1.
A Reflection on
Canada’s 2015
Syrian Refugee
Operation
IN FLUX

2.
TODAY’S FOCUS

3.
1 Background
2 Our Role
3 Adapting
4 The Sprint
5 The Arrival
6 Reflection
TODAY’S FOCUS
Canada’s Syrian Refugee Operation
Case study through a service design lens:

4.
BACKGROUND

5.
Bernard Weil | Getty Images

6.
Bernard Weil | Getty Images
35,147
Relocated to Date

7.
SYRIAN REFUGEES
Context in a nutshell

8.
Peter Macdiarmid | Getty Images
Arab Spring Uprisings

9.
Syrian Civil War

10.
Matteo Rovella Pictures
Mass Displacement
of 4,810,216 People

11.
Khalil Mazraawi | Getty Images
Varied International
Responses

12.
DIFFERENT PERSPECTIVES
From Western Audiences

13.
If Europe fails on the question of
refugees, then it won’t be the
Europe we wished for.
- Angela Merkel

14.
I’m putting the people on notice that are coming
here from Syria as part of this mass migration,
that if I win, if I win, they’re going back.
- Donald Trump

15.
Canadian Press
Key tenet of Trudeau’s
election platform

16.
This is not just about welcoming 25,000
Syrian refugees...
- Justin Trudeau

17.
...It’s welcoming 25,000 new Canadians.
- Justin Trudeau

18.
OUR ROLE

19.
Goverment operation
involving many groups
Federal, provincial, municipal,
military, NGOs & volunteers

20.
Medical ‘SWAT Team’

21.
Mass casualty events, medical
crises, unique emergencies
Can deploy anywhere in the
province, on short notice

22.
Taxi Driver (1976) | Columbia Pictures
Talkin’ to me?

23.
“You’re the human factors guy”
Taxi Driver (1976) | Columbia Pictures

24.
ADAPTING

25.
Show up at 6:00am at this address
and we’ll go from there.

26.
Just soak it all in

27.
Ethnography, co-design,
experience mapping,
prototyping, etc.
Keep the toolbox in mind

28.
Project Description
As part of the Healthcare Human Factors website refresh,
a video will be made to showcase our service offerings
Project Considerations
— motion graphics overlay (if applicable)
Project Brief
HEALTHCARE HUMAN FACTORS PROMO VIDEO
Desired “deliverable”
was undefined

29.
So ask yourself:
What is the ideal output?

30.
THE SPRINT

31.
An ever-evolving situation
— When are they coming?
— How and where will they arrive?
— Who exactly are they?
— Where will they stay? For how long?
— What is their physical condition?
— What is their mental state?
— How many will speak English?
— When will we get answers?

32.
EMAT
1 Provide primary care clinic support
A at arrival point (Pearson)
B at interim lodging sites (ILSs)
Healthcare Human Factors
1 Connect all the dots
2 Package up for EMAT
Whole bunch of organizations
1 Identify & vet refugees
2 Figure out details of their arrival
3 Figure out where they’ll stay
4 Plan for their long-term success

33.
EMAT
1 Provide primary care clinic support
A at arrival point (Pearson)
B at interim lodging sites (ILSs)
Healthcare Human Factors
1 Connect all the dots
2 Package up for EMAT
Whole bunch of organizations
1 Identify & vet refugees
2 Figure out details of their arrival
3 Figure out where they’ll stay
4 Plan for their long-term success

34.
EMAT
1 Provide primary care clinic support
A at arrival point (Pearson)
B at interim lodging sites (ILSs)
Healthcare Human Factors
1 Connect all the dots
2 Package up for EMAT
Whole bunch of organizations
1 Identify & vet refugees
2 Figure out details of their arrival
3 Figure out where they’ll stay
4 Plan for their long-term success

35.
6:00 am
Show up at this address...

