Canadian Partnership for Progress in Health Human Resources
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Transcript of Canadian Partnership for Progress in Health Human Resources
Canadian Partnership for Progress in Health Human Resources Health Human Resources:
Leadership Rooted In Vision, Values, Relationships
October 8, 2009Sister Elizabeth Davis
At the end of the first decade of this 21st century, we – the ones gathered in this room – are called to see with new eyes to hear with new ears to dare with new thinking to act with new passion if we are to help create a truly strong and responsive health system in Canada, a health system built on the strengths and wisdom of health workers.
OUR CALL AS LEADERS
TEACH THE SEA’S STRONG VOICE
Here the tides flow, And here they ebb . . . With a lusty stroke of life Pounding at stubborn gates That they might run Within the sluices of men’s hearts,Leap under throb of pulse and nerve, And teach the sea’s strong voice To learn the harmonies of new floods . . .
E. J. Pratt, Newfoundland
TEACH THE SEA’S STRONG VOICE TO LEARN THE HARMONIES
OF NEW FLOODS
OVERVIEW OF REFLECTIONS Setting the Context Sea’s Strong Voice – Today’s
Realities New Floods – Changing Health
System, Professions Harmonies of New Floods –
Transforming Practice and Research Readiness for and Response to Trust
Given You
They areNurses, physicians, therapists, social workers,
dieticians, technologists, pastoral care workers . . .
Researchers, policy-makers . . .Managers, administrators, clerical staff, support
staff,Housekeeping, food services, facilities’
maintenance . . .Board members, volunteers Persons who make the health system work
They are persons, not simply “human resources”
WHO ARE “HEALTH HUMAN
RESOURCES”?
Planning - right types, mix, distribution of health-care providers to meet the needs of Canadians
Recruitment and Retention - encouraging more people to enter the health-care field and improving working conditions to keep them there
Inter-professional Education - changing the way we educate health workers
Healthy Workplace – integrated, sustainable, diverse, engaged, dynamic workplaces
SCOPE OF ISSUES RE HEALTH HUMAN RESOURCES
SEA’S STRONG VOICE
SOCIAL CHANGE IN WESTERN WORLD
Demographic shifts Role of women Increasing urbanization Increasing cultural diversity Impact of computerization Culture of consumerism Increasing gap between rich and poor Understanding of environment Expectations of public service Credibility of leaders
GENERATIONS Elders (pre-1946): Dedication, sacrifice,
hard work, conformity, law and order, patience, respect for authority, duty before pleasure, adherence to rules, honour
Boomers (1946-1965): Optimism, teamwork, personal gratification, health and wellness, personal growth, youth, work, involvement
Generation X (1965 – 1980): Diversity, thinking globally, balance, techno-literacy, fun, informality, self-reliance, pragmatism
Millennials (1980 - ): Confidence, civic duty, achievement, sociability, morality, diversity, street smarts
EMERGING NETWORK AGE
From the Industrial Age to the Information Age to the Network Age
Network Age Distributed culture Decentralized Citizen-centered not institution-centered
POVERTY IN CANADA
Aboriginal people Recent immigrants Non-permanent residents Visible minorities Persons with disabilities Lone parent families Unattached individuals 2006 Report Card on Child and Family Poverty in Canada
THREATS TO SECURITY Terrorism Epidemic disease Organized crime Conflict over natural resources Climate change Environmental degradation Security is increasingly interpreted as
security of people, not just territory; security of individuals, not just of nations; security through development, not through arms; security of all people everywhere – in their homes, in their jobs, in their streets, in their communities, and in the environment. Dr Mahbub ul Haq (1997)
ENVIRONMENTThe planet’s warming is unequivocal, its
impact is clearly noticeable, and it is beyond doubt that human activities have been contributing considerably to it. Adverse effects include:
Agriculture and food security Oceans and coastal areasBiodiversity and ecosystems Water resources Human health Human settlements Energy Transport and industry Extreme weather events
Climate Change 2007
15
EXPECTATIONS OF CITIZENSTavistock Principles (2001)
Rights – to health and health care Balance – individuals and populations Comprehensiveness = treat illness,
ease suffering, minimize disability, prevent disease, promote health
Cooperation – with those served, with each other, with those in other sectors
Improvement Safety Openness = being open, honest and
trustworthy
NEW FLOODS
CHANGING UNDERSTANDING OF
HEALTHHealth is a state of complete physical,
emotional, social and spiritual well-being; it is a resource for everyday living.
