Creating safe, inclusive spaces for hospital-based health care staff and people who use drugs: an exploratory qualitative study in Vancouver, Canada
Bibliographic record
Abstract
OBJECTIVES: This project sought to contribute to healthy, safe organizational cultures within Vancouver's hospital system healthcare system as one method to address indirect harms of the province's drug toxicity and housing syndemic. A tertiary care inner-city hospital in western Canada partnered with the Eastside Illicit Drinkers Group for Education and Vancouver Area Network of Drug Users to convene a participatory action research project to identify systemic and personal barriers to safe, non-stigmatizing, and effective care at a local health care setting and to propose ways of responding to these conditions. METHODS: We convened semi-structured Listening Circles held in October 2023 with people who have sought care at the urban health care setting, and frontline healthcare workers who respond to them. The Listening Circles included a graphic recorder who illustrated themes as participants spoke about their experiences, perceived barriers to safety and comfort in health care settings, and challenges faced by service providers and service users when interacting with one another. RESULTS: Common themes identified by a graphic recorder included: (1) the importance of time and in the absence of time, relational space between healthcare workers and people who use drugs, (2) shared desire to scale approaches like peer navigation which consider the wellbeing of both service recipients and providers, and (3) the role of systemic forces and organizational practices that obstruct both quality of care and healthcare worker wellbeing. CONCLUSIONS: Healthcare workers and people who use drugs and alcohol report an urgent need for resourced, relational care spaces and peer advocates within their area hospital systems. We will use these themes to inform our next steps in an investigation-as-action effort to improve respect, safety, and equity for all stakeholders across multiple stages of care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.041 | 0.015 |
| Scholarly communication | 0.008 | 0.002 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".