Aboriginal Substance Misuse Services
Accreditation Canada's sector- and service-based standards help organizations assess quality at the point of service delivery and embed a culture of quality, safety, and client- and family-centred care into all aspects of service delivery. The standards are based on five key elements of service excellence: clinical leadership, people, process, information, and performance.
Accreditation is one of the most effective ways for organizations to regularly and consistently examine and improve the quality of their services. The standards provide a tool for organizations to embed accreditation and quality improvement activities into their daily operations with the primary focus being on including the client and family as true partners in service delivery.
Client- and family-centred care is an approach that guides all aspects of planning, delivering and evaluating services. The focus is always on creating and nurturing mutually beneficial partnerships among the organization’s team members and the clients and families they serve. Providing client- and family-centred care means working collaboratively with clients and their families to provide care that is respectful, compassionate, culturally safe, and competent, while being responsive to their needs, values, cultural backgrounds and beliefs, and preferences (adapted from the Institute for Patient- and Family-Centered Care (IPFCC) 2008 and Saskatchewan Ministry of Health 2011).
Accreditation Canada has adopted the four values that are fundamental to this approach, as outlined by the IPFCC, and integrated into the service excellence standards. The values are:
- Dignity and respect: Listening to and honouring client and family perspectives and choices. Client and family knowledge, values, beliefs, and cultural backgrounds are incorporated into the planning and delivery of care.
- Information sharing: Communicating and sharing complete and unbiased information with clients and families in ways that are affirming and useful. Clients and families receive timely, complete, and accurate information in order to effectively participate in care and decision-making.
- Partnership and participation: Encouraging and supporting clients and families to participate in care and decision making to the extent that they wish.
Collaboration: Collaborating with clients and families in policy and program development, implementation and evaluation, facility design, professional education, and delivery of care.
Substance misuse refers to alcohol, drug or other substance use which results in negative consequences for the user. Substances that may potentially be misused include illegal and prescribed drugs, alcohol, over the counter medicines, and volatile substances such as aerosols, gasoline and glue, among others. Polysubstance misuse involving the misuse of multiple substances, is becoming increasingly common. In these standards, the term substance misuse refers to both substance and polysubstance misuse. Substance misuse is a complex issue that is frequently associated with a wide range of other factors and concurrent conditions, including emotional and mental distress: physical, psychological, social, economic and legal problems and poverty. The negative impact of substance misuse extends to clients, their families and the broader community. Substance misuse is often a chronic and relapsing condition that may or may not involve addiction.
When treating substance misuse it is important that a range of readily accessible, evidence-based treatment options is available, including early and brief interventions, residential treatments, and continuing treatment options.
Substance misuse services for Aboriginal adults and youth should be culturally grounded and delivered within the context of culture, family, community, and society. They should be holistic in nature, address coexisting physical and mental health problems, and delivered in a positive service environment that addresses clients' service needs across the continuum of care including pretreatment, treatment and aftercare. Treatment should acknowledge the determinants of health in defining clients' health and well being and be cognizant of the broader sociocultural context in which substance misuse and related problems occur. It should involve an interdisciplinary skilled workforce providing complementary assessments and integrated intervention and incorporating harm reduction or abstinence approaches or both, depending on clients' individual needs, the nature and severity of the problems, and the particular treatment philosophy.
Recovery is viewed as a process not a single outcome or event. It is conceptualized in terms of assisting clients in building a personally satisfying and meaningful life, and not solely in terms of ceasing substance misuse. It involves the accrual of positive benefits and a movement away from uncontrolled substance misuse and associated problems toward health, well-being, and fuller participation in society. A treatment approach that fosters clients' aspirations and hope, and is delivered in a positive service environment is considered vital to sustained recovery from substance misuse.
This set of standards contains the following sections:
- Investing in quality services
- Building a prepared and competent team
- Providing safe and effective services
- Maintaining accessible and efficient information systems
- Monitoring quality and achieving positive outcome
All Accreditation Canada standards are developed through a rigorous process that includes a comprehensive literature review, consultation with a standards working group or advisory committee comprised of experts in the field, and evaluation by client organizations and other stakeholders.
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