<br />
2009<br />
Health Innovation Report<br />
raising the bar on health system performance<br />
Report #3: Transformative culture<br />
<br />
“ We are faced today with the option of either learning the<br />
rules, roles and distribution of rewards in this new game,<br />
or continuing to practice our present skills and becoming<br />
<br />
<br />
the best at a game that is no longer being played. ”<br />
– See Dr. Rob Kolodner’s Health system transformation:<br />
What becomes possible with health IT, page 41<br />
<br />
<br />
<br />
<br />
Dr. Philippe Couillard sets out priorities<br />
for government action — p. 6<br />
<br />
<br />
Why are Alberta and N<a title="HIR #3 2009_English.pdf page 1" href="http://viewer.zmags.com/publication/40a32a63?page=1">2009Health Innovation Reportraising the bar </a> 2009Health Innovation Reportraising the bar <a title="HIR #3 2009_English.pdf page 2" href="http://viewer.zmags.com/publication/40a32a63?page=2">HIREDITORIALEncouraging a transformative cu</a> HIREDITORIALEncouraging a transformative cu<a title="HIR #3 2009_English.pdf page 3" href="http://viewer.zmags.com/publication/40a32a63?page=3">HIRTABLE OF CONTENTSHigHligHts from tHe sec</a> HIRTABLE OF CONTENTSHigHligHts from tHe sec<a title="HIR #3 2009_English.pdf page 4" href="http://viewer.zmags.com/publication/40a32a63?page=4">Second annual conference of the Institutefor Str</a> Second annual conference of the Institutefor Str<a title="HIR #3 2009_English.pdf page 5" href="http://viewer.zmags.com/publication/40a32a63?page=5">From left to right: The Hon. Arthur T.Porter, Mr</a> From left to right: The Hon. Arthur T.Porter, Mr<a title="HIR #3 2009_English.pdf page 6" href="http://viewer.zmags.com/publication/40a32a63?page=6">HIRKEYNOTEWhat can government do toimprove </a> HIRKEYNOTEWhat can government do toimprove <a title="HIR #3 2009_English.pdf page 7" href="http://viewer.zmags.com/publication/40a32a63?page=7">ance (Bismarckian systems). More andmore hybrid </a> ance (Bismarckian systems). More andmore hybrid <a title="HIR #3 2009_English.pdf page 8" href="http://viewer.zmags.com/publication/40a32a63?page=8">Avoid fatalismWhen I was in politics, people acc</a> Avoid fatalismWhen I was in politics, people acc<a title="HIR #3 2009_English.pdf page 9" href="http://viewer.zmags.com/publication/40a32a63?page=9">undermine the foundations of our society,and pub</a> undermine the foundations of our society,and pub<a title="HIR #3 2009_English.pdf page 10" href="http://viewer.zmags.com/publication/40a32a63?page=10"> Government ehealth mean accarfforts to impr</a> Government ehealth mean accarfforts to impr<a title="HIR #3 2009_English.pdf page 11" href="http://viewer.zmags.com/publication/40a32a63?page=11">The Hon. Ron Liepert,Alberta Health andWellness</a> The Hon. Ron Liepert,Alberta Health andWellness<a title="HIR #3 2009_English.pdf page 12" href="http://viewer.zmags.com/publication/40a32a63?page=12">HIRPROvINCIAL HEALTH STRuCTuRESAlbertaPres</a> HIRPROvINCIAL HEALTH STRuCTuRESAlbertaPres<a title="HIR #3 2009_English.pdf page 13" href="http://viewer.zmags.com/publication/40a32a63?page=13">dent on this system functioning smoothly.We appo</a> dent on this system functioning smoothly.We appo<a title="HIR #3 2009_English.pdf page 14" href="http://viewer.zmags.com/publication/40a32a63?page=14">HIRPROvINCIAL HEALTH STRuCTuRESNew Brunswick</a> HIRPROvINCIAL HEALTH STRuCTuRESNew Brunswick<a title="HIR #3 2009_English.pdf page 15" href="http://viewer.zmags.com/publication/40a32a63?page=15">carried out without any consultation,because the</a> carried out without any consultation,because the<a title="HIR #3 2009_English.pdf page 16" href="http://viewer.zmags.com/publication/40a32a63?page=16"> Community involvement in health carebrings</a> Community involvement in health carebrings<a title="HIR #3 2009_English.pdf page 17" href="http://viewer.zmags.com/publication/40a32a63?page=17">Dr. Kieke okma, WagnerSchool of Public Service</a> Dr. Kieke okma, WagnerSchool of Public Service<a title="HIR #3 2009_English.pdf page 18" href="http://viewer.zmags.com/publication/40a32a63?page=18">HIRLESSONS FROm EuROPERecent trends in Europ</a> HIRLESSONS FROm EuROPERecent trends in Europ<a title="HIR #3 2009_English.pdf page 19" href="http://viewer.zmags.com/publication/40a32a63?page=19">she realized that the NHS was the thirdrail of B</a> she realized that the NHS was the thirdrail of B<a title="HIR #3 2009_English.pdf page 