36.
Shadowing

37.
Planning

38.
Mapping

39.
Collaborating &
Synthesizing

40.
Dry-running

41.
Deliverable?
“Guidebook document”

42.
DECEMBER 2015
ONTARIO EMAT
PRIMARY CARE CLINICS
FOR SYRIAN REFUGEES:
SETUP GUIDEBOOK

43.
12EMAT: Primary Care Clinic Setup Guide (Dec 2015)
Recommended Reading
Western Australian Health Care
Providers’ Handbook on Muslim Patients
First Edition 2014
This handbook provides a comprehensive
primer to healthcare workers who
may have little experience in providing
care to Muslim patients. It details
Islamic cultural practices such as
prayer times, outlook on gender, dietary
considerations, and more.
Download PDF here
Western Australian
Health Care Providers’ Handbook
on Muslim Patients
First Edition

44.
Entrance
Reception area
Med
Supplies
BED #2
BED #1
PS area
HS/Masks
Play area
ESP
cart
PS files for assessment
General Filing
Returning Visit Files
Today Assessment Files
Waiting area
Supply area
LEGEND
- Desk with LB 12 - Recycling container
- Sharps container - Storage bin
- Bio-hazard waste receptacle
- Regular waste receptacle
- Security
Secure storage bin for
meds
Soiled Utility
Room
Key Concepts
For privacy and cultural issue, no two doors
of patient exam area should face each other.
And patient flow should not pass in front of
another exam room. Exam room includes PS
area.
Computer
1
2
3
4
5
Suggested Clinic Layout (Generic)
*This suggested layout is based on a generic warehouse space; customization on a per-site basis is to be expected

45.
sk
ily
as
y)
Require
belongings
bag?
First Visit or
Follow-Up?
Follow-
Up
Put belongings
in bag(s);
carry bag(s)
throughout clinic
Y
N
TION (2) REGISTRATION DESK (3) WA
Proceed to
Registration
Queue
Receive patient
First
Visit
Start New
Charting
Folder
Take 2 ID
Stickers; Place
1 on Chart and
1 on Bracelet
Apply
Bracelet to
Patient
Place Chart in
"To Be Seen"
Queue Bin for
Treatment or
Psychosocial
Direct Patient
to Waiting Area
Dialogue with
PT;
Input
Intake Info into
Excel
Ask for Name
Find Chart
in "Follow-Up"
Bin
(Alphabetical;
Last Name)
Write ID onto
New (Blank)
Bracelet
and Apply to
Patient
Patient
still has ID
Bracelet?
N
Dialogue with
PT;
Update
Intake Info into
Excel
Y
Proceed to
Waiting Area
Take Next Chart
from
"To Be Seen for
Treatment"
Queue Bin
Ready for
New Patient
Call Out PT
Name and/o
(Confer wit
Translator a
Necessary
Wait to be Called
and Escorted
by Medical
Professional
Proceed Back
to Waiting Area
Ready for
New Patient
Take Next Chart
from
"To Be Seen for
Psychosocial"
Queue Bin
Call Out PT's
Name and/or ID
(Confer with
Translator as
Necessary)
Entry into Clinic
Observe
Pre-Registration
Signage
Put on mask
(self + family
members as
necessary)
Lodging
Observing
fever?
Y
PATIENT+FAMILYADMIN/CLERKMEDICALWORKERPSYCHOSOCIALER
Require
belongings
bag?
First Visit or
Follow-Up?
Follow-
Up
N
Put belongings
in bag(s);
carry bag(s)
throughout clinic
Y
N
(1) PRE-REGISTRATION (2) REGISTRATION D
Proceed to
Registration
Queue
Receive patient
First
Visit
Start New
Charting
Folder
Take 2 ID
Stickers; Place
1 on Chart and
1 on Bracelet
Dialogue with
PT;
Input
Intake Info into
Excel
Ask for Name
Find Chart
in "Follow-Up"
Bin
(Alphabetical;
Last Name)
Patient
still has ID
Bracelet?

