Técnicas e instrumentos de recolección de datos

Span of Control

Enablers were identified by respondents as key strategies that organizations could undertake to help support manager span of control.

5.5.1

Leadership Education

Community, long-term care and hospitals alike were providing leadership education for their managers. In community care, one CCAC reported providing a leadership development program for a period of six weeks which incorporated leadership competencies. Another CCAC reported leadership education which highlighted

In long-term care, one facility provided mandatory

leadership education on-site while another facility provided financial assistance for managers to attend leadership education sessions.

All hospitals supported leadership education for their managers by either providing on-site education or providing financial support to attend off-site education. One community hospital provides a structured six week core leadership course which requires the participant to complete a project related to enhancing patient satisfaction within a six week period. This education is then augmented with individualized learning plans. Another community hospital provides an on-site leadership day with an emphasis on emotional intelligence and transformational leadership. All three academic health science centres have formal leadership education programs for their managers. One centre’s program is delivered by Rotman and another centre has a partnership with a local university to provide a health care leadership program.

As well, all hospitals reported bursary dollars available for the manager to access for support of further leadership development.

5.5.2

Communication

Communication was specified as a key enabler to

implementing a change in organization structure and role redesign in the community and hospital sectors.

Seeking feedback often and early in the process with key stakeholders was expressed as a “must have” to gain support and build trust.

Communication strategies and tools for ongoing sharing of information and open dialogue with staff and managers included:

• communication forums,

• leadership forums,

• communication boards,

• use of the intranet, and

• coffee with the vice president and chief nursing executive.

5.5.3

Staff Education

Educating those impacted by change was paramount for successful implementation of new initiatives in all three health sectors. Different forms of education were provided based on the type of the initiative. Education ranged from formal education such as structured courses to mentoring and coaching and informal education on the unit or department. General education and communication were provided to all staff regarding the new initiative at ongoing intervals.

All three sectors were committed to providing the required knowledge, skill and support to the managers and staff to ensure a successful implementation of the new initiative as able.

One large community hospital is working with an academic institution to provide guidance regarding the development of the nursing leadership curriculum in their nursing program.

Two hospitals noted the importance of the Nursing Graduate Guarantee (NGG) in supporting their nursing workforce and were successful in hiring all of the new graduates completing the initiative. The NGG is an initiative through the Ministry of Health and Long Term Care which provides a guaranteed 7.5-month employment opportunity in a supernumerary (above staffing) position to support new graduates’ transition into full-time permanent positions, as they become available40. One hospital has worked to provide a nurse residency program specific to their patient population and have been

One large multisite community hospital added more clinical educators to support the increasing number of new graduates requiring orientation and ongoing guidance on the clinical units.

Two hospitals have partnered with local universities to provide on-site post graduate education (BSCN) for their staff.

One large community hospital is partnering with researchers to conduct formal research.

5.5.4

Technology

Technology was identified as an enabler to the

implementation of the changes in practice within all three health sectors. Computerized scheduling and payroll were identified by an academic health sciences centre to reduce the amount of time the manager spends on payroll and scheduling.

One community care access centre has implemented a web based performance appraisal tool to assist with the completion of annual performance reviews and manage some of the geographic barriers inherent in the nature of community care.

One large community hospital has 95% of their clinical record in electronic format. One community care access centre is planning to move to an electronic record system in the future to assist with data collection and documentation. Although some organizations have implemented the technology, most organizations are looking at future implementations.

5.5.5

Role Clarity

All three health sectors recognized the importance of clarifying and defining the role and the accountabilities of the manager in their current, and for some, their redesigned structure.

5.5.6

Professional Practice Structure

Moving to full scope of practice was identified as being essential to support a change to an inter-professional collaborative model of care.

A collaborative inter-professional model of care requires all health professions function to the fullest extent of their training and capability.

As well, a professional practice committee structure was identified by the hospital sector as an enabler to support shared communication and decision making. The majority of hospitals either had in place, or, were in the process of implementing professional and nursing practice councils. One large multisite community hospital and one academic health science centre have implemented unit councils to support shared governance.