Abstract

While the last decade held much rhetoric and debate on the issue of healthcare reform across Canada, little actually resulted in substantive innovations at the integrated service delivery level. Preoccupation with governance and management structural changes, mergers (not always for the better) and funding reform has unfortunately left the system struggling to find new solutions to the "Gordian knot" of access, waiting lists, human resource scarcity, systems integration and continuity of care, to name just a few issues. And it's ironic that the biggest single factor mitigating against new designs for models of service delivery may very well be our collective old mindset still struggling with the challenges of uncertainty, complexity, ambiguity and paradox brought on by new times and ever-increasing expectations. Unfortunately, this often results in resistance to change when, in fact, what is needed is tolerance for and embracing of these challenges to move forward.