Addressing a knowledge gap in the medical community
At Women’s College Hospital (WCH) we believe that quality healthcare
should be available to everyone. We know that after resettlement in Canada,
refugees often face significant barriers to accessing healthcare and have difficulty
navigating the health system. Additionally, refugee patients have unique
healthcare needs, given their often traumatic experiences prior to their arrival
in Canada. That’s why the hospital launched its Crossroads Clinic. Crossroads
provides comprehensive medical services to newly arrived refugee patients.
“The Crossroads Clinic is making an on-the-ground impact for our
patients here in Toronto. At the same time, our team realized that there was a
large knowledge gap within the medical community on the needs of refugee and
refugee claimant patients. We felt that it wasn’t enough to have a single
clinic, we wanted to learn more and share our learnings with other researchers
and clinicians,” said Dr. Vanessa Redditt, a physician at Crossroads and a Women’s
College Hospital Institute for Health System Solutions and Virtual Care (WIHV)
As a result, WIHV and Crossroads have collaborated to launch multiple
research and education projects. For example, WIHV, working with a refugee
health clinic in Calgary, is creating a clinical database to track the health
status of newly arrived refugees noting basic socio-demographic factors, as
well as patients’ health conditions. “We plan to expand this database to
additional refugee clinics across the country to gain a more comprehensive view
of the health conditions and care utilization patterns of refugee populations
in Canada,” said Redditt.
To address the systemic barriers refugee patients face in accessing
care, the research team has conducted a study with York University aimed at
understanding the perceptions of primary care providers. Through a more
comprehensive understanding of providers’ involvement in the care of refugees
and challenges they have faced doing so, WIHV hopes to identify interventions
to support practitioners and in turn improve access to care.
Dr. Redditt and her team have also launched a series of workshops and
studies based out of Crossroads. “We recently launched a cervical cancer
screening study and are piloting a series of perinatal education workshops for
refugee women. The workshop content is particularly focused on health system
navigation, accessing community services and supporting healthy pregnancy and
newborn practices in an unfamiliar context,” Shivani Chandra, a WIHV research
This research program has not only led to quality improvements at
Crossroads but has helped to enhance medical and research education across the
country. The team has shared their initial findings with researchers and
clinicians at major conferences, generating greater understanding of the unique
needs of this patient population. Additionally, through the refugee shelter
outreach program created by WIHV and Crossroads, medical students are gaining a
deeper appreciation of social determinants of health and learning to provide
more sensitive and culturally safe medical care.
“Having the medical students volunteer with our programs, really enhanced the experience for the clients. It allowed students to create a rapport with clients, while also encouraging clients to engage with more people in the wider community. Working together promotes understanding, knowledge exchange and also assists clients with integration into their new communities. ” – Andrea Herod, Transitional Housing Coordinator, Sojourn House
As this research program continues, the team will be looking to dig deeper into how health status and access to care influences integration and social outcomes for refugee communities.
From Research to Practice
WCH’s Crossroads Clinic
Arriving in Canada with the hope of a better life, refugees often deal with the immediacy of finding housing and employment, culture shock and learning a new language. As a result, healthcare can easily slip down the priority list – despite the fact that many had to deal with lack of access to curative and preventive healthcare, psychosocial effects of war and violence during sometimes long stays in refugee camps.
Despite these pressing healthcare needs, a range of factors can impede their access to healthcare resulting in late intervention and potential health risks and complications like difficulty navigating our complex healthcare system, competing resettlement priorities and lack of familiarity with concepts of preventive healthcare.
To address these factors and help make the transition easier for newly arrived refugees, WCH created the Crossroads Clinic, Toronto’s first hospital-based refugee health clinic. The clinic aims to provide comprehensive primary care that is responsive to the unique and unmet needs of refugees during their first two years in Canada.