CEO blog: It’s Election Time – Let’s Look Out for Kids

We are in the countdown to election day in Canada. As politicians knock on doors, leaders debate and pundits opine, 20% of Canada’s population isn’t getting the attention it deserves. Where is the children’s policy platform? Where are the promises which will make a difference in the lives of Canada’s children and the healthcare they receive?

Don’t get me wrong, the top issues all Canadians care about are also issues that are key to the well-being of children and youth – the climate change crisis and healthcare to name two. But this year, organizations that are committed to the health and wellness of Canada’s children are asking Canadians, and the politicians who hope to lead us, to take the needs of kids seriously.

Many Canadians would be surprised to learn that although Canada ranks as a top 10 country to raise children, we aren’t even in the middle of the pack when it comes to children’s well-being (25^th out of 41 OECD countries).

In the Raising Canada report, Children First Canada highlights the top 10 threats to childhood in the country:

1. Accidents and preventable injuries
2. Suicide, depression and anxiety
3. Child abuse
4. Poverty
5. Infant Mortality
6. Obesity and inactivity
7. Food insecurity
8. Immunization
9. Discrimination
10. Bullying

Almost all threats are even greater for marginalized and First Nations children. Children with disabilities are also disproportionately impacted.

As a children’s hospital leader, I’m a witness to the healthcare issues children face and the room there is for progress on child health outcomes relating to mental health and addictions, indigenous child and youth health outcomes and medication safety, highlighted by Children’s Healthcare Canada. For example, up to 75% of medications prescribed for children fall outside of Health Canada’s approved use.

This election season, ask candidates whether they are prepared to take responsibility to promote a healthy and safe childhood and safe and accessible healthcare for all Canadian children regardless of ability, wealth, or geography.

We, as in Canadian voters, can make a difference. For starters, we can elect leaders who will work toward improving the top 10 threats by appointing a Commission for Children and Youth, putting-in-place a strategy for children, publishing a Children’s Budget, committing to increased access to mental health and addictions services, fully implementing Jordan’s Principle so Indigenous children aren’t left further behind, and creating an expert panel on drugs and therapeutics for children.

A recent Children First Canada survey found that Canadians care deeply about the well-being of children and believe in investing in children will pay off in the future. Children don’t vote so they are counting on you, their parents, grandparents and educators to make kids’ concerns ballot box issues in 2019.

CEO blog: Dear Everybody is challenging the media landscape

There is something about the back to school season. Whether it has been years since you last entered a classroom or you are in the middle of your educational life, September feels like a time of renewal and excitement.

It’s also a time of bombardment of images in back to school ads. And as you look at that imagery, and listen to those commercials, and really pay attention, you’ll notice that something… something is missing.

Canadians with disabilities

Everybody wants a chance to be heard. Everybody wants a chance to be seen.

But for 6.2 million Canadians, those chances are too few and too far between.

In Canada, 22% of the population is living with a disability—more than a fifth of the population—but far fewer are seen in the media.

According to a report by GLAAD, out of the characters on primetime TV (during the 2018-2019 season) only 2.1 per cent had disabilities. And only 4.8 per cent of characters with a disability were played by actors who had the disability in real life. 

But let’s go beyond the numbers and try to understand what this really means. For 6.2 million Canadians this means they are barely seen, being excluded from roles they should be playing, and barely being given a platform to share their realities.

Not only do we need to raise those numbers, we need to do more to create fair and accurate portrayals of characters with disabilities in the media. Characters with disabilities are not “heroes overcoming the odds” or objects of pity. Characters with disabilities live the full range of human experience, with feelings, relationships, needs, joys, sorrows, independence and dependence.  They are children, siblings, friends, students, co-workers and more.

And it is time we saw all of that.

Dear Everybody

That is why we at Holland Bloorview Kids Rehabilitation Hospital are once again provoking a conversation.

As one of Canada’s Top 40 children’s research hospitals, we spend countless hours looking at how to improve and enable healthy and meaningful futures for children and families.

But we also spend countless hours advocating for child health and social change.

That is why I am excited to announce the launch of our third Dear Everybody campaign. A national movement, Dear Everybody drives forward the anti-stigma conversation, pushing boundaries and breaking barriers, building on Holland Bloorview’s values of courage, resilience, and equality.

