Case studies
Social Movement Action Framework
Building Public Visibility and Promoting Best Practices at Sandy Lake First Nation Authority
A case study on public visibility from one of RNAO's Indigenous-focused BPSOs, Sandy Lake First Nation Authority
Sandy Lake Health Authority is a designate, Indigenous-focused Best Practice Spotlight Organization® (BPSO®) that manages health programs in Sandy Lake First Nation. Sandy Lake is a fly-in remote First Nation community in Northwestern Ontario. The community is located 600 km northwest of Thunder Bay, Ontario and 450 km northeast of Winnipeg, Manitoba (Sandy Lake First Nation, 2023).
Sandy Lake First Nation Logo and nursing station [Shared with permission by Sandy Lake First Nation Health Authority]
Sandy Lake Health Authority has been implementing various best practice guidelines (BPG) from the Registered Nurses’ Association of Ontario (RNAO) since the beginning of its designation in 2021. These implemented BPGs have included: Assessment and Interventions for Perinatal Depression, Person- and Family-Centred Care, and Promoting Smoking Reduction and Cessation with Indigenous Peoples of Reproductive Age and their Communities.
The change team at Sandy Lake has been building public visibility and promoting best practices within its community by:
Posters created by the Sandy Lake team to promote events and build public visibility of BPSO; [Shared with permission by Sandy Lake First Nation Health Authority]
- promoting BPSO and best practice initiatives such on the local community radio show, announcements on internal media page, word-of mouth, and on-going conversations with health care providers,
- holding several events (e.g., mental health support for prenatal clients, health fairs) to support community wellness and engagement as allowed by pandemic restrictions,
- creating eye-catching posters to promote the events,
- using a closed Facebook page and messenger to communicate with prenatal clients, and
- displaying BPSO logo on Facebook, posters and other materials.
As a result of their collective action, Sandy Lake First Nation Authority has been able to build public visibility, meaning and awareness of their best practice initiatives within their community and region. As an inaugural member of the Indigenous-focused BPSO program, Sandy Lake First Nation has also leveraged provincial and international networks to share their community approaches to promoting prenatal health and wellness with others.
Applying focused strategies and training to achieve a timely change
Staff at the Birchmount and General site locations of Scarborough Health Network in Toronto, Ontario, Canada are committed to providing excellence in clinical practice. In addition to implementing best practice guidelines focused on clinical care, they have also address healthy workplace environment issues including focusing on anti-bullying. Learn more in this case study.
Staff at the Birchmount and General site locations of Scarborough Health Network (SHN) in Toronto, Ontario, Canada are committed to providing excellence in clinical care. At this Best Practice Spotlight Organization® (BPSO®) Best Practice Spotlight Organization (BPSO) – Scarborough Health Network (shn.ca), there was a strong interest and shared concern from staff and leadership teams on the prevention of bullying in the workplace.
In response, they chose to focus on anti-bullying as an area for improvement. To do so, they implemented the Preventing and Managing Violence in the Workplace Best Practice Guideline (RNAO, 2009). Collaborative efforts from the interprofessional team contributed to developing targeted strategies and training, leading to effective action.
Advancing the global Black Lives Matter movement to end systematic racism
The urgent need to end systemic racism gained international traction following the death of George Floyd. Learn more about how an urgent need for action fosters social movement action in this example.
The urgent need to end systemic racism gained international traction following the death of George Floyd. Support for the global Black Lives Matter movement increased, leading to national and international discussions on structural racism and demands to address long-standing problems of police brutality. Calls to action included defunding the police and a global movement for justice, freedom and liberation.
Knowledge-to-Action Framework
Implementing effective interventions for drug and alcohol use using Screening, Brief Intervention and Referral to Treatment (SBIRT)
Evidence-based interventions to support the development of a screening, brief intervention and referral to treatment (SBIRT) for persons who use drugs and alcohol.
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is endorsed by the Substance Abuse and Mental Health Services Administration as an effective intervention for drug and alcohol use. SBIRT has been implemented in multiple health-care settings including acute care.
Implementation leaders were asked to identify barriers, facilitators, as well as implementation strategies that would be most helpful. From this review, implementation leaders perceived that providing ongoing consultation to clinicians for using SBIRT, distributing educational materials to clinicians, and conducting audits and providing feedback were the most helpful.
All implementation leaders voiced the value of available training resources, and peer support as they moved through the implementation process.
Implementation leaders felt more confident leading change in the future due to the knowledge and skills they developed during SBIRT implementation. They also learned the importance of leveraging support from other interprofessional team members, such as social workers and clinical educators.
Read more about it here. Learn more about SBIRT here. Or, review our best practice guideline, Engaging Clients Who Use Substances.
Leveraging innovative quality monitoring - Humber River Hospital
Humber River Hospital is an acute care facility that has used continuous monitoring to determine the impact of BPG implementation and staff performance.
A major acute-care hospital in Toronto, Ontario, Humber River Hospital (now Humber River Health) has used continuous monitoring to determine the impact of their BPG implementation and staff performance.
These tiles, displayed on large screen monitors in a Command Centre (pictured above), are integrated into the daily delivery of care to support physicians, nurses, and other clinical staff. Each row within the tile represents a patient, followed by where they are located. By clicking on a patient, staff can see more information regarding the clinical criteria that put them on the tile.
With every patient, there is an expected time in which the issue should be resolved based on a service level set by the hospital. If the system detects that the process is taking longer than expected, the icon will escalate to amber and then to red, indicating a higher level of alert.
Tiles also include several quality monitoring indicators based on RNAO's best practice guidelines (BPG) related to fall risk intervention, wound and skin management, pain management and delirium management. By centralizing data in the Command Centre, the monitoring indicators empower clinicians so that they can intervene in a timely manner to ensure that best practices are followed.
Read more about this innovative quality monitoring approach here: https://www.hrh.ca/2020/08/04/cc-risk-of-harm/
