Intake & Navigation


How Vaughan and Chigamik used the CIW as part of their intake

 
“If you don’t start in a holistic way i.e. take into account community, you’ll never end up with anything but a fragmented system. It all begins with the first point of contact. If you don’t start there you are forever in catch up mode where both the individual and community are the net losers.” Gary Machan

One strategic lever that some demonstration sites have used to apply the Canadian Index of Wellbeing is their intake process. This is highly significant, since aside from the obvious benefit of obtaining a far clearer picture of the people they serve, what these sites have learned is that there are numerous other benefits.
 
As Ana Katchatourien, Health Promotion Coordinator at Vaughan CHC states, “Clients didn't complain about the extra time for all the questions we had. They seemed to really appreciative what we were trying to do. That and you could really see through our interviews how some of the questions made people think about how there is a lot more to health than they had previously thought.”

Furthermore, “what we noticed is there was actually a really nice flow between our orientation sessions where we explained about the CHC model of Health and Wellbeing, and the intake tool since it confirmed in a really concrete way that our commitment to promoting community wellbeing lies at the very heart of what we are about.”
 
Using the CIW as an intake tool also has some real practical applications. David Jeffery, Executive Director of Chigamik CHC notes “if you ask someone if they are a member of any groups, or volunteer anywhere, it sometimes serves as a prompt for asking people if this is something they would like support in pursuing.”
 
“Using the tool in this way could result in far more effective use of our health care resources, since what often happens is people who are socially isolated have much lower health status, and are more prone to use formal health care providers, when really their needs could be better met by volunteering and joining groups should they be so inclined.”

“Bottom line, I think in the CHC sector we need to move away from this is what clinicians do, and that is what health promoters do, and strive to work in a way where every staff person promotes both individual and  community wellbeing; right from the front receptionist on to our nurses and docs. I believe having a holistic intake can help us get there.”
 

So How Did They Do It?

While there were some variations between how Vaughan and Chigamik performed their intake, listed below are some key factors that contributed to their success.
 
  1. Lead staff were identified on each site who were supportive about the process, and hence brought positive energy into the process.
  2. Proper training was provided to the staff/sites about the intake survey tool by the AOHC Education and Capacity Building Lead.
  3. The intake was part of an overall intake process and not something that was done in isolation such as was described above where in the case of Vaughan it occurred right after the orientation sessions.
  4. The CIW portion of the intake was preceded by a brief preamble about the purpose of the pilot, as opposed to people just being handed a form and asked to fill it in.
  5. Not only was the intake survey translated into French and Spanish but some staff were made available to help for people other ethnicities.
  6. Posters were created along with infographics in waiting areas to promote the Canadian Index of Wellbeing.


Some Initial Key Learnings RE: Phase I

While the initial experience of the pilot sites was positive, this should not be interpreted as suggesting further adaptations/changes with the intake tool/process. On the contrary, the whole purpose of the pilot is to identify areas for future refinement and development. Listed below are several learnings that were gleaned in Phase I.
 
  1. 1. In order for the intake to have broad value, it is better done using an interview format versus it being a form that people fill in. So much of communication is non verbal, need to have a skilled intake worker who is able to pick up on cues i.e. pauses.
  2. 2. Since this can be time consuming, there has been some discussion about whether the intake can be shortened, or at least some questions highlighted as being important to ask verbally i.e. ones that might align with the centres priorities.
  3. 3. Related to #2, there has also been some preliminary discussion as to whether it might make sense to take a few questions that are aligned with the Model of Health and Wellbeing to imbed in the intake, which could then be used to assess change.
  4. 4. Given this tool is very much in its infancy, it should continue to be rolled out in a strictly voluntary manner, and not be presented as something all CHCs will be required to do. Far better to go with CHCs that are receptive than been seen as trying to impose anything.
  5. 5. Due to interest expressed by some partners i..e 211, it might be timely to enter discussions with some key provincial, local partners about investigating the potential for inter-sectoral collaboration between key stakeholders.
  6. 6. Further research needs to be conducted on the suitability of some of the questions with CHC Clients, as well as taking cultural sensitivity into account.
 

Relevant Materials:

Download a sample of the Vaughan CIW Intake Survey (pdf)

Infographic used in waiting rooms: