For the purposes of this brief, three inter-related potential areas of action for Canadian health leaders have been identified:
- Re-align authorities, accountabilities and resources;
- Eliminate racism and increase cultural safety;
- Ensure equitable access to health care.
Health leaders in Canada can work within their organizations to implement wise practices that address the TRC’s recommendations. The most important element in both the design and delivery of these changes, however, is that health leaders are guided by and work with local, provincial, and national Indigenous leaders and organizations. Otherwise, they risk reproducing existing colonial structures in the health care system.
Health leaders should consider the following wise practices to guide them in their work to advance reconciliation. The focus of these wise practices is to effect change at the level of the health care organization or institution. Furthermore, leaders of organizations can advocate alongside their Indigenous partners for system-level changes to policy, funding, and governance.
Policy and System Changes
- Support local First Nations, Inuit, and Métis leaders in conjunction with their national counterparts at the Assembly of First Nations, Inuit Tapiriit Kanatami, and Métis National Council as they negotiate, develop, implement, and evaluate health transformation agreements, and advocate for policy and systems change.
Community Engagement
- Identify key stakeholders for community engagement and build relationships with them. Stakeholders include representatives from local and regional FN/I/M governments and local Indigenous health service organizations, Indigenous clients, and others. When reaching out to key stakeholders, follow engagement protocols articulated by their respective organizations. Create partnership agreements that include process evaluations and accountability measures for any shared initiatives related to Indigenous health and wellness.
- Make reconciliation and Indigenous health equity part of the organization’s strategic plan.
Recruitment and Retention of Indigenous Staff and Health Care providers
- Promote the involvement of Indigenous peoples in the organization by recruiting them for governance and leadership positions, advisory circles, community liaisons, Elders’ councils, and other roles; formalize reporting and action-based accountability by the non-Indigenous leadership to prevent tokenistic or non- meaningful engagement.
- Recruit, retain, and mentor Indigenous staff and health care providers at all levels of the organization, including procurement; create working and learning environments where they can thrive, and where Indigeneity and Indigenous knowledge are valued.
Anti-Racism and Cultural Safety Education
- Provide antiracism and cultural safety education to all members of the organization; develop and implement safe processes for both employees and clients to debrief racist or culturally unsafe experiences in the organization; develop and implement processes to document these instances and track progress.
- Support Indigenous learners in the health professions by creating safe and respectful clinical learning environments that are free of racism and discrimination; participate in health science outreach programs for younger students.
Indigenous Client Care and Outcomes
- Enhance the journey of Indigenous clients through the practice of trauma-informed care and programs such as Indigenous navigators, access to traditional foods and healing practices, support from Elders, and land- based healing; the specific initiatives should emerge from the recommendations made by local Indigenous communities, advisors, and clients.
- In jurisdictions where data related to race and ethnicity is available, track health outcomes for Indigenous vs. non-Indigenous clients in the organization; appropriate Indigenous data stewardship agreements must be developed and followed.
- Understand and support changes to address Indigenous social determinants of health.