Grant: Project Grant

There have been many recent changes (reforms) to how health systems in Canada are structured, including the shift from a regionally-based system to one that is managed by a provincial agency. These system-level reforms change how decisions are made, and the way that healthcare providers, communities and other key stakeholders work together to achieve health system objectives like improved quality, equity, and patient and worker experience. However, these reforms are taking place without any formal evaluation; decision makers do not have the information they need to ensure the new agencies are achieving their intended goals. In this research project, we will compare and evaluate these reforms in four provinces, to help learn from the different experiences of each, and highlight the lessons that can inform ongoing and future reform efforts. Our research includes three main stages. First, we will develop a profile of each province as a preliminary assessment of the provincial agency's role in the health system and how they engage with partners to achieve health objectives. In this stage we will also identify 2-3 priority policy areas for more in-depth study in each province (we call these sub-cases). Second, we will use information from the first activity and interviews with people leading and engaging with these health system agencies to understand the factors impacting how they work, and the tools they use to bring about system change and improvements. Third, we will host structured meetings to reflect on our research findings and to hear from people involved in the health system about how well these agencies work, their structures, limitations and opportunities to strengthen them. This research will be the first to closely examine and evaluate the recent changes to how health systems are structured across Canada. This will provide important information to decision makers to ensure they can support these agencies to get the best possible outcomes for their residents.