Transcript Meaningful Public Engagement

Strengthening Community
Engagement in Ontario LHINs
Julia Abelson, PhD
Centre for Health Economics and Policy Analysis
McMaster University
Presentation to the Change Foundation Symposium
Community Engagement and the LHINs: Truth & Consequences
Toronto, ON, March 11, 2009
From Consultation to
Engagement
 Public consultation
 One-way, top-down, one-way information flow
 Past experiences have produced cynicism and distrust
 Citizen/public/community engagement
 Two-way obligations, information sharing, trusting
relationships
 Linked to deliberation and reason-based decisions
 Effort to correct past failures, re-establish trust between
citizens and government officials
Role of LHINs (Part II, sec.5)
 To plan, fund and integrate the local health system to
achieve the following:

Promote integration

Plan and recommend allocation of resources in
response to health services needs

Engage community in planning and priority setting
through formal channels of community input and
consultation

Establish processes for responding to concerns raised
about health services

Evaluate, monitor, report on and be accountable to
Minister for local health system performance …
Community Engagement and
LHINs (Part III, sec. 16)
 “LHINs shall engage the community of diverse
persons and entities involved with the health system
on an ongoing basis, including about the integrated
service plan and while setting priorities” (Part III,
16.1)
 Community definition (Part III, 16.2a-c):
 Patients and other individuals
 Health service providers
 Employees involved in the local health system
Methods of Engagement
(Part III, 16.3.)
 “The methods for carrying out community
engagement may include holding community
meetings or focus group meetings or
establishing advisory committees”

Specific requirements for engaging with:



Aboriginal and First Nations
French Language health planning groups in each
LHIN
Health professionals advisory committee
Public/
Stakeholders
Government
LHINS
LHINS
Government
Public/Stakeholders
Supports for Community
Engagement
 Choose carefully among CE goals and
audiences for CE outputs
 Develop concepts of effective CE and
measure it as rigorously as you can
 Determine your evaluation priorities
 Build and sustain CE capacity
The Goals of Community
Engagement
 Instrumental: to inform (and potentially
improve) decisions that are more reflective of
patients/public needs and preferences
**instrumental objective of regionalization
 Developmental: to inform, educate and build
citizen capacity
 Procedural/democratic: to legitimize decision
making and to fulfill democratic accountability
requirements
Define effective CE and
measure its achievement
 Convergence among academics, decision
makers and the public about ‘effective’ or
‘successful’ CE
 Contextualize generic definitions
 Standardized approaches to evaluation
across and within LHINs
Example – LHIN Common
Assessment Tool Project
 Common LHIN-tailored evaluation
framework and questionnaire developed
using concept mapping methodology
Determine how “effective CE” is understood
across the LHINs
 Steps:




Brainstorming statements about effective CE
Sorting and rating to determine relationships
and importance
Mapping to visually represent statements about
effective CE and their relationships
“Point Map” Generated from Sort
Data of LHIN Staff
Sample Cluster Solution
Sample Cluster Solution
Determine Evaluation Priorities
(and link these to CE goals)
 Process

Clear communication of objectives, format and how input will
be used
 Outcomes – (How) does effective CE…





Health system knowledge
Capacity for future public involvement
Improved trust of fellow citizens, LHINs and health system
Shape policy, decision making and political process
Contribute to improved integration?
 Context also matters

exerts fostering and inhibiting influences that contribute to
more (and less) effective CE
The Context of Public
Participation (Abelson et al. 2007)
Building and Sustaining
Capacity for Effective CE
 How do we facilitate effective CE in our




organizations, communities and health systems?
What capacity is required to carry this out?
How is the practice of effective CE diffused within
health systems?
Can organizations learn it?
What type of leadership required?
Stay tuned…
 Evaluating the Impacts of Public Engagement: A
Research-Practice Collaboration (Abelson et al.,
CIHR, 2008)
LHINS
Government
Public/Stakeholders
Public/
Stakeholders
Government
LHINS