Forward
INDEX
1 2 3 4 5 6 7 8 9 10
Safeguard Everyone A Permit of Safe Passage
Sustain Capacity Foundations of Wellness
Identify Stakeholders Directories That Work
Engage People Healthy Connections
Compare Data Research as Service, Not Intervention
Create Meaning Metrics That Matter 2 Me
Exchange Knowledge Vernacular Pattern Languages
Design Improvements Projects of Innovation
Evaluate Results Community Based Accounting
Improve Services A Framework 4 Change
We have members across BC, and acknowledge the multiple First Nations traditional territories where we live, work and play. Our organization is housed in the Victoria Native Friendship Centre, and centered in the islands of the mid-Salish Sea, as such we specifically acknowledge our organizational host, the Victoria Native Friendship Centre, and our hosts of several nations, collectively the SENĆOŦEN speaking peoples, also referred to as the Malchosen, the Lekwungen, the Semiahmoo, and the T’Sou-ke. We work on a way forward that is based on mutual respect and marked by stories of our communities cooperating in this time of Truth and Reconciliation. The O_CHI logo is five rings that overlap each other surrounded by a circle of dots. The five rings represent five marginalized communities, Indigenous/Two-Spirit, trans/nonbinary, Sex Workers, People With Disabilities, and Newcomers. The overlap represents the intersectionality of our communities. The colours represent the uniqueness of each, the white our common struggles The O_CHI dash states that equity is never dependent on identity The Silver center represents our common goal of improving wellness in our community The circle of dots represents our ongoing welcome to all to join us.
All Rainbow Health Co-operative Educational Materials are licensed under the Creative Commons Attribution-Non-Commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/bync/4.0/. Not all our documents are licensed for redistribution and are marked as reserved.
This document is not licensed for distribution and is RESERVED, but available for your use per these terms: We respectfully request that normal business standards of confidentiality are maintained and that:
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all information in this document is treated as confidential
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requests for information to any organization regarding this content is solely through Rainbow Health Co-operative
If you have any questions or concerns regarding this document – do not hesitate to contact us.
The Directors, Rainbow Health Co-op Phone – (888) 241-9992 Fax – (888) 623-3481 Email – directors@rainbowhealth.coop
Our Co-op members, who work together to get better together, the work and effort of all O_CHI participants / community members who are generous in sharing their experiences, and the O_CHI Project Leads, Coordinators and Researchers who go above and beyond in our common effort to grow wellness in our communities. Thank You.
Strategic Plan Grants
We acknowledge the financial assistance of the Province of British Columbia
Background Rainbow Health is BC's largest trans, Two-Spirit, nonbinary organization. We are a volunteer based, not-for-profit cooperative that began as a community initiative early in 2014. Our mission is the promotion of gender wellness through education. Gender wellness is the set of personal strategies and public policies that makes our genders a beneficial part of our lives, families and communities. With our partners, the University of Victoria and the Victoria Native Friendship Centre, we engage in Community-Based Participatory Research to develop new training, workshops, community events, and wellness services. In partnership with Norwest Community Health of Winnipeg we provide Hans Kai 4 Trans Facilitator Training, Canada’s most comprehensive gender wellness program. We publish XQQ, Our Community Resource Magazine which provides a community-based directory of transition related services across BC. In 2015, BC’s Minister of Health initiated a six-month review of trans health by over two dozen doctors, psychiatrists, surgeons, and community members (including Co-op members). The recommendations they developed were reviewed by community members from across BC. It remains the most comprehensive review of BC’s trans healthcare to date. The review identified four areas of services, transition related surgery, healthcare provider training, primary care capacity and peer-based community support. These recommendations and standards are the basis of both Trans Care BC (TCBC) and Rainbow Health’s services and programs.
