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Reading: Governance and Leadership Challenges and Strategies for Ontario Health Teams

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Conference Abstracts

Governance and Leadership Challenges and Strategies for Ontario Health Teams

Authors:

Ross Baker ,

University of Toronto, CA
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Paula Blackstien-Hirsch,

CA
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Michelle Nelson,

CA
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Heather Graham,

CA
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Lynne Sinclair,

CA
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Andrew Pinto,

CA
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Alana Armas,

CA
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Rachel Thombs

CA
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Abstract

Introduction

Ontario has approved 42 integrated care partnerships called Ontario Health Teams (OHTs). These partnerships include community-based organizations, patients/caregivers, hospitals, home care, primary care, and other providers. OHT Leadership Councils, comprised of leaders from these organizations, are accountable for designing new care models for targeted populations. Current provider boards have remained intact; but as collaborative leadership, decision-making and accountability proceed, and care becomes more integrated, new leadership and governance structures and processes will be required to address the scale and scope of care delivery. An adaptive learning strategy, the ADVANCE Leadership Workshop and Coaching Academy, has engaged leaders from 37 OHTs.

Aims Objectives Theory or Methods

Through interactions with leaders and governors, we identified leadership/governance challenges for these emerging partnerships, and strategies to address them. The ADVANCE Program offers a virtual environment for collaborative learning that assists leaders and coaches (recruited from 29 OHTs) to identity key practices and tools for developing authentic collaboration, shared leadership, decision-making, and accountability. The Coaching Academy aims to facilitate more effective governance processes and development of participants’ coaching skills.  Interview and workshop data from leaders, board members and coaches, and details from “roadmaps” developed by leaders are used to illustrate challenges and approaches to more effective leadership and governance.

Highlights or Results or Key Findings

Ontario’s strategy for integrated care focuses on “bottom-up” initiatives within a framework of broader top-down strategies and performance goals. Rather than mandating leadership/governance structures and processes, government has created a “low rules” environment to enable OHT partnerships to develop local arrangements. The ADVANCE Program supports leaders, governors, and coaches in developing effective collaborative governance practices. Evaluation of these activities has been very positive. Key findings to date indicate that many leaders and governors have been challenged by the limited time and resources available to engage with partners to develop trusting relationships, a critical foundation for developing integrated care models. Developing a roadmap targeted at key collaborative tools and practices has helped many OHT leadership councils. Provider boards have had only limited guidance on the new governance arrangements, and greater communication between these boards, and between boards and leaders will be critical in supporting the evolution of effective integrated governance.

Conclusions

Ontario Health Teams are still in early stages of development. ADVANCE supports for leadership development and governance effectiveness have drawn positive reactions, underlining the need for such supports. Developing coaching capability within OHTs linked with interactive leadership dialogue workshops has enabled leaders across partner organizations to engage more effectively.

Implications for applicability/transferability sustainability and limitations

Integrated care initiatives have variable trajectories; yet effective leadership and governance, that includes patients/caregivers as leaders, are key components of high performing efforts in any setting. Lessons learned from the Ontario experience suggest that virtual learning and local coaching are an effective approach to improving collaborative governance practices.

How to Cite: Baker R, Blackstien-Hirsch P, Nelson M, Graham H, Sinclair L, Pinto A, et al.. Governance and Leadership Challenges and Strategies for Ontario Health Teams. International Journal of Integrated Care. 2022;22(S2):168. DOI: http://doi.org/10.5334/ijic.ICIC21256
Published on 16 May 2022.

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