QI PROGRAM HISTORY

FORGE AHEAD

The Transformation of Indigenous Primary Healthcare Delivery (FORGE AHEAD) program was launched in response to the growing awareness and understanding of how type 2 diabetes impacts Indigenous populations in Canada. The program created space for community-based participants from eleven First Nations communities to take leading roles in designing and implementing healthcare initiatives that reflected their unique needs, priorities, and concerns. It was a five-year program that supported the local QI teams during their assessment of available healthcare resources and the level of quality of care within their communities to generate testable ideas to create widespread improvements.

FIRST NATION PARTNERS

Tsuut'ina First Nation

Cree Nation of Waskaganish

Maskwacis

Saugeen First Nation

Ebb and Flow First Nation

Cowichan Tribes

Seabird Island Band

Mishkeegogamang Ojibway Nation

Miawpukek First Nation

Kahnawake Mohawk Territory

Opaskwayak Cree Nation

Program Objectives

  1. Assess current healthcare delivery, funding models, and best practices used in First Nations communities in Canada.

  2. Assess community and clinical readiness to address and adopt chronic disease care.

  3. Enhance patient access to available community resources for chronic disease care.

  4. Implement, evaluate, and cost community and clinical QI initiatives to improve chronic disease management.

  5. Develop sustainment strategies and scale-up toolkits for improved chronic disease management.

Key Outcomes

  1. REDUCTION in blood pressure and LDL cholesterol

  2. REDUCTION in A1c

  3. INCREASED measuring for A1c, blood pressure, and LDL cholesterol

  4. INCREASED screening for diabetes nephropathy

  5. INCREASE in clients receiving Canadian guideline recommended care services

Publucations

  1. Exploring quality improvement for diabetes care in First Nations communities in Canada: a multiple case study.

  2. Primary and Secondary Cardiovascular Prevention Among First Nations Peoples With Type 2 Diabetes in Canada: Findings From the FORGE AHEAD Program

  3. Closing the indigenous health gap in Canada: Results from the TransFORmation of IndiGEnous PrimAry HEAlthcare delivery (FORGE AHEAD) program

  4. National Survey of Indigenous primary healthcare capacity and delivery models in Canada: the TransFORmation of IndiGEnous PrimAry HEAlthcare delivery (FORGE AHEAD) community profile survey.

  5. The FORGE AHEAD clinical readiness consultation tool: a validated tool to assess clinical readiness for chronic disease care mobilization in Canada’s First Nations.

  6. Developing community-driven quality improvement initiatives to enhance chronic disease care in Indigenous communities in Canada: the FORGE AHEAD program protocol.

  7. Best Practices for the Prevention and Management of Diabetes and Obesity-Related Chronic Disease among Indigenous Peoples in Canada: A Review.

SOAR: PATHWAY TO WELLNESS

This sister program to FORGE AHEAD was designed to test out adaptations and improve care for people living with diabetes. The name and logo were developed by the community partners.

FIRST NATION PARTNERS

Sheshatshiu Innu First Nation

Oneida Nation of the Thames

Abegweit First Nation

Serpent River First Nation

Program Objectives

  1. Engage community partners and stakeholders to support meaningful participation and leadership.

  2. Review, improve, and adapt the diabetes quality improvement strategy with community partners.

  3. Evaluate the effectiveness of the adapted diabetes quality improvement strategy.

  4. Develop community-driven plans for sustainability and scale-up for the adapted diabetes quality improvement strategy.

The program is currently in the evaluation and knowledge exchange phase and will be wrapped up by March 2022. The main outcomes and publications will be posted here when they become available.
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We acknowledge that Western University is located on the traditional lands of the Anishinaabek, Haudenosaunee, Lūnaapéewak and Chonnonton Nations, on lands connected with the London Township and Sombra Treaties of 1796 and the Dish with One Spoon Covenant Wampum. With this, we respect the longstanding relationships that Indigenous Nations have to this land, as they are the original caretakers. We acknowledge historical and ongoing injustices that Indigenous Peoples (First Nations, Métis and Inuit) endure in Canada, and we accept responsibility as a public institution to contribute toward revealing and correcting miseducation as well as renewing respectful relationships with Indigenous communities through our teaching, research and community service.