New COVID-19 Social Care Guidance tool developed to guide primary care providers in supporting vulnerable patients
A collaboration between members of the University of Toronto Department of Family and Community Medicine (DFCM)’s Global Health and Social Accountability Program, the Upstream Lab, and the Centre for Effective Practice (CEP) has led to the development of a new COVID-19 Social Care Guidance tool. This new tool provides a set of questions and considerations to guide primary care providers in supporting people exposed to social risks that impact health (also called social determinants of health), are caused, or exacerbated by COVID-19, and connect them with the appropriate resources to support them.
"As a new family doctor, I see the huge impact of things like income and living conditions on my patients' ability to manage risk during the pandemic, but time management is a constant pressure,” says Dr. John Ihnat, a member of this collaborative initiative and a family physician at Health Access Thorncliffe Park. “This is the kind of tool that can help me explore such important issues both quickly and in a way that genuinely helps my patients."
Primary care providers have long known that social and economic factors impact health, but it is not yet commonplace to screen patients for these risk factors. However, COVID-19 has made it increasingly important that we acknowledge the impacts of these social determinants of health, as it has become apparent that certain populations are disproportionately affected by the pandemic.
“The understanding that these factors impact our patients’ health predates COVID, but the current context has put a lot of primary care providers in new and unfamiliar environments caring for patients who they don’t know. On top of that, with the hustle and bustle of busy practices, we don’t always think to ask about these things and identify patients who are at risk,” says Dr. Katherine Rouleau, a family physician at St. Michael’s Hospital and the Vice-Chair of Global Health and Social Accountability at DFCM.
The current pandemic has also made it more challenging to address the social determinants of health, says Drs. Kelsey Lawson and Nothando Swan, two Family Medicine Enhanced Skills Residents in Global Health & Vulnerable Populations at the University of Toronto, who are also part of this initiative.
“We collaborated on this tool to ensure that all practitioners had support in asking these crucial questions. These are high-yield questions and resources that will positively impact people’s lives,” they said.
These questions will help primary care providers open a conversation with their patients about these social risk factors, identify new and essential resources in the context of COVID-19, and what the appropriate support and solutions are for them. The ultimate goal is to condition primary care providers to become accustomed to taking these factors into consideration and asking their patients these questions even after the pandemic.
“Many of us see this as a door for something beyond COVID-19,” says Dr. Rouleau. “Our hope within this group is that by creating the habit of asking these questions during COVID-19, people will continue to ask them even after the pandemic.”
Acknowledgements: This tool was developed collaboratively between the DFCM, CEP and Upstream Lab. The contributions from the DFCM were led by the PGY3 students Dr. Kelsey Lawson and Dr. Nothando Swan. The principal team consisted of Dr. Gary Bloch, Dr. Ritika Goel, Dr. Archna Gupta, Dr. John Ihnat, Andrew Lam, Dr. Vanessa Redditt, Dr. Katherine Rouleau, Dr. Andrew Pinto (also lead for Upstream Lab), and Megan Parry.