Issue 20 | December 21, 2022
Monthly Bulletin of the Alliance's Learning Health System
Finding Common Ground: Inuit Wellness Summit
LHS: 2022 In Review
& Sneak Peek of 2023
Help Design our New Evaluation Framework
Alliance 2023: Call for Abstracts
Holiday Reading List
New Tools &
Get Involved: Research & Sharing
Learning Events & Programs
Finding Common Ground Inuk Wellness Summit
by Natasha Beaudin and Crystal Tunnillie
Finding Coming Ground – A Knowledge Mobilization Symposium with Inuit was co-hosted by Pauktuutit Inuit Women of Canada, the Centre for Research on Health and Nursing, and the University of Ottawa on December 8. Inuit, students, researchers, and service providers gathered to share knowledge and experiences. Natasha Beaudin, Social Prescribing Project lead at the Alliance, and Crystal Tunille, a student placement from Carleton University, attended the symposium and shared this report.

Situated in Culture

To start the event in a good way, we began with a prayer and the lighting of the qulliq (traditional oil lamp) by Elder Jeannie Okalik. The qulliq is a symbol of Inuit women’s strength, care and love. Country food was another cultural highlight. Lunch featured a delicious spread of Arctic Char chowder, Musk Ox Chili, and Palaugaa (bannock), with chocolate chip cookies for dessert. Inuit art was also available for purchase.

Innovation and System Change

In the morning, Crystal Martin-Lapenskie, an Inuit entrepreneur, moderated a discussion called Inu-vation: Challenges and Opportunities for System Change. Martin, originally from Hall Beach, Nunavut, has worked as a social service provider. She also works with Indigenous Geographic, a film, production and consultancy company that helps share stories of Indigenous Peoples. 

Representatives from five Inuit-serving organizations in Ontario were on the panel:

In describing Akausivik’s work, Siedule pointed out the incredible resilience of Inuit, who have survived and thrived under conditions that would break most people. She also spoke about the high levels of trauma and complex mental health challenges experienced by Inuit due to the continuing legacy of residential schools and other forms of colonialism, and how this complexity in the population must be met with an equal measure of excellence in care. “In order to deliver excellent care to people who are experiencing more trauma and complex mental health, you have to be very good at your job,” she notes. Cultural safety is essential, and Akausavik’s research reveals that it’s one of the main reasons their clients choose to receive care there. As one client put it, “I don’t experience racism here.” Compassion also infuses every aspect of Akausavik’s work. “When in doubt, do the kindest thing,” says Siedule.

Tochman spoke about the services offered by Tungasuvvingat Inuit (TI) and the policy work they are doing. TI’s social housing program has grown over the past 21 years to support 504 residents. The high prevalence of Inuit homelessness in the south means there is a great need for culturally specific supports. Rooming houses, which provide affordable and somewhat communal housing, can be part of the solution. Unfortunately, gentrification has led to a 62% loss in rooming house spaces in Ottawa between 2021 and 2011. This is making the housing situation for those on fixed incomes, such as Ontario Works, increasingly dire.

Other Highlights

Among the many interesting afternoon sessions, we found two particularly impactful:

  • Co-designing Boating Safety Programs with Residents of the Inuvialuit Settlement Region by Audrey Giles, a professor at the University of Ottawa. Professor Giles has adapted evidence-based drowning prevention programs to make them specific to the culture, location, and circumstances of Inuit living in Nunavut. She spoke about the importance of meaningful community involvement in this work – paying participants for their time, ensuring the training addresses community interests and needs, and reflecting local realities. For example, in Northern Inuit communities, radios and survival suits are more important than lifejackets, which are ineffective in the cold waters of the Arctic, and drowning is more often the result of a vehicle falling through the ice than a swimming accident. 

  • Integrating Inuit Knowledge Down South by Tapisa Kilabuk, a Nunavummiuq (resident of Nunavut) post-secondary student researching Inuit Studies. Kilabuk reflected on her own experiences in a post-secondary Indigenous Studies program, where the curriculum lacked Inuit representation and awareness of Inuit governance. She hopes that her research will help bring about changes she would like to see for herself and future Inuit students. 
Above: Crystal Tunnillie (L) and Natasha Beaudin (R) at the symposium. Top: Elder Jeannie Okalilk lights the qulliq. Photos courtesy of Natasha Beaudin.
Be an EPIC guest author! If you've got a story about research, learning, or quality improvement you'd like to share with the Alliance, our members, and our partners, please email [email protected].
Looking Back; Looking Ahead
An end-of-year update on the EPIC Learning Health System.