The families and clients who enter our doors have always brought so much richness and are constantly effecting change within our walls. From Dear Everybody’s inception, it was important to us that kids and families co-create our campaign. They matter and we wanted them to know their voices do too.

Three years later, we can say that is still at a forefront of our movement.

They’ve spoken, we listened, and now it’s time to share.

Advertising matters

This year, Dear Everybody is taking on the advertising industry. We are asking brands and organizations to help us build a more diverse and inclusive media landscape.

While it excites me that Ali Stroker took home a Tony award and shows like Special and Speechless are making waves in the industry, we still have a long way to go to ensure more actors with disabilities, like George, are given the opportunities to achieve their career goals.

This year, we are encouraging casting agencies to consider accessibility when picking locations. We are encouraging brands to include people with disabilities in their “every day” ads. We are encouraging you to challenge your favourite brands to think about inclusion in their advertising. Why shouldn’t your favourite sneaker brand feature an athlete with a prosthetic limb or your favourite cosmetics brand a young woman wearing an awesome lipstick, who happens to use a wheelchair?

YOU can make a difference

Even the smallest of actions can have a big impact!

I hope you’ll take a small step today and join the movement by visiting DearEverybody.ca and signing the Dear Everybody Agreement.

Once you do share the campaign with your family and friends, especially on social media, read the tip sheets and resources, and join me as we advocate for more inclusive and diverse representation in our media.

It’s time to see what a world without stigma looks like.

It’s time we include disability in the picture.

CEO blog: Checking in on strategy!

It’s hard to believe we are past the midway point of summer 2019 already! There is nothing we love more as Canadians than to complain about our weather but there has truly been nothing to say but “Thank You!” for the hot sunny summer we’ve been having (at least here in Southern Ontario).

As is usually the case, once we get into August thoughts turn to the work ahead in the fall. Let’s face it, we all know the real new year is the first day after Labour Day in September!

This fall also marks the midway point of Holland Bloorview Kids Rehabilitation Hospital five year strategy: No boundaries.

No boundaries at Holland Bloorview

It’s hard to believe that it has been more than two and a half years since the Board of Trustees launched the massive engagement that led to our ambitious No boundaries strategic plan. Our plan was created through 1000+ touch-points with children, youth, former clients (whom we now call alumni), families, staff and community partners. It launched in 2017 at a great event in our cafeteria that was co-hosted with family leader, Alifa Khan. This five year plan challenged us to personalize pathways, discover for action and connect the system powered by mobilizing people and teams, evolving client-centred quality and safety, co-creating with children, youth, families and alumni and leading and modeling social change.

When we launched No boundaries, we committed to a check in to review, refine and refresh our strategic plan in 2019.

Julia Hanigsberg, President and CEO of Holland Bloorview with Alifa Khan, Family Leader

Holland Bloorview staff celebrate launch of No boundaries strategic plan.

Holland Bloorview staff celebrate launch of No boundaries strategic plan.

Why engage in a strategy check in?

Two and a half years ago we said we would hold ourselves accountable to the ambition of the No boundaries strategy. We wanted to make sure that we wouldn’t cruise through the back half of the plan, nor did we want to hit five years and realize that we hadn’t made the kind of impact that is embodied in our vision: the most meaningful and healthy futures for all children, youth and families.

We wanted to make sure that Holland Bloorview was part of any conversation about child health and was influencing meaningful social change. In addition to having a bold strategy, we aspired to support it with a people-focused culture that would be second to none. After all, probably the most quoted business axiom ever is that “culture eats strategy for lunch.”

At the halfway point of our No boundaries strategy, much has changed for children, youth, alumni, families and Holland Bloorview staff: in the public policy environment with the change of provincial government and a federal election coming in fall 2019; in the research and innovation ecosystems; in technology, among our academic and healthcare partners; in the healthcare system and in community and home. A strategy check in will give us an opportunity to step back from our day-to-day work to explore what is progressing, what might need to evolve, and what we might need to consider to ensure we are making the biggest possible impact.

What will we achieve with the strategy check in?

With the strategy check in we will:

• Lead an engaging and meaningful strategy process with our children, youth, families, alumni, staff and partners;
• Share No Boundaries accomplishments to date; and
• Ensure we are on the right course and evolve as necessary.

How do you get involved?

We plan on creating a rapid and powerful strategy check in process between September and October 2019 with our children, youth, families, alumni, staff and partners. There will be many ways to get involved including in-person sessions in October and through digital engagement opportunities (keep an eye out for updates on our website and social media channels).

