementation of an innovative intersectoral primary care intervention in Quebec. International Journal of Integrated Care. 2022;22(S3):449. DOI: http://doi.org/10.5334/ijic.ICIC22380
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Published on 04 Nov 2022.

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