Mapping the Chronic Care Experience and Applying Theory of Change Thinking for Healthcare Improvement

Held April 17, 2013


One in two Canadians is living with a chronic disease. That’s 16 million people or roughly half of the population of Canada, with one in seven having a “high-impact, high-prevalence” chronic illness. But healthcare in Canada was largely designed to treat acute episodes of illness, not chronic conditions. How can we move toward a more active and organized response for the management of chronic diseases in Canada?

This session of Improvement On Call will introduce an approach to mapping the current chronic care experience and applying theory of change thinking toward healthcare improvement. It will also share the experience of a healthcare leader who has undertaken this approach in the redesign of the CSSS des Sommets service delivery model toward a population based approach to improve quality of life for “chronically ill” patients – 5% of the population, consuming 85% of all healthcare resources – and, ultimately to improve how they use health services in the region.

On April 17th and 18th , 2013 join CFHI, Francois Champagne, Professor of health care management, health policy and health care evaluation in the Department of Health Administration, Groupe de recherche interdisciplinaire en santé (GRIS), and France Laframboise, Nurse Executive, Centre de santé et de services sociaux des Sommets for a discussion on developing and executing a theory of change for healthcare improvement in chronic disease care. Plus, join the live interactive discussion about how participants can apply lessons on adapting and applying the theory of change approach in their own organization.


Theory of change development is central to understanding the long-term goals of improvement efforts, clarifying the purpose of healthcare improvement with a simple illustration of problem(s), solution(s) and outcome(s) (doing WHAT, to WHOM, WHY and with WHAT RESULTS?). Led by a change management expert in healthcare and hearing first-hand from a healthcare decision maker, by the end of the session participants will understand:

• How to use a series of probing questions to apply the theory of change approach to map and clarify their healthcare improvement efforts.

• How this approach can be applied in a health and social services region context and with what results.

Guest Speakers:

Francois Champagne imageFrancois Champagne Dr. François Champagne is full professor of health care management, health policy and health care evaluation in the Department of Health Administration, researcher in the Groupe de recherche interdisciplinaire en santé (GRIS), and collaborator in the Unité de santé internationale at the Faculty of Medicine, Université de Montréal where he was program director for the Ph.D. in Health Care Organization (Public Health) from 1986 to 2000 and was director of the Groupe de recherche interdisciplinaire en santé from 1993 to 1997. Dr. Champagne was a FRSQ research scholar from 1983 to 1994. He has published books in French, English, Spanish and Portuguese on epidemiology in health services management, research methods, evaluation, quality assurance, and health care organization performance. His current research interests are in the area of strategic management, interorganizational networks, integrated delivery systems, organizational performance and the use of evidence in management. He was one of the co-leaders of HEALNet, a Canadian network of centres of excellence dedicated to research on optimizing the use of research funding to improve decisions in the health system. Since 1976, he has repeatedly acted as a consultant to health care organizations and governments in Canada, France, Africa, Brazil, Haïti, the United States and China.

France LaFramboise imageFrance LaframboiseA nurse by training, Mrs. Laframboise has 25 years of experience in healthcare management, in particular at the Hôpital du Sacré-Cœur in Montréal from 1987 to 2001. She also served as Director of the Quality of Care and Services at the Des Sommets health and social service centre from 2004 to 2009. There she played a role of transformational leadership towards teams of clinicians and managers in the adoption of modern changes to practices and management methods. Together with the EXTRA program, she has worked actively on introducing complex case management nursing for large consumers of care and individuals suffering from comorbidity in the Des Sommets territory through the Health Challenge project. This project is recognized by the MSSS, the AQESSS and the Commissaire à la santé du Québec and is deployed in more than 45 health and social service centres, university hospital centres and affiliated hospital centres in Québec and beyond. With the support of integrated clinical data, she currently serves as Assistant Director of Clinical Services at MMT, where she advocates the adoption of new ways of thinking and of doing things in order to achieve the proactive and integrated management of chronic conditions in the community. Her active involvement and her reflective approach are applied at many levels, to the planning, execution and assessment of strategic and operational actions that support superior clinical performance and advanced integration of care and services within the system. She sits on the Board of Directors of the ASSS and chairs the care and services performance and planning committee that reports to the Board of Directors of the Laurentides region. She also sits on the boards of the Ordre des infirmières et infirmiers du Québec and the Ordre régional des infirmières et infirmiers de Laurentides-Lanaudière. She was a fellow of the prestigious national EXTRA program, and is a graduate of the International Masters for Health Leadership program. She will complete a certificate program in crown corporation governance in 2014. She is a lecturer on the quality of care at Université du Québec en Outaouais.

Guest Moderator:

Armand Boudreau imageArmand Boudreau Mr. Boudreau has worked in the health and social services field as a professional, a manager, a senior executive and a consultant for more than thirty five years. He is recognized for his abilities in strategic settings and in developing partnerships with organizations that share the same objectives but have at times very divergent interests.

Mr. Boudreau not only has an excellent understanding of the issues and operational imperatives of the health system, he also is well known by health officials at the local, regional, provincial and federal levels of the Canadian system. He is fluent and works effectively in both French and English. Mr. Boudreau has worked as a senior executive in the health system for over twenty years. His most recent executive position was that of CEO of the Régie de la santé et des services de l’Outaouais. This regional health authority has since become the Agence de la santé et des services sociaux de l’Outaouais.

He has been active as a management consultant since 2002. He offers a variety of services from strategic planning and coaching, to organizational diagnostics and organizational development. He is also involved in the development and implementation of various projects. Mr. Boudreau has directed the development of a national organization dedicated to the improvement of quality health care to Francophone communities in a minority situation in Canada. As the first CEO of this organization he directed the implementation of seventeen networks in the country. He promoted an approach based on collaboration and community participation which led to an official accreditation of many of the seventeen French Language Health Services Networks by a number of provincial governments.

Mr. Boudreau has Masters Degrees in Social Work and Public Administration. He began his career as a social worker and manager in Northern Ontario and then moved into the Québec system as a senior executive.

Mr. Boudreau is also interested in health services research which led him to participate in the creation of the Canadian Center for Analysis of Regionalization and Health (CCARH). He was Chair of the Center for the five years of its existence. He has also been involved quite extensively with the Canadian Health Services Research Foundation (CHSRF) as a consultant to the design and development of the EXTRA program. He continues to be involved with the EXTRA program as an Organizational Project Coach for the Quebec Fellowship Teams.