The process of change related to health policy shift: reforming a health care system

Abstract

Efforts of governments to adjust the responsiveness and efficiency of their health care systems are evident across the globe. In the seemingly constant search for solutions providing both better health outcomes and manageable costs, the directions and designs for change are neither consistent nor well studied. Opportunities for shared learning concerning what strategies for transforming health care systems lead to effective and sustainable change are being missed. There is an urgent need to study and understand the processes of change initiated by health policy shifts aimed at controlling health care costs, altering health service delivery and influencing outcomes of health care. In partial response to this need, research was initiated to study health policy transition within the Western Canadian province of Alberta. The primary objective of this research was: to identify, describe, compare and contrast the processes of change adopted and implemented in a variety of health authorities as a result of health policy shift. Change processes initiated by a specific health policy shift (the restructuring of Alberta’s health care system) were explored from the perspective of the change agents (individuals managing the health system reforms) in order to discover indicators of effective change and to identify questions for further consideration and testing in relation to change process related to health policy shift. This qualitative exploratory study coincided with real time alteration to the health system via legislated health policy shift. Findings relate changes in the structure, process and outcome of the health policy transition. Additionally, a number of questions linked to the reported findings are highlighted to encourage additional and continuing efforts to improve understanding of change process related to health policy shift.