Health Human Resources:
Leadership Rooted In Vision, Values,
Relationships
October 8, 2009
Sister Elizabeth Davis
At the end of the first decade of this 21st
century, we – the ones gathered in this room –
are called
to see with new eyes
to hear with new ears
to dare with new thinking
to act with new passion
if we are to help create a truly strong and
responsive health system in Canada, a health
system built on the strengths and wisdom of
health workers.
Here the tides flow, And here they ebb . . .
With a lusty stroke of life
Pounding at stubborn gates
That they might run
Within the sluices of men’s hearts,
Leap under throb of pulse and nerve,
And teach the sea’s strong voice
To learn the harmonies of new floods . . .
E. J. Pratt, Newfoundland
 Setting
the Context
 Sea’s Strong Voice – Today’s Realities
 New Floods – Changing Health System,
Professions
 Harmonies of New Floods – Transforming
Practice and Research
 Readiness for and Response to Trust Given
You

They are
Nurses, physicians, therapists, social workers,
dieticians, technologists, pastoral care workers . . .
Researchers, policy-makers . . .
Managers, administrators, clerical staff, support staff,
Housekeeping, food services, facilities’ maintenance . . .
Board members, volunteers
Persons who make the health system work

They are persons, not simply “human resources”
Planning - right types, mix, distribution of
health-care providers to meet the needs of
Canadians
 Recruitment and Retention - encouraging
more people to enter the health-care field
and improving working conditions to keep
them there
 Inter-professional Education - changing the
way we educate health workers
 Healthy Workplace – integrated, sustainable,
diverse, engaged, dynamic workplaces

SEA’S STRONG VOICE
 Demographic
shifts
 Role of women
 Increasing urbanization
 Increasing cultural diversity
 Impact of computerization
 Culture of consumerism
 Increasing gap between rich and poor
 Understanding of environment
 Expectations of public service
 Credibility of leaders
 Elders
(pre-1946): Dedication, sacrifice,
hard work, conformity, law and order,
patience, respect for authority, duty
before pleasure, adherence to rules,
honour
 Boomers (1946-1965): Optimism,
teamwork, personal gratification, health
and wellness, personal growth, youth, work,
involvement
 Generation X (1965 – 1980): Diversity,
thinking globally, balance, techno-literacy,
fun, informality, self-reliance, pragmatism
 Millennials (1980 - ): Confidence, civic
duty, achievement, sociability, morality,
diversity, street smarts
 From
the Industrial Age to the
Information Age to the Network Age
 Network
Age
Distributed culture
Decentralized
Citizen-centered not institutioncentered
 Aboriginal
people
 Recent immigrants
 Non-permanent residents
 Visible minorities
 Persons with disabilities
 Lone parent families
 Unattached individuals
2006 Report Card on Child
and Family Poverty in Canada
Terrorism
 Epidemic disease
 Organized crime
 Conflict over natural resources
 Climate change
 Environmental degradation
Security is increasingly interpreted as security of
people, not just territory; security of individuals,
not just of nations; security through development,
not through arms; security of all people
everywhere – in their homes, in their jobs, in
their streets, in their communities, and in the
environment.

Dr Mahbub ul Haq (1997)
The planet’s warming is unequivocal, its impact is
clearly noticeable, and it is beyond doubt that
human activities have been contributing considerably
to it. Adverse effects include:
Agriculture and food security
Oceans and coastal areas
Biodiversity and ecosystems
Water resources
Human health
Human settlements
Energy
Transport and industry
Extreme weather events
Climate Change 2007
 Rights
– to health and health care
 Balance – individuals and populations
 Comprehensiveness = treat illness, ease
suffering, minimize disability, prevent
disease, promote health
 Cooperation – with those served, with
each other, with those in other sectors
 Improvement
 Safety
 Openness = being open, honest and
trustworthy
15
Health is a state of complete physical,
emotional, social and spiritual well-being; it
is a resource for everyday living.
Examples of Implications:
Value of one’s own experiences
Social, psychological and spiritual factors
Gender as health determinant
Health of person, family, community, population and
earth
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Move from traditional inward-looking, reactive
culture to outward-looking, proactive culture
Shift from profession-centred to patient-centred,
client-centred culture
Blurring professional boundaries
Changes in law re scope of practice/responsibilities
Increased expectations of interprofessional
collaboration in education and practice
Focus on evidence-informed practice
Increasing demands for accountability and
transparency
Internationalization
Loss of control over working conditions
Collaborative patient-centered practice is designed
to promote the active participation of several
health care disciplines and professions. It

enhances patient-, family-, and communitycentred goals and values

provides mechanisms for continuous communication
among health care providers

optimizes staff participation in clinical decision
making (within and across disciplines)

fosters respect for the contributions of all
providers
Health Canada, 2003
Climate of mutual respect and trust
 Cooperation = formal communication,
independent decision-making (shared

information, consultation)

