Date of Submission

7-23-2023

Document Type

DiP

Degree

Doctor of Education

Department

Education

Keywords

healthcare change management; transformative leadership; health professions education; critical reflexivity; critical appreciative inquiry; evaluative thinking

Abstract

This Organizational Improvement Plan is designed for Open Doors (a pseudonym), a Canadian hospital invested in providing stigma-free, social, and structural determinants-based care to patients who are marginalized from healthcare vis-à-vis previous experiences of exclusion and institutional trauma at healthcare settings. In the context of deepening scrutiny on healthcare institutions for their role in perpetuating systemic oppression and for failure to mitigate inequitable health outcomes for marginalized populations, Open Doors’ commitment to justice-centered care offers a compelling case study in hospital-based strategies for addressing health inequity. The specific Problem of Practice (PoP) addressed is the hospital’s care team’s limited capacity for providing trauma-informed care for patients from diverse communities who face complex, intersecting, and systemic barriers to hospital-based care. Broader systemic failures and contextual factors shaping this PoP are discussed and situated using organizational theory and the recent groundswell in literature on socially conscious caregiving. The need to instigate transformative, adaptive third order change to address the PoP is highlighted using transformative and adaptive leadership theories. Critical appreciative inquiry and dialogic change models are blended to propose a change framework that can mobilize such change within Open Doors’ context. Guided by the change framework and an evaluation-driven design process, a specific solution is detailed, namely, a patient-centered design and learning hub. A detailed change plan is presented, whereby patients, staff, community representatives and leaders are invited into a knowledge-based, dialogic process of co-creating intersectional, trauma informed practices to address a high-priority intersectional area of need for Open Doors.

Keywords: healthcare change management; transformative leadership; health professions education; critical reflexivity; critical appreciation; evaluative thinking

Share

COinS