National Health Care Leadership Conference June 2008 The Calgary Health Region’s Public Participation Framework – From Theory to Action Presented by: Bretta Maloff, Director, Healthy Living on behalf of Farah Bandali, Donald Barker, Joyce Buzath, Keith Donaghy, Ray Harrison, Bretta Maloff, Sean McIntyre, Micheline Nimmock and Mona Pinder
Framework Development • In 1998 the Board called for development of a framework that would outline: • Values • Operating principles • Opportunities • Public Participation defined as “the process by which public concerns, needs and values are incorporated into governmental decision making”
Framework Development • Community Affairs Committee (Board) • Project parameters • Advisory Committee • Literature review • Integrated data and proposed Framework • Review process • Final Framework
THEORY …………..
Research History Casebeer, A., MacKean, G., Abelson, J., Maloff, B., Musto, R., Forest, P. (2008). Engaging the public voice in health care decision-making. In Organizing and Reorganizing: Power and Change in Health Care Organizations (pp. 123-139). New York : Palgrave Macmillian. Thurston, W. E., MacKean, G., Vollman, A., Casebeer, A., Weber, M., Maloff, B., et al. (2005). Public participation in regional health policy: a theoretical framework. Health Policy, 73(3), 237-252. Maloff B., Bilan D., Thurston WE. (2000). Enhancing public input into decision making: Development of the Calgary Regional Health Authority public participation framework. Family and Community Health . 23(1):66-78. Maloff, B., & Penman, Y. (2000). Strengthening Community Action for Health and Wellness . Calgary: Calgary Regional Health Authority.
Learnings – Consultation • Endorsed framework is useful in guiding health practice • Both generative and deliberative processes are possible • Expanding reach to engage public participants • Process that unfolds over time and is on a continuum • High quality participation processes including: • Instrumental supports • Clarity of purpose • Role expectations • Feedback loop • Context setting and background information • Opportunity for further engagement with the Region
THEORY TO …. ACTION Timing is everything……….
Regional Context • Strategic Service Plan 2006 – 2010 • Participatory model with active engagement of the consumer – Patient/Family/Health Care Consumer Focus – Informed and Involved Patients and Families • Updated Vision and Mission • Vision: healthy communities • Mission: leaders in health – a partner in care
Regional Context (contd.) • Community Service Development Strategy • Customized geographic approach • Develop Partnerships “ … will tap into and enhance community capacity by increasing collaboration and partnerships with citizens, communities and other organizations to plan, deliver and evaluate health services.” • Organizational structure change with emphasis on Citizen Engagement • Interest and relevance across portfolios
Scan of Public Participation Models Primer on Public Involvement (2006). Ontario: Health Council of Canada. Community Development and Public Participation (2005). Winnipeg Regional Health Authority. Planning for Effective Public Participation (2005) . International Association of Public Participation. http://www.iap2.org. engage! Framework and Tool Kit (2004, 2 nd Edition) . The City of Calgary. Framework for Community Engagement (2003) . Vancouver Coastal Health. Public Participation Framework (2001) . Calgary Health Region.
Public Participation Framework 2001 • Emphasis on the Health Systems context • Influencing Regional decision-making process “…an organizing tool to guide decisions to be made by the Calgary Health Region and that the Calgary Health Region actively seeks input on.” Health System
Public Participation in Health Framework 2008 • An ‘overarching’ framework • Reflects 3 contexts within which public participation occurs: Individual Health System Society
Public Participation in Health Framework 2008 Individual Health System Influencing their Influencing own Health care and organizational policies developing and decisions skills/knowledge to participate Society Influencing determinants of health through creating shared vision and ownership among intersect oral groups and policy advocacy
Public Participation in Health Framework 2008 (contd.) • Comprehensive, reflects all the ways the Region engages the public • Greater emphasis on embracing the whole range of the public participation continuum, including empowerment Inform Consult Involve Collaborate Empower Continuum adapted from IAP2 Public Participation Spectrum, 2005
Public Participation Continuum Continuum Purpose Information Decision Commitment to Flow Maker the Public Sharing information to create CHR Public To keep the Public informed. Inform awareness and educate the One-way flow of information CHR public. from CHR to the public Gathering public input, advice Public CHR To listen to the Public’s Consult and feedback in order to One-way flow of information perspectives. CHR influence decision-making. from public to the CHR Involving the public in an Public CHR To ensure Public’s perspectives Involve exploration of views, An interactive exchange with a are reflected in the alternatives CHR perspectives and interests, with two-way flow of information developed and provide emphasis on listening and between the public and the CHR feedback on how their input achieving mutual influenced the decision. understanding. Engaging the public in a Public CHR To work together to develop Collaborate collaborative policy and/or An interactive exchange with a and make decisions and/or Joint decision-making process two-way flow of information recommendations. around a particular issue. between the public and the CHR Empower Enabling the public to make Public CHR To facilitate and support the decisions and take action in An interactive exchange with a Public’s planning/ decision- Individual / areas that affect health. two-way flow of information making process. Community between the public and the CHR Adapted from IAP2 Public Participation Spectrum, 2005
Applications Inform Consult Involve Collaborate Empower Calgary Apple Temperature Patient/ Primary Injury Magazine Check Family Safety Care Prevention Council Networks Coalition Facilities Websites Region3 SACHYN Planning Aboriginal Community Health Stroke council Prevention Initiative
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