Summary of Our_Community Health Initiative (O_CHI) 0_CHI is a multi-year, BC-wide Community-Based Participatory Research Project that is investigating what systemic change would be for the T2NBY Community. O_CHI is a mixed methodology research project that establishes ongoing community resources to accomplish its objectives, while maintaining a commitment to equitable access by the Indigenous community. 0_CHI views systemic change through a strengths based lens that sees a world where the T2NBY community is a respected, vital and important member of society. The start of that change is to see ourselves in that community as vital, important and worthy of respect. Our people have lived amongst all peoples, in all places, in all times. We sit where others don’t so that all might have a place. We walk where others don’t so that there are new paths. We bridge between the here and the away. We are Peacekeepers and Pathfinders. Our task is to awaken our kin to their work in this world. 0_CHI is an incubator of Community Projects of Innovation. The incubator consists of a core resource of support coordinators, a program manager, a project lead and researchers for each project. The incubator is housed at the Victoria Native Friendship Centre, and the coordinators are staff of the partner organizations. 0_CHI projects begin with a year long community consultation period, the end result is a Pattern Language, an integrated set of statements that state the practicalities and principles of problems and their solutions in a consistent format that follows international standards for Pattern Languages making it accessible to a wide range of communities. Using those guidelines, a team consisting of the sponsor, coordinators, and researchers develops a pilot project plan which becomes the basis of a grant application to fund a pilot session of the project. All Projects separately and collectively:
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Identify patient cohorts with specific needs within the T2ENBY community Develop community capacity to lead in all aspects of the research project Establish a base line of delivery and experience metrics usable by multiple agencies Ensure the safety of those directly associated with the project and those they interact with Identify service provider, healthcare system, government and community member stakeholders Design a pilot program to address the needs identified by a specific patient cohort Demonstrate and analyze the pilot program, including comparison to baseline metrics
Projects are evaluated by the Trans, Two-Spirit, Nonbinary Community Council of BC whose purpose is to define, maintain, and exercise a set of community-based standards for transition related services, healthcare, and research. The primary community deliverable of the 0_CHI project is the establishment of the T2ENBY Council.
Why This Project Matters Growing the changes needed for healthier communities requires: A convincing argument consisting of a clearly stated need and an effective solution The authority to speak and access to decision makers who will listen A network of persistent communities working together to create improvement for each Our work is to create the conditions where this growth happens. O_CHI establishes the community capacity needed to ensure that resources directed to our community’s healthcare are allocated equitably and effectively.
Group conduct We commit to a code of conduct for meetings based on our group agreement. Parliaments use a Mace symbolizing the right to meet. Some groups use a stick. Some use a different object, like a unicorn. We decide what we will use. Here we use the word wand for that object. Our wand represents our right to meet, make decisions and signals a code of conduct of how we treat each other. Our wand represents rights that belong to our group and not the individuals in our group. Here are some words to open a circle
If your voice has not been heard, let this wand make it so Yin, the listening encompasses Yang the talking, both are needed Listen carefully - do not repeat what has already been shared Listen with respect, support, compassion and quietness Listen without interrupting, Listen without giving advice If an elder is present, they speak first When you are handed the wand, first say your name If you do not wish to speak, pass it on When you finish, hand the wand to the person next to you Once round the circle, hold out your hand to speak again And the wand is passed to you To close the circle, the wand is handed back to its safekeeper
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we are treaty peoples We first commit to a framework that promotes equal, non-oppressive relations between various identities. To anchor ourselves in that framework we can’t ignore the displacement of Indigenous people and occupation of their lands. As Treaty Peoples, we are responsible for establishing and maintaining mutually respectful relationships. A critical part of this process involves repairing damaged trust by making apologies, providing individual and collective reparations, and following through with concrete actions that demonstrate real societal change. WE ACKNOWLEDGE WITH RESPECT THE INDIGENOUS PEOPLES ON WHOSE TRADITIONAL TERRITORIES WE LIVE,WORK, AND PLAY AND WHOSE HISTORICAL RELATIONSHIP WITH THE LAND AND WATERS CONTINUES TO THIS DAY The KAIROS Blanket Exercise (KBE) is an interactive learning experience that teaches and internalizes Canadian-Indigenous history. It was developed in response to the 1996 Report of the Royal Commission on Aboriginal Peoples—which recommended education on this part of our shared history as one of the key steps to reconciliation. KBE covers over 500 years of history in a two hour participatory workshop. It can create the emotional understanding necessary for reconciliation. We acknowledge KAIROS as the creator of this teaching tool. For more information, go to: www.kairosblanketexercise.org THESE CARDS ARE A GIFT FROM RAINBOW – IF THEY HAVE LOST THEIR USE – PLEASE GIFT THEM FORWARD W E G E T B E T T E R T O G E T H E R
