Healthcare Management Forum

St. Joseph's Healthcare Hamilton (SJHH) supports a grassroots green team, called Environmental Vision and Action (EVA). Since the creation of EVA, a healthy balance between corporate projects led by corporate leaders and grassroots initiatives led by informal leaders has resulted in many successful environmental initiatives. Over a relatively short period of time, environmental successes at SJHH have included waste diversion programs, energy efficiency and reduction initiatives, alternative commuting programs, green purchasing practices, clinical and pharmacy greening and increased staff engagement and awareness. Knowledge of social movements theory helped EVA leaders to understand the internal processes of a grassroots movement and helped to guide it. Social movements theory may also have broader applicability in health care by understanding the passionate engagement that people bring to a common cause and how to evolve sources of opposition into engines for positive change. After early successes, as the limitations of a grassroots movement began to surface, the EVA team revived the concept of evolving the grassroots green program into a corporate program for environmental stewardship. It is hard to quantify the importance of allowing our staff, physicians, volunteers and patients to engage in changes that they feel passionately about. However, at SJHH, the transformation of a group of people unsatisfied with the organization's environmental performance into an ‘engine for change’ has led to a rapid improvement in environmental stewardship at SJHH that is now regarded as a success.

St. Joseph's Healthcare Hamilton (SJHH) appuie une équipe verte sur le terrain, du nom d'Environmental Vision and Action (EVA). Depuis la création d'EVA, de nombreux projets environnementaux ont découlé d'un sain équilibre entre les projets de l'organisation et les initiatives sur le terrain dirigées par des leaders spontanés. Dans une période relativement courte, les réussites environnementales de SJHH ont inclus des programmes de réacheminement des déchets, des projets d'efficacité et de réduction énergétiques, de nouveaux programmes de transport, des pratiques d'achats vertes, une valorisation verte en clinique et en pharmacie et une augmentation de la participation et de la sensibilisation du personnel. La théorie des mouvements sociaux a aidé les leaders d'EVA à comprendre les processus internes d'un mouvement sur le terrain et à l'orienter. Elle peut également avoir des applications plus vastes dans le secteur de la santé, car elle peut permettre de comprendre la passion que les individus peuvent canaliser dans une cause commune et de faire évoluer des sources d'opposition en agents de changement positif. Après les premières réussites, les limites d'un mouvement sur le terrain se sont mises à émerger, et l'équipe d'EVA a ravivé le concept de programme organisationnel pour la gouvernance environnementale. Il est difficile de quantifier l'importance d'autoriser le personnel, les médecins, les bénévoles et les patients à s'engager dans des changements qui les passionnent. Cependant, au SJHH, la transformation d'un groupe de personnes insatisfaites par le rendement environnemental de l'organisation en « agents de changement » a suscité l'amélioration rapide de la gouvernance environnementale, qui est maintenant considérée comme un succès.

Alberta Health Services formally came into existence on April 1, 2009, potentially signaling the start of a new wave of health restructuring in Canada. This article situates that change in the context of international trends in health restructuring and reviews some of the challenges faced by the new organization.

A persistent physician shortage challenges the ability of our healthcare system to meet the growing health needs of our aging population. Health system redesign must maximize the efficient use of available human resources. The Alberta Westview Primary Care Network (WPCN) introduced the Primary Care Clinical Associate (CA) program in 2005. This interprofessional collaborative practice model recruits nonphysician health professionals from various disciplines as autonomous, independent practitioners. They are associates of the family physician and use their full scope of practice to jointly care for a panel of patients in family practice settings. Three years after its inception, the CA program has grown steadily from two initial participating family practices to its current implementation in six of seven WPCN clinics. The present direction of Canadian primary healthcare reform is towards team approaches. Accordingly, the CA program has wide applicability provincially across Canada. The objective of this article is to describe in detail the design of the WPCN CA program including its conceptual framework and operational strategies and to share program implementation learning. This knowledge transfer will enable replication of the WPCN CA model, where appropriate, in other jurisdictions.

Healthcare executives report that it is difficult to access the research literature and once found, it is frequently not relevant. A study was conducted to explore ways in which healthcare executives, enrolled in the EXTRA program, used a virtual desktop environment. Despite some design and function limitations, the desktop was perceived positively by most participants and was effective in supporting evidence-informed practice and decision making.

This study evaluates the effectiveness of a performance-focused methodology for engaging multidisciplinary, frontline healthcare teams in making behavioural changes that improve patient care and health system efficiency. Results include significant declines in average length of stay in hospital and waiting time for surgery, and a dramatic increase in early patient ambulation. Performance-focused methodology using key performance indicators, targets, measurement, and ongoing feedback, supported by non-monetary incentives, can quickly improve healthcare outcomes.