• Project Profiles
  • NICU Feeding Practices
  • Approaches to Public Health Nursing
  • HKN Gap Analysis
  • Evidence Literacy Project
  • Assessing Patient Complexity
  • Early Identification of Autism
  • Measuring Quality Care
  • Young Adults in Long-Term Care
  • Reducing Medication Errors
  • Making Exercise Sticky
  • Stroke Guidelines
  • Driving Change in Mental Health
  • Help for New Mothers
  • Mentoring Makes a Difference
  • Pay-for-Performance
  • Good Care is About People
  • Working Better Together
  • Health Technology Assessment
  • Looking at the Link between Pain and Aggression
  • Reviewing Determinants of Health
  • End of Life Care Decisions in Focus
  • Rural Health Service Delivery
  • Looking at Organizational Problems
  • Integrating Evaluation with Planning
  • Rural Health Needs
  • Suicide Prevention
  • Student Health
  • Hepatitis A Immunity Project
• Participant Profiles
• Knowledge Infostructure
• Celebrating the Legacy

New Ways of Looking at Organizational Problems

In November 2007, SEARCH Canada received funding from the Public Health Agency of Canada's National Collaborating Centre for Methods and Tools (NCCMT) to adapt an exercise that has been highly successful within the SEARCH Classic program and pilot it in a health organization. The Adapted Consultation Exercise (ACE) engages participants in a process that provides new ways of looking at an organizational problem. The ACE encourages creativity and innovation, and values outside knowledge as a "new view model."

The pilot was an opportunity for SEARCH Canada and NCCMT to refine the ACE so that it could be applied as part of a larger suite of capacity-building programs in public health organizations. The exercise was done in collaboration with the Public Health department of B.C.'s Interior Health Authority. Interior Health serves a large geographic area in the southern Interior that includes larger cities and numerous rural and remote communities.

The problem to be tackled was fall prevention in the elderly. "We've been working on this for some time, in close collaboration with the B.C. Ambulance Service," says Kelly Wilson, Patient Safety Coordinator for Interior Health. "We're trying to get upstream of the problem by having paramedics who respond to falls have the ability to refer patients for a home-care assessment. The idea is to prevent another fall, which frequently leads to hip surgery or some other acute care."

For the Interior Health pilot, three separate groups were assembled to study the issue: clients (senior citizens); insiders (those directly involved with the problem); and outsiders (administrators not involved with the problem but with a lot of experience in organization-wide implementation). The groups worked on the problem for two half-days and then presented their solutions to an expert panel. They were encouraged to think innovatively and venture out of their comfort zone.

"This was a very useful process," says Roger Wheeler, Interior Health's Corporate Director of Public Health. "We have struggled with implementation across the health authority because of our geography and diversity. Typically, we assign a project or program leader and they get together with stakeholders to come up with a plan. One of the take-aways for me was that it's really helpful to form and involve these groups early on in the planning process so that it's a more robust consultation - much more valuable than simply having feedback on a draft plan."

Dr. Cathie Scott, a SEARCH faculty member from Alberta Health Services in Calgary, thinks the ACE fulfilled its promise of sparking innovation. "While there are other approaches to process innovation, many such tools are designed to be applied to clinical processes that are well-defined. The ACE takes innovation into different contexts - enabling creative approaches to implementation problems that have broad application."