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Dr. Joshua Tepper and Gail Paech

Change Day 2018 – Building on a Good Thing

Change is not a one-time event. It is not a box you can check off and then move on.

Health care systems can be changed and made better, but the prospect can be overwhelming. However, as individuals we can all commit to changing something we do for the better and making a difference at the local level.

Which is why the Change Day Ontario campaign will take place for the second consecutive year from Sept. 13 to Nov. 22 with the sponsorship of Health Quality Ontario and AMS Healthcare.

Last year’s Change Day campaign was a tremendous success, demonstrating the commitment of those working in Ontario’s health care system to make individual or group commitments to improve the compassionate care they provide.

During that campaign, 6,092 pledges for change were posted on the Change Day Ontario website from across the province from multiple sectors and from a wide range of people including frontline staff, administrative workers, health system volunteers, patients, families, students and others. More than just numbers, an assessment of last year’s program in May demonstrated a significant number of those making pledges had followed through on them.

In addition, 52 organizations, agencies and associations partnered with us to get the word out about Change Day Ontario and 372 individuals acted as ambassadors and encouraged others to get involved, make pledges and act on them.

Beginning in the United Kingdom’s National Health Service five years ago, Change Day has since been embraced by many countries and it has become a global movement. In Canada, in addition to Ontario, Change Day occurs in British Columbia, Alberta and Saskatchewan. Change Day inspires people to identify changes that will improve the quality of health and care locally, empowers people to realize that they have the potential to make these changes happen and mobilizes people to make improvements.

Pledges were as varied and creative as those involved in our health care system. A couple of examples:

An occupational therapist at St. Michael’s hospital talked of her pledge to give elderly patients the ability to take ownership of their own health-care goals: “I remember an elderly patient who never wanted to get out of bed for rehab, even though mobilization was important to his recovery. We took the time to get to know him, his preferences and his routines, and discovered he loved drinking coffee. Not just any coffee: Tim Hortons coffee! So, every day, we walked together to get his coffee, and that walk became part of his rehab.”

I pledge to take the time to escort a lost patient or visitor to the place they are looking for; I would take this opportunity to talk with them to ask if they have suggestions of improvements or would like me to thank a colleague for them. Individual Pledge, Montfort (translated from French)

Achieving significant change in any health care system is a challenge, as was eloquently explained in a commentary published in the BMJ earlier this year, by Australian quality expert Jeffrey Braithwaite, professor of health systems research. However, despite the resistance of health care systems to change and the challenges to implementing change, Braithwaite noted individuals can have a major impact.  “Change is accepted when people are involved in the decisions and activities that affect them …” he said.

“Those on the frontline of care (clinicians, staff, patients) navigate change through their small part of the system, adjusting to their local circumstances, and responding to their own interests rather than to top down instructions. …All meaningful improvement is local, centred on natural networks of clinicians and patients. One size fits all templates of change … too often fail. We must encourage ideas from many sources; care processes and outcomes will vary whatever we do.”

All of this speaks to the value if not the necessity of involving everybody in bringing meaningful change to Ontario’s health care system and to the power of a movement like Change Day Ontario.

Once again, this year, we are asking people to pledge to do something personally meaningful for themselves, for those they care for, or for their team or organization, all in the spirit of building a better and more compassionate healthcare system.

Make a pledge between Sept. 13 and Nov. 22.  Your involvement can truly make a difference and can inspire others to make a pledge too.

You can learn more about Change Day at  And remember to join us in a tweet chat on November 22 as we celebrate our pledges across the province and successes.

Dr. Joshua Tepper is CEO of Health Quality Ontario. Gail Paech is CEO of AMS Healthcare (@AMSHealthcare)


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