Rural Site Visit Project

For more information, click on: RCCbc Rural Site Visit Project

Fifth report: June 2017 – November 2020 (PDF)
Fourth report: June 2017 – May 2020  (PDF)
Second report: June 2017 – June 2019 (PDF)
Third report: June 2017 – December 2019(PDF)
First report: June 2017 – December 2018 (PDF)

Please note that each report encompasses feedback from all rural communities engaged since the beginning of the Project.

Overview

In 2017, the Joint Standing Committee on Rural Issues (JSC) tasked the Rural Coordination Centre of BC (RCCbc) with visiting every Rural Subsidiary Agreement (RSA) community between 2017 and 2020. These visits will connect with rural practitioners and communities to hear about the context of rural practice and health care delivery (what innovations exist, what works well, what the biggest challenges are) and feed this information back to the JSC to better support feedback loops between rural practitioners and the programs that support them.

The Rural Site Visits Project will engage Health Partners (Health Professionals, Health Administration, Policy Makers, First Nations, Community, and Academic Institutions) within each community. From these community meetings, information is collected, anonymized and analyzed to identify the major themes affecting health care delivery in rural communities in BC. As a commitment to the communities, RCCbc sends a bi-annual Community Feedback Report to provide project updates and share the learnings from innovative solutions found throughout the visits. This is the fifth Community Feedback Report to date. To view previous reports please visit our website (ruralsitevisits.rccbc.ca).

Due to Covid-19, the Rural Site Visits Project has postponed trips since March 16, 2020. Other areas of focus have been redirected to:

Launching a Site Visits and Innovations website featuring searchable innovations collected around the province to help address health care issues and connect community contacts to one another
Writing research papers on the Site Visits project process and overarching themes, and cultural safety and racism

Improving the communication and engagement processes for Indigenous community visits Trialing virtual Site Visits and reviewing their effectiveness and sustainability

The hope to resume trips will be dependent on each community and ensuring all parties are safe and comfortable with our visits before we start reaching out again.

Thank you again for all your support.

Dr. Stuart Johnston and Krystal Wong

Community Feedback Reports
The Rural Site Visits Project engages health partners (health professionals, health administration, policy makers, community, and academic institutions) within each community visited. From these meetings, information is collected, anonymized and analyzed into themes to identify the major themes affecting health care delivery in BC rural communities. 

As a commitment to the communities, RCCbc is providing bi-annual Community Feedback Reports to provide updates on project progress and share learnings from innovative solutions found throughout the visits.

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Ruralinnovations.ca launched on September 11, 2020 to all participants and stakeholders with over 100 innovations posted.

Some of the key features include:
– Browsing by either categories or key word searches
– Submitting your own innovations
– An Innovations Concierge to help connect users or find the most relevant innovations for them
– Joining a mailing list to keep up to date
– A whiteboard YouTube video overviewing the innovations inventory

Every 2-months a new batch of approximately 40 innovations will be added. The next focus will be an engagement and marketing strategy to raise awareness about the innovations inventory and Innovations Concierge. Some ideas and opportunities include finding venues to share information such as conferences, symposiums, meetings; collaborating with partners to cross-share information; creating a podcast; hosting open forums for communities.

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This open-ended guide provides a sample of questions that may be asked during the Site Visits meetings.

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Two and a half years after its inception, the RCCbc Site Visit project has reached its half-way point with over 100 rural BC communities visited.

101 Rural Subsidiary Agreement (RSA) communities representing all corners of the province have been visited, more than 350 meetings with the Health Care partners recorded and over 4,000 pages of valuable transcribed feedback generated. 

We would like to express our thanks with all those who have been a part of our process and for help us reaching out to rural communities across BC.

We look forward to the next 100 communities of the Rural Site Visits project!

Dr. Stuart Johnston
Director, Rural Site Visits Project

Krystal Wong
Program Coordinator, Rural Site Visits Project

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Title
How can rural community-engaged health services planning affect sustainable health care system changes? – A process description and qualitative analysis of data from the Rural Coordination Centre of British Columbia’s Rural Site Visits Project

Authors
C Stuart Johnston, Rural Co-ordination Centre of British Columbia, Canada
Erika Belanger, Rural Co-ordination Centre of British Columbia, Canada
Krystal Wong, Rural Co-ordination Centre of British Columbia, Canada
David Snadden, University of British Columbia Faculty of Medicine, Northern Medical Program, Prince George, BC, Canada. (Corresponding Author: david.snadden@ubc.ca)

Abstract

Objectives
The objectives of the Rural Site Visit Project (SV Project) were to develop a successful model for engaging all 201 communities in rural British Columbia, Canada, build relationships and gather data about community health care issues to help modify existing rural health care programs and inform government rural health care policy.

Design
An adapted version of Boelen’s health partnership model was used to identify each community’s Health Care Partners: health providers, academics, policy makers, health managers, and community representatives. Qualitative data was gathered using a semi-structured interview guide. Major themes were identified through content analysis, and this information was fed back to the government and interviewees in reports every six months.

Setting
The 107 communities visited thus far have health care services that range from hospitals with surgical programs to remote communities with no medical services at all. The majority have access to local primary care.

Participants
Participants were recruited from the Health Care Partner groups identified above using purposeful and snowball sampling.

Primary and secondary outcome measures
A successful process was developed to engage rural communities in identifying their health care priorities, whilst simultaneously building and strengthening relationships. The qualitative data was analysed from 185 meetings in 80 communities and shared with policy makers at governmental and community levels.

Results
36 themes have been identified and three overarching themes that interconnect all the interviews, namely Relationships, Autonomy and Change Over Time, are discussed.

Conclusion
The SV Project appears to be unique in that it is physician led, prioritizes relationships, engages all of the health care partners singly and jointly in each community, is ongoing, provides feedback to both the policy makers and all interviewees on a 6-monthly basis and, by virtue of its large scope, has the ability to produce interim reports that have helped support system change.

Article Summary

  • This study process has adapted Boelen’s health partnership model and is unique in that it is physician led, prioritizes relationships, engages all of the health care partners singly and jointly in each community, is ongoing, provides feedback to both the policy makers and all interviewees on a 6-monthly basis.
  • A successful method of engaging with rural communities and building relationships and trust across multiple stakeholder groups is described that contributed to influencing positive health care system changes.
  • As all communities in one province are being visited a picture of rural health care initiatives and challenges is highly comprehensive and therefore able to influence policy.
  • One of the main limitations in this study is that because the interviewers were experienced health care providers, power differentials may have existed which may have introduced bias in the discussions.
  • A potential limitation is the enormous amount of data to handle and analyze in a rigorous way, which was mitigated by having two full time analysts working together to ensure consistency with frequent meeting with the research team to consider and agree emerging themes.