https://www.equityorientedcare.org/home daily 1.0 2021-09-15 https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f3ff03bf559905dead92e68/1599717949645/media_BLog_HealthEquitySeries_2.jpg Home https://www.equityorientedcare.org/ethics-aims daily 0.75 2020-09-10 https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f59c8407dcf243c53a35380/1599719503229/IISC_EqualityEquity.jpg Ethics & Aims - You may have seen helpful graphics that attempt to explain the difference between equality & equity. Here’s an interesting read about why some graphics can reinforce deficit-thinking of differently abled & racialized folks. https://culturalorganizing.org/the-problem-with-that-equity-vs-equality-graphic/ https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f4217b161f8cf24f5bae571/1598166973185/justice-rising-ECHO-AND-EARL-23.jpg Ethics & Aims - What is Equity? Equity is not the same as equality. Equality is about providing the same to everyone. Equity is supporting someone in the ways they need in order for all of us to achieve the same outcomes. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f59874d654f8b4023773a84/1599702884984/logic_model2-1.jpg Ethics & Aims https://www.equityorientedcare.org/photovoice daily 0.75 2020-09-10 https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f4fd96490bc773755115aa5/1599068553507/antonette_bike.jpg Photovoice: un/safety in clinic spaces - Peer Antonette highlights her experiences engaging in this process, safety in the clinic and how that can change over time, and delights us with her poetry: https://youtu.be/i0vqJiIXFck https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41a3e585783706be1f85dc/1598137350450/IMG_0029.JPG Photovoice: un/safety in clinic spaces - Kat, Blackfoot It’s just one tree sitting there. I have had dreams of this one tree. And, I don’t know why, I don’t understand why I have dreams of this one tree. It doesn’t matter how it loks, its just this one tree on a hill or on a side soewhere or in the Rockies somewhere. The one tree, I don’t know, but it always makes me feel safe every time I think about it or go to it. In my dreams or if I am feeling stressed out or something, then I will close my eyes and go to it. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41998a1f6b051d9f4f46de/1598165524325/k1.jpg Photovoice: un/safety in clinic spaces This is my peer group, this is the only peer group that I have ever been to, but this is my peer group, the only one that I want to go to. It’s my group, it has the flowers, it has the tables, it has someone sitting there who is going to eat and it has other people sitting there talking. And I like that, it makes me want to cry. It’s a nice feeling, something that I am going to miss. Cause I don’t think that we should take that away. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41a626e79b782feec5ecc6/1598138117394/IMG_1598.JPG Photovoice: un/safety in clinic spaces - Laural It’s like the doors of perception, behind where the light is shining, you’ll find love. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41c6f59cd6131f92ab4a80/1598146467791/CIMG7000.JPG Photovoice: un/safety in clinic spaces They don’t seem to give you a choice. If it’s womxn’s night, I’ve tried to make an appointment during the day if it’s important. “Oh it’s womxn’s night tonight, come tonight.” All the regulars that go and they don’t want to leave. When I finally get to see her, like two minutes in ther, she’s saying “okay, time to go.” I’m not very happy about that. You don’t see us once in a while? We come and we try and make an appointment at the front. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41bef796cb8352b44acf5a/1598144254386/harm%2Breduction.jpg Photovoice: un/safety in clinic spaces - Harm reduction cart Because it’s so nice and colourful. You don’t see the needles at all, but people know where they are. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f420c820f73c2195effdff2/1598164104488/mirror.jpg Photovoice: un/safety in clinic spaces Antonette, hybrid I love the mirror because it’s there. And you’ve got the handwashing thing, soap, water, clean. Touch up your make up, your lips. I like mirrors. You see everything that’s going on. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41c8730f73c2195efac4e9/1598146830463/CIMG7002.JPG Photovoice: un/safety in clinic spaces I took a picture of a tv because that is what I do everyday when I am at home or at the clinic, it takes my mind off of waiting and being bored and stuff. I feel comfortable and safe doing that. It was nice to watch it without having to read the lips. You’re not guessing what the movie is about. Here they don’t turn the volume on. Cause the security doesn’t like it on. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41c19ca4e40060b3b2a71a/1598144969042/20200213_164240.jpg Photovoice: un/safety in clinic spaces Empty clinic with a sign out front. Looks safe when it’s empty. Less people the safer it feels. I’m not in there, so I’m ok. A lot more inviting with less people in it. It’s intimidating, who’s in the waiting room. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41c2c47999cb5b508f1e7c/1598145254801/20200309_190446.jpg Photovoice: un/safety in clinic spaces This one of course also has the escape route, the bike. If you knew how to ride the motorbike you would feel a lot more safe. Gate indicates change, moving from one space to another, move from danger to safety, or safety to danger. A gate of new opportunity, gate of discovery, makes you feel safe inside. You can keep the cold, cruel world at bay, if you are inside the gate, and the security guard to watch. The security guard makes me feel safe, makes my bike feel safe. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41ac1f0f73c2195ef82ebd/1598139536202/IMG_1604.JPG Photovoice: un/safety in clinic spaces Hard to capture what I wanted to capture. Just how grimy it was. I’d say that a Kits Clinic wouldn’t look this way, so why is it ok for here? That relates to respect. Maybe you live up to your surroundings? https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41ca527e9b7e522a512b7e/1598147229612/IMG_0041.JPG Photovoice: un/safety in clinic spaces - Clinic Support Attendants (CSAs) [The CSA] walks you out….gives you the biggest smile. I feel more safe with the gates, cause there’s a guy outside when we went to Heatley and he was giving ladies problems. And then [CSA] he went outside and got the guy to move away, so they make me feel safe. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41be5cd9abee0b99fcb457/1598144129452/homeless.jpg Photovoice: un/safety in clinic spaces I think that some people are nodding off, cause they don’t have a place to live and so, this is a safe place and some people fall asleep. I was homeless. We were homeless before but we moved here and we were homeless when we were teenagers, older teenagers and I was going to work at ___ cafe, where HAVE cafe is and I was working there, but we were homeless, so I was up all night. We had no place to go, you know its like you need a place to just sit there. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41c52361f8cf24f5b4d8ca/1598145983830/CIMG6900.JPG Photovoice: un/safety in clinic spaces - Annie, Nuxalk Nation When I phoned, nobody answered. I come down here and they’re all talking about what they’re gonna be doing when they’re off. Maybe an hour before closing down. They’re standing in a group of four, maybe five talking about their home life. I had to stand there for five minutes before someone even noticed me, a couple of times. Didn’t want to be rude, but still. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f4206e87e9b7e522a55ca6f/1598162669963/injection.jpg Photovoice: un/safety in clinic spaces > Yes it’s safety, supervised safety. Harm reduction being out in the open. I think all drugs should be legalized, decriminalized & free. Those companies are making so much, they should be providing them. If children grow up around it, it ceases to be traumatizing. People could be discrete [if it was legal]. It’s the stigma of using that causes people to just get it in them and make a mess. People are dying just because of the secrecy, people’s attitudes, the way they’ve been brought up to think about it, it’s all unhealthy. It’s unsafe. And then the whole incarceration system that goes with it. Unnecessary. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41c0472428047f123ccc9d/1598144617213/reception.jpg Photovoice: un/safety in clinic spaces I feel safe with that one. This one I feel safe because it is opened up, you can see the people, the receptionists. Compared to here, you have to lean over or talk in the little things when they are just right there. When [Pender] it’s just open. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41c22bef576864daf72381/1598145094420/20200213_174934.jpg Photovoice: un/safety in clinic spaces Wisdom, courage & love. We should always carry that with us, the love and the courage. I hope find the wisdom that you are looking for there to answer your concerns. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41ab027999cb5b508cfebf/1598139304274/IMG_1599.JPG Photovoice: un/safety in clinic spaces The whole angels thing. Angels are here. Some of the staff are somewhat angelic to work here. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41bf4f381f2c334d3aa195/1598144345492/bathroom.jpg Photovoice: un/safety in clinic spaces I chose the harm reduction, but I like it because it opened up the bathroom area where you wash your hands and all that. The Heatley, I like their bathroom, how they have it all set up it’s so bright around that area where you can not see sometimes in that area where the lights are so low. […My daughter, I] go to the bathroom with her. This one, I could just sit there and she’s right there. So it’s nice and bright. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41bc62074c471375d16e78/1598143608705/phleb.jpg Photovoice: un/safety in clinic spaces Tara I don’t like that room at all. Because of the needles and all. It needs more artwork or some kind of calming music. So you don’t pay attention to - cause I always go like this when they are taking blood. I just don’t like needles. At the site of a needle, I want to throw up. That’s why they need something to distract. There’s a lot of posters of blood work, of how much blood work they are going to take out. You know, the tubes. Even when they have the gloves out, you see it, you smell it. Just the thought about it. Cause I used to give myself a shot. Methotrexate shot by myself for a couple of years or so, before i started coming in to get it. I do not like that medication at all. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41fc9396cb8352b44ff423/1598160039406/IMG_0033.JPG Photovoice: un/safety in clinic spaces - Bathrooms > They didn’t look clean. I want to walk into a bathroom and it looks clean…at least half clean. Like, I can sit down on it. > I really hated that when that guy came into the bathroom. I didn’t like that. you’re in the bathroom and they open the door, It shoulodn’t be a guy in there, that’s really upsetting. I don’t like how that happened. Sometimes that’s how we got dates whether you really wanted them. And, if he’s security, why is he like that. It’s not nice. They should have women going in there. I didn’t even finish going to the bathroom. > Yeah it’s so much harassment right now. I’ve had nothing but problems going to the bathroom anywhere lately. > I’ve actually asked for accompaniment to go to the washroom now. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f4207988938b128602f6e65/1598162847274/chairs.jpg Photovoice: un/safety in clinic spaces - Waiting Room Safety from violence > I think we need to help people be safe here. > He got my cigarettes. Stole them. Someone pulled a scarf right off my neck one day cause they were too cold. Pulled a scarf right off my neck going out the door here. > [Security] is cranky, if [security] doesn’t like you, [security will] put you down. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41fa1926f6c17cdf00a94b/1598159409862/CIMG6924.JPG Photovoice: un/safety in clinic spaces - Bigger group themes Harm Reduction > I felt safe outside there. > If [children] grow up around it, it ceases to be “other".” A kid might say “oh, mommy what’s that?” and mom can explain. > That’s when I was ten years sober. I didn’t want to come out that day. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f41ff5ca662a5713442c90e/1598160758224/gate.jpg Photovoice: un/safety in clinic spaces - Gates > The gates are safety from violence. > i don’t like the gates because I have gotten stuck on both sides and not been able to get out. That’s my main thing of feeling scared, feeling like I can’t get out. And, I feel like I’m being stuck or pushed back or something. These gates represent that. I can’t, I can’t, its just too much for me. > I seen the gates all over and oh god. you felt like you were in jail again, get arrested again or I why should go to the Dr.? I scared to go because it’s like a jail. The bars and that aren’t welcoming at all. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f42053bd9abee0b990256cd/1598162320574/CIMG6997.JPG Photovoice: un/safety in clinic spaces - The Seven Sacred Teachings > I took them because some of the words that were on the signs, I thought, made me feel comfortable…Wisdom and Respect. > I think that’s what kept me alive is um seeing the strength and Wisdom and respect. Seeing those words, at different places… on the counter at the social workers office I used to read it and put one on each of my shoes and I’d always watch on my feet… those signs and affirmations that were a comfort. Helped keep me safe. > So it take a long time for me to trust. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f420f177e9b7e522a5657a8/1598164812783/IMG_1593.JPG Photovoice: un/safety in clinic spaces - 2SLGBTQIIA+ inclusive art & symbols https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f4209b78938b128602f8dee/1598163391671/chairs2.jpg Photovoice: un/safety in clinic spaces - Seating > Um i don’t know, I just find that they are just, not comfortable. > I thought that they were nice and clean, just like the safe injection picture that I took. They were nice and clean. > It’s intimidating who’s in the waiting room. The chairs too close. I would not have a place to sit. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f420e4cd9abee0b9902ed04/1598164584192/CIMG6929.JPG Photovoice: un/safety in clinic spaces - Good times I had some fun times chasing the dragon there ‘cause I can’t shoot needles anymore. I felt safe outside there, sunny days, everyone is there having a good time and chasing the dragon. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f420cef7851a152fd1337a4/1598164218204/cross.jpg Photovoice: un/safety in clinic spaces - Strengths: East Van Community Pride [I like this art] cause it has east van on it. And it has the hand sanitizer beside it. I don’t know, it just reminds me of east van - community pride. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f420de6d9abee0b9902e38e/1598164463017/belonging.jpg Photovoice: un/safety in clinic spaces - Spirit, resilience, belonging This is the themes, last year’s themes at the Hope and Shadows. Spirit and resilience, belonging was this year and I made both of these, actually. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f420f7c7e9b7e522a565a08/1598164894228/IMG_1597.JPG Photovoice: un/safety in clinic spaces - Maps of Indigenous territories & Indigenous art https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f4210556c65f16b60059565/1598165083707/flower.png Photovoice: un/safety in clinic spaces - Plants & flowers And it would be nice to see some plants in doctor’s offices. And flowers. https://www.equityorientedcare.org/pac daily 0.75 2020-09-10 https://www.equityorientedcare.org/eoc daily 0.75 2020-09-17 https://www.equityorientedcare.org/support daily 0.75 2020-08-21 https://www.equityorientedcare.org/equity-walkthroughs daily 0.75 2020-09-10 https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f4d9ed856777619e28d7e53/1598922475173/CIMG7003.JPG Equity Walk-Throughs - Washrooms Points raised: Sometimes washrooms are not clean, hygienic or accessible. Male staff entering female washrooms is triggering. Gendered washrooms are sometimes unsafe for trans & non-binary folk. Early closure of washrooms (at 5pm) was perceived as stigmatizing of homeless folk Solutions: Clean, hygienic and accessible washrooms. When doing washroom checks please ensure that female staff are checking female washrooms. Staff need to address gender policing regarding washroom use. Clinics need to assess washroom accessibility & closures. VCH document on washrooms & safety: http://www.vch.ca/Documents/DTES-Washroom-Design-and-Use-Recommendations.pdf https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f4dbea332a7ea184a4ccc5e/1598930617808/ag_sacredroom.jpg Equity Walk-Throughs - Treatment Rooms Points Raised: “[The Sacred Room] feels very safe - I would love to take my grandchild here.” [Pender group room]: loved the wall colours, loved the clients’ art. Lights sometimes too bright, or not bright enough. “When they take your blood out of you and there is people walking by and they stare right at you. And it’s like, ok, this is private.” Clinical spaces can be triggering of past bad experiences. Solutions: More sacred spaces. Effort put into art & pictures on the walls, plants in the space appreciated. Different lighting options. Ensure privacy & confidentiality. Being mindful that clients have been traumatized in clinical spaces, naming it, and checking in about options to enhance safety. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f457c84bb0b1537ebdf133a/1598389405871/CIMG6906.JPG Equity Walk-Throughs - Entrance Points raised: Cannot tell from outside that they’re clinics Lots of activity at entrance intimidating Concerns about cleanliness Closed gate can be understood as clinic is closed; be triggering; or be considered supporting of safety from violence. Solutions: More obvious, brighter, lighter signage outside Entrance areas kept clean of dirt and clutter Having CSA & other staff to indicate clinic is open, to welcome people in, and to address problematic behaviour. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f4dbc4056777619e2917242/1598930007341/CIMG6902.JPG Equity Walk-Throughs - Waiting Area Points Raised: A lot of busy information, signs, not well-organized, outdated, not positive. Lack of inclusive signage/messages. Loved the chalkboard. Seating too close, hard to move, intimidating. Male aggression toward gender marginalized clients with little or no intervention. Solutions: Process for monitoring signage, what gets put up or taken down. Inclusive, accepting, welcoming signs, messages & art. Chalkboard or other shared communication space for engaging patients. Seating spaced out so that one does not have to sit next to someone. Staff intervening when there is violence. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f421a5596cb8352b451aabd/1598167856192/ Equity Walk-Throughs - Front of Clinic Contact Points raised: “We got lost down here and couldn’t find the place.” “Smiles when you first walked in.” Staff having personal conversations with other staff in client use areas. Solutions: Staff are available to welcome and direct clients as they come in. Awareness and use of positive body language. Client-centered conversations in client use areas. https://www.equityorientedcare.org/team daily 0.75 2020-08-23 https://www.equityorientedcare.org/language daily 0.75 2020-09-24 https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f6c3643cfe74f2b67ac56d5/1600927338117/FB_IMG_1599843719147.jpg Charting, Documentation & Language https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f6c3788f5c0333cad837595/1600927632829/FB_IMG_1599843753422.jpg Charting, Documentation & Language https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f6c36eccfe74f2b67ac64b6/1600927480181/FB_IMG_1599843724940.jpg Charting, Documentation & Language https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f6c370b2e37aa70f99bf811/1600927509336/FB_IMG_1599843738769.jpg Charting, Documentation & Language https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/5f6c37ba44f38b40c4bca3ef/1600927682231/FB_IMG_1599843760172.jpg Charting, Documentation & Language https://www.equityorientedcare.org/community-of-practice daily 0.75 2020-10-26 https://www.equityorientedcare.org/placemaking-graffiti-our-gates daily 0.75 2021-09-15 https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/61423ae9966ebf00ed6b7fd4/1631730426520/2299769048907070312.jpg Place-making: Graffiti our gates! - Faites-le ressortir Quel que soit le cas, la façon dont vous racontez votre histoire en ligne peut faire toute la différence. https://static1.squarespace.com/static/5f2a16ca3a7e6c3cbf4d619c/t/61423b0710390535c189986a/1634706886922/-2725531068223965569.jpg Place-making: Graffiti our gates! - Faites-le ressortir Quel que soit le cas, la façon dont vous racontez votre histoire en ligne peut faire toute la différence.