Dec 19, 2024
As we approach the end of the year, this is often thought of as a time of reflection. A time of introspection. A time when you might take stock of the past year and consider setting a goal to improve an area of your life.
At HQC, we have improvement down to a science.
As you might expect, system-wide change is not straightforward. The quality of our health is determined by many factors, with many interdependent parts of the system at play, including social and economic influences such as where you live, work, and age. This complexity requires an integrated approach to bring about improvement – not just in pockets of the province but across all of Saskatchewan.
As a leading health system partner for over 22 years, we’ve developed such an approach, and we’re currently putting it to the test to address complex health care challenges.
How we accelerate improvement across the health system
In 2024, we refined our strategic approach, combining the latest evidence from health improvement research with decades of our own experience implementing large-scale change throughout Saskatchewan.
Our recipe for meaningful, sustainable improvement involves four key attributes:
We apply this four-staged approach to every project, initiative, and strategy we undertake as an organization. Our commitment is to collaborate, integrate, and create synergies with our health system partners and community organizations to achieve the best possible outcomes.
However, as Henry Mintzberg once said, “Learning is not doing; it is reflecting on doing.” So, before we welcome in 2025, let’s reflect and take a closer look into what we’ve learned using this strategic approach.
Understand the System
In complex systems such as ours, the pathway to improvement is far from linear. There is no singular solution, no clear understanding of what will work, for whom, and in what context. Given this, we cannot simply start by implementing “the solution.”
Instead, we start by creating a shared understanding about the factors that contribute to the challenge we’re facing.
For example, we consider what’s happening in the system, what patterns we’re seeing, what factors contribute to these patterns, and what assumptions or beliefs individuals hold about the challenge at hand.
HQC does this work by gathering information through environmental scans, surveys, and talking with our partners — synthesizing evidence and interpreting results to better describe the challenge at hand as well as identify promising ideas for improvement.
What we’ve learned so far…
As we experiment with fostering a shared understanding, we’ve found value in the promising practice of participatory system mapping.
This method involves co-creating visual maps of those who are part of the system, their connection to one another, as well as the factors that either help or hinder the challenge at hand and how those factors interact. In our experience, these maps provide a valuable overview of the intricacies impacting the challenge we’re facing, revealing areas of the system where inventions could make the greatest impact.
Build Shared Commitment
In any improvement initiative, it’s tempting to jump from idea generation straight into execution – that is, to move quickly to implement the ideas we think will be the solution. However, it’s worth spending the time and effort ensuring you have the framework to sustain improvement.
Before we mobilize for any action, we need to develop a collective commitment with our partners, identifying where we’ll focus our efforts to address the challenge we’re facing.
By convening our partners in facilitated sessions, we collectively define our goals, share ideas, and prioritize actions to advance system-wide change. Most importantly, this work involves time and intention dedicated to developing trusting relationships with system partners.
What we have learned so far…
In April 2024, we partnered with UK-based National Health Services (NHS) Horizons to host an accelerated design event, an evidence-based approach to co- designing large-scale change through tailored facilitation and collaborative work techniques.
Bringing together over 100 health system and community partners, we cultivated a collective understanding, built shared commitment, and identified key actions to enhance community-based care for older adults in Saskatchewan – an initiative we call Thrive at Home. What we were able to achieve in one day might have taken three months to achieve by conventional methods!
To capture the ideas and innovations circulating the room, we applied rapid insight methodology to summarize and synthesize the actionable next steps stemming from the event into our Thrive at Home Insight Report.
Create Conditions for Mobilization
All improvement requires change. And mobilizing change in a large system is a big undertaking.
Before we dive into execution, we need to first lay the foundation for effective, sustainable system-wide change.
At HQC, we generate motivation for improvement by:
- Convening key partners to facilitate connections and coordinate collective action
- Facilitating activities by working together rather than in silos
- Communicating to inspire motivation for innovation
- Building capability for change through training in improvement methodology
- Designing and implementing evaluation tools to measure successful change initiatives
- Developing structures to foster system-wide adoption
What we have learned so far…
This past year, HQC applied the power of impact networks to our strategic approach. Unlike social networks, this type of network is purposefully designed to connect individuals and organizations to advance learning and action for a common purpose.
When we hosted our accelerated design event in April, we brought together a wide range of folks from community, health, and social sectors to build a shared understanding of the challenges facing older adults. Without system-wide coordination among the organizations and individuals involved in this work, we recognized the opportunity to step into this role to keep the momentum going and organize for broader impact.
As a result, we launched our own impact network, dubbed the Thrive at Home Action Community, to strengthen connections, build relationships, and accelerate learning to drive action.
Organize for Action
Finally, organizing for action is where it all comes together.
This is where the rubber hits the road – where we learn what’s working and what’s not, when improvements are rapidly tested and implemented, and how innovation takes shape across the system.
During this stage of our strategic approach, HQC facilitates emerging innovations, evaluates system-wide results, communicates progress to sustain momentum, and onboards new partners to spread system-wide improvement.
What we have learned so far…
Inspired by the energy behind the impact network, the Thrive at Home Action Community is coming together in focused working groups, called Action Hubs, to address challenges impacting older adults, such as transportation, system navigation, and home support.
Together, the Action Hub teams breakdown the complexity of system-wide challenges into bite-sized, short-term action cycles focused on a particular area. We provide support through coaching and facilitation to develop tangible goals, coordinate action plans, and initiate improvement measures.
Looking back to move forward
Of course, once we’ve progressed through each phase of our strategic approach, our work isn’t over… We’re continually seeking to understand the system, build a shared commitment, create conditions for mobilization, and organize for action. In this way, our strategic approach acts as a continuum, always in motion and always innovating.
Each cycle offers us an opportunity to learn from our successes – and failures – while gaining new perspectives and insights into where to adjust our tactics. As a result, we’re always honing our approach to accelerate improvement in health and health care for all who call Saskatchewan home, now and into the future.
With the new year on the horizon, I encourage you to reflect on your approach to reaching your goals. In our experience, your approach to change is what makes all the difference. Trust me, it’s worth the effort.
From all of us at HQC, happy holidays and best wishes for 2025!
Tanya is the Senior Director of Strategic Initiatives at the Saskatchewan Health Quality Council. Part of her work oversees HQC’s process to test, learn and implement new methods and approaches to large-scale change.
