AHS chair wants hospitals to make more decisions

The new chairman of Alberta Health Services wants local hospitals to make more decisions, a move that's being tested in a pilot project at Rockyview Hospital in Calgary.

AHS planning major structural changes following pilot project at Calgary hospital

The chairman of AHS wants hospitals to start making decisions again 2:50

The new chairman of Alberta Health Services wants local hospitals to make more decisions, a move that's being tested in a pilot project at Rockyview Hospital in Calgary, CBC has learned.

Stephen Lockwood says he has the full backing of the province to move some of the decision-making out of the corporate offices.

"You're going to get a lot quicker decision. And to me, quicker decisions means happier employees. They're now engaged," he said in an exclusive interview.

"Their morale will be better, they'll feel more part of the organization. You'll also have patients that are getting answers quicker so I think they go hand-in-hand."

Lockwood unveiled the new management scheme earlier this month at a meeting in Calgary attended by about 100 senior AHS executives.

One manager, who spoke on condition of anonymity, said many were in shock after the meeting and wondered who was in charge, the AHS executive or Lockwood and the board of governors.

"It’s asinine," the manager said. "We just get things in order and this will throw everything into chaos again."

The manager said Lockwood told the meeting every hospital, every facility will have its own site-based management. But it’s not immediately clear whether this decision making will extend to areas that have been centralized in recent years.

Other frontline medical staff welcomed the news.  

"For full agility, and adept response to patient needs, that has to happen on a local basis," said Dr. Lloyd Maybaum from the Calgary Physicians' Association.  

"Each hospital has slightly different issues and nuances and we need to have the ability and flexibility to respond to those kinds of demands and concerns."

Moving away from centralized model

With this pilot project, AHS appears to be moving away from the centralized model that was created in 2008 when the province eliminated the nine health regions in favour of the single, province-wide board.

In an internal AHS memo obtained by CBC News, chief executive officer Dr. Chris Eagle told staff the changes will support, "local decision making, allowing leaders the freedom and accountability to lead, and simplifying the health system by seeing it through the eyes of patients and communities."

Eagle however, offers no details saying, "that would defeat the purpose of allowing leaders at every level at (Rockyview General Hospital) to create a model from the ground up."

But he said that, "in a nutshell, what is changing is the way we make decisions and take action. Decisions should not be passed up and down the AHS organization chart. That is bureaucracy.

"Decisions will be made as close as possible to where health care is delivered, many at the level of a self-managed operating unit. How is an operating unit defined? That’s part of the discussion and the debate." 

Former AHS executive shocked by proposals

Shown the internal AHS memo, one former senior Alberta Health Services executive, who also spoke on condition of anonymity, said the policy change was "unbelievable," and represented "a huge step backwards."

"If you want to look at the best healthcare practices in Canada, the best healthcare practices in North America, the best healthcare practices anywhere in the world, this is not the model," the executive said.

Centralization of support services, such as purchasing, is widely accepted as the best way to reduce costs.

"You want to achieve the lowest possible administrative costs to be able to allocate the highest possible spending on patient care," the former executive said.

Not all decisions will be made locally, Lockwood said. The corporate office and the regional zones will still play a role.

"Decisions that need to be made at the zone, they will retain those; and things that need to be done at ... the corporate office, they will stay at that office," he said.

Moving to a single board hasn't saved money or improved health care, said Sandra Azocar, executive director of the Friends of Medicare. She says millions of dollars were spent on employee severance and on the costs of centralizing administration.

"The four years that we've had of this experiment has not worked," she said.

"We have not seen a decrease in healthcare expenditures," said Azocar. "There's no transparency, no accountability. We're not definitely seeing any improvement. So where is this money going?"

With files from the CBC's Kim Trynacity and Charles Rusnell