Days are (already) getting shorter!

Enjoy the end of summer with friends, family and loved ones. It’s going to be a busy and exciting fall at Holland Bloorview!

CEO blog: National Bereaved Parents Month

“What we once enjoyed and deeply loved we can never lose, for all that we love deeply becomes part of us.”

– Helen Keller (www.whatsyourgrief.com)

I just learned that July is National Bereaved Parents Month.

At the end of June, I attended Holland Bloorview Kids Rehabilitation Hospital’s 3^rd annual Celebration of Life. It was my first time attending (it takes place on a weekend afternoon and “mom-ing” had conflicted with the first two years). The event memorializes all the children who our teams have cared for who have died. There were some parents and siblings there whose children had died scarcely a year ago and who had been actively under our care at the time of their death. There were others whose children had died decades ago and decades after they were our patients.

We looked at pictures of young people who have died since the last ceremony, shared time in the garden weaving an art piece with ribbons representing every lost life and planted new perennials in their honour.

Each family wanted to share with me. I heard stories of their late loved ones, from favourite music to goofiest gaff. So many wanted to share stories of incredible caring from my team – in one case grabbing a nurse and bringing her to me because “I want her to hear me saying this to you.”

This Celebration of Life was meaningful but sparsely attended. Perhaps that’s because we are bad at talking about grief. We are great at celebrating success – check out the average Instagram feed for the “highlight reels” that people typically post. But we don’t know what to say to the bereaved. We struggle to find the right words, to get over our fear of saying the wrong thing and our fear of being in the presence of pain.  To be present with loss we have to be willing to be vulnerable.

Speaking of vulnerability,  the night before the Celebration of Life, I was emailing with Marylyn Ballantyne, our incredibly wise and experienced chief nurse executive and sharing that I was worried I would “lose it” at the event. I had to speak and wasn’t sure if I’d make it through without crying; something that I hate doing in professional settings. Her response:  it’s okay to lose it.

Respect for ways that anyone experiences loss (for example, the choice to come to an event or not, to share one’s own experiences or to keep them private) is one thing I believe is important. There is no “right” way to grieve.

I’m still learning every day how to be compassionately in the presence of loss, my own and others. The only thing I know is that the only way to get better at it is to simply do it.

_____

Julia
@Hanigsberg

Supporting LGBTQI2S at Holland Bloorview

An interview with Randy Mulder

After Randy Mulder, a Therapeutic Recreation Assistant at Holland Bloorview, got in touch with me following devastating events that shook up the LGBTQI2S community in Canada and abroad, I knew that I wanted to hear more. I wanted to understand  how he was feeling and if there was anything we could do to ensure staff felt supported and had a safe space to connect and voice their feelings.

Randy and I met, we brought in Chief People and Culture Officer Tracey Millar and held a workshop facilitated by psychotherapist, Sly Sarkisova, at The 519. From there, Randy grabbed the reins and Holland Bloorview’s LGBTQI2S community network was born.

With Meenu Sikand’s arrival at Holland Bloorview as Executive Lead Equity, Diversity and Inclusion we are hoping that other community networks will grow and thrive building on Randy’s initiative.

In honour of Pride Month, I asked Randy answer a few questions about himself and the network.

1. What is the last book you read? Last show you streamed? Last movie you saw in a theatre?

I am reading Blackening Canada: Diaspora, Race, Multiculturalism by Paul Barrett, which I found at the U of T bookstore.  When I want to keep informed or need to dig deeper into sex, sexuality, religion, world politics, I read books about philosophy and sociology to get a better sense of what is going on locally, nationally, and internationally.  For creativity, I collect and read comics and graphic novels.

I love watching Star Trek again and again and again.  Star Trek shows are my security blanket.  They get me through life!  Mostly streaming through Netflix.

I watched Godzilla: King of the Monsters. This movie brought back memories of old Japanese sci-fi films.

2. Do you use any social media? Why or why not?

I used to use Facebook often and as the years went by I use it less frequently as it has become more about ads, memes and seems to have a negative vibe.  I do like keeping in touch with family abroad as I have family in the Netherlands, British Columbia, and Alberta.

