Inter-professional Connectedness
As the introductory course to the Master of Health Studies (MHS) degree, MHST 601 provided me a self-directed learning experience to understanding health in Canada. A valuable experience for me was when I examined chronic cardiac disease from my professional lens and then used the inter-professional connected environment with my peers in this class. Social Media use in this course for me was primarily the creation of my e-Portfolio. The experience in reviewing and reading my peers e-Portfolio’s allowed me to learn about topics from their perspective, specifically the blogs on chronic disease and vulnerable populations.
My experience of curation was further expanded during the creation of my resource page to highlight resources I found relevant topics. Hall et al (2021) discusses how the use of social media has been extremely valuable to professionals during the COVID-19 pandemic. It really resonated with me that social media “promoted sharing of resources and discussion around the meaning of COVID-19 disruptions for health professional education” and that “through these social media efforts, participants could personalize their professional development, share and acquire knowledge, and engage in global dialogues to address just-in-time needs” (Hall et al 2021).
Federal and Provincial Health Systems in Canada
The evaluation of my professional leadership role in the broader health care system helped me understand how I impact delivery of modern health. This includes my accountability to professional association. Tommy Douglas is described as the “Father of Canadian Medicare” as he gave us our Medicare system in Canada. Tommy had a dedication to social equality and equal access to medical where the medical bills are paid by the government and not the patient (CBC, 1962). This created the Canadian Health Act (CHA) which outlines the criteria for health insurance plans which need to be met by provinces and territories in order for them to receive full Federal cash transfers in support of health. In the end, all Provinces and territories are required to provide reasonable access to medically necessary hospital and doctors' services (Health Canada, 2012).
In my current role as manager with Alberta Health Services (AHS), I am accountable for ensuring operations follows approved process to allow patients equal access to health care. AHS processes are in alignment with the Canadian Health Act (CHA) principles. As a leader, I rely on the following resources to action the CHA principles and guide local and provincial standardized best practices:
Cardiac Sciences Executive Leadership Committee
Cardiac Sciences SCN Committee
Community of Practice – Nationally, Provincially and Calgary Zone
Libin Cardiovascular Institute
Public Health Agency of Canada
Health Canada
Alberta Chief Medical Officer of Health
Provincial Funding for Cardiac Sciences Programs, Procedures and Tests
Understanding Health and Determinants of Health
In this unit, I really appreciated the various social determinants and how they impacted various chronic health conditions in Canada. My greatest learning was when researching the modern definition of heath. Overtime as medicine and science have evolved, the definition of health has also taken shape to adapt with our modern society. The modern heath definition that resonates with me the most is when in 1982, Stokes, Noren and Shindell took the concept further by defining health as: “a state characterized by anatomic, physiologic, and psychological integrity; an ability to perform personally valued family, work, and community roles; an ability to deal with physical, biologic, psychological, and social stress” (Stokes, 1982). Stokes definition is helpful and relevant today as it speaks to socio-economic factors.
WHO (2021) has listed “examples of the social determinants of health, which can influence health equity in positive and negative ways” and Canada (2021) has identified the following 12 main SDH that align with examples provided by WHO.
Income and social status
Employment and working conditions
Education and literacy
Childhood experiences
Physical environments
Social supports and coping skills
Healthy behaviours
Access to health services
Biology and genetic endowment
Gender
Culture
Race / Racism
Multilevel Approaches to Understanding Health - Beyond the Individual
Multilevel approach to managing a specific population or chronic disease requires systematic collaboration on various levels. Social Ecological model is one way to look at the factors to consider when managing a specific population or chronic disease. The below figure serves as resource that can “assist leaders, and managers with research, policy and program development with mapping out the key factors for interprofessional teams at different stages of their evolution” (Misfledt, 2017).
Chronic Disease Prevention and Management
Management of chronic cardiac disease is through agreed upon AHS guidelines, protocols and patient resources. These tools are created in collaboration from various stakeholders which includes – Alberta Health, Cardiovascular SCN, The Libin Institute and Heart and Stroke Foundation. The goal of our care is treatment and also focusing on patient education on prevention and management in the community. AHS (2016) describes chronic disease management as “provides care that helps people with chronic disease improve their quality of life and live as long as possible. Chronic disease management emphasizes several approaches in managing chronic diseases effectively.
