June 26, 2012 Dartmouth, NS

Rest, Reflect, Recover, Share

Protocol Half-Time

Welcome & Frame

Moving Up the Field

the health equity protocol and develop next steps for the next part of the process).

Brent will be looking to see how this is addressed in the protocols particularly in CDPC and EH. Over the summer, Brent will produce a refined product. Just as with the Standards, it is not clear at this point what the refined product will look like and thats OK (weve been in similar situations before).

EH (A-Team) Team Environmental Health

TEAMS SWAP

Teams hand over materials to Brent

In this phase of work, the protocol teams developed the raw material required for the protocols. On Monday, each team gave Brent a copy of their raw material. At first glance, each set of raw materials for each area of focus is very different and that was expected. After a quick review of the raw material, Brent shared his thoughts with the group: Todays football analogy is appropriate. While football highlights often show the exciting throws and catches and touchdowns, the reality is that the game is won in the trenches where things can be quite brutal and there is a real fight to gain ground. Tough decisions and difficult conversations arose during Standards which we consciously deferred to the protocol stage. We had a tough challenge with tight timelines and we delivered and moved the yardsticks farther down the field. The foundational standards didnt require protocol development. Specifically, workforce development is better addressed through a strategy; infrastructure is better addressed through ongoing processes in follow-up to the renewal report; and emergency management is less clear so

REST & RECOVER

Take Stock & Celebrate

In keeping with the football analogy from April, today is the half time show in the development of protocols for public health in Nova Scotia! The development work is strategic, being done play by play so we can move the ball up the field one play at a time, moving strategically towards the goal posts. The purpose of the half-time show is for teams to swap ends of the field of play (i.e. share the work); allow teams to rest briefly and recover from the play of first half (i.e. celebrate what we've accomplished so far); to reflect on controversial incidents or exceptional play (i.e. hear team keys stories, insights and highlights) and to analyze the game (i.e. refine

Through this intense process over the past two months, weve built on previous work done in public health as we developed detail about how and what we do. The detail of the protocols is future focused which meant at times we were working in a grey zone. Although we were challenged by time and the process, we got lots done in a short time and the protocols have potential for huge impact in our system.

Team Awards: To celebrate the time, effort, thinking and commitment that went into this Phase of work, we took a moment to recognize the teams of people who made this possible.

Most Chill Team CDPC Most Metaphors Team Healthy Communities Most Therapeutic Team Healthy Development Triple Threat Team -- Understanding

REFLECThighlights & ANALYZE Stories, insights and

REFLECThighlights & ANALYZE Stories, insights and

Every great story has a beginning, middle and an end and usually a challenge at the core. The protocol teams stories were no different! Hearing each story allowed us to deeply connect with and learn from the experience of others. Each team shared their story, insights and highlights from their work. From these stories we learned about connections (where there are intersections with another protocol or touch points with other standards); key learnings (insights and ahas); challenges and hard hits; and where they landed (organizing framework about how they thought about the work). Some of the nuggets included: The framework was challenging at times, had to make it fit. Once teams got clumps figured out, it allowed them to go forward. Getting going was a challenge; large groups were more challenging to organize. Some teams landed more on how we do the work not the what. Others had to let go to let grow. The work was too detailed at times, had to move more up stream. How to dream big while being realistic and practical. It was difficult to balance enforcement roles versus more newer collaborative approach. The focus clearly was on intended populations (children, youth, families, etc.). Language was important. Structure was not a constraint. Staying true to the principles and agreements of team to draw us back to the centre. Connecting with the other protocol teams was important. Importance of hosting was highlighted. Facilitators of connection intention, goal and purpose of the team, common understanding of the work, hospitality fostered connection. The role of the questioner on the teams and the overall diversity among the teams was helpful. The process was a challenge but also a gift.

NEXTWhats Next PHASE 4 STEPS Strategizing

Phase 1: Develop the Framework
December 15, 2011

Phase 2: Design the Work Process

January 13, 2012

Phase 3: Apply the Framework

April to June 2012

Phase 4: Draft the Protocols

June 2012 onwards

Refining the Health Equity Foundational Requirement

Lynn Langille presented a draft health equity lens for the group to review. The questions in the draft lens spoke to staff at the session and people suggested a need to balance the questions between the general and the specific. Overall, people felt that a tool/lens would be helpful for implementation of the protocols and recognized that different tools for different levels of the system may be helpful. There was a sense in the room that a tool/lens could be used for planning and priority setting. We need to think about the health equity lens questions across the departments (government, agencies, local, provincial, regional) that we partner with to support health equity. This will make the difference. It is not yet clear if the lens should be a separate document or embedded in the protocols of if we need to use/incorporate existing tools such as Community Development Policy and Food Security Lens. With Lynns guidance, a group of people have stepped forward to refine the lens.

What weve learned from the Standards that we can apply to moving forward with Protocols We need a system approach with intentional direction involving multiple levels of engagement system, PHSLT, managers, regional. An inconsistent roll out is to be avoided. Getting feedback is important and getting feedback at different stages is critical in the process, with feedback being a collective, not individual process. Being clear on the request the givens and expectations will be necessary as well as being able to see package all together, not just a portion. Engaging staff along the way was also emphasized. Staff need to understand how we got here so intentional sharing and preparing the ground is needed. Providing a supportive environment which allows people to see and do the work outlined in the Protocols will help shift the mindset from Protocols being a product to Protocols being our practice. Part of building this understanding and support should include sensitizing the CEOs/VPs/Executive, as well as meeting with Primary Care and engaging partners who will be impacted early and often by sharing where PH is with stakeholders. We need to use simple language. A system (local and provincial) team which shares and engages around the protocols would be helpful.

The Stories of the Protocol Teams

Protocols Half-Time Show