Coordination = defined roles, some shared
decision-making (shared vision, goals and planning;
shared resource)

Collaboration = defined roles, frequent
communication, shared decision-making, one
system
 Teamwork – specific tasks, patient-centered
 Collective responsibility – organizational integration
 Shared leadership, control, risk and accountability
PRESENT CULTURE IN
HEALTH CARE
Focus on care of individual
PREFERRED CULTURE
IN HEALTH CARE
Focus on care of individual,
family, community,
environment
Lack of patient centeredness Involvement of patient/client
in decision-making
and family in decision-making
and care
Struggle with quality and
Culture of quality and safety
safety, variation
Depersonalization of care
Personalized care
Priority to acute care
interventions
Priority to spectrum of
health and health care
Public mistrust of system
Public confidence in system
PRESENT CULTURE IN PREFERRED CULTURE IN
HEALTH CARE
HEALTH CARE
Growing distance between
personal and system goals
Segregated professions
Mutual trust, cooperation
and coordination among
health professionals and
other staff members
Workforce shortage
Workplace disquiet & stress
Leadership focus on
protection
Alignment of personal and
system goals
Integrated but not
assimilated professions
Collaboration among health
professionals and other staff
members
Sustainable and engaged
workforce
Healthy workplace
Passionate and humble
leadership
PRESENT CULTURE
IN HEALTH CARE
PREFERRED CULTURE
IN HEALTH CARE
Attention to formal
Attention to group
structures, regulations
affiliation, teamwork,
and reporting relationships coordination
Attention to structural
and procedural change
Attention to cultural
change
Fragmentation, silos
Integration
Elitist language, symbols
Common language, symbols
Hierarchical structure
Dynamic, organic structure
 Had,
held, shared, grown
 “Something significant left to do”
 Vision Community
Values are sets of freely chosen
convictions which compel action as
they are cherished and publicly
affirmed.
Charles McCoy
Visionary
Catalyst
Partner
Decision-maker
Inspirer
Facilitator
Implementer
Evaluator
 Manage
diversity
 Respond within changing social realities
 Be inclusive
 Understand globalization and health care
reform
 Reintroduce values of flexibility,
discovery and innovation
 Tell stories
 Create environments allowing creativity,
questions, risk
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Research
 Interdisciplinary and collaborative
 qualitative and quantitative
 investigative and evaluative
Input and participation at every stage of
research process
Link with wider national and international
professional community
Research agenda = gender-sensitive and inclusive
Recognition of diverse communities
Increased number of health services researchers
Means of transforming research results into
health policy and practice
 Stretch
into new ways of thinking
 Leave behind what is no longer
appropriate
 Interconnect practice, education,
administration, and research
 Value networks
 Re-inspire spirit
Leaders act wisely
Leaders act courageously
Leaders act passionately
 Awareness
of complexity
 Skills development
 Strengths of tradition
 Emotional preparedness
 Reflection
 Ceremonies and celebration
 Symbols
 Confidence/conviction
May the light of your souls guide you.
May the light of your souls
bless the work that you do
with the secret love and warmth of your hearts.
May you see in what you do
the beauty of your own souls.
May the sacredness of your work
bring healing, light and renewal
to those who work with you
and to those who see and receive your work.
May your work never weary you.
May it release within you wellsprings of
refreshment, inspiration and excitement.
May you be present in what you do.
May you never become lost in bland absences.
May the day never burden.
May dawn find you awake and alert,
approaching your new day with dreams, possibilities
and promises.
May evening find you gracious and fulfilled.
May you go into the night
blessed, sheltered and protected.
May your souls calm, console and renew you.
Adapted from
John O'Donoghue, Anam Cara