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Focus on rural health

SHR develops ambitious rural health strategy


It's ambitious, with its 44 recommendations to make rural health care better.
The Saskatoon Health Region (SHR) has developed a Rural Health Strategy for their region, focusing attention on the 80,000 people or 27 per cent of the SHR's population residing outside of Saskatoon.
The strategy, written over the past 18 months, was accepted by the Saskatoon Regional Health Authority at their regular meeting on November 10.
The strategy was developed with the objective of strengthening its rural services and improving the health and well being of its rural residents.
The report states that the SHR, like other national and international health jurisdictions, faces many challenges in serving the health-care needs of rural residents.
However, it also notes that the health status of people in rural parts of the SHR, like Humboldt and the surrounding communities, is just as good as those in Saskatoon, which is unlike the rest of the country.
The health status of rural Canadians is, on average, poorer than their urban counterparts. No so in the SHR, with a few exceptions.
But providing health care in a rural setting is still different, the SHR believes - not better, not worse, just different.
Though during their extensive consultation process with stakeholders in developing this strategy, Kelvin Fisher of the SHR, who helped develop the strategy, said they found a lot more similarities than differences between the rural and urban environments, the differences they did find are important ones.
"The differences are significant enough to require us to be flexible," Fisher said, and come up with creative ways to address them.
To that end, the strategy lists 44 recommendations which encompass a wide variety of issues, and are intended to provide direction to the SHR with respect to significant issues impacting rural health in the region.
Some of these recommendations, the strategy states, can be implemented immediately. Others will require further exploration and review, additional financial resources, or collaboration with other stakeholders.
What this Rural Health Strategy does is define priorities, noted Fisher.
It is not intended to be an all encompassing document with a detailed prescription of how the SHR should deliver health care to its rural residents. It is intended to provide insight and direction with respect to the significant issues impacting rural health in the region.
"It gives us a guidepost of where to focus our efforts," Fisher said.
It's a reference point to move forward, he added. And it will be emphasized in the SHR's plans in the coming years.
"It's good to know this is what we're moving towards," he said.
The recommendations are all realistic, Fisher believes, though to reach some of the targets will take some time, he admitted.
Which of the 44 recommendations are the most important?
Fisher couldn't say.
"They're all important. They all build upon the central themes we heard," he told the Journal last week.
Those central themes are called "foundational recommendations" in the strategy, as they are "so integral to the overall strategy."
Those three foundational recommendations are:
1. Develop a communications plan to raise the awareness of employees and the general public, as well as internal and external stakeholders, of the uniqueness of the rural environment, including both the capacities and constraints of rural service delivery.
2. Develop a meaningful process to actively engage citizens in the reviewing, planning and implementing of strategies and ideas to maintain and increase people's health and well-being in their community.
3. Actively support and collaborate with the Ministry of Health in the development of a provincial rural health strategy.
The strategy is meant to stretch over a five to 10 year period - it's not short-term, Fisher emphasized. But they are already in the process of implementing parts of it.
"We're already starting work on almost half of the recommendations," Fisher said.
For example, recommendations five and six ask that the region establish a plan to increase the use of Telehealth throughout the region, and increase the Telehealth numbers of sites to Wynyard and Watrous by March 2011, then to Wadena, Strasbourg, Lanigan and Wakaw before 2013.
They are working on establishing the site at Wynyard already, Fisher noted.
They are also already working on the second recommendation, which is to improve the SHR's external and internal websites to include information specifically for rural health sites. They have begun to upgrade their internal website, Fisher said, and once that is done, will make changes to their external website.
That they have a vision for rural health is a key piece of the puzzle for the SHR, Fisher noted. For the first time, they have a vision that recognizes the diversity and uniqueness of rural life, and it is something that will be a priority for the SHR as they move forward, Fisher said.
"It will override all the work we do," he said.
"There are not a lot of comprehensive rural health strategies in Canada," Fisher noted. In fact, before embarking on the process of writing one for the SHR, they could only find one other like it, from British Columbia.
"It's fairly unique, we believe, especially in Canada. It's fairly comprehensive and broad," Fisher said.
It is also a strategic document, which means that the next step is to develop an implementation plan to address each of the 44 recommendations.
In December, the SHR will be assigning departments to lead the implementation of each of the 44 recommendations.
Many of them will require collaboration, Fisher said.
"We as a region can't do it alone," he said. "We're going to need a lot of collaboration and partnerships to get it done."
Recommendation 19 -which is that the Region research and explore options, including establishing partnerships with municipalities and community organizations, to remove barriers to clients accessing services due to lack of available transportation - is a good example of this.

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