Facebook Messenger is my favourite for communication as it does not have ads and memes and your conversations are more private.  I like sharing images and stories with people 1-on-1 rather than posting on Facebook.  Privacy and building strong interpersonal relationships with family and friends come with huge benefits with regards to empathy, compassion, and grace.  I spend less time on social media and more time in my communities, especially the 519 Community Centre and Gay Village.  Being informed and volunteering my time locally is of the utmost importance for my life and survival.

The social media site I enjoy the most is YouTube. I also like video games, computers, and anything technology.

3. Who have been your biggest influences?

My friends and family are very supportive. My life coach, Cecile Peterkin, has been my greatest influence and an asset to understanding who I am and how I should live my life to its fullest potential as an artist, teacher, and therapeutic recreationist.

4. What do you appreciate most in your friends?

Support.  Unconditional love. Time.

My friends have pulled me through some struggles over the years with the loss of my father, and close friends in the LGBTQI2S community.  They got me through to having fun again!

5. What’s your favourite thing to do?

I love walking throughout Toronto. My max was an 18 km walk to the Scarborough Bluffs from downtown and beyond.  I love drawing and painting. Socializing in the gay village is my main love.

6. What do you consider your greatest achievement?

Getting into Teacher’s College.  It was one of the most difficult goals I ever succeeded in achieving. It took me almost a year to work out how I would answer questions on the applications. I really struggled with my learning disabilities and ADHD back then.  I really didn’t believe in myself or what I could actually achieve. My life coach, professors, learning strategist and school counsellors at OCADU, friends and family supported me and I fell to my knees in tears when I got into UOIT! My life changed forever after that.

7. What do you like the most about working at Holland Bloorview? What would you like us to do better?

I love being able to collaborate on projects with other team members across disciplines.  I love being able to apply my art practice, teaching practice into therapeutic recreation programs!

More examples, scenarios, support and education on the importance of collaboration would be amazing.

8. How did you end up working at Holland Bloorview and what do you do here? What would surprise people most about your job?

I began volunteering at Holland Bloorview in Therapeutic Recreation and Bloorview School Authority with school teacher Paul Alcomo.  Paul has been a great influence in me going to teacher’s college and therapeutic recreation.  The recreation staff liked my volunteer work so much that they told to me to apply for work and I still work as a therapeutic recreation assistant today.

I think people would be surprised by the varied programs I have to make to accommodate the needs of our clients and the amount of freedom I have to adjust programs for the needs of the kids. For example, clients may need hand over hand support to make art with a paint brush, may need a brush adapted to suit their needs, may need a larger canvass, or may even need more emotional support.

9. Tell me about the LGBTQI2S community network initiative you launched at Holland Bloorview? What motivated you? What more do you want to achieve?

I created this LGBTQI2S support and dialogue meeting forum for staff to share their stories and their struggles and successes in life.  When the violence towards gay people at Pulse night club occurred and serial killer Bruce McArthur was caught in Toronto, the gay community was reeling in years of pain and sorrow.  I wrote an email to the CEO at Holland Bloorview, Julia Hanigsberg, about these tragedies and we met to look for a support system for people at Holland Bloorview.  Immediately we thought support meetings throughout the year would benefit staff with regards to any pain or sorrow they may have in their life.

I would hope to see more initiative from other staff to create their own meetings or events that would fulfil their needs for positivity and success.

10. What advice would you give someone at Holland Bloorview who wanted to launch their own community network initiative?

I would suggest they meet with the CEO, Julia Hanigsberg, to begin the process of brainstorming what that may look like for them.  Julia has the positivity and experience in these areas to be a strong influence in how they can achieve this goal and implement a successful plan.  There is strength in numbers with regards to support in community networks.

11. What does Pride Month mean to you? What is your favourite thing to do during Pride?

Pride Month brings together the whole country and beyond.  Local communities can connect and share their ideas and events that create a more diverse and inclusive world for people in the LGBTQI2S world.  Allies can join in the support and fun.  Intersectionality, sex, and sexuality are terms to focus on, teach about, and experience hands-on with regards to making the world a better place to live and work together!

I love to go the 519 Community Centre to support all walks of life and I love to dance and socialize!

CEO Blog: “Ontario’s Health Care Transformation—the View from the Kids’ Table”

I’m not a fan of hyperbole. So, take me at my word when I say that we are going through unprecedented health care transformation in Ontario. What is this transformation all about? What’s the view through the lens of child health? And what should you be paying attention to?

