Establishing a first-rate leadership model in a Surgery Program


The Challenge: Engage medical staff in leadership and decision making

In complex modern healthcare organizations it can be advantageous to find ways to engage medical staff in program administration. Such was the case at the New Brunswick Atlantic Health Sciences Corporation’s (AHSC) Surgery Program at the start of this project. There was a strong desire to engage staff more actively in program decision-making, problem solving and direction setting so that they could demonstrate more ownership and responsibility for program decisions.

The Improvement Project

Dr. James O’Brien, a Plastic Surgeon at Horizon Health Network, began by reviewing literature from the U.S and UK about engaging physicians in leadership. (Since this EXTRA improvement project was launched, AHSC has been incorporated into the Horizon Health Network). O’Brien and his team designed an improvement that included a comprehensive new governance model and administrative framework in which physicians and non-physicians were vital to decision-making. The project included establishing a Medical Director position for the Surgery Program. Also important to the project’s eventual success was a communication plan for key stakeholders, regular meetings with the Medical Director and Administrative Director to monitor progress, and the development of an evaluation framework. The project was comprehensive, embracing a philosophy of inclusion and collaboration.

The Result: Engaging physicians in a more action-oriented system

After researching evaluation tools for his improvement work, O’Brien learned that stakeholder focus groups would be the most appropriate tool. The responses O’Brien has received from the groups make it clear that the project has led to improvements. Some groups have responded “yes” to the question of whether physician engagement is now better with the new executive committee structure than under the previous system. Many interviewees have said the new system is “useful, effective and action-oriented”. Others have noted that surgeons feel they are being listened to in staff meetings.

The Impact: Improvements and key learnings to be rolled out across the health region

Simultaneous to O’Brien’s evaluation of the EXTRA improvement project, a multi-city and multi-program concept was initiated called the Clinical Program Network. The intention is to use these networks and the lessons learned from the surgical governance project to develop Horizon Health Network’s future governance structure.

James OBrien image


Dr. James O’Brien
Plastic Surgeon Horizon Health Network
Saint John, NB


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