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Premiers’ health report a good start but important opportunities missedBy Ivy Lynn Bourgeault

Premiers’ health report a good start but important opportunities missedBy Ivy Lynn Bourgeault

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Published by EvidenceNetwork.ca
The health care report released last week following the Premier’s meeting in Halifax, which focused on moving from innovation to broader health system action, represents a critical step in a more collaborative and engaged approach.
The health care report released last week following the Premier’s meeting in Halifax, which focused on moving from innovation to broader health system action, represents a critical step in a more collaborative and engaged approach.

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Published by: EvidenceNetwork.ca on Mar 06, 2014
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05/15/2014

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umanitoba.ca
http://umanitoba.ca/outreach/evidencenetwork/archives/7801
Premiers’ health report a good start but important opportunitiesmissed
The health care report released last week following the Premier’smeeting in Halifax, which focused on moving from innovation tobroader health system action, represents a critical step in a morecollaborative and engaged approach. The recommendations contained in the report
From Innovation to Action
, regarding the three inter-related areas of health humanresource management initiatives, team-based models of careand clinical practice guidelines, also highlighted how we musttake better advantage of our knowledge infrastructure to better address these key issues. The recommendations also called for a platform for ensuring the ongoing identification anddissemination of information on innovative models in order tohelp promote the adoption of leading practices.The report highlighted a series of innovations or promising practices which should be scaled up to improve theefficiency of health care in Canada. But how and why were these innovations chosen? It seems ironic that, inrecommending more evidence-informed policy and practice, a more systematic, evidence-based approach was notundertaken in the choice of innovations.One of the promising practices that could have been highlighted, around the need for shared workforce planningmodels, would be the work undertaken by the pan Canadian HHR (Health Human Resources) Planning Toolkit whichhelps planners select models that match their particular needs and resources.Some of the ‘innovations’ highlighted are not particularly new. Take the promotion of
lean management 
 for example.During the last round of health care cuts in the mid 1990s, this approach was employed as a means to cut costs. Weneed to heed lessons learned from that era: bottom up approaches identified by front line workers tended to be moresuccessful than those imposed from the top down.Just as important as which innovations are chosen is how these innovations are to be scaled up to broader healthsystem action. What prerequisite contextual features need to be in place in order to, again, achieve the desiredresults?The situation for innovators can often be quite different from that for adopters. This kind of information is critical to thedevelopment of deployment strategies for specific innovations, particularly in the case of the health workforce because of the complex manner in which health professional practice and workplace environments are regulated.In the case of team-based care, for example, we know that there are still some significant barriers at the practicelevel, as well as in terms of funding and the regulation of health professionals, that prevents them from workingtogether collaboratively and to their full scope. A better understanding of the advantageous and not so advantageousfeatures of the context of health professional practice is a particularly promising area in which to develop aconcentrated applied health research strategy. But it is an area in which we need more dedicated resources from our research infrastructure. A key facilitator of many of the recommendations in the Premier’s report would be a coordinated pan-Canadian healt

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