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"We define stakeholders as: any individual, group of individuals, organizations, or political entity with a stake in the outcome of a decision. We define the public as those stakeholders who are not part of the decision-making entity or entities.

We define public participation as: any process that involves the public in problem-solving or decision-making and that uses public input to make better decisions.

This Code of Ethics is a set of principles, which guides us in our practice of enhancing the integrity of the public participation process. As practitioners, we hold ourselves accountable for these principles and strive to hold all participants to the same standards.

PURPOSE
. We support public participation as a process to make better decisions that incorporate the interests and concerns of all affected stakeholders and meet the needs of the decision-making body.

ROLE OF PRACTITIONER
. We will enhance the public's participation in the decision-making process and assist decision-makers in being responsive to the public's concerns and suggestions.


Principles:

TRUST. We will undertake and encourage actions that build trust and credibility for the process among all the participants.

DEFINING THE PUBLIC'S ROLE. We will carefully consider and accurately portray the public's role in the decision-making process.

OPENNESS
. We will encourage the disclosure of all information relevant to the public's understanding and evaluation of a decision.

ACCESS TO THE PROCESS. We will ensure that stakeholders have fair and equal access to the public participation process and the opportunity to influence decisions.

RESPECT FOR COMMUNITIES
. We will avoid strategies that risk polarizing community interests or that appear to "divide and conquer."

ADVOCACY
. We will advocate for the public participation process and will not advocate for interest, party, or project outcome.

COMMITMENTS. We ensure that all commitments made to the public, including those by the decision-maker, are made in good faith.

SUPPORT OF THE PRACTICE
. We will mentor new practitioners in the field and educate decision-makers and the public about the value and use of public participation (IAP2)"

Paul Gallant is a member of IAP2 Canada.


 What are the key principles that maximize potential for successful
 transformational change in healthcare?


 7C Principles Explained: 

The excerpt below informs the briefer published  HealthCare Leaders’ Association of BC (HCLABC) Sept. 2010 Newsletter version. The brief version without references is available in pdf below. See page 7.


See_Page_7_7Cs

Researched by Paul Gallant with input from Graham Dickson, Geoff Rowlands & Marilynn Kendall for HCLABC.

1. Clear direction: Focus on a long term vision within a whole systems context. A long-term focus that emphasizes the urgency of the change and helps people frame the extent of the change is necessary. Included within this principle is the need to sustain the change momentum and “stay the course”. 

2. Communicate: Use direct and relentless communication. Communication that includes dialogue and therefore presumes “listening to others” as a crucial component of the communication process must be constant and often. The communication process needs to leverage both the existing strengths and successes of the organizations undergoing the change process. 
 
3. Care: Champion the caring aspect of healthcare. Champions ensure a focus on the patient’s or person’s journey and do so from a foundation of caring. This journey includes caring for oneself (as individual citizens and caring for oneself as a provider within the system). 

4. Change readiness: Assess the change readiness of the organization(s) and individuals. Proceed with a consciousness of peoples’ ability to cope and adapt to the demands of change, and plan to address their needs. Build capacity within people and the organization. The complexity of the systems that are undergoing the change must be understood and anticipated by participants. 

5. Community: Use a Community Engagement approach. Effective leaders of change involve people affected by the change in its design and implementation. In addition to engaging both middle ground and grass roots employees, leaders are encouraged to involve stakeholders from members of the immediate community and, of course, professional associations that are affected. 

6. Culture: Address culture. Consider the cultural impact of the mergers of different organizations’ values, beliefs, professional and routine practices. Each organization has a set of customs, traditions, and ways of doing business that are different from one another. For example, combining larger and smaller organizations, such as acute care and residential care organizations, or primary care and acute care organizations, distinct and diverse cultures must be addressed. 
 
7. Construct: Ensure a sufficient structural framework exists to support the transformation. Structure is a critical factor of transformational change. Without a sufficient structural framework there is little possibility of being successful in the transformation process. Decision makers and other stakeholders need to know the processes for communication, how to access resources, how decisions are made, and where responsibilities and accountabilities reside. Be explicit rather than assume that others are aware of, understand, and interpret the framework in a consistent manner. Such assumptions often prove to be inaccurate. If a sufficient framework does not exist, work towards creating a common structural framework for people to implement transformational change. 