20" href="http://viewer.zmags.com/publication/40a32a63?page=20">RecommendedreadingComparative Studies andthe P</a> RecommendedreadingComparative Studies andthe P<a title="HIR #3 2009_English.pdf page 21" href="http://viewer.zmags.com/publication/40a32a63?page=21">HIRLESSONS FROm EuROPEFrance: Public private</a> HIRLESSONS FROm EuROPEFrance: Public private<a title="HIR #3 2009_English.pdf page 22" href="http://viewer.zmags.com/publication/40a32a63?page=22">of course, the funds needed to accomplishall thi</a> of course, the funds needed to accomplishall thi<a title="HIR #3 2009_English.pdf page 23" href="http://viewer.zmags.com/publication/40a32a63?page=23">HIRLESSONS FROm EuROPEThe Netherlands: Gover</a> HIRLESSONS FROm EuROPEThe Netherlands: Gover<a title="HIR #3 2009_English.pdf page 24" href="http://viewer.zmags.com/publication/40a32a63?page=24">the care package and become the respon-sibility </a> the care package and become the respon-sibility <a title="HIR #3 2009_English.pdf page 25" href="http://viewer.zmags.com/publication/40a32a63?page=25">Private health care delivery in Canada</a> Private health care delivery in Canada<a title="HIR #3 2009_English.pdf page 26" href="http://viewer.zmags.com/publication/40a32a63?page=26">from start to finish, SCI is horizontally integra</a> from start to finish, SCI is horizontally integra<a title="HIR #3 2009_English.pdf page 27" href="http://viewer.zmags.com/publication/40a32a63?page=27">Dr. Rob Kolodner,Department ofVeterans Affairs</a> Dr. Rob Kolodner,Department ofVeterans Affairs<a title="HIR #3 2009_English.pdf page 28" href="http://viewer.zmags.com/publication/40a32a63?page=28">HIRLESSONS FROm THE uSHealth system transfor</a> HIRLESSONS FROm THE uSHealth system transfor<a title="HIR #3 2009_English.pdf page 29" href="http://viewer.zmags.com/publication/40a32a63?page=29">back to the point of care or even directlyto ind</a> back to the point of care or even directlyto ind<a title="HIR #3 2009_English.pdf page 30" href="http://viewer.zmags.com/publication/40a32a63?page=30">allocated billions of dollars towards increas-in</a> allocated billions of dollars towards increas-in<a title="HIR #3 2009_English.pdf page 31" href="http://viewer.zmags.com/publication/40a32a63?page=31">own use, such as tracking their sleep,diet, or p</a> own use, such as tracking their sleep,diet, or p<a title="HIR #3 2009_English.pdf page 32" href="http://viewer.zmags.com/publication/40a32a63?page=32">tive way. The EHR system VHA deployeduses both g</a> tive way. The EHR system VHA deployeduses both g<a title="HIR #3 2009_English.pdf page 33" href="http://viewer.zmags.com/publication/40a32a63?page=33">FIGURE 3Change in Washington DC VA medical care </a> FIGURE 3Change in Washington DC VA medical care <a title="HIR #3 2009_English.pdf page 34" href="http://viewer.zmags.com/publication/40a32a63?page=34">Each year, the percentage of orders en-tered by </a> Each year, the percentage of orders en-tered by <a title="HIR #3 2009_English.pdf page 35" href="http://viewer.zmags.com/publication/40a32a63?page=35">and direction — the degree of informationaccess,</a> and direction — the degree of informationaccess,<a title="HIR #3 2009_English.pdf page 36" href="http://viewer.zmags.com/publication/40a32a63?page=36">2010 Conference of the MUHC-ISAIPreparing our he</a> 2010 Conference of the MUHC-ISAIPreparing our he<a title="HIR #3 2009_English.pdf page 37" href="http://viewer.zmags.com/publication/40a32a63?page=37">Dr. Andrew Wister,Dept. of Gerontology,Simon Fr</a> Dr. Andrew Wister,Dept. of Gerontology,Simon Fr<a title="HIR #3 2009_English.pdf page 38" href="http://viewer.zmags.com/publication/40a32a63?page=38">HIRDISCuSSION PAPERSThe aging of thebaby bo</a> HIRDISCuSSION PAPERSThe aging of thebaby bo<a title="HIR #3 2009_English.pdf page 39" href="http://viewer.zmags.com/publication/40a32a63?page=39">style shows conflicting patterns, but theoverall</a> style shows conflicting patterns, but theoverall<a title="HIR #3 2009_English.pdf page 40" href="http://viewer.zmags.com/publication/40a32a63?page=40">people 65 and over experienced fewermyocardial i</a> people 65 and over experienced fewermyocardial i<a title="HIR #3 2009_English.pdf page 41" href="http://viewer.zmags.com/publication/40a32a63?page=41">increased expectations regarding health,health c</a> increased expectations regarding health,health c<a title="HIR #3 2009_English.pdf page 42" href="http://viewer.zmags.com/publication/40a32a63?page=42">account