Shelter Health Network Patient Navigator
Bridging the Gap Between Healthcare and Community
Since 2005, the Shelter Health Network (SHN) has served Hamilton’s highest-risk populations by enabling collaboration between healthcare professionals and social service agencies.
In recognition of the many barriers faced by this population, Wayside House and SHN have created a new Patient Navigator position made possible by a generous grant from The Allen and Milli Gould Family Foundation.
The Patient Navigator receives referrals from SHN’s network of healthcare professionals and assists these clients in achieving their goals as defined by the social determinants of physical and mental health. For example, clients who require assistance making appointments, fulfilling their basic needs or completing service related paperwork have all been helped by our Patient Navigator.
Bridging the Gap Between Healthcare and Community
Since the role’s inception in November 2021, over 1700 hours of direct care have been provided to over 60 of Hamilton’s most vulnerable individuals. The Patient Navigator works with a diverse array of agencies including Ontario Works, YMCA, Mission Services and a number of local drop-in centres and care facilities.
Their commitment helps to extend healthcare out of the doctor’s office and into the community at large. In a system where falling through the cracks is unfortunately all too common, Wayside House and the Shelter Health Network are dedicated to providing a reliable safety net.
1700 hours of direct care provided in
collaboration with 20+ agencies since
November 2021
60 clients referred to Patient Navigator from SHN doctors who maintain a 20 client caseload.
An additional 20 individuals on waitlist
What are the Advantages of the Patient Navigator
Housing
- Bridged 30+ individuals to private, supportive & transitional housing e.g. YMCA and Residential Care Facilities
- Works with 20+ community partners to connect with and assist especially those experiencing homelessness
- Helped 10+ precariously-housed clients maintain their tenancies
- Secures shelter beds when necessary
Food Security
- Works with Good Shepherd Venture Centre and Mission Services Good Food Centre to provide groceries to at least 35 clients on a monthly basis
Recovery
- Has facilitated 40+ treatment groups at Wayside House
- Provided one-on-one counselling to 120+ residential clients
- Maintains relationships with clients after completion of program
- Completes referrals to detox and other addiction treatment services
Finances
- Connects clients with Ontario Works/Ontario Disability Support Program; accompanies clients to appointments
- Collaborates with clients on budgeting and financial plan making
Health Care
- Accompanied 100+ clients to specialist appointments
- Establishes and maintains connections with primary caregivers
- Assists with health card and birth certificate applications
- Provided nalaxone and training to 50+ clients; developing ion-service training
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Certifications & Funding
Wayside House of Hamilton is funded by the Ministry of Health and the generous support of our community partners. We are a proud member of Addictions & Mental Health Ontario, an integrated system of 150 service providers across the province. We have been accredited by the Canadian Centre for Accreditation since 2016, a designation that signifies our commitment to compassionate, quality service.
