Perspectives on Indigenous cultural competency and safety in Canadian hospital emergency departments: a scoping review

Sherpa Romeo green journal. Permission to deposit author manuscriptBackground: Emergency departments are primary health care entry points for Indigenous persons in Canada. They are also among the settings where Indigenous patients report access barriers and discriminatory treatment. Cultural competency and cultural safety have been proposed as approaches to improving emergency care. Aim:To identify and elaborate upon barriers and facilitators of cultural competency and safety in Canadian Emergency Departments. Methods: We conducted a scoping review to search published and grey literature to identify and extract data on definitions, measures, facilitators and barriers of cultura lcompetency and safety. Results: Six articles met inclusion criteria. Studies presented perspectives from patients, care providers, health care organizations, and Indigenous knowledge holders. Key themes emerged across studies and stakeholders. These include: Interpersonal relationships between patients and care providers; cultural competency training; Emergency Department capacity; and racism and discrimination. Conclusion: We recommend that Emergency Department cultural competency and safety initiatives i) be built up on post-colonial understanding and partnerships with local Indigenous communities ii) provide practitioners with competencie sin relationship-building and self-awareness iii) orient ED resources and services to meet the needs of patients with limited access to non-emergency health care and iv) aim to prevent discrimination.Ye

Solution Model for Enhancing the Experiences of Urban First Nations and Métis Patients Accessing and Navigating the Health System for Inflammatory Arthritis Care

Health system innovations that better support Indigenous patients, particularly in urban settings, exist in primary health services, but this has not been translated and integrated into specialty care. We sought to identify the experiences of urban First Nations and Métis patients with inflammatory arthritis in accessing and navigating the health system. We used a qualitative research method called Patient and Community Engagement Research Program (PaCER) led by patients using an iterative three phase process: Set, Collect, and Reflect. Initial access and continuity of specialty care can be facilitated with collaboration between primary and specialty care in an urban Indigenous health service model, where health system change was built on culturally responsive models of care