Change Day comes to Canadian health care – but will it make a difference?

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  • TapOff says:

    how many provinces too part in this one day? one day of hospital medicine only? one day of patient centred unhierarchical awarneness? one day of not thinking about ‘risk management’ for institutions or providers as opposed to actual patient care and the risks patients take entering the very narrowly defined health system? one day in thinking differenly about holistic, team based health care problem solving and policy improvement and ‘silo busting’.

  • Tracy says:

    Although we might look to others to change or bring about change, Change Day asks us to look to ourselves instead. While this can be scary and intimidating, it can also be empowering as it makes us instrumental to and responsible for the change we are seeking.

    For those of us who have made or will make a Change Day pledge, a conscious decision is involved. This decision sees thoughts, ideas and desires transforming into action. As such, Change Day ripples have the potential of existing well beyond the actual day itself, making every day a day for change…a change day.

  • Darren Larsen says:

    The best place to start is where you are.
    Interesting that BC is taking a breath to evaluate, but we must be careful that this is not branded a loss of confidence. I am sure that this will lead to a much more effective engagement when it comes back next year! It’s smart to analyze the outcomes and the level of engagement. This is process is well recognized in the business world, like rapid cycle prototyping in the startup space. Something that we are just figuring out in Healthcare.
    Now how to scale and spread?

  • Bullcrap says:

    The only change that a dependent employee can make on their organization is to change jobs.

    He who does not hold the purse strings does not hold the power.

    This is as true now as it has ever been.

  • Damian Roland says:

    Great this article has sparked debate and commentary. A summary of our efforts can be found here in a Pecha Kucha format… Damian :)

  • Mary Freer says:

    The success of Change Day here in Australia is measurable. The focus for us has been collective responsibility and growing self agency. We are seeing greatest impact when we raise the importance of particular areas of concern. For instance powerful government and individual response to the focus on bullying and harassment. This is one example where it is not solely about great leadership – it is about ‘leaders everywhere’ and collective responsibility to build a safer culture.
    People work ChDay around the things that we collectively need most traction on. Hospital CEOs report that change day improves creativity and innovation. We have seen one large hospital reduce their clinical waste by 50% and have fun doing it.
    It’s not the complete magic bullet to improving the healthcare system – we don’t expect it to be. It is an extremely low cost opportunity for our health and care workforce to make public their aspirational pledges to do better. Who wouldn’t want 77,000 people all saying “let’s do great work”?

  • Dr. Franklin Warsh says:

    This will probably be 100x more useful than the current situation, with administrators trying to ram the MBA school flavor-of-the-month down the throats of front line providers.

  • Peter G M Cox says:

    This is a very laudable attempt by those “at the sharp-end” of healthcare to initiate change and I hope (and believe) it will produce to some positive results.

    However, Dr. Danielle Martin’s comments are particularly appropriate: significant organisational change only occurs as the result of the LEADERSHIP (and example) provided by the most senior levels of management (and, conversely, lack of it produces the poor morale referred to in the article).

    It would be particularly encouraging to hear that those in such leadership positions were committed to participating in this initiative themselves (in PRACTICAL terms, i.e. through action, not exhortation).

    • Damian Roland says:

      Great point here. One of the things we realised in Change Day (in the UK) was that while we were promoting what is in essence a bottom up approach we were very cogniscent of the fact that leadership from senior positions was also required. We encouraged kick-starters in our second year to bring the top and bottom together! (example from the Chief Executive of the hospital I was working at)

      • Cavin says:

        Bring the top and bottom together? – the tops are already so far up their bottoms they do not really know the real front line problems. Tasting a a few awful meds and laying on a spinal board for an hour does NOT truly give you insight to how patients are suffering from cut backs. try lying in a hospital bed from Friday (after 6 pm) to Monday at Noon in excruciating pain from a nephrostomy tube that was pushed too far in. (Urology placed the tube earlier on Friday) – Kidney reduced in size, pain became unbearable by 7 pm but Urology does work on weekends. The hospital sedated my wife until Monday at noon. Monday the tape holding the tub in place was lifted and the tube retracted by 1 cm, tape replaced -instant relief.
        My wife had the nephrostomy tube put in because of a leak from the ureter between the kidney and bladder got damaged from her radical hysterectomy surgery. (cervical cancer)
        A brilliant urologist (with 30 years experience) tried to catch that leak with a Foley catheter. Left her that way for 3 weeks before we could get another appointment. She ended up in the Emergency department with septicemia ( a serious infection )
        This was only the tip of the ice berg of problems my wife encountered from “Health care Professionals” Not in a 3rd world country, but at a well known hospital in Toronto Canada.
        Personally, I could not care if you smile or not – and I do not need balloon animals either. I would just like better treatment. The System needs an entire overhaul – never mind a day change.
        My wife is dying from cancer because of several trip ups in our medical system. It is irrelevant how poor the Meds taste when your dying.
        ( 1 hour on a spinal board ?) well, try lying in your own urine after the clamp came off the nephostomy bag, in a hospital bed for half an hour during nurses shift change. She got a skin rash.
        Again, The System needs an entire overhaul – never mind a day change.

  • Simona says:

    Re: “Change Day is nice, but it’s like you’re picking one wedge of the pie. It’s not a full quality improvement cycle”.

    Food (or pie?) for thought: I believe Change Day is about touching people’s hearts. It calls on people’s deepest purpose. It looks to unleash the ingenuity that is bursting in frontline staff but is far from being utilized. It’s about culture. Talking about a PDSA cycle when you have unmotivated staff is like trying to make an omelette without breaking the eggs.

    Organization culture eats – and will eat – strategy for breakfast, lunch and dinner.
    Every time.

    That is why I pledged, and why I believe that we can ALL make a difference.

  • Dennis Kendel says:

    I’ve participated in Change Day in Saskatchewan in each of the past two years. Change Day was hosted by the Health Quality Council (HQC) which is committed to CQI in healthcare with a goal of making care more patient/family centered. I’ve served on the HQC Board of Directors since its inception which has enabled me to gain an appreciation for the challenges inherent in large scale change. During the course of each of these two Change Day campaigns I witnessed very board engagement of healthcare workers and students in reflection about what they can do personally to improve their health and the health of others. I do feel this social movement has a positive impact on the culture of healthcare but admit it is very difficult to assess how sustained that impact may be

  • Colleen Kennedy says:

    This is a great question! You can watch stories regarding Change Day BC’s impact at: Our report full of stories and actions is coming soon too! Definitely a healthy ripple across the province.


Vanessa Milne


Vanessa is a freelance health journalist and a form staff writer with Healthy Debate

Joshua Tepper


Joshua Tepper is a family physician and the President and Chief Executive Officer of North York General Hospital. He is also a member of the Healthy Debate editorial board.

Jill Konkin


Jill is a professor in the Department of Family Medicine at the University of Alberta.

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