Programming Connection

Ontario Hepatitis C Team: Elevate NWO 

Elevate NWO
Ontario
2014

Quick Facts

Goal (immediate)

To increase access to hepatitis C care and treatment for priority populations in northwestern Ontario; to increase knowledge and awareness to prevent the transmission of hepatitis C among priority populations in northwestern Ontario; to increase collaboration, coordination and evidence-based practice across the range of stakeholders responding to hepatitis C

Goal (ultimate)

To establish hepatitis C care and treatment services that will help curb the spread of hepatitis C by ensuring that people are diagnosed and treated

Population

People living with hepatitis C, People who use injection drugs

Participants

People living with hepatitis C, people who use drugs

Setting

Community

Required Resources
  1. Outreach worker. Provides hepatitis C and HIV prevention services and education, including presentations and harm reduction supply distribution, to clients and other service providers.
  2. Community developer. Builds relationships and partnerships with organizations and agencies to raise awareness about hepatitis C in the community and builds relationships with service providers who may have a similar client base.
  3. Case manager. Works with clients with hepatitis C who need counselling or other psychosocial support, as well as clients who are starting treatment or who are on treatment. Monitors the health progress of clients and facilitates referrals to other services.
  4. Treatment nurses. Follow up with clients who have been referred for treatment, work with them to make sure that they are ready for treatment, and monitor their progress during treatment and for six months after treatment.
Scope and Duration

Ongoing

Date Started

2011

Region

Ontario

Recruitment

Self-referral, referral from physician for treatment

Challenges
  1. Systemic issues. Lack of appropriate housing, access to quality food, and sufficient spaces for mental health and addictions treatment are all challenges for Elevate NWO’s clients.
  2. Geography. Elevate NWO serves a catchment area roughly the size of France but provides most of its services in Thunder Bay. It is difficult to maintain client and service provider relationships at such far remove. The agency has used a number of strategies to reduce the impact of distance on client services, including developing strategic partnerships in other communities, visiting remote communities as often as possible and using telehealth for counselling and treatment.
  3. Reaching Aboriginal communities. Elevate NWO’s catchment area includes a number of Aboriginal reserve communities and Thunder Bay has a significant community of urban Aboriginal peoples. Maintaining strong relationships with Aboriginal-focused service providers remains a challenge.
Evaluation

Elevate NWO conducts an annual Health Agenda Review to determine client satisfaction with services. Client satisfaction is assessed through a client feedback survey (see Program materials). Typically, the client survey is distributed at the Elevate NWO Christmas party in December. Respondents are entered into a draw for a $100 food card.

The survey is advertised in the weeks leading up to the party with an announcement in all food bank bags distributed at Elevate NWO’s offices. At the same time, Elevate NWO reminds clients of the steps that have been taken at the agency to respond to feedback from the previous year.

Client feedback in 2013 was overwhelmingly positive:

  • 100% of clients who accessed health clinic appointments rated them as excellent or good
  • 95% of clients who accessed harm reduction services rated them as excellent or good
  • 94% of clients who accessed the support group rated it as excellent or good
  • 88% of clients who accessed the hepatitis C nurses rated their care as excellent or good

The agency also tracks the number of people on treatment and their success rates. Between 2009 and 2013, the hepatitis C team started 48 people on treatment. Of those, 32 achieved a sustained virological response, a 66% success rate.