Integrated Health Initiative Vision: a new generation of health leaders for New Brunswick

August 9, 2023 should be regarded as a major turning point for health and long-term care in New Brunswick. 

For decades in most other provinces, there have been academic programs that focus on healthcare organization and leadership.  Ontario was the first with University of Toronto’s prestigious graduate program followed by a superb program at University of Ottawa then York University.  With University of Toronto being the pace-setter in the 1950’s with Dr. G. Harvey Agnew, other universities picked up the need for education of those who are currently working in some level of healthcare leadership or those aspiring to do so.
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Aided by a large Kellogg Foundation grant in the late 1970’s, other universities across the country developed such programming; in Atlantic Canada the superb program was developed at Dalhousie, initially with the leadership of legendary Dr. Peter Ruderman, and it has become a key element of health care services in that province and beyond.

New Brunswick was slow on the uptake and did not take advantage of the Kellogg grant when it was originally offered.  In the meantime, the Canadian College of Health Leaders has been developed as the focus of a national standard for education of those involved in careers in health and long-term care management and leadership.  The College has had a rigorous program of knowledge and education requirements for membership which, followed by experience, can lead to Certification and eventually to a Fellowship.  All levels require rigorous acquisition of knowledge and continuing education.  CCHL serves as a serious asset in recruiting key health executive talent, in networking, sharing knowledge and best practices, and promoting and recognizing excellence.

For young people entering the established programs at Dalhousie and the many other programs, they are exposed to a level of professionalism and networking not otherwise available through conventional academic courses from the day of entry.  In my day, albeit a few years ago, in addition to faculty, all of whom were achievers in their fields (Administration, Social Work, Accounting, Economics, Medical Practice, Public Health, Human Resources), we were exposed to all the “big names” in health and long-term care leadership from the beginning.  And the curriculum was designed to provide a breadth of education and critical thinking that is absolutely essential for those who function even at middle management levels in health and long-term care.

University of Moncton has a Master’s program available for francophone students and that really needs much promotion and support by the health and long-term care sectors.  This program is led by Dr. Claire Johnson.

Since there has been no such program in English in New Brunswick and since basic educational requirements in health organizational studies have never been priority for positions of influence, so many wonderful people, well-motivated, get assigned to these important roles in which learning the basic knowledge requirements is an on-the-job experience.  Frankly, this places them and the organizations, however otherwise skilled they are, at a serious disadvantage.

There are hundreds, if not thousands, of positions in the New Brunswick health and long-term care regulatory and service delivery sector in which a certain core of knowledge is not only desirable but is absolutely essential for optimum job success.  It is not difficult to determine if persons holding some of those positions have that core knowledge or not.

Along comes UNB’s Vice-President Dr. Petra Hauf with a vision that aligns with the needs and directions of health and long-term care.  I first met her in 2020 when, during the pandemic, I wrote my book on Health Care Reform in New Brunswick.  She was in the early stages of establishing the vision for the Integrated Health Initiative to be based at the Saint John Campus.  What a breath of fresh air….open to new ideas, new concepts, bringing the academic world into alignment with what are popularly defined as “crisis areas in New Brunswick public policy:  Health and Long-Term Care”. 

As the pandemic wore on and we saw the challenges that managing the pandemic presented to regulators, hospitals, doctors offices, and long-term care facilities, it took not a little imagination to see how knowledge base and networking could make the system function so much better.  Here we had so many regulators and service providers learning about some of the basics of leadership, communication, infection prevention and mitigation, along with managing through crisis all for the first time.

Will a fully implemented Integrated Health Initiative solve all health and long-term care leadership crises?  There is no silver bullet.  But basic education, training, and networking can go a long-ways with every practitioner working through normal days let alone crisis days.

The intent of the Initiative is:

1. Roll out new education pathways designed to foster a resilient and innovative healthcare workforce;
2. Invest in health research that fills critical knowledge gaps;
3. Partner with private sector to accelerate knowledge transfer and commercialization of health innovation;
4. Bring clinical learning infrastructure to the Saint John Health Cluster.
   
   

Each of these statements of intent will need much fine definition and planning in order for IHI to become completely successful.  But with the faculty and support staff that Dr. Hauf is assembling, I have every confidence that will happen as the initiative progresses.  For instance, the issue in health research is critical; already there is wonderful clinical research happening in New Brunswick; but on the service delivery and execution side of the ledger it is a bit fractured and needs focus and direction.

The New Brunswick Health Council publishes great reports based on the reviews they do but knowledge translation has been a challenge; that is, great information, now how does it get applied.  Also, Loch Lomond Villa and York Care Centre have been involved in applied research for years with some great work being done.  But the crises borne out in the pandemic demonstrated how NB suffers from a consolidated base of good systems research, publishing authoritative actionable statistics.

At University of Toronto School of Hygiene, for instance, they have had academic and research super-stars in the persons of Dr. Peggy Leatt and Dr. Raisa Deber whose work has been very highly quoted and referenced and has found its way into government regulatory documents for years.  Other Universities hosting such programs across the country have made the same contribution to provincial and national health policy.

Thought leadership and policy change is noted in the list of intended impacts and that is, certainly, an area woefully deficient in this huge segment of our New Brunswick system of service provision. 

It is an ambitious vision but as a former leader and founding member of the CCHL, I take the vision as a sign of hope for New Brunswick.  At the ground breaking, President Paul Mazerolle explained the $27.2 million in funding for construction of the 65,000 sq ft building on the SJ Campus, received another gift by generous donors of $1 million and reported on a continuous fund development campaign to secure further capital funds. 

Those who are serious about reform in health and long-term care have much to celebrate with this announcement.  A broad education made available for those who have interest in careers in these fields, in our own province is one of the keys to future quality service delivery.  Education and training, as championed in Canada by Dr. G. Harvey Agnew, is a powerful building block.  Best wishes UNBSJ.
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Ken McGeorge,BS,DHA,CHE is a retired career health care CEO, part time consultant, and columnist with Brunswick News; he is the author of Health Care Reform in New Brunswick and may be reached at [email protected] or www.kenmcgeorge.com