for part of the paradoxical trendmention</a> account for part of the paradoxical trendmention<a title="HIR #3 2009_English.pdf page 43" href="http://viewer.zmags.com/publication/40a32a63?page=43">bulge in our senior population. We can exp</a> bulge in our senior population. We can exp<a title="HIR #3 2009_English.pdf page 44" href="http://viewer.zmags.com/publication/40a32a63?page=44">HIRDISCuSSION PAPERSHealth care systemreorg</a> HIRDISCuSSION PAPERSHealth care systemreorg<a title="HIR #3 2009_English.pdf page 45" href="http://viewer.zmags.com/publication/40a32a63?page=45">the regional structure and are primarilypaid by </a> the regional structure and are primarilypaid by <a title="HIR #3 2009_English.pdf page 46" href="http://viewer.zmags.com/publication/40a32a63?page=46">ABScope of responsibilityFor larger more popul</a> ABScope of responsibilityFor larger more popul<a title="HIR #3 2009_English.pdf page 47" href="http://viewer.zmags.com/publication/40a32a63?page=47"> In Canada as in the other countriesbeing re</a> In Canada as in the other countriesbeing re<a title="HIR #3 2009_English.pdf page 48" href="http://viewer.zmags.com/publication/40a32a63?page=48">SKthe Canadian “system”, which is really aset </a> SKthe Canadian “system”, which is really aset <a title="HIR #3 2009_English.pdf page 49" href="http://viewer.zmags.com/publication/40a32a63?page=49">ment, developing tools for payment byresults, im</a> ment, developing tools for payment byresults, im<a title="HIR #3 2009_English.pdf page 50" href="http://viewer.zmags.com/publication/40a32a63?page=50">The second annual provider round tablehosted by </a> The second annual provider round tablehosted by <a title="HIR #3 2009_English.pdf page 51" href="http://viewer.zmags.com/publication/40a32a63?page=51">Top row, left to right: Ms. Ann Lynch,Dr. Jeanne</a> Top row, left to right: Ms. Ann Lynch,Dr. Jeanne<a title="HIR #3 2009_English.pdf page 52" href="http://viewer.zmags.com/publication/40a32a63?page=52">HIRROuND TABLENursing in an evolvinghealth </a> HIRROuND TABLENursing in an evolvinghealth <a title="HIR #3 2009_English.pdf page 53" href="http://viewer.zmags.com/publication/40a32a63?page=53">preparation as entry to practice for regis-tered</a> preparation as entry to practice for regis-tered<a title="HIR #3 2009_English.pdf page 54" href="http://viewer.zmags.com/publication/40a32a63?page=54">difficult to articulate the unique contribu-tion</a> difficult to articulate the unique contribu-tion<a title="HIR #3 2009_English.pdf page 55" href="http://viewer.zmags.com/publication/40a32a63?page=55">Categories of nurseAll nursing professions are</a> Categories of nurseAll nursing professions are<a title="HIR #3 2009_English.pdf page 56" href="http://viewer.zmags.com/publication/40a32a63?page=56">ing for the Medical Mission at the MUHCand newly</a> ing for the Medical Mission at the MUHCand newly<a title="HIR #3 2009_English.pdf page 57" href="http://viewer.zmags.com/publication/40a32a63?page=57">diagnosis, treatment and continuing careof peopl</a> diagnosis, treatment and continuing careof peopl<a title="HIR #3 2009_English.pdf page 58" href="http://viewer.zmags.com/publication/40a32a63?page=58"> “We need to become much clearer aboutwhat</a> “We need to become much clearer aboutwhat<a title="HIR #3 2009_English.pdf page 59" href="http://viewer.zmags.com/publication/40a32a63?page=59">the incorporation of advanced practicenurses. Wh</a> the incorporation of advanced practicenurses. Wh<a title="HIR #3 2009_English.pdf page 60" href="http://viewer.zmags.com/publication/40a32a63?page=60">Immediate prioritiesrecognized by roundtable pa</a> Immediate prioritiesrecognized by roundtable pa<a title="HIR #3 2009_English.pdf page 61" href="http://viewer.zmags.com/publication/40a32a63?page=61">HIRCASE STuDYThe oncology nurse navigator ro</a> HIRCASE STuDYThe oncology nurse navigator ro<a title="HIR #3 2009_English.pdf page 62" href="http://viewer.zmags.com/publication/40a32a63?page=62">Tofind outmore:Ms. Andréanne Saucier;Associa</a> Tofind outmore:Ms. Andréanne Saucier;Associa<a title="HIR #3 2009_English.pdf page 63" href="http://viewer.zmags.com/publication/40a32a63?page=63">The MUHC-ISAI’s Partners’ Advisory Council</a> The MUHC-ISAI’s Partners’ Advisory Council<a title="HIR #3 2009_English.pdf page 64" href="http://viewer.zmags.com/publication/40a32a63?page=64">Whywould a university hospitalwant to shape hea</a> Whywould a university hospitalwant to shape hea