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group rights & Duties We commit to sharing support for each other, to sustain our group for others in the same need and to take care of group responsibilities. As such our group: Meets in physical and socially inclusive space Has the rights of self-determination regardless of group origin Has the right of substantial input in programs that affect us Has an open, discernable and accessible membership process Has an open, discernable and accessible governance process Resolves decisions through consensus to the furthest degree possible Manages a service schedule where each person takes their turn Suggested minimal service roles are: The Keeper - Keeps the meeting space and times organized. Maintains agreements with landlord and others. Opens and closes the meeting. The Second – Keeps the group connected with other groups. Represents the group at other meetings. Does announcements at the meeting. The Gatherer – Keeps track of group resources. Maintains bank account and group literature. Passes the hat at meetings. The Greeter – Keeps track of group members. Maintains service schedule, posts notices and updates on social media. Greets people at meeting.
Our Additions
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personal Rights & Duties I commit to building resilience in myself to accept diversity in others and that together with others I am responsible to create safer spaces, so I: Along with all others, have the right to self-define my own sexual orientation and gender identity, gender beliefs, gender pronouns and gender expression, and to not be discriminated against due to my gender identity or expression. These rights are protected in Federal and Provincial law. Recognize for myself and others, the equal rights of all members of the human family with no exclusion on the basis of gender identity or expression, transition status, history of substance use, source of income, mental health history, race, ethnicity, culture, nationality, ability, age, class, appearance, religion or sexual orientation. Value, in myself and others, diversity of; identity, beliefs, values, culture, age, language, appearance, ability, family structure, gender and sexuality. Speak with “I” statements Remember and respect pronouns These safe-r space guidelines Am responsible for what I say & do have been developed Am aware of the impact of my behaviour overtime by a number Acknowledge that everyone makes mistakes of community groups Am open to resolution when I make a mistake and they represent a Ask for consent before engaging in physical contact history of learning better ways Remember that I may unintentionally trigger others our spaces Remember that that others may unintentionally trigger me can be Assume that others are acting from a place of positive intent shared Communicate my needs and speak up if I am uncomfortable Respect the physical, mental and emotional boundaries of others Respect the physical, mental and emotional boundaries of myself Respect the confidentiality of information and narratives shared with me Avoid making assumptions about the identity and experiences of others Do not speak for the group unless requested to do so at a group meeting Maintain the anonymity of group members outside of our meeting spaces THESE CARDS ARE A GIFT FROM RAINBOW – IF THEY HAVE LOST THEIR USE – PLEASE GIFT THEM FORWARD W E G E T B E T T E R T O G E T H E R
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Group decisions
We commit to reaching an agreement before making a decision We use consensus to the furthest degree possible, but we can agree to disagree We start by getting together. Our group only makes decisions when it is together. The minimum quorum are the people in service positions. We can meet virtually. A Proposal is the next step. A proposal is ‘a suggestion put forward for discussion’. As group members we are responsible to be present and to state our position. A Simple Proposal is verbal, a Structured Proposal is written. Complicated suggestions call for written proposals. Start with: ‘My suggestion is….’ Work together to make sure everyone understands the issue and the proposal to resolve it - before moving on to a decision. Consensus is a non-voting process by which an entire group comes to an agreement. The inputs of all participants are synthesized to arrive at a final decision acceptable to all. Through consensus we are not only working to achieve better solutions, but also to promote the growth of community and trust. People can and should work through differences to a mutually satisfactory position. It is possible for one person's insights or strongly held beliefs to sway the whole group. No ideas are lost, each member's input is valued as part of the solution. These consensus guidelines were developed by
Voting is choosing one alternative from several. Diverse people will have differences of opinion and our governance framework needs to allow for that. Voting supports our commitment to robust inclusion. Our goal of consensus is balanced by the right of the majority to make decisions while protecting the rights of the minority. Voting does not have to be Yes or No. Regardless of our positions and seniority – we have an equal vote in what we decide. Default is Concordance unless rules state otherwise. We decide the appropriate majority. Simple Majority = 51-65%, Super Majority = 66-74%, Concordance = 75-95% Six Steps of a Proposal 1 – State the suggestion 2 – Clarify, questions and answers 3 – Test, Five Finger, non-binding If consensus, record, if not 4 – Modify, list pros and cons 5 – Assess, table or proceed 6 – Vote, record for and against
