High-performing health systems share six key levers focused on the lived experiences of patients and those delivering care – they can be replicated across the country
When MPs return to Ottawa after spending time in their ridings, many will have heard healthcare concerns raised by constituents, including difficulties accessing care, workforce shortages and fragmented transitions between services.
Many will also have heard about care that is working locally, often quietly. Communities and care teams have optimized how care is delivered in ways that rarely make headlines but offer powerful lessons for strengthening healthcare across Canada and supporting system-wide improvement.
Across Canada, there is no shortage of good ideas, pilot projects or case studies that showcase excellence in care.
In Huntsville, Ontario, a creative community partnership co-located a primary care clinic with the local library. Led by a nurse practitioner, the team cares for more than 1600 people. Three out of four clients say it helped them avoid an emergency department visit. Likewise, in Neil’s Harbour, Nova Scotia, a primary care team added a nurse prescriber to improve same and next-day access. Since implementation, a quarter of patients with less urgent needs have been redirected from the emergency department to primary care.
In Edmonton, the Glenrose Rehabilitation Hospital focused on adopting relationship-centred leadership approaches. Within three months, patients’ sense of being heard increased by 32 per cent, while negative staff sentiment dropped from 40 per cent to just two per cent.
In Nunavut’s most remote communities, care is provided through nursing stations. The problem: staff were effectively on call around the clock, fueling burnout and turnover. When registered nurses familiar with the communities started providing after-hours support virtually, it reduced strain on frontline staff, improved retention and enhanced patient safety.
Each of these changemakers has their own context. They are working in unique ways, tailored to local needs.
What they have in common is the use of proven approaches to make care better.
High-performing health systems put people at the centre, valuing both those who receive care and those who deliver it. Evidence shows that they share six key levers that drive continuous improvement, lead to excellence in care, and provide a practical lens for policy and system design.
Specifically, they:
- Partner meaningfully with patients, caregivers and communities
- Engage health workers and teams
- Equitably address the needs of people and communities
- Enable policies and structures that make improvement easier
- Strengthen organizational and system capacities
- Use timely and relevant evidence.
Without replicating these conditions systematically, innovation can stall or lead to pilot fatigue.
But sharing and scaling solutions is possible.
A team in Winnipeg, for instance, tackled high rates of antipsychotic use in long-term care. They pioneered non-drug approaches that benefit people living with dementia and their families, as well as care providers. Based on their success, we worked with teams in other jurisdictions to adapt the approach to their contexts – and then partnered with three Atlantic provinces and Quebec. Over half the time, medications were stopped or reduced.
Local successes matter, but they are not enough on their own. We need health systems intentionally built to make success repeatable. We need patients, providers and communities as partners and co-designers in system change. And we need coordinated efforts at all levels so that safer care, quality improvement and resilience is the norm.
The future of Canadian healthcare won’t be defined by the next great idea, but by whether we enable healthcare providers and systems to reliably deliver great care, every day, in every community.
Photo courtesy of DepositPhotos