Self-care and self-management: supporting people to take an active role in managing their own care to be as healthy as possible and to prevent complications from occurring.
Disease management: interdisciplinary teams providing high quality, evidence-based care, including the use of pathways and protocols or clinical practice guidelines.
Case management: the active management of high-risk individuals with complex needs within an integrated care system.
Proactive strategies: the ability to identify at-risk individuals and groups within the population, carry out needs assessment, understand resource and activity levels and identify trends.
Upon reflection on the strategies described, it becomes quite clear that we need to change the way we provide health care. We need to ask important questions and flag social determinants of health in patient charts and records. We need to explore and offer program funding options, community programs. outreach options and most importantly removing our personal biases form a system perspective. At the patient level be guidelines, policies, education, monitoring progress and sharing reports with data. Here are some additional “Important factors at the team level are supportive team dynamics, role clarity, effective and clear team leadership and accountability, and effective informal and formal communication” (Misfeldt, 2017).
Vulnerable Population
In this unit I explored vulnerable populations in Canada related to chronic cardiac disease. I have chosen to focus on curating resources on prevalence of chronic cardiac disease in the aging population and women. The report on Canadian seniors really highlights the impact and burden of our aging population on our health care system (Canada, 2021). Triposkiadis (2019) takes a closer look at the impact of age on our heart and its structures. It also discusses top risk factors that impact on cardiovascular aging and what lifestyle modification should be implemented in childhood to reduce risk. Heart and Stroke (2021) explain that we know women have smaller arteries. They also lay down heart cholesterol in smaller vessels. This has implications when we diagnose and treat heart disease.
Future Direction
Over the last few weeks, I have been using LinkedIn to network and as a virtual platform for ongoing professional development. Selecting specific groups to follow to increase my knowledge and share infographics or articles I found very interesting. I am looking forward to continuing and growing my use of virtual platforms and utilizing social media as professional accounts. By selecting chronic cardiac health as my focus in MSHT 601, it allowed me to further hone into the elderly and women as vulnerable patient populations in Alberta. Now being aware that cardiac disease is increasing, Kreatsoulas (2009) shares that” dissemination of knowledge and the application of effective strategies are essential in improving population health and reducing the burden placed on health care resources”. To make this change, we require a multilevel strategy and engagement from public, health care providers and our government. My greatest “a-ha moment” from MSHT 601 is as a Cardiac Sciences manager how will I continue to use social media platforms to increase awareness on the management of cardiac disease in the elderly women.
References
Canada (2021). Aging and Chronic diseases: a profile of Canadian seniors.
CBC. (1962). Tommy Douglas, Canada’s Father of Medicare [Video, time 1:13].
Hall, E., et al. (2021). Harnessing the Power of Social Media to Support a Professional Learning Network During the COVID-19 Pandemic, Journal of Continuing Education in the
Health Canada. (2012). Canada’s health care system.
Heart & Stroke Foundation (2021). Transforming women's heart health: A cardiologist's
Kreatsoulas, C., & Anand, S. (2009). The Impact of Social Determinants on Cardiovascular
Disease. Can J Cardiol 2010;26 (Suppl C):8C-13C. 10.1016/s0828-282x(10)71075-8
Misfeldt, R. et al. (2017) Creating high performing primary health care teams in
Alberta, Canada: Mapping out the key issues using a socioecological model. Journal of Interprofessional Education & Practice,2017,6. doi.org/10.1016/j.xjep.2016.11.004
Stokes J, Noren J, Shindell S. Definition of terms and concepts applicable to clinical preventive medicine. Journal of Community Health. 1982;8(1):33–41. 10.1007/BF01324395
Public Health Agency of Canada, (2021). Government of Canada. Social determinants of health and health inequalities - Canada.ca. https://www.canada.ca/en/public-hea
lth/services/health-promotion/population- health/what-determines-health.html.
Triposkiadis, A. et al. (2019). Cardiovascular Aging and Heart Failure: JACC Review Topic of the Week. Journal of the American College of Cardiology, 74(6), 804-1097. https://doi.org/10.1016/j.jacc.2019.06.053.
World Health Organization. (2021). Social Determinants of Health. World Health Organization. https://www.who.int/westernpacific/health- topics/social-determinants-of-health.
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