Why is the government transforming health care?

I remember when my kids were little and their fever always spiked in the late evening when the doctor’s office was closed, so we’d trundle off to the emergency room. There are other times you have a quick question about your health, but instead of being able to send an email or have a five-minute call, it can take weeks for an appointment. If you are the parent of a child with a chronic condition or serious medical disorder, you likely have binders of records you cart around to hospitals and specialists because you don’t have confidence that anyone but you can pull it all together and keep track.

That’s what we mean when we say Ontario’s system is highly fragmented. Parts of the system don’t connect easily for people and families. Seamless digital access to health records is uncommon. Often people wait too long for services that they need or get “stuck” in hospitals because other parts of the system (e.g. long-term care) aren’t available when they need them.

And while Ontario has some of the lowest number of hospital beds per person (while sustaining some of the best health care outcomes, amazingly talented clinicians, groundbreaking research and best educational institutions globally), health care is still costing us all a lot—and because we pay for most of it through our taxes, we care about keeping costs at a minimum.

We all want pretty reasonable things: improved patient experience, improved overall health, and keeping costs at a minimum. Health care as an industry has also woken up to the fact that better patient care experiences, enhanced wellness, and less burnout for physicians, nurses, personal support workers, therapists and other health care providers has an inevitable positive impact on patient care.

So, in short, better health, better experience of giving and receiving care and the provincial budget are all key drivers of the reforms.

What is the government doing?

The first element is the invitation to create Ontario Health Teams. This would include all the service providers and partners required for optimal health of the people within a particular geography. The mix would include primary care (physicians, nurse practitioners), home nursing and other home supports, hospitals, school health, children’s treatment centres, transportation, emergency responders and public health.

The other element of the transformation is something called Ontario Health. It brings under one “roof” (a single board of directors) a number of health funding, coordinating, standards and quality setting organizations (e.g. local health integration networks, Cancer Care Ontario, Health Quality Ontario and others).

How is the government doing this?

The short answer is: fast! Many have described the process of self-assessment for Ontario Health Teams as a “low rules environment”. The government indicated that it might approve three to five health teams in the first round, within only a few months, and received well in excess of 150 applications.

What is the view from “the kids table” on this health transformation?

Kids aren’t little adults. The way we care for children needs to be designed around their wellness needs. They experience a variety of unique health conditions and their health exists within the ecosystem of their family, school and community. Families are also the most unpaid caregiving workforce in children’s health care.

Most children don’t receive their health care in specialty children’s hospitals. Their care happens at the family doctor, at the local community hospital, in school, through public health. For 85% of children who are mostly well, their health services experience will be routine and infrequent.

Moreover, the investment in children’s health will reap a long-term return on population health. For example, treating chronic conditions early can prevent a greater need down the road. An even better example is prevention—keeping children from getting sick in the first place.

Finally, because of the enormous progress of medical research and medical care, very ill children, premature babies, children with disabilities, medical complexity and rare disorders, are moving into adulthood with ensuing health and social service needs. Planning and making sure our “new” health system works for those children today, as youth, and into adulthood is something that must happen. But plans for children can be eclipsed because the demographics and chronic conditions of aging, surgical interventions like knee and hip replacements, or the insufficient numbers of long-term care beds are taking up most of the air time. Seniors vote and kids don’t.

What should you be paying attention to?

Across Ontario, family doctors are still often solo practitioners, leaving them and their patients vulnerable and frustrated. Highly integrated and high-functioning health systems include well-organized and integrated primary care. Pay attention to how and whether Ontario Health Teams are including and engaging primary care providers.

Another thing you may want to do is “follow the money”. You should care about the cost of the health system because, as taxpayers, you pay for it. You should care about how appropriately funded it is because you use it for yourself and your family. We know that the government will want to drive cost out of the health system, but if our system gets cheaper before it gets better (organized, integrated and more streamlined) then you should be worried.

And finally, keep in mind that sign you see when you drive in your neighbourhood:

“Slow down! Watch for children”

“Slow down! Watch for children” means that if the system we are creating doesn’t work well for the kids, it probably isn’t going to work for any of us in the long run.

Slow down. Watch for children. The future of health care is depending on you.

 

Based on remarks given at the 2019 Annual General Meeting of the Medico-Legal Society of Toronto.

