Peel Region Public Health Department (ON)

  • Beverley Bryant, Manager, Education and Research, Peel Region Public Health Department, Brampton, Ontario

Workforce Development at Peel Public Health

This intervention explores how a fundamental change is embedded in a large organization with a diverse workforce. The organization, Peel Public Health, is a local public health authority with over 700 employees. This workforce is comprised of employees of several professional designations, hierarchical layers and differing roles and responsibilities. The change is a mandate to fully understand and apply key principles of public health practice, known internally as The Public Health Way and within that, to systematically use research evidence in program and practice decisions. These layered changes have created a tension at the front line. On one hand, staff have experienced confusion, apprehension and frustration, as well as a lack of understanding of the meaning of the change. On the other, they are enthusiastic and motivated about the changes which are occurring. The goal of this project is to design an intervention to build, in all staff, the knowledge and skills needed to function in this new environment. Ultimately, the goal is to increase comfort with on-going, large-scale organizational change.

Normalization Process Theory was used as a theoretical framework for conceptualizing the issues and planning the intervention. The theory brings to light the particular importance of ‘sense-making,’ the process of creating a coherent story so that all personnel have an understanding of the drivers of the change. A second element of the theory is the importance of bringing clarity to changes in employee’s roles as a result of the change. Individuals, teams, supervisors and managers must at times re-design whole workflows, change the way various team members inter-relate, and reassign responsibilities.

Supervisors and managers have been identified in previous internal Peel Public Health studies as being a trusted and reliable source of information for staff. Peel Public Health employees need their immediate supervisors to provide context, interpret their environment and be able to explain the rationale and impact of planned change.

A two day training session, known as the Leadership Bootcamp, was the primary intervention for the project. Over 80 participants spent two days in didactic and interactive sessions, exploring the concepts of The Public Health Way, Evidence-Informed Decision Making (EIDM) and Managing Change. Senior leaders, including the Medical Officer of Health, spent hours of face time with the participants, discussing key points, dealing with issues and concerns and building common understanding among the leaders. Key outcomes of this work, demonstrated in a pre and post survey, were increased understanding of The Public Health Way and EIDM and an increase in overall understanding of how all of the changes fit together.

In the second day of the training the leaders participated in a workshop designed to identify key knowledge and skills they believe necessary to not only survive, but to thrive in this changing world. These results form the basis for further workforce development, related not only to The Public Health Way and EIDM, but also to Program Planning and Evaluation, further work on Change Management as well as facility with the use of data and numeracy skills.

This Intervention Project reinforced the essential role of Peel Public Health’s middle management in supporting and interpreting organizational changes. In addition, the importance of setting the stage with senior management and gaining ‘buy-in’ was highlighted as we sought to commit over 80 management staff during the two day process. Finally the use of theory was found to be an important guiding factor, allowing this complex process to be segmented into meaningful parts in order to focus our activity.