By Tanishq Suryavanshi and Michael K. Parvizian
Over the past few months, patients and healthcare providers alike have been encouraged to make pledges to improve compassionate quality care in Ontario as part of an inaugural movement called, Change Day Ontario.
Nearly 6000 voices have made pledges on the site and social media ranging from the individual to the institutional; from those geared towards better understanding the patient perspective, to actively combating systemic discrimination on a hospital ward, from promoting safe and effective use of technology to improving equitable access to mental health and addiction services.
One pledge promised to “always demonstrate high quality and safe care through positive patient identification every patient, every time.”
As debates peak about the future of our healthcare system, and as healthcare technology continues to evolve rapidly, initiatives like Change Day Ontario have an important place in fostering a culture of change at the frontlines.
Yet, despite the enthusiasm of its supporters, Change Day is not without its critics. Some have questioned the effectiveness of the pledges and whether they will produce tangible benefits. Others speak to the difficulties individuals face trying to achieve change and emphasize the need for institutions to facilitate pledges from the front line.
But the true value of Change Day runs much deeper than the individual pledges themselves.
The first Change Day was sparked by the sense of disempowerment and frustration workers felt in the NHS. The NHS’s top-down approach to improvement had created frustration among the front-line workers, and bred pessimism about the possibility of reform. In an effort to inspire change, junior doctors reached out to senior leadership through Twitter and emphasized the need to facilitate system-wide leadership in healthcare improvement.
The resultant Change Day helped to foster a culture of change, by empowering workers to solve problems they experienced on a daily basis. Promoting change as a necessary part of a complex system, and providing avenues to do so, is what makes initiatives like Change Day so important for Ontario.
Change Day was brought to Ontario this year by Associated Medical Services and Health Quality Ontario.
Similar to the NHS, Ontario struggles when it comes to achieving change. A lack of unified vision and principles due to complex bureaucracy and fragmented accountability have left us without a culture that embraces continuous improvement and quality care.
In addition to this aversion to change, Ontario’s healthcare system is navigating complex challenges. Rising costs, political tensions and increased demands are straining stakeholders across the system, and bringing the sustainability of our system into question. Promising new technologies are being explored as potential solutions but disruptive technologies and rapid systemic reform are not always compatible with a system averse to change.
A well-known aphorism in management states that “culture eats strategy for breakfast.” Strategies to implement large innovative solutions in a system unable to adapt to changing environments are ineffective, as solutions are likely to be rejected at the frontline. Unless the value of change is demonstrated, and emphasized as a normal part of day to day work, well intentioned initiatives will have difficulty effectively solving problems in Ontario.
Bringing Change Day to Ontario provides value in the way it influences the culture of our system. Inspiring workers in the system to question how they do things, and encouraging them to try something new, sends an important message.
This change in culture is a step in the right direction, but more action than just Change Day will be required to convince healthcare stakeholders that Ontario truly values this message.
Institutions such as hospitals, universities, and government must act to ensure the message carries on, rather than reverting back to the status quo.
Solidifying this culture of change will contribute to creating an adaptable healthcare system in Ontario. This adaptability is key to addressing the strains of Ontario’s healthcare system, and accommodating disruptive new technologies to positively transform care.
Tanishq Suryavanshi is a medical student at McMaster University and a Contributor to EvidenceNetwork.ca. He is a co-leader of the Rapid Response Team at the Ontario Medical Students Association (OMSA) and is a researcher with the Global Strategy Lab at UOttawa and YorkU.
Michael K. Parvizian is a first-year medical student at McMaster University, with interests in health policy and resource utilization. He is a member of the Rapid Response Team at the OMSA, and a current Queen Elizabeth Scholar in Health Systems research.