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Executive Training for Research Application
Formation en utilisation de la recherche pour cadres qui exercent dans la santé
The EXTRA program was set up with a grant from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.
© Canadian Health Services Research Foundation
2007-02-11
Title
Leadership in the use of research-based evidence:Physician Leadership Stories from EXTRA
Terrence Sullivan PhDPresident and CEO
Cancer Care Ontario
Academic Program LeaderEXTRA
Exective Training for Research
Application (EXTRA) is a fellowship
program designed to train health
services leaders to become even
better decision makers by learning
how to find, assess and interpret
evidence from research.
Program Partners
� Canadian Health Services Research Foundation
� Canadian College of Health Service Executives
� Canadian Medical Association
� Canadian Nurses Association
� Consortium of 13 Quebec partners represented by
Agence des technologies et des modes d’intervention en santé (AETMIS)
EXTRA Curriculum
6 modules spread over 4 residency sessions
� Promoting the use of research
� Appraising quality and relevance of research
� Becoming a leader in the use of research
� Using research to create and inform change
� Sustaining change in organizations
� Synthesis: IP presentations and building a CoP
� Health information management topics integrated across all
modules
“It is not the critic who counts; not the one who points out how the strong stumbled or where the doer of deeds could have done better. The credit belongs to those in the arena; who strive valiantly; who fail and come up short again and again…”
Theodore Roosevelt
Evidence-based management
� Evidence-based management is affected by ORGANIZATIONAL CONTEXT
� What constitutes GOOD EVIDENCE (enlightenment, tactical, political, instrumental?)
� Complex problems transcend professional and organizational boundaries
Stewart, R.S. 2002. Evidence-Based Management: A Practical Guide
for Health Professionals. Oxford: Radcliffe Medical Press.
6. leadership and managing organizational politics
4. dyadic leadership: coaching and mentoring
2. capacity to initiate and exploit strategic moments
5. leadership in groups: peer assessment in leading people
3. clinical and collaborative leadership
1. leadership and effective communication
EXECUTIONPEOPLETRANSFORMATIONS
STRATEGY
Health Leadership Competencies in the EXTRA
Program
Executive Training for Research Application
Formation en utilisation de la recherche pour cadres qui exercent dans la santé
The EXTRA program was set up with a grant from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.
© Canadian Health Services Research Foundation
National Health Care Leadership Conference
June 12, 2007
Dylan A. Taylor MD FRCPC FACC CHESite Medical Director
University of Alberta & Stollery Children’s HospitalsCapital Health
Edmonton Area
Physician Integration in a Multi-Specialty Ambulatory Care
Project
Problem:
– Physicians may not perceive their interests to
be aligned with the health system
– Physicians may not perceive themselves to be
part of the decision-making process
• They have been alienated
• They function independently from other members of the health care team
The Four Worlds of the General HospitalAdapted from Glouberman & Mintzberg
Care
Nurses
Cure
Doctors
Control
Managers
Community
Board
Managing the Care of Health and the Cure of Disease - Part I: Differentiation. Health Care Management Review 26(1):54, Winter 2001
Project Challenge
Engaging physicians
– Commitment
– Participation
– Contribution
Leadership Challenge
To model leadership that will successfully engage physicians
Communication
Effective communication
Strategic moments
Collaboration
Dyadic structures
Cooperation
Group leadership
Organizational politics
Executive Training for Research Application
Formation en utilisation de la recherche pour cadres qui exercent dans la santé
The EXTRA program was set up with a grant from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.
