Each month the Nat SCI Care Strategy newsletter shares examples of excellence and best practice in action, introducing practitioners and experts at their work.

This month our theme is access; how does the SCI community get access to rehab and care away from centres of excellence. In many remote and rural areas, clinical practitioners may not see that many people with SCI and they may also find it difficult to stay up-to-date on best practices.

Jason Daoust, who is the Professional Practice Lead for Physiotherapy for the North Zone of Alberta Health Services, talks about his experiences with initiatives that support the SCI community in remote and rural areas.       

There needs to be support for the care team back home too. Research has shown that best outcomes happen by using best practices in care. However, in remote and rural areas where a person with SCI may be one of only a handful of cases each year, best practices may not be common knowledge.

As Jason points out, clinical practitioners working in a community may go weeks to months and sometimes more than a year before encountering a client with spinal cord injury. Whereas, working in a rehab hospital, they not only see those clients every day but they’re also immersed in best practices. There’s both familiarity and easy access to resources for clinical management, diagnosis and care. How do we make sure that remote and rural teams also have this level of support?

“…[I do] have the skills and knowledge, but it's not right at my fingertips because I'm not dealing with it on a daily basis” 

As well as recognizing the person and their experience, care and support also need to be tailored to location – what services are available in the community and how accessible are they?

As Jason says, there’s a difference between rural north and rural south in his home province, Alberta, and this will play out across Canada. For this reason, it’s important to think not only in terms of location while listening to what people with lived experience (PLEx) need, but also to consider the experience and skills of clinical practitioners in the area. Is there enough clinical experience to fill the gap?

“We need to think about the person's journey right from where did their injury start? …we need to have people with experience in [each] phase…"  

One way to bring resources into remote areas is by webinar; virtual meetings and presentations have become much more accessible over the last few years, with tech platforms increasing ability to engage and interact. Delivered either in real time or accessible as recordings, experts in centres of excellence can bring best practices to clinical practitioners away from urban areas.

Providing contact details encourages connection. A simple email or website opens up another resource that the care team can access.

“Maybe there's a researcher presenting with someone with lived experience, and that really resonates with a clinician. [So] We asked our presenters to also include their contact information and [they] are usually happy to do that.”

How will clinical practitioners wade through all the information and resources, asks Jason? There are now a lot of online resources available but not all are easy to access, and not all are valid sources of information.

Jason acknowledges that this can be overwhelming to busy practitioners, especially when they start to look outside an organization. Knowing where the information comes from is key to making sure it is also valid. Reputation counts.
In creating resources, Jason says it’s important to be mindful, to stay focused, and also to think about how people will navigate through the information.

“…we have a ton of resources…it's overwhelming. It's like trying to decide what to watch on Netflix.” 

Resources

• Models of Care Delivery...: A Scoping Review from Chester Ho et al (2021)     
• CAN/HSO S3402:2022 (E) Integrated People-Centred Spinal Cord Injury Rehabilitation Program was open for public review earlier this year   
• Yes, We Can! resource book on sexual health and function for wheelchair users  
• The effect of rurality and distance from care on health outcomes, environmental barriers and healthcare utilization patterns in persons with traumatic spinal cord injury  

Coming Up Next!

Next month, we’re continuing our theme of accessibility to services and support, and looking at why it's important to engage with a diversity of voices with lived experience of SCI.

Until then, please leave your feedback or share your story.
 

ABOUT: Praxis started an engagement process in 2019 to create a national care strategy aimed at building on the strengths and collective wisdom of the spinal cord injury (SCI) community across Canada. Based on community consultation, this process led to Being Bold: Toward a National Spinal Cord Injury Care, Health & Wellness Strategy Discussion Document & Consultation Report, a discussion document, and then to the follow up community report, SCI Care for Canada: A Framework for Strategy and Action, which lays out a framework for an actionable National SCI Care Strategy.

The ongoing vision will ensure a national system of care built on evidence and practices that support people with SCI to live their best life in the community. As the ‘backbone’ organization in this initiative, Praxis is sharing best practices drawn from across Canada; instead of searching for solutions in isolation, the national strategy will give people access to peer experiences and stories of excellence that show best practices in action and their impact daily life.