1. Health Human Resources: Leadership Rooted In Vision, Values, Relationships October 8, 2009 Sister Elizabeth Davis

2. At the end of the first decade of this 21 st 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.

3. 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

5. 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

6. They are Nurses, 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”

7. 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

8. SEA’S STRONG VOICE

9. 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

10. 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

11. From the Industrial Age to the Information Age to the Network Age Network Age Distributed culture Decentralized Citizen-centered not institution- centered

12. 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

13. 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)

14. The 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 areas Biodiversity and ecosystems Water resources Human health Human settlements Energy Transport and industry Extreme weather events Climate Change 2007

15. 15 Rights Rights – to health and health care Balance Balance – individuals and populations Comprehensiveness Comprehensiveness = treat illness, ease suffering, minimize disability, prevent disease, promote health Cooperation Cooperation – with those served, with each other, with those in other sectors Improvement Improvement Safety Safety Openness Openness = being open, honest and trustworthy

17. Health 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 determinant Health of person, family, community, population and earth

18. 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

19. Collaborative 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 valuesenhances patient-, family-, and community- centred goals and values provides mechanisms for continuous communication among health care providersprovides mechanisms for continuous communication among health care providers optimizes staff participation in clinical decision making (within and across disciplines)optimizes staff participation in clinical decision making (within and across disciplines) fosters respect for the contributions of all providersfosters respect for the contributions of all providers Health Canada, 2003 Health Canada, 2003

20. Climate of mutual respect and trust Climate of mutual respect and trust Cooperation = formal communication, independent decision-making (shared information, consultation) Cooperation = formal communication, independent decision-making (shared information, consultation) Coordination = defined roles, some shared decision-making (shared vision, goals and planning; shared resource) Coordination = defined roles, some shared decision-making (shared vision, goals and planning; shared resource) Collaboration = defined roles, frequent communication, shared decision-making, one system Collaboration = defined roles, frequent communication, shared decision-making, one system Teamwork – specific tasks, patient-centered Teamwork – specific tasks, patient-centered Collective responsibility – organizational integration Collective responsibility – organizational integration Shared leadership, control, risk and accountability Shared leadership, control, risk and accountability

21. PRESENT CULTURE IN HEALTH CARE PREFERRED CULTURE IN HEALTH CARE Focus on care of individualFocus 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 carePersonalized care Priority to acute care interventions Priority to spectrum of health and health care Public mistrust of systemPublic confidence in system

22. PRESENT CULTURE IN HEALTH CARE PREFERRED CULTURE IN HEALTH CARE Growing distance between personal and system goals Alignment of personal and system goals Segregated professionsIntegrated 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 shortageSustainable and engaged workforce Workplace disquiet & stressHealthy workplace Leadership focus on protection Passionate and humble leadership

23. 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, silosIntegration Elitist language, symbolsCommon language, symbols Hierarchical structureDynamic, organic structure

25. Had, held, shared, grown “Something significant left to do” Vision Community

26. Values are sets of freely chosen convictions which compel action as they are cherished and publicly affirmed. Charles McCoy

27. Visionary Catalyst Partner Decision-maker Inspirer Facilitator Implementer Evaluator

28. 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

29. 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

30. Stretch into new ways of thinking Leave behind what is no longer appropriate Interconnect practice, education, administration, and research Value networks Re-inspire spirit

32. Leaders act wisely Leaders act courageously Leaders act passionately

33. Awareness of complexity Skills development Strengths of tradition Emotional preparedness Reflection Ceremonies and celebration Symbols Confidence/conviction

34. May 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.

35. 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