The Alliance for Healthier Communities continues to grow as a learning health system. We are grateful to all our member organizations the system and community partners who are on this journey with us. Together, we have accomplished some great things in 2022, and even more is coming in 2023! Read on for highlights of the past year and a sneak peek at what's next.
In 2022, the EPIC Learning Health System...

  • Supported 13 CHCs and 40 Seniors' Active Living Centres across Ontario who are working together to provide social prescribing referrals and programs through Links to Wellbeing.

  • Continued to supported our sector's Community Vaccination Promotion initiative. Participating organizations have now reached over 32,000 individuals and families in person and over 250,000 through social media, contributing to nearly 20,000 choosing to be vaccinated against COVID-19.

  • Contributed data to 12 ICES-led research projects.

  • Led or co-led 12 new research projects (in addition to many others already underway). These include studies on virtual care, patient-reported outcome measures (PROMS), health promotion/community development, equitable screening for cancer and diabetic retinopathy, and more!

  • Produced a new OHRS Benchmarking report to help our CHC members track and compare their financial and statistical data.

  • Supported 7 communities of practice for community vaccination, social prescribing, ACES and Community Resilience, Safer Supply Programs, and EMR/Data Management.

  • Research and learning partnerships with 6 graduate, undergraduate, and post-doctoral students.

What's coming next year? New initiatives on the horizon include:

  • More expansion of Social Prescribing with a new Social Prescribing for Mental Health program.

  • A reimagined and streamlined Community Initiatives Reporting Tool.

  • A refreshed and updated Evaluation Framework.
The National Safer Supply Community of Practice was named
one of Canada's ten Health Heroes for 2022 by Best Health,
a publication of Reader's Digest Canada.
Help Wanted!
Evaluation Framework Update Working Groups
Alliance members: Sign up by January 16 to join one of the working groups that will support the Community Health Centre (CHC) evaluation framework. We're seeking representation from a diverse set of stakeholders including clinical and interprofessional health care providers, managers, administrative staff, and data management coordinators.

The CHC Evaluation Framework (EF) was designed in the context of the Model of Health and Wellbeing and reflects the strong history of collaboration between our member centres. They have come together over many years to determine what data reflect who they are and how they want to be collectively evaluated.

The EF guides what is entered and collected from each member organization's EMR system. It enables us to measure our sector's collective outcomes and impact. The Framework is revised every three years to ensure that the data fields and response options continue to reflect current practice, as well as any relevant changes in the broader service delivery context. It is due for an update in 2023, and we're seeking participation from across our sector in the process.

To support the EF update, we'll be convening three working groups with distinct areas of focus:
  • Registration/sociodemographic data.
  • Individual service event data.
  • Personal development group data.

Decisions about additions, revisions, and deletions will be made through consensus. Any recommended changes will go to all centres for feedback by email/survey options, and any confirmed changes to the data fields or response options will be approved by EPIC and then communicated to TELUS and the BIRT team.

The working groups have a target start time in February 2023. Each one will meet several times to review and discuss relevant data fields and response options. The expected time commitment is approximately 8 hours over 4 months.
To join one of the working groups or learn more about this update,
please email [email protected] by Monday, January 16. 2023.
Alliance 2023 | Connected Communities: Building Equitable Integrated Healthcare
Call for abstracts now open!

Save the date! The Alliance's next annual conference takes place on June 7 and 8, 2023, in Toronto. This year's theme, Connected Communities: Building Equitable Integrated Healthcare, prompts us to discover the opportunity in health system transformation. Join us as we explore how to move beyond the current crisis and build an integrated care system that centres health equity, community, and wellbeing.

Research evidence demonstrates that integration alone is not enough to transform health care. However, when an integrated care system centres health equity and community voices, it has the power to improve the health of a whole population. Comprehensive primary health care is  the foundation of such a health system, and Connected Communities: Building Equitable Integrated Health Care, we'll learn together how to strengthen and build on that foundation. We'll hear about community-led innovations, evidence-informed practices, and emerging research that together can inform and empower transformative change.
Let's build Connected Communities together!
Your EPIC Holiday Reading List

You've got your coziest blanket, a mug of your favourite warm beverage, and a comfy spot to curl up in. All you need is something to read. These recommendations from Alliance staff and partners will inspire you, help you relax, and fuel your curiosity and imagination through the holidays and beyond.
Four Thousand Weeks: Time Management for Mortals by Oliver Burkeman. Burkeman encourages us to rethink our cultural fixation on productivity. Life is short; let go and use your time to do the things that are most important to you! Recommended by Natasha Beaudin, Alliance for Healthier Communities.