Examples of Implications:Value of one’s own experiences Social, psychological and spiritual factors Gender as health determinantHealth of person, family, community,
population and earth
CHANGING HEALTH PROFESSIONS Move from traditional inward-looking,
reactive culture to outward-looking, proactive culture
Shift from profession-centred to patient-centred, client-centred culture
Blurring professional boundaries Changes in law re scope of
practice/responsibilities Increased expectations of interprofessional
collaboration in education and practice Focus on evidence-informed practice Increasing demands for accountability and
transparency Internationalization Loss of control over working conditions
COLLABORATIONCollaborative patient-centered practice is
designed to promote the active participation of several health care disciplines and professions. It
enhances patient-, family-, and community-centred goals and values
provides mechanisms for continuous communication among health care providers
optimizes staff participation in clinical decision making (within and across disciplines)
fosters respect for the contributions of all providers
Health Canada, 2003
STAGES OF COLLABORATION Climate of mutual respect and trust Cooperation = formal communication,
independent decision-making (shared information, consultation)
Coordination = defined roles, some shared decision-making (shared vision, goals and planning; shared resource)
Collaboration = defined roles, frequent communication, shared decision-making, one system
Teamwork – specific tasks, patient-centeredCollective responsibility – organizational
integration Shared leadership, control, risk and accountability
PRESENT CULTURE IN HEALTH CARE
PREFERRED CULTURE IN HEALTH CARE
Focus on care of individual
Focus on care of individual, family, community, environment
Lack of patient centeredness in decision-making
Involvement of patient/client and family in decision-making and care
Struggle with quality and safety, variation
Culture of quality and safety
Depersonalization of care
Personalized care
Priority to acute care interventions
Priority to spectrum of health and health care
Public mistrust of system Public confidence in system
PRESENT CULTURE IN HEALTH CARE
PREFERRED CULTURE IN HEALTH CARE
Growing distance between personal and system goals
Alignment of personal and system goals
Segregated professions Integrated but not assimilated professions
Mutual trust, cooperation and coordination among health professionals and other staff members
Collaboration among health professionals and other staff members
Workforce shortage Sustainable and engaged workforce
Workplace disquiet & stress
Healthy workplace
Leadership focus on protection
Passionate and humble leadership
PRESENT CULTURE IN HEALTH CARE
PREFERRED CULTURE IN HEALTH
CARE Attention to formal structures, regulations and reporting relationships
Attention to group affiliation, teamwork, coordination
Attention to structural and procedural change
Attention to cultural change
Fragmentation, silos Integration
Elitist language, symbols
Common language, symbols
Hierarchical structure Dynamic, organic structure
HARMONIES OF NEW FLOODS
VISION Had, held, shared, grown “Something significant left to
do” Vision Community
VALUESValues are sets of freely
chosen convictions which compel action as they are cherished and publicly affirmed.
Charles McCoy
ROLES OF LEADERSVisionary Catalyst Partner
Decision-maker Inspirer
FacilitatorImplementer
Evaluator
LEADERS AS PRACTITIONERS
Manage diversity Respond within changing social
realities Be inclusive Understand globalization and
health care reform Reintroduce values of flexibility,
discovery and innovation Tell stories Create environments allowing
creativity, questions, risk
LEADERS AS RESEARCHERS Research
Interdisciplinary and collaborative qualitative and quantitative investigative and evaluative
Input and participation at every stage of research process
Link with wider national and international professional community
Research agenda = gender-sensitive and inclusive
Recognition of diverse communities Increased number of health services
researchers Means of transforming research results
into health policy and practice
LEADERS AS VISIONARIES Stretch into new ways of thinking Leave behind what is no longer
appropriate Interconnect practice, education,
administration, and research Value networks Re-inspire spirit
READINESS TO RESPOND
Leaders act wiselyLeaders act courageouslyLeaders act passionately
READINESS TO RESPOND
Awareness of complexity Skills development Strengths of tradition Emotional preparedness Reflection Ceremonies and celebration Symbols Confidence/conviction
BLESSINGMay the light of your souls guide you.
May the light of your souls bless the work that you do
with the secret love and warmth of your hearts.
May you see in what you do the beauty of your own souls.
May the sacredness of your work bring healing, light and renewal
to those who work with you and to those who see and receive your work.
May your work never weary you. May it release within you wellsprings of refreshment, inspiration and excitement.
May you be present in what you do. May you never become lost in bland
absences. May the day never burden.
May dawn find you awake and alert, approaching your new day with dreams,
possibilities and promises. May evening find you gracious and fulfilled.
May you go into the night blessed, sheltered and protected.
May your souls calm, console and renew you.
Adapted from John O'Donoghue, Anam Cara