The First Nations Health Authority (FNHA) has launched two new quality improvement resources on its website. Grounded in culture and led by community, this initiative supports the First Nations Perspective on Health and Wellness and helps to further cultural safety and humility with all health systems and partners. The project's working groups were comprised of members from both the FNHA Quality Improvement and Safety (QIS) Network and the First Nations Health Directors Association. Community health leaders, Knowledge Keepers and quality improvement champions across BC provided the vision and contributions towards the creation and completion of the BC First Nations Perspective on Quality and the BC First Nations Pathway for Quality Improvement.
The FNHA has been exploring interest in a First Nations-led accreditation approach since 2013. In response, from September 2019 to June 2022, the FNHA Quality Team hosted the opportunity to develop an Indigenous-led approach to quality and ongoing quality improvement. The project outcomes were supported by extensive environmental scans, ongoing feedback and broader engagement within the FNHA, with accrediting bodies and both provincial and national health partners.
As the content evolved, both the Perspective on Quality and Pathway for Quality Improvement were co-designed and co-created to be impactful, vibrant and to resonate; with the intent that organizations and health teams would take each and 'make it their own'. Diverse Nations, communities and organizations can utilize this approach and related resources to better integrate their community priorities, values and First Nations ways of being, learning, doing and knowing.
The BC First Nations Perspective on Quality
The BC First Nations Perspective on Quality offers key principles and guidelines to help inform an approach to quality and quality improvement that is designed by and for First Nations health and healing organizations.
The principles most important to First Nations in BC include respect, being relational, being person-centred, having a community-driven approach, and always meeting safety and cultural safety. Each principle was developed based on input from BC First Nations champions who lead quality and safety initiatives in their communities and health service organizations.
In the graphic above, the woven basket reflects the continual weaving of principles and practices that build stronger health and wellness services, representing individual and collective efforts to provide seamless, integrated and person-centered care. The people represent the organizations, partners and clients working together to support individuals, families and communities. The sun and moon in the background represent the everyday efforts towards health and wellness.
“The basket holds all the wellness, medicine and tools in our life to be grateful for, which brings us joy. Quality is ceremony. To do ceremony as our ancestors have taught us is about walking in their footsteps." - Elder Syexwáliya / Ann Whonnock
The BC First Nations Pathway for Quality Improvement
The BC First Nations Pathway for Quality Improvement is guided by the BC First Nations Perspective on Quality. This pathway creates a shared understanding of the steps in a quality improvement process, recognizing that ongoing improvement efforts are everyone's responsibility.
The pathway encourages health organizations to foster a culture of
continuous quality improvement and learning through ongoing reflection,
evaluation and feedback. Organizations can identify areas for improvement with their
services to communities that are grounded in culture and cultural safety. The
pathway evolves quality and quality improvement led by First Nations, ensuring
a self-determined path forward.
In the graphic above, the braid integrates the five principles of the BC First Nations Perspective on Quality throughout the process. The strands leading into the braid demonstrate the collaborative intentions and actions between clients, organizational staff and partners who are working together to create improved services, organizations and partnerships.
Indigenous teachings lead Indigenous practices
This BC-focused effort has been wanted and welcomed by FNHA-supported and accredited First Nations health organizations, as well as participating accrediting bodies and health care partners. It is a needed step towards furthering health service quality and safety that is BC First Nations based, paced and led. It supports the peer-based approach by FNHA QIS Network quality champions that “Indigenous teachings lead Indigenous practices."
To date, the initiative has been presented at Health Quality BC's 2023 Quality Forum, and it is supporting Accreditation Canada's efforts to improve the accreditation experience with their Indigenous Health Services Program. Various First Nations health organizations are also applying the approach and learnings to support their health planning, programming and quality improvement goals.
“We will continuously improve for future generations. It is about being willing to share and adapt to do things better. It is how we teach our children, by doing and learning as part of the ceremony, knowing the steps, doing it right." - Elder Syexwáliya / Ann Whonnock
We invite you to learn more about this Indigenous-led and innovative approach to quality, safety and improvement – to help inform strategic conversations, strengthen operational priorities and partner for meaningful change. To access the resources, please visit the FNHA Community Accreditation and Quality Program at: https://www.fnha.ca/what-we-do/health-system/community-accreditation-and-quality-improvement or email CommunityQuality@fnha.ca
