Educating for Practice Using collaborative leadership to improve health education and practice

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1 Educating for Practice Using collaborative leadership to improve health education and practice Institute of Medicine Global Forum on Innovation in Health Professional Education November 29 th, 2012 Sarita Verma & Maria Tassone Co-Leads Canadian Interprofessional Health Leadership Collaborative

2 The CIHLC is an innovation collaborative that is focusing on collaborative leadership to transform health systems 2

3 Many systemic challenges are driving change across Canada System sustainability and affordability Workforce planning Disease trends (chronic disease management, mental health, cancer) Public health, primary health and access to care Social Accountability Patient safety and quality of care Aging population 3

4 The journey from interprofessional education to practice has been supported by research and funding in the past decade Commission on the Future of Health Care in Canada Health Canada Canadian Interprofessional Health Collaborative Accord on Health Care Renewal Advisory Committee IPE Offices established The Future of Medical Education in Canada 4

5 Ongoing initiatives continue to drive the IPE/C agenda across Canada Successes include: Regional collaboratives established to scale local successes across larger systems Educational and instructional curricular activities and IPE courses Continuing professional development focusing on enhancing collaborative competencies IPC-based learning experiences Community-engaged IP education and leadership 8 accrediting bodies representing 6 health professions are collaborating to develop material that focuses on accreditation of IPE The Canadian Interprofessional Health Collaborative, a prominent national organization, continues to advance the IPE/C agenda 5

6 The CIHC s Interprofessional Competency Framework consists of six pillars 6

7 Our project sees collaborative leadership as a critical enabler of the Lancet Commission s recommendations Systemic issues identified by the Lancet Commission include: Weak leadership to improve health-system performance * Poor teamwork Persistent organizational silos o Narrow technical focus without broader contextual understanding o Episodic encounters rather than continuous care * Adapted from 7

8 Stronger leadership is not enough and new models must be explored Healthcare systems are extremely complex and cannot be effectively managed by a few leaders Under traditional leadership models, only the leader s full potential is accessed, and leaders don t have all the answers Collaborative leadership enables access to the full potential of the knowledge and expertise of followers 8

9 Collaborative leadership takes interprofessional teamwork a step further Enables leadership to come from multiple points by sharing power and decision-making Engages diverse perspectives Unlocks full human potential Promotes ownership and commitment to change initiatives Allows people to lead from where they stand Transcends professional and organizational boundaries 9

10 Health leadership will look different in the future Full engagement of team members can help unlock each individual s innovative potential - their ability and desire to put forth new ideas that generate value From limited innovative capacity To dramatically increased innovative capacity 10

11 The CIHLC s goal is to co-create, develop, implement and evaluate a global collaborative leadership model Using a pan-canadian approach with global engagement, the CIHLC will: Develop a collaborative leadership model for health system change. Build and leverage existing partnerships within Canada and abroad - enhance the facilitation and implementation of collaborative leadership programs. Utilize existing IT mechanisms and social media to maximize cost-effective methods to effectively support communities in leadership training. Develop new academic productivity and scholarship that will influence global policy reform. Develop an evaluation framework that measures planned and emergent change at the educational, practice and system levels. 11

12 The CIHLC s deliverables and outcomes include: Collaborative leadership competencies Collaborative leadership curriculum for health care students, practitioners and leaders Evidence-based products anchored in the principles of social accountability Evaluation framework for systematic implementation Global education and practice partnerships Health reform with improved health outcomes 12

13 Transformative System Change The CIHLC is following a five phase plan Phase 1 Phase 2 Knowledge Acquisition Phase 3 Knowledge Development Phase 4 Knowledge Application Phase 5 Knowledge Dissemination & Transfer Setup Reviews and scans of scientific literature, interviews, and international comparisons Curricular innovation and integration of best practices; development of an evaluation framework Pilot testing in urban, rural, northern, distributed contexts; international testing; practice settings Presentations, publications, international symposia, IOM workshops, evaluations, reports 13

14 The CIHLC s work will be grounded in the principles of social accountability Community Curriculum Equity Relevance Quality Designed and delivered based on a thorough needs assessment Efficiency Evaluation Proactive and responsive to changing needs of those the project will serve 14

15 Is there a common definition of collaborative leadership in the context of health system change? Review of peer-reviewed literature 183 articles, 24 theoretical books Findings Collaborative leadership is a widely used term with multiple meanings, which can be tracked to the emerging emphasis on managing in complexity and more integrated ways of working There is a distinction between (formal) leaders who do collaborative things and leaders charged with fostering collaboration and forms of leadership that are inherently collaborative in structure or manner 15

16 The CIHLC s current definition of collaborative leadership: Collaborative leadership is a way of being, reflected in attitudes, behaviours and actions that are enabled by individuals, teams and/or organizations, and integrated within and across complex adaptive systems to transform health with people and communities, locally and globally. 16

17 Key informant interviews will help refine and validate the CIHLC definition of collaborative leadership Key informants will also help us learn about existing examples of collaborative leadership models, best practices, educational methodologies and products Methodology: Progress to date: Qualitative semi-structured interviews (n=30-40) Key Informants o o o o o o Senior Canadian educators Senior thought leaders in interprofessional education Government and hospital leaders International thought leaders in health International thought leaders in leadership Student leaders across the health professions Developed methodology for data collection & analysis Developed list of potential interview candidates (n=80) Developed interview protocol Developed information packages for key informants Submitted Research Ethics Board application 17

18 A systematic literature review on existing healthcare leadership curricula is being conducted The systematic literature and narrative reviews will answer three research questions: 1. What are the impacts of leadership programs in health on learners knowledge, skills, attitudes and behaviour/processes and on system change? 2. What are the competencies addressed in existing leadership educational programs? 3. How are the competencies addressed in terms of contexts, content, learning activities, delivery mechanisms and evaluation methods Selection criteria: An education-based program or intervention with explicit objectives related to leadership and health. Target audience: learners from pre-licensed health program or from the health sector (practitioners and managers) Presence of primary data of interest (impacts at the system level, measure of K,S,A,Bs among learners) and/or presence of secondary data of interest (content, learning activities, delivery mechanisms, evaluation methods) 18

19 There are three components in our proposed evaluation framework which are guided by six reinforcing lenses Complex Adaptive Systems The Project (Implementation Evaluation) RE-AIM Framework Phase Based Evaluation Questions Value Creation Social Accountability Knowledge Mobilization The Process of Collaborative Leadership The CIHLC as a case study of collaborative leadership Developmental evaluation The Product (Impact) Plug and play webbased evaluation tools Kirkpatrick Framework Theory-Based Participatory Utilization-Focused 19

20 Collaborative leadership will help improve health across the continuum of education to practice Collaborative Leadership Engagement and empowerment of all stakeholders Innovation and ownership across a complex system Health System Transformation Reduced cost of care Improved patient experience Improved population health 20

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