© Canadian Health Services Research Foundation
2007-02-11
2007-02-112007-June 12
Title
Leadership Collaboration: Applying the Co-management Model for evidence-based change
John Knoch PhD
Executive Director, Clinical Support Services
David Thompson Health Region
Alberta
Introduction
� Context: Change through regionalization
� Intervention Project purpose
� Clinical and Collaborative Leadership
� What we’ve done
� Challenges
� Lessons learned
� What EXTRA is doing for me
Context:Change through regionalization
� First regionalization in 1995
� Second major restructuring in 2003
� Operational Reviews in 2004 for regional Laboratory Services, regional Diagnostic Imaging and Medicine Programs
� Recommendation: implement Co-Management dyad model
Intervention Project purpose
� Regionalization resulted in a conflict of cultures
� Establish a new structure that brings physicians
into the decision-making process
� Outline a clear decision-making model that
complements organizational values
� Ensure physician and non-physician leaders are
engaged in appropriate decisions
� Influence physician and non-physician behaviour
Clinical and Collaborative Leadership
� Team must have a clear purpose
� Culture – common goals and values
� Mechanisms to overcome resistance
� Strong communication protocols
� Mentor and coach leaders
� Persuasion and Perseverance
What we’ve done
� Senior Management commitment
� Researched similar models
� Coalition of formal and informal leaders
� Job Description and Competencies
� Implemented New Bylaws and Committees
� New structure began January 2007
� Survey of Medical and Admin Director
Challenges
� Focused and clear purpose
� Culture shift -- anchor change throughout organization
� Role clarity between and within Administration and Physicians
� Evaluation to ensure desired outcomes in Quality and direct care
� Overcome passive and active resistance
Lessons learned
� Clinical and Collaborative Leadership competency
� Seize the strategic moment
� Organizations need to learn from each other
� Components of co-management: complementary leaders, communication, collaboration, competencies and control
What EXTRA is doing for me
� Excellent Faculty, Guest speakers and support staff
� Network with executives across Canada, in both official languages
� Assisting my organization to think through a problem
� Desktop and Research tools
� Develop skills in research, critical analysis and leadership
� Community of Practice
Executive Training for Research Application
Formation en utilisation de la recherche pour cadres qui exercent dans la santé
The EXTRA program was set up with a grant from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.
© Canadian Health Services Research Foundation
HOW TO INVOLVE PHYSICIANSIN YOUR ORGANIZATION’S CHANGE STRATEGIES
Presented by Carl Taillon, M.D.
Vice-President – Medical Affairs
Centre hospitalier universitaire de Québec
Healthcare Leadership Conference
Toronto – June 2007
INTRODUCTION
� January 2004 : Clinical practice � Health
management
� April 2005 : Vice President Medical Affairs
� June 2005 : FORCES / EXTRA Program :
� 2005-2007 : Intervention project :
« How to address medical
demobilization ? »
PLAN
� Strategies to improve physician’sinvolvement.
� Favourable conditions for implementingchange.
� Behavioural attitudes to consider with
physicians.
STRATEGIES TO IMPROVE PHYSICIAN’S INVOLVEMENT
CÔTÉ A. Gestion. Vol. 32, # 1, Spring 2007
� Compulsion (contrainte)
� Resources to train physician (structure
d’encadrement)
� Link a change process with a symbolicobjective (doter la démarche de
changement d’un objectif symbolique
rassembleur)
STRATEGIES TO IMPROVE PHYSICIAN’S INVOLVEMENT
CÔTÉ A. Gestion. Vol. 32, # 1, Spring 2007
� Address any particular expectations (répondre à certaines attentes particulières)
� Persuade (recourir à la persuasion)
� Pilot studies (utiliser des projets pilotes)
FAVOURABLE CONDITIONS FOR CHANGE
� « Social cohesion »
� Stable environment
� Confidence
WILS (mobilisation collective)
PoliticalMutual
understandingCognitive
TechnicalCo-operationConative
SymbolicSocializationAffective
ChangeComportmentDimensions
TO COME …
� Leadership…
One application. A two-year fellowship. A lifetime of benefits.
For more information about EXTRA and for details on how to apply:
www.chsrf.ca/extra
CURRENT CALL FOR APPLICATIONS: October 1, 2007
CLOSE OF COMPETITION: February 29, 2008
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