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A message from the Guest Editor

2011, Healthcare Management Forum

n healthcare, we talk a great deal about the importance of leadership for quality improvement, for innovation and to create patient-centred care. Little can be accomplished or sustained without dedicated leaders at every level of the system. Yet, it often seems that we are content to see the emergence of a leader as a happy chance, almost a corporate genetic mutation, but leaving such an essential element of success to an accidental combination of personality and opportunity borderlines on being irresponsible. Mark Vimr certainly thinks so. He is the Executive Vice President of Clinical and Professional Programs and Services and Chief Nurse Executive at St. Joseph's Health Centre in Toronto, but he is also a fellow of the Executive Training for Research Application (EXTRA) program, and his story of developing a program to turn physicians into inspiring, transformational leaders is one of five accounts of EXTRA change initiatives we bring to you in this special edition of Healthcare Management Forum.

GUEST EDITORIAL A message from the Guest Editor Maureen O’Neil, President, Canadian Health Services Research Foundation I n healthcare, we talk a great deal about the importance of leadership for quality improvement, for innovation and to create patient-centred care. Little can be accomplished or sustained without dedicated leaders at every level of the system. Yet, it often seems that we are content to see the emergence of a leader as a happy chance, almost a corporate genetic mutation, but leaving such an essential element of success to an accidental combination of personality and opportunity borderlines on being irresponsible. Mark Vimr certainly thinks so. He is the Executive Vice President of Clinical and Professional Programs and Services and Chief Nurse Executive at St. Joseph’s Health Centre in Toronto, but he is also a fellow of the Executive Training for Research Application (EXTRA) program, and his story of developing a program to turn physicians into inspiring, transformational leaders is one of five accounts of EXTRA change initiatives we bring to you in this special edition of Healthcare Management Forum. The EXTRA program takes mid-career healthcare executives from across Canada and puts them through a two-year part-time program on how to use research and change-management techniques to run their organizations better. It is managed by the Canadian Health Services Research Foundation (CHSRF) in partnership with the Canadian College of Health Leaders, the Canadian Nurses Association, the Canadian Medical Association, and a consortium of 12 partners in Quebec represented by the Institut National d’excellence en santé et services sociaux (INESSS). The Canadian government awarded CHSRF $25 million in 2003 to operate EXTRA for 10 years; the first two dozen executives began the program the following year. Mark enrolled with the 2008 cohort. Like each of the 178 EXTRA fellows so far, he came to the program with a proposal for a project that tackles an important policy or administrative issue in his organization. His project aims to build leadership qualities in physicians; you can read about his progress. You will also find the story of David Schramm’s efforts to reduce adverse events among surgery patients at The Ottawa Hospital. Patty Chapman focuses on increasing safety at Bluewater Health in Sarnia, Ontario, specifically by improving heart attack care and medication reconciliation for all patients. Megan Ward is developing a process to ensure the systematic use of research evidence in the Peel Region public health department where she works. Elaine Rankin is encouraging better collection and use of data for evidence-informed decision making at the Cape Breton Health Authority. These articles all offer useful examples of how EXTRA develops healthcare leaders, but beyond that they are a powerful illustration of our work at the Canadian Health Services Research Foundation; our goal is to encourage innovation and improve quality and performance in order to build better healthcare for all Canadians. Through EXTRA, as you will see in this issue, CHSRF helps healthcare leaders to resolve a specific challenge in their workplace. So far, some 90 organizations have sent people to the EXTRA program, contributing to a culture of quality and performance improvement in healthcare administration across Canada. EXTRA is only one of the many ways in which CHSRF helps accelerate positive change in healthcare. Our new education program for citizens appointed to healthcare boards, which provides them with skills and knowledge to help improve the quality of care and patient safety within the organization, is being expanded across Canada. The program features a governance toolkit developed by the Canadian Patient Safety Institute. Our conferences—such as Picking Up the Pace, which focused on innovation in primary healthcare, and CEO Forum, which focused in 2011 on quality and accountability—offer healthcare leaders information, analysis, and an opportunity for dialogue on ways to promote system change. Our events provide a forum where healthcare providers and policymakers from Canada and around the world can exchange ideas and experiences in order to improve the delivery of healthcare. S4 Healthcare Management Forum ● Forum Gestion des soins de santé – Spring/Printemps 2011 GUEST EDITORIAL CHSRF also aims to give patients an effective voice in healthcare. Health institutions determined to learn from patient experiences and preferences can improve the quality of care they provide. Our patient engagement initiative, launched in 2010 and jointly funded with the Health Council of Canada and the Max Bell Foundation, selected through competition 10 evidence-informed interventions that, along with an accompanying research project, will help determine the best ways to engage patients in the design, delivery, and evaluation of healthcare. Another round of interventions will be funded in 2011. As healthcare costs rise and our population ages, there is widespread public concern about the sustainability of Canada’s healthcare system. Canada will have to make choices to ensure that the most effective investments are made in improving the health of its citizens. CHSRF is an organization people can turn to for ideas about effective innovations in healthcare. It makes connections and provides opportunities for healthcare leaders to learn from one another. It is a source of reliable evidence on policies and practices that improve the performance of the healthcare system to benefit all Canadians. Our EXTRA fellows, as you will see, contribute to improvements in their own organizations. Healthcare Management Forum ● Forum Gestion des soins de santé – Spring/Printemps 2011 S5