Relational Work Is the Work: Virtual Healthcare Transformation for Rural, Remote and First Nations Communities in British Columbia.

The healthcare crisis across unceded First Nations' territories in rural, remote and Indigenous communities in British Columbia (BC) is marked by persistent barriers to accessing care and support close to home. This commentary describes an exceptional story of how technology, trusted partnerships and relationships came together to create an innovative suite of virtual care programs called "Real-Time Virtual Support" (RTVS). We describe key approaches, learnings and future considerations to improve the equity of healthcare delivery for rural, remote and First Nations communities. The key lessons include the following: (1) moving beyond a biomedical model - the collaboration framework for health service design incorporated First Nations' perspective on health and wellness; (2) relational work is the work - the RTVS collaboration was grounded in building connections and relationships to prioritize cultivating trust in the partnership over specific outputs; and (3) aligning to the core values of co-creation - working from a commitment to do things differently and applying an inclusive approach of engagement to integrate perspectives across different sectors and interest groups.

Facilitated reflection meetings as a relational approach to problem-solving within long-term care facilities.

Care workers have valuable knowledge to contribute to the improvement of their work environments. Yet incorporating their perspectives into organizational decision-making within long-term care facilities (LTCFs) has been an ongoing challenge. In this article we investigate a promising practice that brought workers and management together in weekly and bimonthly facilitated reflection meetings to identify and resolve problems. Drawing on observations as well as individual and group interviews, we sought to understand whether and how this intervention worked from the perspective of participants. Our study found that one of the main achievements was creating a safe space for workers to speak honestly. They felt heard and treated with respect. In this context, they were willing to surface concerns, failures, and problems for collective deliberation and action. The inclusion of a range of occupational groups ensured that the solutions developed were sensitive to context, including organizational and occupational realities. While the outcomes of the process were impressive, this paper highlights the relational work that created trust, respect, and a spirit of collaboration. We suggest that such facilitated reflection processes may serve as an important strategy to improve the organization of work in LTCFs, one that is particularly well-suited to the dynamic and relational nature of care.