Browsing by Author "Aryal, Sarina"

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    Implementation of an In-Shelter Drug Poisoning Management Program in Calgary, AB: A Qualitative Study of Staff Perspectives and Experiences
    (2024-11-22) Aryal, Sarina; Tang, Karen; Campbell, David; Milaney, Katrina; Sawatzky, David
    Background: Substance use has disproportionately impacted people with lived experience of homelessness (PWLEH) and the organizations that support them. Emergency housing shelters continue to experience a significant increase in drug poisoning events, while having limited medical training to appropriately respond to them. In-shelter drug poisoning management programs have emerged as potential solution to this issue, by having on-site medically trained healthcare professionals present to provide emergent medical care for these events. However, limited information exists on the implementation of these program in shelters. Objective: To explore the implementation of the newly implemented in-shelter drug poisoning management program, the Riverfront Dynamic Overdose Response Capacity (DORC) program, through the perspectives and experiences of staff involved in its development and delivery. Methods: A qualitative descriptive study using an ethnographic approach was used for this study. Participants were staff at the Calgary Drop-In Centre including dedicated program staff, program planners, and general shelter staff. Data collection involved interviews and field notes which were analyzed using a thematic analysis approach. Data were coded inductively by two independent coders. These codes were combined to develop themes which were reviewed and refined both individually and within the larger research group. Findings: Twenty staff members involved in the development and delivery of the program participated in 17 interviews and 6 observations. The Riverfront DORC program was perceived to be beneficial in responding to drug poisoning events and other emergent medical needs because of the onsite emergency medical team. However, participants perceived that the program led Riverfront DORC program clients to experience isolation from social or recreational opportunities and other supports found in other areas of the building. Lastly, participants commented on the challenges with the implementation of the program due to micro-and-macro factors such as limited communication between program planners and frontline staff, competing spatial and staffing needs, and conflicting policies around drug use in the building. Conclusion: The findings of this study describe the key aspects of implementation that affected the optimal delivery of in-shelter drug poisoning management programs. Shelters intending to implement similar programs must take into considerations the micro and macro factors that may act as a barrier for successful implementation.