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Spotlight 3

Indigenous cultural safety

Illustration of a person with long hair in silhouette surrounded by line drawings representing elements of nature: birds flying, the sun, plants, and landscapes.

We received 27 complaints reporting a wide range of experiences concerning a lack of culturally competent care for Indigenous patients.

What's the best way forward?

How Patient Ombudsman is responding

In years 4 and 5, Patient Ombudsman received 27 complaints from 25 complainants reporting discrimination or a lack of culturally sensitive care for Indigenous patients in hospitals, long-term care homes, and home and community care. The complaints were wide ranging. They included reports that health care providers were unwilling to listen to patients and family members, use of racial epithets, and refusal to include traditional healing in the patient’s care. Some complainants reported insensitivity, delays or denial of care based on erroneous assumptions that patients were inebriated or seeking drugs. In most cases, the complainants were not aware of the HSOs’ internal complaints processes or their ability to engage with Indigenous navigators.

In 2019, Patient Ombudsman recognized that our own organization needed to focus on thoughtful and meaningful approaches to working with complainants who identify as Indigenous as they engage with our complaint resolution service. We identified the need to build our own capacity to work with Indigenous patients and caregivers with sensitivity and cultural competence, and to further understand the experiences of Indigenous people in their interactions with Ontario’s health care system.

In January 2020, Patient Ombudsman launched an Indigenous Strategy and began the important work of connecting, listening, and learning from key stakeholders in Indigenous health. A working group was established and began engaging in outreach to Indigenous health care leaders and key stakeholders to help guide our work and identify gaps and opportunities to improve our practices.

Patient Ombudsman prioritized hiring an Early Resolution Indigenous Specialist to support complaint resolutions for Indigenous patients and caregivers, to assist in our community outreach, and to continue building cultural competence across Patient Ombudsman. Alethea Kewayosh, Ontario Health’s Director of the Indigenous Cancer Care Unit kindly volunteered to participate on the recruitment panel and has been an invaluable resource to Patient Ombudsman.

While the recruitment process was underway, a member of the existing Early Resolution Specialist team with experience and training in Indigenous health care volunteered to take on dedicated responsibility for complaints from Indigenous patients and caregivers.

The COVID-19 pandemic interrupted Patient Ombudsman’s ability to fully implement the Indigenous Strategy. In addition to significantly increasing the volume of complaints to Patient Ombudsman, COVID-19 restrictions and the transition to working from home created challenges with outreach efforts. However, in January 2020, we welcomed our first Early Resolution Indigenous Specialist.

This commitment remains a priority for Patient Ombudsman, and the working group has identified a number of priorities for further action including:

Continuing education to build cultural competence across Patient Ombudsman.

Ongoing outreach efforts to inform our practices and raise awareness of our services.

Reviewing and revising our intake and complaint resolution processes to ensure Patient Ombudsman is a safe space for Indigenous patients and caregivers to raise their concerns.

Enhancing our website to provide specific information and resources for Indigenous patients and caregivers.

Improving our data collection to guide further improvements.