_____

Julia
@Hanigsberg

 

5 Things You Need to Know to Build Effective Models of Child, Youth and Family Engagement

Three very different hospitals. Three very different programs. Nonetheless, The Change Foundation’s recent case study of family integrated care in the Mount Sinai Hospital NICU (Toronto), Holland Bloorview Kids Rehabilitation Hospital (Toronto), and CHEO (Ottawa), shows 5 key learnings that can underpin any healthcare people engagement initiative.

1. Imitation is the sincerest form of flattery: start with what has worked elsewhere

Mount Sinai built the pilot for its family integrated care (FICare) model in their NICU on Estonia’s “humane care” to make parents/guardians an integral part of a baby’s care team. It was a natural fit as they had an active parent advisory group and had a history of working closely with families. They applied the model in a rigorously designed pilot project and then followed up with an international randomized controlled trial.

Holland Bloorview based its model on the core concepts of dignity and respect, information sharing, participation and collaboration promoted by the Institute of Patient and Family Centered Care.

CHEO relied on a lean methodology approach to co-design a renewal of its framework for child, youth and family engagement in order to better reflect the demographics of the community it serves.

2. It doesn’t happen without the right leadership

Leadership is mission critical and the ideal leadership depends on the organizational culture, strengths, and when and where obstacles will be encountered. So at Mount Sinai this was the pediatrician-in-chief and director of the Maternal-Infant Care Research Centre. At Holland Bloorview, the then president and CEO personally championed a refreshed client and family-centred care strategy and change-management framework to integrate best practices and evidence. While, at CHEO, what proved successful was partnership between the manager of patient experience and the team leader for quality improvement with the chief of staff as the executive sponsor thereby building support from physicians and clinicians.

3. Iterate, iterate, iterate: learn from mistakes, course-correct, persevere

Each program encountered challenges along the way and found unique solutions. For example, at CHEO, recruitment of youth and especially those from vulnerable populations for Family and Youth Forums proved challenging. They found success by looking outside the hospital to build relationships and trust in the community and by creating different ways to participate. Rather than a standing monthly engagement meeting, some people preferred to attend a one-time workshop on a specific issue, or participate in an online forum.

Mount Sinai didn’t anticipate that nurses would be worried about job losses and later they had concerns about the shift from “doer” to “teacher”. Enlisting the support of champions within the nursing team and among parents to educate was a key lesson learned.

At Holland Bloorview there were bumps in the road too. At first, family leaders participating on committees had experiences of feeling left out or singled out or simply not being given the information they needed to participate effectively. Change management for staff included a formal process to apply for family leaders as committee members and giving staff the tools they needed to effectively engage family leaders in the work of the hospital.

4. Start with strong foundations and invest in ongoing scaffolding

CHEO is building child, youth and family engagement into the project approval process and recognizes the need for continued support of the engagement framework. At Mount Sinai, parent education, nurse education, environmental support and psycho-social support (i.e. peer-to-peer support) are the pillars to aid continued partnership. And, at Holland Bloorview, the Client and Family Integrated Care team are the subject matter experts who focus on embedding child, youth and family leadership in all aspects of the hospital’s work. Family mentors work with new family leaders and “family as faculty” bring their experience to individuals and groups of providers.

5. This is culture change: seek out successes to celebrate

The high profile that Mount Sinai’s NICU received by demonstrating FICare’s positive impact on health outcomes and parent-child bonding generates pride amongst staff, which in turn increases their support and commitment to FICare. At Holland Bloorview one on-going form of celebration is the Spotlight recognition program that enables families to recognize staff for demonstrating client and family-centred care. Staff take pride in receiving a Spotlight and the recognition builds and reinforces client and family-centred behaviour. The best recognition can be witnessing the success first hand. CHEO is measuring and evaluating and points at an example to a plan that emerged from a series of facilitated meetings held by the Youth Representation Council: “We give our opinion, and combined with the opinions of the children and the parents, it turns into a beautiful well-designed structure.”

As parts of the healthcare system we all strive to innovate – to exercise creativity aligned to our mission and vision in order to bring value to the communities we serve and to our organization. Innovation will only thrive with an effective balance of the ideal leadership and local passion and cultural change. The Change Foundation’s case studies on successes in engagement give healthcare organizations concrete examples to follow and demonstrate the value of learning from the experiences of others and customizing to the local context.

_____

Julia
@Hanigsberg