5 Fingers: I will champion this, it’s the best ever!
4 Fingers: I like this, it sounds good.
3 Fingers: I will support this, it’s acceptable.
2 Fingers: I have concerns about this, but will try it.
1 Finger: I prefer to resolve concerns, but will go ahead with it.
Fist: I will not go along with it.
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Group thinking We commit to sharing an open and engaging environment where all participate and there are no bad ideas Group Parallel Thinking is a group circle where each of us tries on the same Thinking Hat to consider something from the same point of view. The Six Thinking hats are shown below. We can use this process to decide a question, sort out an issue, or resolve a suggestion or proposal to the group. We start with blue, and pick the following order depending on the subject. We go around the circle, each trying on the current Hat, sharing our comments. In a more formal process, we keep notes of our thinking. We can assign a note taker, use index cards or share an online document to record comments. Five Finger ranking of each comment can be used to finish the process. This helps us to determine where we agree the most and the least. We can use the comments as the basis to synthesize a common statement. Six Thinking Hats and Parallel Thinking was developed by Edward de Bono
The Blue Hat is thinking about thinking. We ask – what is this about?
The Green Hat focuses on creative alternatives. We ask – what else is possible about this?
The Red Hat signifies feelings, hunches and intuition. We ask – how do we feel about this?
The White Hat calls for the information that is known or needed. We ask- What do we know about this?
The Black Hat is the devil's advocate. We ask – what are the issues about this?
The Yellow Hat is benefits & optimism. We ask - why is this worth our time?
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Rainbow Health Co-operative
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We acknowledge that as service providers we rely on an intangible Social License rooted in the perceptions and opinions held by our community about services and providers of services. A Social License is an inalienable attribute of any community. As service providers we are called to stewardship of this privilege.
This intangible social license is made tangible through a Community License. To operate without consideration of such a license is to act in a nonconsensual manner. It remains non-permanent because perceptions change as new information is acquired, and our obligation to maintain our license on an ongoing basis. More info at xqq.ca/communitylicense
What are Pattern Languages? “ We cannot solve our problems with the same thinking we used when we created them� Albert Einstein
Vernacular Pattern Languages Vernacular Pattern Languages are the addition of the conscious use of the collective unconscious (intuition) and parallel thinking to the process of creating a pattern language. Here are the basics.
2008—250 Million Transistors Average 2018—7-8 Billion Transistors Average
Vernacular: The form of a language that a particular group uses naturally.
Rapid Requirements Discovery
Introduction Defining requirements is still the best tool we have for reducing the risks associated with developing solutions to business problems. A solution that does not fulfill the needs of the business is not a solution at all. Moreover, if an organization does not understand all of the requirements that must be satisfied in order to solve the business problem, it will be impossible to know what the solution must entail. With the business world being pressed to always do more with less, faster than ever before, the process for defining requirements must be highly optimized for quick results. To address the challenge of defining requirements in a highly compressed timeframe, CSG has developed the Rapid Requirements Discovery (RRD) technique.
