Program overview :

Enabling Chronic Disease Management Services in the Lil’wat Nation Through Virtual Health

Vancouver Coastal Health

The virtual health team at Vancouver Coastal Health (VCH), in collaboration with the VCH Sea to Sky chronic disease management team and the Lil’wat Health and Healing Centre, adapted an existing framework to support chronic disease management services within the Lil’wat Nation community. This initiative aimed to improve access to culturally safe and uniquely tailored education for Lil’wat Nation community members living with diabetes, addressing a previously unmet need.

Objective and purpose of the promising practice 

The primary objective of this promising practice was to improve access to culturally safe chronic disease management and care in communities like Lil’wat Nation. The virtual health team prioritized building strong relationships with Lil’wat Nation community partners by conducting engagement sessions, completing cultural safety training, assessing the appropriateness of transitioning to virtual access and developing a culturally sensitive curriculum.

Approach 

Engagement

The project involved the VCH Sea to Sky chronic disease management team, community leaders and the virtual health team collaborating with the Lil’wat Health and Healing Centre leadership and clinician team to provide the resources necessary for delivery of care through virtual means as part of their diabetes education series.

Educational seminars, co-led by a Lil’wat Health and Healing Centre clinician and the VCH Sea to Sky chronic disease management team, were tailored to support community members living with chronic diseases, such as diabetes and pre-diabetes. The Lil’wat Health and Healing team guided the development of the curriculum, ensuring that the community’s (community members and health service providers) needs and perspectives were central to the project. Providers and clinicians committed to identifying champions to collaborate in the design and decision-making process. This approach was in line with Vancouver Coastal Health’s commitment to inclusive and community-driven healthcare.

Outcomes

Prior to the development of the diabetes educational program, Lil’wat Nation community members were primarily accessing diabetes support through the phone or on a 1to1 basis with the VCH team. The launch of the educational program has improved access to a hybrid virtual model in which patients access diabetes support both virtually and in-person. This model incorporates culturally-safe and uniquely tailored diabetes support for the Lil’wat Nation community. In addition, the series provides the opportunity for social connection and support within a group setting.

The current diabetes education program is held annually, with a goal to increase to twice a year. The program aims to engage up to 20 new participants in the diabetes education series. Additionally, after completing the series, the program will continue to offer individualized sessions for participants. This project continues to explore future opportunities to expand as relationship-building efforts are sustained and our understanding of community needs deepens. Through the education series we've identified a need to enhance access to lab services, particularly for HbA1c testing. Lil'wat Health and Healing has since launched their HbA1c testing program with several patients on the first run, testing will serve as a valuable complement to the educational sessions.

Impacts and learnings

Key takeaways 

• Stakeholder engagement was crucial in designing a program that meets the needs of the Lil’wat Nation community.
• Continuous collaboration between the virtual health team, the VCH Sea to Sky chronic disease management team, and the Lil’wat Health and Healing team led to the integration of sustainable new technologies, stronger relationships between decision-makers across organizations, and a better understanding of their needs and limitations.
• Prioritizing collaboration and relationship building supported a natural evolution of the project and program delivery rather than focus on a timeline-based management approach.
• Support for digital devices and resolving software and hardware issues were essential, especially given the limited staff in rural areas.
• Pre-existing relationships with key leadership members facilitated engagement.

Facilitators

• Strong partnership between the VCH Sea to Sky chronic disease management team and the Lil’wat Health and Healing Centre. 
• Access to Zoom virtual meeting platform and an OWL conferencing device for meetings.
• Collaboration between operational teams, including IT staff and management.

Barriers

• Ongoing IT support was needed to address issues with technology during sessions.
• Limited response and feedback to surveys hindered the understanding of attrition and other issues.

The virtual health team at Vancouver Coastal Health, in partnership with the VCH Sea to Sky chronic disease management team and the Lil’wat Health and Healing Centre, developed a culturally safe and uniquely tailored framework to support delivery of chronic disease management services to Lil’wat Nation community members. This initiative, which includes virtual diabetes education sessions, enhances access to chronic disease care and overall population health.

For more information:

Abigail Gillego, Project Manager
Virtual Health Team
Vancouver Coastal Health
abigail.gillego1@vch.ca