Consistency was later suggested as an eight principle.


*Reflect and Discuss*

Healthcare leaders are asked to reflect and discuss the above in the context of changes currently underway, recently completed, and forthcoming within British Columbia’s healthcare sector; specifically: 
 
1. “How well are these principles being applied in current transformations occurring in healthcare?”   See poll results next page.

2. “Does everyone affected by the change agree that there is a sufficient structural framework to support the transformation, and understand their role in it?” 

References

-Anderson, L, Malby, B, Mervyn, K, Thorpe, R (2009). The Health Foundation’s position statement on effective leadership development interventions. London: The Health Foundation. 
-Bridges, W., & Bridges, S. (2009). Managing Transitions. New York & Cambridge: Da Capo Lifelong Books.                                                                                                                                        -Bunker, KA and Wakefield, M. (2006) The Dozen Dos of Change Leadership. Harvard Manage Mentor Excerpt from "Leading in times of change." Article reprint No. U0605A. Reproduced by Canadian Medical Association with permission from Harvard Business School Publishing. This article is available as part of Harvard Manage Mentor 10. Original article: Bunker, K. A. & Wakefield, M. 2006. Leading in Times of Change. Harvard Management Update, 11(5): 3-6.
-Caldwell DF, Chatman J, O’Reilly III CA, Ormiston M, and Lapiz M. (2008). Implementing Strategic change in a health care system: the importance of leadership and change readiness. Healthcare Management Review; 33(2): 124-133.
-Campbell, R. J. (2008). Change management in health care. The Health Care Manager 27(1), 23-39. -Cortvriend, P. (2004). Health Services Management Research: An Official Journal Of The Association Of University Programs In Health Administration / HSMC, AUPHA [Health Serv Manage Res], ISSN: 0951-4848, 2004 Aug; Vol. 17 (3), pp. 177-87; 
-Denis, JL. (2002). Governance and Management of Change in Canada’s Health System. Discussion Paper No. 36. Commission on the Future of Health Care in Canada. 
-Dickson, G. (nd) The LEADS in a Caring Environment Leadership Capacity Framework: Building Leadership Capacity Across Canada to Lead Systems Transformation. 
-Dickson, G. (nd). Leadership for Change Lessons As Learned from Interviews of Key Informants in the Context of Primary Care Reform. 
-Ford, R. Complex leadership competency in health care: towards framing a theory of practice
Health Serv Manage Res, Vol. 22, No. 3. (1 August 2009), pp. 101-114. 
-Heading, G. (2009). Strategic leadership culture and change in, health services Cancer Institute NSW. Discussion Paper. Website www.cancerinstitute.org.au/publications 
-Leaders for Life (2008). Systems Transformation. HCLABC (update with current version) 
-M McGrath, K., Bennett, DM., Ben-Tovim,DI.,Boyages,SC, Lyons, NJ and O’Connell, TJ (2008). Implementing and sustaining transformational change in health care: lessons learnt about clinical process redesign. MJA 2008; 188 (6 Suppl): S32-S35.
-Reeleder D, Goel V, Singer PA, Martin DK. (2006). Leadership and priority setting: The perspective of hospital CEOs. Health Policy, 79:24-34. 
-Robbins B, Davidhizar R. (2007). Transformational leadership in health care today. Health Care Manager. 26(3):234-9. 
 
References Future recommended reading that is not health care specific though contains examples from the healthcare and speaks to “culture.”

Henein, A. & Morissette, F. (2007). Made in Canada leadership: Wisdom from the nation's best and brightest on leadership practice and development. Mississauga, Ont.: Jossey-Bass.

Logan,D., King, J. & Fischer-Wright (2008). Tribal Leadership. Leveraging natural groups to build thriving organizations. esp. pps 192-193 & 198-199. NY. Collins Business


 
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