What is Rapid Requirements Discovery? CSG processes have evolved over the course of many years from our involvement in scores of projects. Our approach to defining requirements is based on our experience with what consistently works well to produce good results. The RRD technique is an important component of the larger CSG process framework, and is oriented to the need for quickly understanding and documenting requirements. Borrowing from established methodologies such as CRC, Rational Unified Process and Agile development, the RRD process is intended to identify and document the essential requirements that will drive the design, development and quality assurance of the intended solution. The technique can be effectively applied to business processes as well as software development projects. Through well-facilitated “conversations” (requirements discovery sessions), small groups (3 to 6 people) composed of business stakeholders, subject matter experts, technical experts and end users collaborate to expose “raw” requirements. The essence of these raw requirements is captured in the form of “essential elements” of the software system. There are five core elements that pertain to requirements. These are: Business and System Goals Assumptions and Constraints Actors Subjects Processes As initially described, the RRD technique relies on facilitated group conversations involving the people who are sources of requirements information. The facilitator will guide and direct the conversation, focusing the group discussion around specific topics of interest (i.e., business processes). The conversations are intended to be highly interactive with rich and full participation from all members of the group. Depending on which stage in a project the RRD conversation is taking place, the scope of the conversations will vary. In the early stages of the project, conversations will tend to be broad and fairly high-level. In later stages, the scope of conversations will tend to be narrow and detailed. In either case, the kinds of information captured from the conversation will pertain to one of the five core elements listed previously. During the RRD conversation, the group gathers around a large table. The tools provided for the group include color-coded 3x5 index cards and markers. The cards are used to capture raw requirements data, which will emerge from the group discussions. Each of the five core elements, as listed above, is
Rapid Requirements Discovery Whitepaper
represented by a unique card color. At the start of the conversation session, the facilitator will describe the process, the ground rules, and how the cards will be used. “Creating” cards is a function of the group, not just the facilitator. During the course of a conversation, whenever a new element is mentioned, the group is responsible for briefly documenting the element on the appropriately colored card. For example, there could be a discussion about a customer ordering a product. From this brief snippet of a conversation, there could be five cards created: A Subject card would be created for a Customer An Actor card would be created for a Customer A Subject card would be created for an Order A Subject card would be created for a Product A Process card would be created for the Order Entry Process Note that in this example a Customer can be both an Actor (as someone who visits our Web site) and a Subject (business class). Note also that the Order Entry Process card was implied rather than explicitly identified. When a card is created to capture an element, additional information about the element is written on the card. The idea is to capture just enough information to adequately represent the element. Typically this includes some sort of label and a brief description. All members of the group are encouraged to create cards whenever they hear something new in the conversation that relates to one of the core elements. Once a card is created it goes out to the middle of the table and is “community property”, meaning that anyone in the group can modify the card, if they choose to do so, to further enhance understanding. This promotes lively and productive discussion by encouraging participants to contribute thoughts and ideas, and to validate, or perhaps even challenge, the opinions of others in the group. In this way, the cards further stimulate the discussion, while at the same time, help to record important information that can be later “mined” for detailed requirements. RRD conversations will focus on the topics relevant to the business problem being addressed. Topics of discussion will tend to include business processes, business rules, business entities, data, transactions, related systems, workflows, technology assumptions, constraints, etc. As cards are created, the group will discuss what the card represents, and will seek to reach consensus about the definition of the card. Later, the contents of the cards will be further elaborated by the requirements analyst to produce other useful artifacts such as process models, use cases, and in many instances, detailed requirements statements. In this way, the raw requirements elements are further refined to produce deliverables that are most useful for the projects. In follow-up to the RRD conversations, when necessary, the requirements analyst will spend oneon-one time, as required, with the appropriate subject matter experts to fully flesh out detailed requirements. The key to getting the desired results from this process is the effective facilitation of the RRD conversation sessions. These sessions are intended to bring together all of the people who are essential sources of requirements, and through skilled facilitation, the business and domain knowledge held by individuals within the group can be extracted and documented. Using this technique, critical requirements information from participants can be efficiently harvested, producing valuable results very quickly.
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