Full Report

As a result, standardized evaluative tools and
processes for CDM initiatives need to be established
at the outset of work and carried out in a consistent
manner throughout the project. 27 A continuous
quality improvement loop enables practice teams to
measure performance, identify gaps in care and make
incremental, evidence-based practice adjustments.
Resource availability
The pilot projects were undertaken mostly by current
staff who took on additional tasks and responsibilities
with limited additional funding. Although the lack of
financial resources, time and staff impeded pilot project
implementation, these shortages may pose proportionately
greater obstacles to the scale and spread of the
improvement work. If improvement is indeed a priority,
it should be reflected in resource allocation.
Building leadership capacity
Strong and committed leadership is essential to
address challenges and carry out successful change.
According to Kotter, 28 such leadership involves:
• creating a climate for change by creating a vision,
establishing a sense of urgency, and forming a
powerful guiding coalition
• enabling change by engaging stakeholders,
communicating the vision, empowering change
agents and creating short-term wins
• consolidating incremental improvements to achieve
greater change and institutionalize new approaches
This evaluation shows NWT has the CDM vision,
the engaged stakeholders and the short-term wins.
Through its emerging integrated CDM strategy, the
Department now looks to reaffirm the project’s sense
of urgency, strengthen its guiding coalition, clearly
communicate its vision, identify change agents and
empower local champions by removing obstacles
and allocating appropriate resources. Institutionalized
change will be secured as improvements accrue and
staff adopt new tools and approaches as standard
components of patient care.
Making the Case for Change
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