2020 brings with it the opportunity for substantial positive and needed change in Alberta’s health “system”.  An opportunity if pursued properly, will show the rest of the country how it can be done well.

Much has been said and indeed the media has been full (since before the last provincial election) of comments about the fears of change and the projected negative impact on people working in this system.  While a portion of these concerns may have some basis, taking a strong and sometimes exaggerated negative position does not support the needed improvements for providers nor patients.  Even when it appears there may be negative consequences, efforts need to focus on how to achieve positive improvement goals and bring those forward. 

There is no question that there will be change.  It must come.  The current status is not acceptable to continue forward.  Historical opposition to change has resulted in a system that has been slow to innovate or even keep pace.  While there has been some purchase of shiny new technology and some utilization of it.   There is a critical need to adopt or develop a management culture that continuously seeks to make it easy for people to do their best work as full partners with patients.  Everyone needs to be active contributors to the care of their health and safety.

The top-down, command and control culture that comes from what is essentially a politically managed monopoly must change.  The “care” for patients and providers alike can only be provided through teamwork.  Teamwork that values the strengths of everyone, expecting them to step up to the front, partnering in care when their expertise is needed.  The existing culture does not deliver this, nor does the anti-change attitude.

In the past, the different factions have pitched their own positions to justify and to protect themselves from the uninformed and overly assuming public. 

The result has sustained a system that is not safe, in the very real sense of the word, for either patients or providers.  The priority of these peoples’ safety has too often been second place to (government or association/organizational) political safety.

In 2020 we have the opportunity in Alberta, to make positive improvements in safety for patients and providers.  It will take a new level of forward-looking visionary collaboration and choices taken.  Decisions need to be made, not on past practices or for the continued short-term benefit of those that currently control the system, but to engage and enable the people that know what can and should be done better.  The experience and knowledge of everyone on the team must be utilized.  Patients and their families have the real experience and the perspective to contribute to the changes required.  The entire team needs to be engaged and empowered to establish the absolute priority of safety and to ensure this is religiously maintained going forward.

Over the coming months, the public will be faced with elevated rhetoric around what potential changes mean to some of the different players.  There also will be some comments about the consequences for others, including patients.  What the public needs to do and must do, is sort through these campaigns to distill out what the real impact will be on patient and provider safety.  Is it going to degrade it, maintain it or improve it?  This analysis must go deeper than the shallow comments made by those defending their current status or positions.  It also must look forward to what is possible.  What new developments are coming and how plans can be made to use the best of them to move forward quickly.

There has been an effort to consult and report to the government potential areas of improvement in operations and fiscal efficiency.  Those reports have not yet been released.  Some of the players have said much about the dire consequences of suspected change recommendations though, and this approach further underlines the need for Albertans to look deeper.  What the public needs and deserves, is a more complete explanation of all aspects of what is proposed when it is proposed.  This explanation must include a description of how each proposal will prioritize patient and provider safety and improve care.  Full transparency must be the foundation for successful collaborative work to ensure positive improvement.

If the government focuses on cost savings or on political safety over people, (which has been the focus of multiple governments in the past) that will not be acceptable.  If the players in the system focus on their compensation and job security over the physical and emotional safety of their members and of patients, that is equally unacceptable. 

There is a collaborative path to follow to improve what is best for all people involved.  If those who are genuinely interested in the safety and well-being of everyone in the system work together, with some give and take for long term improvements, we will get there.  Without that, we will be stuck with more of what we have had in the past and that is absolutely not acceptable going forward.  People are being harmed now, both as patients and providers and that must change.

Full transparency required for system improvement

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