BY REBECCA ANTHONY

The Institute of Healthcare Improvement (IHI) is an international organization dedicated to quality improvement in healthcare. IHI offers online coursework that is free of cost for health care students that focuses on quality improvement and safety for the delivery of healthcare. The IHI Open School Change Agent Network (I-CAN) is an international community of learners from countless disciplines and geographies, who are committed to applying leadership and community organizing skills to improve health and health care in their local settings. IHI Open School provided us with a framework and the necessary guidance and knowledge to plan and improve our community engagement initiative. Specifically, it provided us with the Plan, Do, Study, Act framework to implement our project and improve upon it through each iteration.

As a final project of the Bachelor of Science in Nursing at UBC-Vancouver, students engaged in a multitude of community engagement projects that are aimed at improving healthcare quality and safety and health promotion. For our initiative, we collaborated with the Union Gospel Mission (UGM) to host free foot soak clinics during their lunch service. The UGM is a charitable organization in Vancouver’s Downtown Eastside (DTES). Every day, they provide free meals, emergency shelter, and recovery programs to people living with poverty, mental illness and addictions in this neighbourhood.

Our foot soak service offered clients accessing the lunch service to soak, clean and have their feet massaged and dried thoroughly, and to get a new pair of socks; a small action that goes a really long way in Vancouver’s damp weather. During this time, the UBC student nurses were able to engage with clients, assess their foot health, talk about their general health and their concerns and make a referral to primary health care services in the community if desired and indicated. Simultaneously, students were able to get to know some of the real people living in this community and were able to gain some understanding of how social positions intersect as the social determinants of health can impact an individual, a community and populations health and well-being. Every six weeks students working through their community health rotations would cycle through and participate in hosting the foot soak clinics.

On March 3, 2017, with the support of UBC Faculty members Ranjit Dhari and Dr. Maura McPhee, I co-presented with fellow student Maryam Koochek, at the Quality Forum 2017 in Vancouver, B.C. We participated in the rapid-fire presentation series: Engaging Students in High Quality Care. We shared the story of our IHI I-CAN quality improvement project. We shared that through this work we were most proud of the positive rapport and long term relationship we have built with our partners and the pope accessing UGM; people look forward to the UBC nursing foot soak clinics, and even though we are not the same people each time, we are known in the community as a group of people who are there to listen and care. The greatest lesson we learned throughout this experience has been that creating sustainable change is not easy; It is complicated and nuanced and it takes a lot of hard work and creativity. It cannot happen overnight or even in 8 weeks. What you think is important for the client is not always accessible for them. You need to change from a minset of “fixing” to a stance of listening and supporting. Our presentation was met with overwhelming positivity and interest from the audience, including an offer to collaborate with other health professions, to come roll up their sleeves next to us.

The I-CAN project also received the 2017 Quality Culture Trailblazer Award-  Runner Up. Read more about the award here.