Essays

Essays July 2013

How to incorporate Inter-professional Education (IPE) into Health Sciences programs: The Waterfront Campus Project at George Brown College

Dr. Kathy Cowan Sahadath and Lorie Shekter-Wolfson

Positioning for the Future

In the summer of 2012, George Brown College (GBC) undertook a two-pronged, groundbreaking change: it relocated about 230 full-time academic faculty and staff and 3500 full-time students to a 320,000 square-foot facility―the George Brown College Waterfront Health Sciences Campus directly on Toronto’s harbourfront.

In parallel, the school is embarking on a multi-year initiative to incorporate Inter-professional Education (IPE) into its Health Sciences programs. IPE involves learning about, from and with other disciplines while learning in areas of common interest in the practice of health-care.  GBC is enabling graduates to be successful collaborators in health-care practice with the ultimate goal of improving patient outcomes. This cultural change toward interdisciplinary learning and teaching is a reflection of the demand in the Health Sciences professions for a more collaborative approach to the delivery of health-care. The move to the Waterfront Campus will be a key enabler for IPE at George Brown College.

GBC’s continued advancement presents both challenges and opportunities. To meet the growing need and demand for the Centre for Health Sciences, the College has undertaken the creation of a 320,000 square foot campus housing the Centre for Health. Currently, GBC’s Centre for Health Sciences is one of the largest programs in the community college system within the Province of Ontario in terms of student enrolment.

At George Brown College, the vision, first realized in 2003, identified the need for a more inter-professional education model to support an improved collaborative-practice approach in health-care delivery.  This vision is best expressed by the College:

  • To create a single-site Centre for Health Sciences building that embraces an inter-professional learning education framework with an emphasis on health
  • To create an environment that is vital and innovative for future generations of students

The new campus will bring together corporate and academic departments with both current and new staff who have previously not worked in the same location before. It will bring together four schools consisting of the School of Dental Health, School of Health and Wellness, School of Health Services Management, and School of Nursing to be at the forefront of the future health-care. It will also create an open work environment that will encourage many of the faculty and staff out of their private offices and into a large collaborative and inter-disciplinary workspace. The change is significant and groundbreaking.

The report, Building on Values: The Future of Health Care in Canada (2002), described the need for investing in more and differently-trained health-care providers. It cited a “crisis” in the health-care workforce―numbers are decreasing while the demand is increasing―and called for a review of how health-care providers are trained. The industry must move from a traditional profession-focused education to a more “patient-centred” approach.  This approach places an emphasis on team-based learning and understanding of the importance of “multidisciplinary teams and networks of providers working together to address patients’ health needs”.  In response to these new challenges and this sense of urgency in the health-care system, George Brown College has become a leader in driving this change.

Project Overview and First Steps

This case study recognizes three distinct phases to this major change initiative and will highlight the change management activities that are supporting the growth in George Brown College and in meeting the health and education needs not only for the City of Toronto, but across Canada.

Phase 1 set the foundation for a number of innovative opportunities and interventions to build the case for change.  Examples included renovating space for pilot collaboration and interactive use of learning technologies, creating newly integrated curriculum with faculty members from across departments and organizational governance changes to a single director for the Centre for Health Sciences.  By the time the funding was needed for Phase 2, the case for change was firmly supported. An external change management consultant joined the team in Phase 3 and further advanced the change management strategy and implementation plans by focusing on specific change management principles for continuous improvement and operational readiness.

The Project and Leadership Governance

The three phases to this project included advancing the vision through a lengthy process of developing, shaping and implementing the IPE curriculum and involving staff collaborating in new ways; secondly, the planning and design process addressing funding and approvals for a new campus to accomplish the vision; and finally focusing on the people readiness and move requirements associated with transitioning to this new campus.

In the early stages of the project there was an opportunity to build a foundation for managing the change, assessing how the impact would affect the people and the college through project sponsorship.  The need for an increased focus on managing this transformational change required strong leadership for the project to succeed, and a collaborative process initiated by project sponsors right from the beginning of the project has contributed to project success.  This commitment to managing the change, sponsorship and governance provided the guidance, decision making and accountabilities required for successful project implementation while balancing and coordinating the overall needs of the college.

A key change management challenge was leadership team involvement, communicating about the project, and being prepared to deal with concerns across the college.  Two separate but connecting teams, the Construction and Design/Structural Advisory Team created in Phase 2 and the Operational Readiness Chairs Committee created in Phase 3 and their governance structures, both reporting to the Waterfront Steering Committee and chaired by the President, provided oversight and governance to ensure alignment and inclusiveness of all groups, academic and non-academic. The Chairs of the Operational Readiness Committees ensured that key issues raised by the respective committees were addressed, aligned and that there was continuity across committees. The Waterfront Campus Governance Structure was a unique approach to ensure school interests and program success were met.

Expected challenges 

The project teams anticipated a number of potential issues that were to be addressed in the change management strategy, including:

  • Potential negative impact on the personal lives of faculty and staff resulting from new commuting patterns.
  • Concerns from some faculty and staff about changes to daily work routines and relocation from an office to open workspace environment.
  • Managing the integration of corporate and academic functions and work environments.
  • Managing the integration of Health Sciences programs delivery.
  • Establishing new business process changes and ensuring adoption of new policies and procedures.
  • Managing cultural changes from the amalgamation of smaller, more intimate groups, into a larger entity. This includes individual and organizational sense of identity and identification.
  • Managing work dynamics as individual’s spheres of influences, privileges, working relationships, and neighborly interactions are redefined.