Bitter Almonds by Lilas Taha. This novel is a love story set against the backdrop of real-life events in Palestine. It was written by an award-wining, rising American author born in Kuwait to a Syrian mother and a Palestinian Father. Recommended by Rima Al-Dajani, Alliance for Healthier Communities.

Field Guide to the Haunted Forest by Jarod K. Anderson. These short, meditative poems celebrate the magic of nature and remind us that we humans are a part of that magic. Recommended by Catherine Macdonald, Alliance for Healthier Communities.

Heroin: An Illustrated History, by Susan Boyd. A history of Canada’s drug policy from several centuries back until the present. Recommended by Robyn Kalda, National Safer Supply Community of Practice.

Overdose: Heartbreak and Hope in Canada’s Opioid Crisis, by Benjamin Perrin. "A book that’s probably most useful to help make the case for drug decriminalization for people on the more conservative end of the political spectrum, who are are most comfortable with the words of sources who are authority figures." Recommended by Robyn Kalda, National Safer Supply Community of Practice. 

Happy City: Transforming Our Lives Through Urban Design, by Charles Montgomery. "Very readable! And an excellent summary of the research on what makes cities pleasant and workable." Recommended by Robyn Kalda, National Safer Supply Community of Practice.

A Psalm for the Wild-Built, by Becky Chambers. Once upon a time the robots all went away from the humans, and now one is back to check in. "A thoughtful and comforting novel, good for a mental break." Recommended by Robyn Kalda, National Safer Supply Community of Practice.

Educated, by Tara Westover. This is the memoir of a woman whose family prohibited her from attending school, describing her pursuit of education, which started at 17. Recommended by Sasha Strong, former placement student at the Alliance for Healthier Communities.

The Immortal Life of Henrietta Lacks, by Rebecca Skloot. An important recollection of the experience of Henrietta Lacks, whose cells were taken without her knowledge and used in numerous scientific discoveries. Rebecca Skloot examines this event's ethical and societal implications and delves into the systemic inequalities that have existed in the medical field. Recommended by Sasha Strong, former placement student at the Alliance for Healthier Communities.

Thinking Fast and Slow, by Daniel Kahneman. An important recollection of the experience of Henrietta Lacks, whose cells were taken without her knowledge and used in numerous scientific discoveries. Rebecca Skloot examines this event's ethical and societal implications and delves into the systemic inequalities that have existed in the medical field. Recommended by Sasha Strong,former placement student at the Alliance for Healthier Communities.

101 Essays That Will Change The Way You Think, by Brianna Wiest. A wonderful collection of thought-provoking essays that cover a wide range of topics that may broaden your perspective, stimulate critical thinking, and challenge your assumptions about the world and your place in it. Recommended by Sasha Strong, former placement student at of the Alliance for Healthier Communities. 

As We Have Always Done: Indigenous Freedom through Radical Resistance by Leanne Betasamosake Simpson. Simpson makes clear that the goal of Indigenous Resistance can no longer be inclusion in a colonial multicultural mosaic. Instead, she calls for unapologetic, place-based Indigenous alternatives to the destructive logics of the settler colonial state.

The Spirit of Intimacy: Ancient Teachings In The Ways Of Relationships by Sobonfu E. Somé. Somé is one of the first and foremost voices of African spirituality to come to the West. In The Spirit of Intimacy, she shares ancient ways to make our intimate lives more fulfilling and secure and offers powerful insights into the "illusion of romance," divorce, and loss.

Your Name Is a Song by Jamilah Thompkins-Bigelow, illustrated by Luisa Uribe. Frustrated by a day full of teachers and classmates mispronouncing her beautiful name, a little girl tells her mother she never wants to come back to school. In response, the girl's mother teaches her about the musicality of African, Asian, Black-American, Latinx, and Middle Eastern names on their lyrical walk home through the city. 
Have you read something inspiring lately?

EPIC News publishes reading lists twice per year, and we would love to include your recommendations! All genres and forms are accepted. Please include a link and a sentence about why you think it's worth reading.