46.
Treatment Area
StaffInventoryProcess
Station
Step
Purpose For medical staff
conducting assessments:
• Clear separation from
waiting area and other
treatment areas for
privacy reasons
• Easy access to medical
supplies & cleaning
Required:
• 2 x medical professional
(RN, NP, and/or MD)
(Medical staff must have at
least 1 female on shift at a
time for cultural sensitivity)
Required:
• Primary PT assessment
Possible escalations:
• To MD (consult call)
• To EMS
• To Psychosocial health
• To Diagnostics
4
Treatment
Required per station:
• Bed for PT + 2 chairs
• LP12 or AED + table
• Crash bag
• Biohazard container
• Sharps container
• Privacy (room / dividers)
Treatment bed
LP12 or AED
Temporary dividers
as necessary
Chairs and/or table
for supplies

47.
24EMAT: Primary Care Clinic Setup Guide (Dec 2015)
Pearson Infield Terminal Setup
Gate 523:
Flow of refugees
disembarking from plane
into terminal; walk through
glass entryway to Gate 521
CBSA Officers on the lookout for
communicable diseases to escalate to
PHAC RNs if necessary
PHAC RNs
Welcome Centre
CBSATerminals
Gate 521:
Welcome to Canada!
Proceed to CBSA
Waiting Area
Service Canada
EMAT
CBSAWaitingArea

48.
Flow through Pearson (Detailed)
Fit to fly? Y
N
DND HCPs:
1 x MD
1 x RN
Staffed on plane
Event Start
IME Screening
at Origin Point by
DND Personnel
Jordan/Lebanon
1.0
Board plane and
travel to
Toronto, Canada
2.0
Arrival at
Pearson Airport
3.0
Disembark
(Gate 523)
4.0 MD/RN
identified
for med
assistance?
N
Y
Proceed to
receive primary
care assessment
@ EMAT
EMAT
Proceed to
PHAC
Quarantine RNs
PHAC
Quarantine
flag for
EMAT?
N
Y
Proceed
to CBSA
Processing
5.0
Proceed to
Welcome Centre
(Receive clothing)
7.0
Identifies patients in need of assistance
Placement
arranged?
Placement to
pre-arranged
location in
Canada
8.A
Proceed to
Interim Lodging
Site (ILS)
8.B
Y
N
Self-identify
for medical
assistance?
N
Y
Proceed to
Service Canada
(Receive SIN #)
6.0
EMS
Critical?
YN
Exit to EMS
(Peele Medics)
Proceed to Next Station
in Process
(CBSA if not yet processed, or
Service Canada if they have
already gone through CBSA)
CONTINUE ON
EMS
Critical?
YN

49.
70EMAT: Primary Care Clinic Setup Guide (Dec 2015)
Inbound refugees will be gradually acclimatized to Canadian culture, but are
expected to undergo a period of learning and education regarding acceptable
practices and behaviour that may greatly contrast what is normal for them.
Accordingly, all clinic staff are expected to exercise appropriate sensitivity,
tact, and discretion in handling culturally sensitive scenarios that may arise.
SITUATIONS REQUIRING ESCALATION:
Call EMAT EOC: 1-800-680-7260
When in Doubt: Call EMAT

50.
Rolling with the punches
— Info changing all the time
— Lots of unknowns
— Intense / urgent situation
— Little time to manicure output
— Unique design challenges
(language + cultural + religious customs)

51.
THE ARRIVAL

52.
DECEMBER 2015
First flights @ Pearson

53.
Stacey Newman | Shutterstock.com

54.
Mark Blinch | Reuters

55.
Nathan Denette | The Canadian Press

56.
REFLECTION

57.
Looking back
— Service design is a powerful “lens”
— Work within your constraints
— Be thankful you live in Canada :)
— If you want to get involved...
#WelcomeRefugees

58.
Bernard Weil | Getty Images
A Reflection on
Canada’s 2015
Syrian Refugee
Operation
THANK YOU

59.
Questions?