Abstract
The research undertaken describes a regional health authority’s approach to managing a shift away from acute hospital care towards more community-based, health-promoting service orientations in line with new legislated responsibilities.1 It builds on earlier research of province-wide efforts to create new ways of organizing work within new regional health authority structures. The initial study explored “what matters most” to managing the restructuring of Alberta’s health care system and identified ten variables as critical to the transition to regionalization in Alberta.2 Four were seen to be pre-requisites to effective change: sustaining political will; pacing; resourcing; and, committing to change. Six others were described as continuous process variables: leading; communicating; informing; learning; planning; and, adjusting. This case study looks closely at the operation of these variables in a specific change process within the wider context of the Alberta health reforms.
Résumé
La recherche entreprise décrit l’approche suivie par les autorités sanitaires régionales pour gérer la transition vers moins de soins intensifs en milieu hospitalier et plus de services communautaires de promotion de la santé, en accord avec les nouvelles responsabilités imposées par la législation.1 On y pousse plus loin les recherches déjà menées sur les efforts déployés dans la province pour concevoir de nouvelles façons d’organiser le travail dans le cadre des nouvelles structures des autorités sanitaires régionales. L’étude initiale examinait « ce qui compte le plus » pour gérer la restructuration du système de soins de santé de l’Alberta et identifiait dix variables essentielles pour la transition vers la régionalisation en Alberta.2 Quatre d’entre elles étaient considérées comme des conditions sine qua non à un vrai changement, à savoir: le maintien de la volonté politique; le rythme du changement; l’octroi de ressources; et l’engagement à changer. Les six autres étaient décrites comme des variables continues du processus, à savoir: mener; communiquer; informer; apprendre; planifier; et ajuster. Cette étude de cas examine de près le fonctionnement de ces variables dans un processus de changement spécifique, dans le cadre plus large des réformes du système de santé en Alberta.
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