Send your suggestions to [email protected].
Tools and Resources

UPDATED! Common QIP indicators for community-based primary health care. In last month's issue, we highlighted the Common QIP Indicators, which are a great option for Alliance Member Organizations to consider when choosing indicators for their 2023/24 QIPs. Since then, the technical specifications have been refined for clarity. Check them out here!

Resources to Support Decisions about Virtual Care. The Alliance is collecting virtual care resources and research to help your providers and clients make the most appropriate choices about when and how to provide care virtually. This page currently includes guidance and toolkits from Ontario Health, Healthcare Excellence Canada, and the Canadian Institute for Healthcare Improvement, plus over a dozen research articles, presentations, and posters. We'll keep adding new items as they become available, so check back frequently!

Webinars and Podcasts: In Case You Missed It (or Want to Revisit It)

Recorded webinar: Introducing the OHRS Benchmarking Report. This webinar was held on December 13 to support Alliance members in using the new report, which was released last month. A recording is available here along with the slide deck. After watching, please take a minute to tell us how we did. The report is available to Alliance members on our community portal. For questions about the OHRS report, please email [email protected].

Recorded webinar: Climate-conscious inhaler prescribing. This webinar was presented by the Primary Care Collaborative and CASCADES. It describes how inhalers contribute to the carbon footprint of health systems, problems related to inhaler prescribing, and practice change that results in immediate reduction in emissions. Featured presenters are Dr. Kimberly Wintemute and Dr. Celia Culley. Dr. Wintemute is an assistant professor at the University of Toronto’s DFCM and a practicing family physician in the Southeast Toronto FHT. Dr. Culley is a clinical pharmacist and an expert on sustainable healthcare. Check out the recording and slide deck here.

Training and Learning Resources

The Alliance for Healthier Communities is launching a Community of Practice (CoP) for finance and data management staff at Alliance member organizations. This CoP will make it easier for participants to connect with one another for collaboration, mentoring, and support. Depending on the needs and interests of the group, CoP activities may include presentations or workshops, sharing sessions, and focused conversations around shared challenges and topics of interest. If you are interested in participating or learning more, please take a moment to share your contact information and answer a few questions here.

Indoor air quality office hours: This program is for anyone who works at a community space or congregate setting and would like advice about how to reduce the transmission of COVID-19 through indoor air quality measures. Free, 25-minute consultations with air quality experts from the University of Toronto and the University of Waterloo are available from January through July 2023. Details here. To schedule an online appointment, email Pearl Buhariwala at Unity Health.

Recent Publications

eHealth Data Standards and Data Stewardship for Social Determinants of Health in Support of Ontario Learning Health Systems: a State-of-the-Art Review of the Literature. This report by Jennifer Lawson, a health researcher at McMaster University, describes an overview of current Social Determinants of Health (SDoH) data standards in Ontario, along with recommendations to spread and standardize the collection of SDoH data in a way that supports learning health systems and advances health equity.

Using the quadruple aim to understand the impact of virtual delivery of care within Ontario community health centres: a qualitative study, by S. Bhatti, S. Dahrouge, L. Muldoon, and J. Rayner. This article, published recently in BGJP Open, was written by Alliance staff and research partners. It aims to help us understand the impact of virtual care on healthcare system performance.
Looking for more?

Consider subscribing to these newsletters to receive regular updates from Alliance system partners:
Research & Sharing Opportunities
Research Partners Needed

Primary care clinicians needed: Help guide comparative research about the care and outcomes in different PC models for people living with dementia. A research team from Arizona State University and Dalla Lana school of Public Health want to understand what enables effective communication and diagnoses with primary care clients who have mild cognitive impairment (MCI) or early-stage Alzheimer disease or related dementia (ADRD). They're comparing different models in Ontario, Arizona, and New York State. Interested? Consider joining the project's steering committee. For more information, please email Allie Peckham email Allie Peckham at Arizona State University.

Clinical Trials and Participatory Research

Research opportunity for Alliance member organizations: Goal-oriented care in Community Health Centres. A research team at the Lunenfeld-Tanenbaum Research Institute is recruiting primary health care teams (6-8 clinicians and interprofessional providers) from four CHCs to participate in this study. If you are familiar with goal-oriented care and have either used this approach or are willing to try it, you can help them understand how it’s implemented in a real-world setting. They’ll use what they learn to make the model more accessible and feasible. Participants will be asked to reflect on their experiences with goal-oriented care in interviews. Check out the infosheet or email Carolyn Steele Gray or Dagje Boeykens for more information.  

