DWHLI and CNA celebrate their partnership and plan 2016 events

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Earlier this month Judith Skelton Green, Julia Scott and I sat down with Anne Sutherland Boal, CEO of the Canadian Nurses Association, and Carolyn Pullen, Director of Policy, Advocacy and Strategy to put the final touches to our partnership agreement to offer together our 27th Leadership Institute.

Dorothy Wylie, retired Professor of Leadership at University of Toronto Nursing, after whom the Institute is named, and Karima Velji, President of CNA, joined us for dinner and celebratory toasts.

A few collaborative events are scheduled for 2016. In February we will offer a webinar about leadership competencies for health care professionals, and their importance in today’s complex and rapidly transforming environments.

We are hard at work designing a leadership workshop for participants at CNA’s Biennium in June in St John’s NB. In October we will offer our 27th week-long Institute with CNA. We are thoroughly enjoying our collaboration – truly a “meeting of the minds” – as we are very much on the same page about the value and importance of leadership at every level and in every discipline providing healthcare today.

Self Organizing on First Day in the Polyclinic

I had been anticipating my first day at the Polyclinic and had some natural apprehensions. Where to go and how to get there on the subway and then streetcar? How much time to allow? How to find the Workforce Entrance Gate on that huge perimeter of the Athlete’s Village? Would I know what to do at the clinic? What would my colleagues be like? Did I have all the necessary badges and uniform parts? Really helpful to have had the Olympics experience! (See earlier blogs on this site).

On arrival Day 1, I realized I was not alone with my questions. As a dozen or so of us gathered in the entrance hall to find out what’s next, I could sense there were many others who felt the same way. A brief welcome by the leaders who had been working for months and even years to plan for this day, and a quick tour of the facility, and it was “let’s get to work to get this place setup and operational”.

Teams self-organized in minutes to get at the jobs. Some got busy setting up lines on the floor to direct people to different stations (ER, Pharmacy, Family Medicine, Sports Rehab and Specialty Clinics, which included Radiology, Ultrasound and MRI). Others began to get reception desks and appointment books ready for action.

One of my jobs that day was to count and organize splints and braces, setup a cart with a sample of each, and store the others for easy access. The storage room looked like this! IMG_4405

The athletes weren’t in the Village yet so we had some time to get organized but teams were starting to come in soon. It was Game On to be ready.

The Polyclinic as a Complex Adaptive Human System

As well as supporting my country and city – and the benefits of international Sport in general – I love my volunteer gigs at the Games (2010 Olympics and 2015 PanAms) for 3 main reasons: i) it keeps me in touch with what’s new and different in clinical practice in healthcare; ii) helps me understand how younger, newer practitioners are the same or different from my demographic group, and iii) fuels my curiosity and understanding of complex human systems and how they operate and learn.

Thus this blog, which I’m using as a personal discipline to categorize my learning in some meaningful way. Putting pen to paper – actually fingers to keyboard – forces me to clarify for myself, and for you the reader, some of what is swirling in my head about systems, how they develop, learn and change, and hopefully continue to grow and improve.

I love watching complex adaptive systems in action – how the many parts of a rich, intricate and complicated system make the whole, how the system’s purpose – in this case to provide welcoming, meaningful healthIMG_4408care to the athletes and team members of the Toronto Pan Am Games – is played out by hundreds of people learning how to work in concert with others to make it happen.

The Polyclinic pictured here is a temporary structure located in the centre of the Athletes Village in the Donlands in Toronto. It is surrounded by Athletes’ living areas that will be turned into beautiful condos after the Games. It is a really nice part of town, easily accessible public transportation, easy access to lots of great spaces, with a brand new YMCA on site, and I’m told most of the condos are already sold.

Volunteering in the Polyclinic Pan Am Games Toronto 2015

Canada Day was my first volunteer shift in the Polyclinic in the PanAm Athletes Village Polyclinic. If you don’t know what a Polyclinic is, you’re not alone. My understanding is that it is a European term that denotes a health/medical clinic that provides a wide variety of services – thus “poly” from the Greek meaning “many”. In this case, many services.

The PanAm Polyclinic provides all kinds of services from Family Medicine to a fully-stocked ER, Specialty Services such as Dermatology, Cardiology, Dental, Optometry – Bochner Eye Institute and Loblaws are donating time, expertise and hundreds of pairs of glasses for the teams – and of course, full Sports Rehab Services (Physio, Massage, Chiropractic, and Sports Medicine, Physiatry).

There is also a Public Health office staffed with City of Toronto nurses to deal with any outbreaks or other public health concerns – there are thousands of condoms on all the services desks for the taking – they are snapped up quietly by many – and not just the athletes!

I am one of 3000 volunteers in the Health/Medical Services at the Polyclinic and the many Competition Venues and Fields of Play across the Games. There are about 6500 participating athletes from 41 different Pan American countries, competing in 36 different sports.

Planning has been in the works for 6 years and has involved 16 different communities surrounding Toronto the north, west and east. According to the Chief Chef for the Games, 500,000 meals will be served in the Athletes’ Village alone. These Games are the largest multi-sport event ever hosted in Canada. The cost for public security and traffic management is in the neighbourhood of $250M.

If you watched the Opening Ceremonies Friday night – or better still were actually there, you’ll know that it’s all very exciting for Toronto!

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Thinking about Occam’s Razor

While watching an episode of Madame Secretary the other night, I was interested to hear the main character mention Occam’s Razor as she wrestled with a complex issue and the need to get at the variables, understand them and make decisions about how to proceed. Knowing my interest in complexity and complex adaptive systems (CAS) theory, a friend told me about Occam’s Razor awhile ago. I had never come across it before, despite lots of reading about complexity and complex systems – obviously not reading the right things, Ann! Thanks.

Wikipedia tells us that Occam’s Razor (which is also sometimes written as Ockham’s Razor) is a problem-solving principle devised by William of Ockham in the 13th C – believe it or not. William was a respected English Franciscan friar, philosopher and theologian.

The principle of Occam’s Razor states that among competing hypotheses which predict equally well, the one with the fewest assumptions should be selected. Other, more complicated solutions may ultimately prove to provide better predictions, but—in the absence of major differences – the fewer assumptions that are made, the better – according to the theory.

Called also the Law of Parsimony, it tells us to KISS or keep it simple, and not over-complicate. This of course makes a lot of sense and it also reminds us to quantify, qualify and verify our assumptions. Wikipedia goes on to say “ For each accepted explanation of a phenomenon, there is always an infinite number of possible and more complex alternatives, because one can always burden failing explanations with ad hoc hypothesis to prevent them from being falsified; therefore, simpler theories are preferable to more complex ones because they are better testable and falsifiable.”

The fact that we are still considering William of Ockham’s ideas, 7 centuries later boggles the mind, and makes me question how much more we know or don’t know today than we did centuries ago.

It also makes me wonder about the fit between Occam’s Razor and complex adaptive systems’ theory. This is for another time.