Reflections on the first year of West-Central Montreal Health
Dr. Lawrence Rosenberg
Ever since the Integrated Health and Social Services University Network for West-Central Montreal came into existence on April 1, 2015, everyone in the network has been living a significant journey of experience. While these are still relatively early days, we believe that journey has been a positive one.
In fact, we take pride in the many improvements in access and continuity of care that have been introduced at a time of major organizational restructuring. At the same time, we have remained sensitive to the burdens of illness and social circumstance in the lives of those whom we serve—and this has been (and continues to be) the litmus test of our efforts.
During 2015-2016, the process of inquiry—asking why, and why not—has assumed great importance, with thoughtful reflection playing a vital role as we work to transform our system of health care and social services. This begins with clarity of thought: realizing who we are and what we are trying to do—choosing, to quote Cardiologist Thomas Lee, “whether you want to be a critic or a playwright.”
We believe that those of us who have committed endless hours over the past year to building and strengthening our healthcare network have already made this choice. Moreover, the importance of learning as we go has loomed large for many of us. This notion has been described by author Robert Quinn as “building the bridge as you walk on it.”
Little happens as a result of one person acting alone. When we embarked on this journey, we invited everyone to share the work and to benefit from the synergy of teamwork—the so-called “wisdom of crowds”. Working as a single organization, we have become better aware of how to learn from conflict in order to harvest the wisdom of diversity.
This first year of CIUSSS West-Central Montreal has also been one of promoting a culture of measurement and excellence. Needless to say, an inordinate amount of time has been devoted to collecting and analyzing data. However, we have learned—or perhaps relearned—that there is no substitute for the validity, reliability and integrity of data. We were also humble enough to accept that, on occasion, we had to discard incorrect beliefs and accept information that was contrary to what we had hoped for or expected.
Shortly after our network’s inception, the new senior management team came together, and we agreed that our Number 1 goal would be to become a user-centred organization, emphasizing exceptional experiences for patient, clients and residents. This would be accomplished through continuous quality improvement, a reduction of variation, and respect for people.
We also sought a comfortable equilibrium between retaining the valuable aspects of the past while embracing the future. There is always tension between the old and the new, between continuity and autonomy, between the continuum of the past and a leap into the future. While acknowledging that each generation builds on the achievements of the one that preceded it, getting it right is difficult. With too much central control, you crush individuality, innovation and motivation. With too little, you risk anarchy. Balance is everything.
So where does this leave us? We find ourselves looking for better ways to care for one another, which is why we must always be innovating. We also believe in simple solutions and in holistic care—that is, the integrated care of people across our network’s continuum. We believe in saying “no” to numerous projects in order to focus on the few that are truly meaningful.
We believe in close collaboration between—and the cross-pollination of—our different missions to allow us to innovate. And frankly, we believe we should not settle for anything less than excellence in everything we do, with the humility to admit when we’re wrong and the courage to change.
In closing, permit us to cite 19th-century art critic John Ruskin: “The highest reward for a man’s toil is not what he gets for it, but what he becomes by it.” Whatever was achieved in 2015-2016 was due to the commitment and dedication of the medical staff, nurses, the allied healthcare professionals, the general staff, the Board of Directors, the foundations and the volunteers of CIUSSS West-Central Montreal. Their tireless efforts enabled us to provide our population with care of superior quality, as we all strived to make our network a showcase for this province.
Alan Maislin Lawrence Rosenberg, M.D., Ph.D
President, Board of Directors President and CEO