Do you have older adult clients who are experiencing loneliness? A research team at Baycrest is studying the use of a virtual, at-home program aimed at promoting brain health. Participants will engage in either mindfulness meditation or brain training for 8 weeks and complete online sessions and surveys to assess the impact of the interventions. Compensation will be provided. To be eligible, participants must be over 60 years of age, living in Ontario, and have access to a mobile device or computer with an internet connection. Full details and contact information here. Register here

Need help with client engagement and communication? Get access to the Canadian Primary Care Information Network (CPIN), tailored messages for your vaccine-hesitant clients, and up to three additional communications and survey campaigns on topics of your choice. Family physicians at the University of Ottawa and Monfort Hospital are studying how automated patient engagement systems like CPIN can improve communications with clients about COVID-19 vaccines. Get more information here or email the study team. 

Interviews and Focus Groups

Social workers in primary health care: Your insights are needed. Researchers at the U of T are inviting you to help inform recommendations on how best to organize social work practice in interprofessional primary care settings. In this phase of a mixed-methods study, social workers from primary health care teams across Ontario will participate in semi-structured, 60-minute group conversations about their daily practice during the pandemic. All data collected will be kept confidential, and you will not be identified in study results. Dr. Rachelle Ashcroft, an Associate Professor of Social Work at the University of Toronto, is leading this study. For more information or to get involved, email Simon Lam, Research Coordinator. 

Primary Care Providers: Is at least 60% of your practice made up of clients who experience marginalization in some way? Do you have high (70%+) cancer screening rates for these clients? Consider sharing your insights and approach through a 1/2-to-1-hour interview with researchers from Women's College Hospital. Learnings will be used to develop targeted cancer-screening interventions. Remuneration will be provided. For info, see this flyer and email Arlinda Ruco at WCH.

How have newcomers to Canada experienced health and social care from community organizations since the beginning of the pandemic? RÉAC! Responsive services for newcomers in the context of the COVID–19 pandemic is a study led by researchers in Quebec and Ontario who are exploring this question. They are looking for newcomers (arrived 2016 or later) who are refugees, asylum seekers, or without status to participate in discussion groups. Participants will be compensated. For more information, see this feature from our July issue and the project website for more information.


Does your organization provide health care or other supports to refugees and asylum seekers? Researchers at the University of Calgary are looking for people working in clinical, public health, or settlement organizations to answer some questions via an online survey. They want to understand who provides care to refugees and asylum seekers in Canada, how this care is coordinated and delivered, how it differs among jurisdictions, and how COVID-19 has impacted it. Participate by completing this short survey. In lieu of an honorarium, the research team will donate $10 to support refugee student scholarships. See flyer (English or French) for more information.

Help shape the future of virtual health care in Ontario! Researchers at the University of Toronto and University of Ottawa are looking for primary health care clients and caregivers in Ontario to take a 15 to 20-minutes survey about their experiences and expectations with virtual care appointments as a patient or caregiver with a doctor, nurse, or another healthcare professional in a family practice. See the flyer for more information. The survey can be accessed at the links below:
BONUS: Participating primary health care clinics can get a personalized survey link and a custom report on the experiences of their clients. If this opportunity interests you, please contact Simon Lam, research coordinator.

Collaborative Learning

SPIDER Learning Collaborative: De-prescribing dangerous medications. Can data-driven QI activities help de-prescribe potentially harmful medications, for medically complex senior clients? Help answer this question and improve health outcomes for your clients by participating in a 12-month learning collaborative. EMR queries will be provided to help participating Alliance members identify clients who would benefit. Contact Jennifer Rayner for more information.
Learning Events & Programs
January 26, 12:00-1:00 pm. Lunch 'n' Learn Webinar: Support for your 2023/24 QIPs. Presented in partnership with Ontario Health, this webinar will help guide primary health care organizations as they develop their 2023/24 Quality Improvement Plans (QIPs). Register here.

Last Thursday of every month, January - April 2023, 1:00 -
2:30 pm | Monthly Webinar Series on Mobilizing to Promote Health and Well-Being for Older Adults. These webinars are hosted by Core Canada. Register here for all upcoming sessions.
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