IPAC Health Care Leaders Forum
Welcome to the IPAC Health Care Leaders Forum. In this section of our website we hope to provide you with information, research and presentations on topics of interest to leaders in the Canadian Health Care system. Whether you are a leader at the Board level or at the Senior Management level or in the front line of a health care provider in Canada, we believe that there are many issues of common concern related to the governance and management of our system that we hope to address.
Health Learning Transformation Project
The Health Learning Transformation Project (HLTP) is an innovation project in the health care area which involves the transformation of three health care organization using organizational transformation techniques including the development of balanced scorecards, strategy maps, accountability agreements and process improvements using LEAN methodologies. The results of these processes will be tracked, documented and the learnings harnessed and shared through publications and workshops. The project is supported by the Ontario government.
HLTP Partners
Since February 2008, IPAC has been working with three health care organizations in Ontario to help them develop their internal capacity and to develop new tools and processes in order to effectively and efficiently deliver quality and safe health care. These three organizations are:
North York General Hospital;
York Central Hospital; and
South East Community Care Access Centre
ED-PIP: Stories of Resilience, Reliability and Results
As part of HLTP, IPAC was engaged to develop case studies of the Ministry of Health and Long Term Care's "Emergency Department - Process Improvement Project" (ED-PIP). This 8 month initiative which ran from March – October 2009 engaged front-line staff from across these organizations in ‘quality by design’ decision-making, planning, piloting and implementing of process improvement changes in Emergency Departments and across Inpatient Units. With Wave 2 just finishing and an additional 17 Ontario Hospital sites added to the roll-out, ED PIP may be one of the most significant transformational efforts to take place in Ontario hospitals in decades. In its early days PIP has clearly demonstrated success by enhancing the quality of the patient experience through improved access to care and flow through the system at the following Wave 1 sites:
• Groves Memorial Hospital, Fergus
• Guelph General Hospital, Guelph
• St. Mary’s General Hospital, Kitchener-Waterloo
• Grand River Hospital, Kitchener-Waterloo
• Cambridge Memorial Hospital, Cambridge
The case studies provide a context for specific process improvement strategies that could be adopted in other hospitals and outline the challenges or barriers that may prevent the adoption of these process improvements. This study considers:
• the significance of a learning culture that builds capacity and resilience in its people;
• the importance of process improvement designs that enhance system effectiveness and efficiencies and increase overall reliability in care delivery and patient outcomes; and
• the value of a management and performance measurement infrastructure that encourages and supports the desired results of the transformation
With a spirit of persistent crafting and sustaining of robust strategies and improvements in care, these ‘stories’ and ‘lessons learned’ can influence, inspire and dare us to consider what is possible as we continue the journey of healthcare reform in the province of Ontario.
Below are the Case Studies of Wave 1 of the ED PIP journey.
ED PIP Case Studies - Wave 1
Health System Transformation Readiness Assessment Survey
In late 2007 and early 2008, IPAC conducted a survey that will help gauge whether your local health system is ready to undertake the significant transformational journey that is part and parcel of the implementation of LHINs and the reform of the health care system in Ontario.
At a high level respondents believe there will be significant change in the next 2-3 years, but there is no clear vision, that there is trust within their organization but not between organizations and that they do not feel that they have the support of their partners BUT, they believe that they will successfully achieve the desired outcomes. Read the full results in the file attached below.
Health Care Governance
Ontario’s health care system is still very much in the early stages of a “fundamental transformation”. One of the key questions that has been raised as the system undergoes transformation to a regionally integrated model is “Will local governance survive?”
This question was the subject of the Institute of Public Administration of Canada’s “Healthcare Leaders’ Dialogue on Governance Renewal” held on January 16, 2008. We asked whether local community Boards be eliminated, or should they be transformed to align with the fundamental transformation of the health care system.
The background paper (attached below) entitled “How can Local Healthcare Governance Survive?” is intended to provoke your thinking on this topic. What do you think about the health system’s strategic directions over the next few years? Where will the transformational journey lead? Will the Service Accountability Agreements with the Local Health Integration Networks facilitate the results that the delivery system needs to achieve?
Why did the Ontario government decide to keep independent governance Boards in the Ontario healthcare system? Western Canadian models of integrated healthcare delivery systems got rid of local governance years ago when they created regional delivery models. Will the Ontario government continue to maintain independent local governance as a key feature of an integrated regional healthcare system.
The closing speaker at the conference was Ron Sapsford, Deputy Minister of Health and Long-term Care who addressed the issue of local governance and the transformation of the system and of the Ministry. The Deputy's remarks are attached below.
Healthcare Leaders Conference
Canadian Public Administration Special Issue on Health Care
As part of IPAC's focus on health care, in December 2006, the Institute published a special issue of Canadian Public Administration that focused on health policy and innovation in Canada.
The following are the articles that are available in this issue:
From good intentions to successful implementation: the case of patient safety in Canada by Paul G. Thomas
La responsabilisation du patient dans un contexte de télésoins à domicile by Marc Lemire, Guy Paré and Claude Sicotte
A cancer control strategy and deliberative federalism: Modernizing health care and democratizing intergovernmental relations by Michael J. Prince
Health reform and privatization in Alberta by John Church and Neale Smith
Whatever happened to regionalization? The curious case of Nova Scotia by Martha Black and Katherine Fierlbeck
Reinvigorating publicly funded medicare in Ontario: new public policy and public administration techniques by W. Michael Fenn
Health System Redesign
Change management scholars tell us that for change to occur, people must first have a common understanding of their circumstances --the “whole truth” about their shared reality -- and, that they need to hold a shared vision for the future.
A “vision” is a picture of the future that they seek to create together.
When an organization, or a system of organizations, understand the “gap” that exists between their current reality and their emerging vision, then they will be able to determine what they need to do to “close the gap” between their reality and their vision.
As LHIN partners reflect on vision vs. reality within their network, they first need to consider the perspectives of Customers/ Patients/Citizens. What do they experience today? What should it be like in the future? How will you close the gap?
Health system partners also need to think about their own internal Structures & Value-Creating Processes. What is the whole truth about your current circumstances, and, what is your emerging vision of the future?
LHIN partners need to reflect on the Essential Skills & Capacity-Enablers that people have now -- and what they will need to realize your emerging vision -- and to achieve the results for which people will be accountable for achieving.
Healthcare partners also need to be grounded in a realistic Financial Resources Perspective: what are your current realities, and, from a public interest (owners’) perspective, how should it work in the future?
Finally, in terms of the Culture Perspective on the healthcare sector, what is the “whole truth” about our current circumstances in the sector -- and in your LHIN -- and, what do you want to be different in the future?
To provoke your thinking on these issues, we’ve set out in the attached paper what might reflect some of your current realities and provide a glimpse of what could be our emerging vision. The question is: How would you close the gap between your emerging vision and the realities in your Local Health Integration Network?
Health System Redesign
| Document Title | Size | Revision | |
|---|---|---|---|
| Health System Redesign Process | 328.00 kB | Jan 30, 2008 | Health System Redesign Process |
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