Creation of the Indigenous Support Line for health system navigation and culturally safe access to care: a quality improvement project

Indigenous Peoples face inequities in health and healthcare access due to colonial history and systems. To work towards the Truth and Reconciliation Commission of Canada's Calls to Action and the United Nations Declaration on the Rights of Indigenous Peoples, Alberta Health Services has collaborated with a Wisdom Council of engaged Elders and Indigenous community members to tailor programmes for Indigenous Peoples. The Indigenous Support Line (ISL) was created based on the Wisdom Council's advice to provide an Indigenous-specific concerns line, which later expanded into a telehealth line to address any health questions or access issues, including health system navigation and access to Western and Indigenous health and wellness supports. Working from an ethical space guided the process, and Indigenous ways of knowing and Western approaches were respectfully integrated throughout. The percentage of calls answered or abandoned within 10 min was tracked as a key measure for quality improvement, coupled with a patient survey to measure access, accessibility, effectiveness and safety that included several open-ended questions that were treated as qualitative data and analysed using thematic analysis. Between June 2022 and February 2024, 92.7% of inbound calls were answered or abandoned within 10 min. A total of 86 respondents completed the survey, with 100% indicating they were satisfied with the service. Qualitative findings showed respondents felt satisfied with the line and the Indigenous Listeners, were respected during their call, and felt supported to have their concerns addressed. The ISL was successful in increasing Indigenous Peoples' access to care in a culturally safe environment.