Engaging family doctors in clinical practice innovations has often been seen to be a difficult challenge. It is happening in some creative ways with the Hamilton Family Health Team.  

The approaches to leadership and change in Hamilton are similar to those stated in Starfield Consulting's recent study Beyond Boundaries: Lessons from Leaders (King and Peterson 2006). In that study, we identified common characteristics and behaviours of leaders who had successfully implemented complex change in public service and healthcare systems. Research interviews were conducted with 40 leaders who each had successfully led a change initiative involving multiple organizations, jurisdictions or highly siloed functions within an organization. A full copy of the original research study can be found at www.starfield.ca.  

This is the fourth and last article in this series. It provides an example of the value of emergent leadership and identifies some factors that help set the conditions for such leadership to emerge. The interviews were conducted recently and hence go beyond the original study. The article illustrates how Ontario's Ministry of Health and Long-Term Care, some of the original leaders in the Hamilton Team and Chief Executive Officer Terry McCarthy have created an environment that fosters emergent leadership. Their approach has accelerated the delivery of both increased access and improved patient care.