Concurrent Sessions

D7 Community Services Workers: Addressing an Equity Need in Primary Care Organizations (PCO)

Theme 7. Clinical innovations to address equity

Presentation Details

  • Date: 10/18/2016
  • Concurrent Session D
  • Time: 9:30am – 10:15am
  • Room: Pier 7 & 8
  • Style: Presentation (information provided to audience, with opportunity for audience to ask question)
  • Focus: Balance between both (e.g. Presentation of a best-practice guideline that combines research evidence, policy issues and practical steps for implementation)
  • Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Administrative staff, Representatives of stakeholder/partner organizations

Learning Objectives

  1. Extending community partnerships within primary care organizations through a Health Links’ approach
  2. The role of Community Service Workers (CSW) embedded in primary care organizations
  3. Data on the effectiveness of the initiative
  4. Challenges and mitigation strategies with scaling up and spread in an urban primary care setting


Qualitative and quantitative data will be presented to demonstrate the value and need for this role.  Anecdotal feedback from physicians and other health professionals has been positive. On the average there have been 430 referrals annually addressing a variety of  unmet social needs related to education, unemployment, food insecurity, housing, social isolation, social safety net, Aboriginal status and disability.  Income insecurity is the number one unmet need for patients. Examples: CSWs assisted  patients in accessing emergency funds so heat and water would not be shut off and assisted frail seniors in navigating government services and  forms.


  • Linda Robb Blenderman, RN, BScN, MSc, Kingston Health Link Project Coordinator, Kingston Health Link
  • Laura Cassidy, Comm, Quality Improvement Decision Specialist, Kingston Health Link
  • Francine Janiuk, RN, BScN, MPA, Nursing Manager, Queen’s Family Health Team

Authors & Contributors

  • Maria Sherwood B.A., B.S.T. Community Services Worker, Kingston Health Link
  • Sheena Lyons, Community Services Worker, Kingston Health Link
  • Michael Curtis, B.Sc., Community Services Worker, Kingston Health Link