Grant: Project Grant

Emergency Departments (EDs) in Canada often operate over-capacity and are under increasing pressure. Consequently, despite intentions to uphold principles of fairness, particular groups of people continue to experience inadequate and inequitable treatment in EDs, including Indigenous people, racialized newcomers, people with mental illnesses, facing homelessness, experiencing interpersonal violence or using substances. Stigma and discrimination operating in health care can discourage access to care, result in reliance on EDs, interfere with effective care delivery, and increase human and financial costs. This project will develop a framework for health equity interventions to promote the provision of equity-oriented care (EOC) in Emergency Departments (ED). Through an integrated knowledge translation approach consisting of a three-way collaboration among health researchers, Indigenous leadership and health care leadership we will produce a framework to promote equity for Indigenous people in ED that can be applied beyond the context of ED and beyond promoting equity for Indigenous people. The framework will integrate evidence-based strategies to address stigma and discrimination faced by both Indigenous and non-Indigenous people including that related to racism, gender and heteronormativity, substance use, housing instability, commercial sex work, or mental illnesses. We will work with three EDs in different settings: an inner-city, a large suburban area and a rural serving regional centre to develop, test and refine the framework. This research has great potential to promote equitable health care and health systems, and dramatically improve health outcomes by targeting people who have the greatest health challenges and unmet needs, contributing to repeat ED visits. The research is innovative in its implementation and testing of tailored interventions at an organizational level, leadership structure, and meaningful collaboration across professions and sectors.