Healing the emergency department: exploring the role of an Indigenous patient advocate
Bibliographic record
Abstract
Background: Although the Emergency Department (ED) acts as an entry point into the acute healthcare system, it is often a source of anxiety and uncertainty for Indigenous patients. Racism and discriminatory practices in the ED, resulting in Brian Sinclair’s untimely death at Winnipeg’s Health Sciences Centre in 2008, and Joyce Echaquan’s viral plea for help before she died in a Quebec hospital in 2020, show the need for increased patient advocacy. The literature surrounding the use and role of a patient advocate in the ED is limited. However, the few hospitals that have utilized a designated ED patient advocate have reported higher patient satisfaction. With this in mind, this study examines the potential for an Indigenous patient advocate patients in the ED. Objectives: The objectives of this thesis were to examine (1) why culturally unsafe care continues to persist for Indigenous Peoples in ED environments and (2) the feasibility of a newly imagined Indigenous patient advocate role in the ED. Methods: In this qualitative study, eight semi-structured interviews were conducted with Indigenous and non-Indigenous healthcare professionals who have worked or currently work in advocating for Indigenous patients to ensure greater cultural safety generally and in the ED of a major tertiary care hospital in Winnipeg, Manitoba (Canada). Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Results: Results indicate that high-pressure situations, specifically in the ED, are where racist incidents are likely to transpire. Participants identified the dangers the Indigenous patient advocate might encounter in the health care system and recommended how to improve the Indigenous patient experience. Conclusion: The findings reveal that cultural safety training and system wide policy changes are required to heal the ED, namely creating an environment where an anti-Indigenous racism agenda is reflected in all emergency medicine workings and system operations.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.017 | 0.020 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.021 | 0.017 |
| Scholarly communication | 0.007 | 0.006 |
| Open science | 0.003 | 0.009 |
| Research integrity | 0.003 | 0.008 |
| Insufficient payload (model declined to judge) | 0.003 | 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".