Change management was recognized by the sponsors in the early stages of the project and addressed in many ways.  Developing an early communication strategy, working closely with academic staff in addressing the needed changes and incorporating them in the initial project design were implemented to support the vision and expected changes. 

Change Management Principles

The strategy for creating an appropriate and effective change management approach for this project was based on a number of guiding principles.

1. Understand the Change

Accurately characterizing the nature of the changes to be made was critical for the development of the Waterfront Campus Change Management Strategy. The relocation takes place within the broader context of a cultural shift towards IPE. Additionally, the physical move would have implications beyond an adjustment in space, such as the changes in business processes and commuting patterns.

2. Address Each Stakeholder Group

GBC‘s Centre for Health Sciences consists of four different Schools, with a number of programs within each of those Schools. The relocation would affect each differently, and each group would approach the move with a slightly differently organizational context. Recognizing and identifying the differences allowed the team to develop strategies that addressed these specific needs.

3. Ensure Comprehensive Levels of Engagement and Start Engagement Early

Change planning requires a large level of engagement with organizational leadership as well as with the individuals experiencing change. The engagement process started early and faculty and staff understood why changes would be started proactively so that their expectations could be managed and concerns addressed before they became a point of resistance. 

4. Leadership is Critical

Leadership played a critical role in this organizational change project, particularly in an academic environment where authority is decentralized. Leaders understood their role, visibly supported the project, and delivered key messages about the project when needed.  The change team had access to organizational leadership, and also provided coaching and guidance to leaders about what change support was needed and when.

5. Adapt Change Management Strategy to Project Phase

Stakeholders required different types of change management support before, during, and after the relocation. The Change Management Strategy recognized this and planned different approaches and activities as the project progressed.

Introducing a change management approach to organizational readiness

Preparing people for change, facilitating staff and faculty in understanding their new work environment, creating linkages to the vision for IPE, moving in the direction of the desired cultural transformation and moving to an integrated curriculum had been well underway by college leadership and project teams already in place.  Further change management emphasis and activities in Phase 3 focused on the organizational readiness to support the move to the Waterfront Campus:

  • An Organizational Diagnostic was conducted with the project sponsors, project team, and stakeholder representatives. The Diagnostic defined key stakeholder groups affected by the move examined the specific context of the move for each group, and determined risks or key change needs of each group.
  • A kick-off meeting with the project sponsors and project team was held to clarify expectations and boundaries for the change management strategy. The link between the relocation and the greater cultural change to IPE was a part of this discussion to define the integration required between both initiatives.
  • An assessment on the relocation, cultural change, and organizational structure of the Health Sciences programs, was undertaken.

Early Deliverables and Successes

Change management assessments of organizational readiness identified a number of positive accomplishments achieved over the course of the project:

  • Corporate and academic groups have been brought together from early stages of the project to ensure technology and academic spaces are aligned.  Traditionally these groups have not worked together; they are now planning and integrating collaboratively.
  • Engaged over 120 people in the process by integrating key groups in design decisions around creating spaces to collaborate and teach differently.
  • Through a process of engagement, best practices have been implemented for developing collaborative relationships between the architects, the planners, staff and faculty to “taste, feel and smell” what it is like to be part of a team.
  • Established significant partnerships where the sector meets education, including research, placements and sharing of expertise.
  • Met with key players to get advice on the space design and curriculum model.
  • Incorporated feedback that included need for cultural competencies, involvement of families in simulation scenarios, acknowledging health-care is delivered across the spectrum (health e-home environment).
  • Utilizing Prosci's ADKAR (Hiatt, 2006) model of Awareness, Desire, Knowledge, Ability, and Reinforcement, to confirm high scores indicating a strong understanding of the case for change and a reflection of the work accomplished in Phase 1 and 2.

Practical Implications

The GBC Waterfront campus project was undertaken to provide the efficiency and the effectiveness that consolidating programs at one location provides, allowing for growth, profiling space and revenue opportunity. A changing health-care industry, empowered students, new approaches in education and technological advancements have created an environment where change is becoming ‘business as usual.’ In this environment, GBC recognizes the importance of building the competency to rapidly and successfully meet new challenges:

  • That change is transformational not just transactional.
  • That all aspects of the project need to understand the vision. Events and actions may change but the vision remains constant.
  • Ensuring that everyone is engaged in the process whether they are moving or not.
  • The development of an extensive training initiative that brings key groups together to learn about the new teaching technologies that are built right into the campus. 

The GBC Waterfront campus project expects the eventual outcome of such change to be a transformed and renewed institution.  Though the college is in the midst of transformational change, leadership continues to create dialogue and participation so that both academic and corporate members can effectively understand and operate within new expectations that this change brings.

 

References

Hiatt, J.M. (2006). ADKAR: a Model for Change in Business, Government and our Community: How to Implement Successful Change in our Personal Lives and Professional Careers. Loveland, Colorado: Prosci Research. 

Romanow, R.J. (2002).  Building on Values: The Future of Health Care in Canada.  Final Report of the Commission on the Future of Health Care in Canada. Ottawa: Queen’s Printer. 

Waddell, T. (Ed). (2010). Framework for Action on Interprofessional Education and Collaborative Practice. Geneva, Switzerland: World Health Organization Press.

 

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