Creating safe, inclusive spaces for hospital-based health care staff and people who use drugs: an exploratory qualitative study in Vancouver, Canada

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 part...

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Main Authors: Aaron Bailey, Elizabeth Bishop, Agnes T. Black, Elizabeth Dogherty, George Sedore, Marge Humchitt, John Onland, Jane Milina, Varun Bangar, Heather Mackie, Herb Varley, Tyler Byrd, Sven Black, Kristine Auigbelle, Carina Nilsson, The Eastside Illicit Drinkers Group for Education
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Harm Reduction Journal
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Online Access:https://doi.org/10.1186/s12954-025-01158-3
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author Aaron Bailey
Elizabeth Bishop
Agnes T. Black
Elizabeth Dogherty
George Sedore
Marge Humchitt
John Onland
Jane Milina
Varun Bangar
Heather Mackie
Herb Varley
Tyler Byrd
Sven Black
Kristine Auigbelle
Carina Nilsson
The Eastside Illicit Drinkers Group for Education
author_facet Aaron Bailey
Elizabeth Bishop
Agnes T. Black
Elizabeth Dogherty
George Sedore
Marge Humchitt
John Onland
Jane Milina
Varun Bangar
Heather Mackie
Herb Varley
Tyler Byrd
Sven Black
Kristine Auigbelle
Carina Nilsson
The Eastside Illicit Drinkers Group for Education
author_sort Aaron Bailey
collection DOAJ
description 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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spelling doaj-art-4173f6b388924f42bb51e3bde9bcde192025-08-20T03:41:40ZengBMCHarm Reduction Journal1477-75172025-03-0122111310.1186/s12954-025-01158-3Creating safe, inclusive spaces for hospital-based health care staff and people who use drugs: an exploratory qualitative study in Vancouver, CanadaAaron Bailey0Elizabeth Bishop1Agnes T. Black2Elizabeth Dogherty3George Sedore4Marge Humchitt5John Onland6Jane Milina7Varun Bangar8Heather Mackie9Herb Varley10Tyler Byrd11Sven Black12Kristine Auigbelle13Carina NilssonThe Eastside Illicit Drinkers Group for EducationCanadian Institute for Substance Use Research, University of VictoriaDepartment of Education, Simon Fraser UniversityProvidence Health CareProvidence Health CareThe Eastside Illicit Drinkers Group for Education, Vancouver Area Network of Drug UsersThe Eastside Illicit Drinkers Group for Education, Vancouver Area Network of Drug UsersThe Eastside Illicit Drinkers Group for Education, Vancouver Area Network of Drug UsersThe Eastside Illicit Drinkers Group for Education, Vancouver Area Network of Drug UsersThe Eastside Illicit Drinkers Group for Education, Vancouver Area Network of Drug UsersThe Eastside Illicit Drinkers Group for Education, Vancouver Area Network of Drug UsersThe Eastside Illicit Drinkers Group for Education, Vancouver Area Network of Drug UsersThe Eastside Illicit Drinkers Group for Education, Vancouver Area Network of Drug UsersThe Eastside Illicit Drinkers Group for Education, Vancouver Area Network of Drug UsersThe Eastside Illicit Drinkers Group for Education, Vancouver Area Network of Drug UsersAbstract 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.https://doi.org/10.1186/s12954-025-01158-3Drug toxicity crisisFrontline healthcare workersEmergency careAcute carePeer navigationHarm reduction
spellingShingle Aaron Bailey
Elizabeth Bishop
Agnes T. Black
Elizabeth Dogherty
George Sedore
Marge Humchitt
John Onland
Jane Milina
Varun Bangar
Heather Mackie
Herb Varley
Tyler Byrd
Sven Black
Kristine Auigbelle
Carina Nilsson
The Eastside Illicit Drinkers Group for Education
Creating safe, inclusive spaces for hospital-based health care staff and people who use drugs: an exploratory qualitative study in Vancouver, Canada
Harm Reduction Journal
Drug toxicity crisis
Frontline healthcare workers
Emergency care
Acute care
Peer navigation
Harm reduction
title Creating safe, inclusive spaces for hospital-based health care staff and people who use drugs: an exploratory qualitative study in Vancouver, Canada
title_full Creating safe, inclusive spaces for hospital-based health care staff and people who use drugs: an exploratory qualitative study in Vancouver, Canada
title_fullStr Creating safe, inclusive spaces for hospital-based health care staff and people who use drugs: an exploratory qualitative study in Vancouver, Canada
title_full_unstemmed Creating safe, inclusive spaces for hospital-based health care staff and people who use drugs: an exploratory qualitative study in Vancouver, Canada
title_short Creating safe, inclusive spaces for hospital-based health care staff and people who use drugs: an exploratory qualitative study in Vancouver, Canada
title_sort creating safe inclusive spaces for hospital based health care staff and people who use drugs an exploratory qualitative study in vancouver canada
topic Drug toxicity crisis
Frontline healthcare workers
Emergency care
Acute care
Peer navigation
Harm reduction
url https://doi.org/10.1186/s12954-025-01158-3
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