Primary care capacity is an ongoing challenge throughout both the province and the country. The increased need for primary care access amidst the COVID-19 pandemic necessitated the transition of Regent Park Community Health Centre’s COVID-19 vaccine clinic into a primary care clinic called the Wellness Hub.
In collaboration with St. James Town Community Corner, Sherbourne Health, and DET OHT, the Wellness Hub aimed to serve refugees, immigrants, racialized individuals, and LGBTQ+ communities. The clinic focused on preventive screenings and chronic diseases management.
In part one of this two-part dialogue (read part two), Monika Dalmacio, Director of Clinical Operations at Sherbourne Health, and Maryam Ebrahimpour, Senior Director of Primary Health Care at Regent Park Community Health Centre, delve into the clinic’s journey of transition.
What were your initial observations while managing the COVID-19 vaccine clinic before it evolved into the Wellness Hub?
Maryam Ebrahimpour: There was certainly a heightened need for COVID-19 vaccination across the Downtown East neighborhoods. We brainstormed ways to make access as barrier-free as possible. As subsequent waves occurred and boosters became available, we recognized the importance of community education. This led to the evolution of the vaccine clinic into a vaccine engagement initiative. A group of dedicated community volunteers received training on vaccine education before going out into their communities. They would go to skating events, university job fairs, and even playgrounds. Sometimes they escorted individuals directly to vaccine administrators for a warm handover. While other times they encouraged them to ask further questions.
What were some of the care needs that led the transition of COVID-19 vaccine clinic into an enhanced primary care clinic?
Monika Dalmacio: Throughout the COVID-19 pandemic, many clinics had to redirect their resources toward vaccination and testing. This led to a reduction in preventive screening and disease management. Consequently, individuals postponed screening or regular check-ups for chronic illnesses like diabetes and hypertension. Some likely went undiagnosed during this period, facing challenges due to the lack of in-person support. As things began to reopen, catching up became a daunting task for primary care providers. However, the Wellness Hub provided crucial support across the system, with a specific focus on unattached individuals, racialized communities, and those living in poverty. Unlike a walk-in clinic, the Wellness Hub offered comprehensive care services. This included preventive screening, chronic disease management, access to a system navigator, and health education from a registered nurse.
Maryam Ebrahimpour: Many people had additional needs beyond COVID-19 vaccination. This was particularly true for those who could not return to their home countries due to closed borders or faced uncertainty regarding their immigration status. So, when they required care beyond vaccination, they turned to the vaccine clinic. We have anecdotal accounts of numerous newcomers, refugees, and non-status folks who were unattached or whose primary care providers were not available.
What challenges did the Wellness Hub face in providing services to the Downtown East Toronto population?
Maryam Ebrahimpour: One of our challenges was expanding our services into spaces that were not initially designed for clinical purposes. During the pandemic, it made sense to provide vaccines in the lobby. However, as our services transitioned to offering primary care, requiring private spaces for sensitive conversations, lobby spaces were no longer suitable. We had to balance staying in a location familiar and well known to our clients while ensuring there were spaces that allowed for private conversations.
Monika Dalmacio: Ensuring ongoing care for those in need became challenging due to the time limitations imposed by the funding, as it risked leaving them without a primary care provider once the funding ceased. The primary care system is at capacity. That makes it difficult to find a permanent primary care home for the Wellness Hub clients. Our team has been determined and persistent in building connections with physicians in our community to facilitate the transition for individuals from the Wellness Hub. At Regent Park and Sherbourne Health, we have endeavoured to keep our doors open for primary care. However, our primary care providers also have their limitations in terms of capacity. Even across the system, we recognize the difficulty people face in finding family doctors or nurse practitioners, as highlighted in the news.
******************************** To be continued *********************************
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