Case studies

West Park Healthcare Centre, an RNAO BPSO, is a rehabilitation and complex care centre in Toronto, Canada. They applied a compelling call to action to implement these RNAO BPGs: Assessment and Management of Pain, Client Centred Care and Prevention of Falls and Fall Injuries in the Older Adult. 

With support from senior leadership, interprofessional change teams – including nurse leaders, such as advanced practice nurses and nurse practitioners – were responsible for leading the implementation strategies, which included taking collective action. Implementation efforts focused on engaging in quality improvement measures, promoting the culture and values of evidence-based practice and aligning their implementation efforts to the organization’s culture and values. 

As members of the implementation teams, the nurse leaders were influencers who aimed to build collaborative and committed relationships amongst the interprofessional team and create a work environment that empowered staff to take evidence-based action. The team embraced diverse perspectives and knowledge to allow for adaptations to the local context.     

Central West Specialized Developmental Services (CWSDS) is a pre-designate Best Practice Spotlight Organization® (BPSO®.) During the BPSO pre-designation process, the CWSDS change team has built a strong core leadership structure to support the implementation of best practices, by including both formal and informal leaders.

The CWSDS change team relied on the following strategies to build a strong core leadership structure:

CWSDS’s RNAO-BPSO organizational structure. Figure provided with permission by CWSDS.

• embedding the RNAO BPSO pre-designation process within the organization’s strategic plan.
• emphasizing the interprofessional nature of the initiative by encouraging professionals from all disciplines to become involved.
• engaging an interprofessional team of stakeholders within the organization with the change, including direct support professionals, managers, food services, human resources staff, and members of the communication and information technology teams.
• encouraging stakeholders to become trained RNAO Best Practice Champions and to participate in RNAO events.
• making sure all stakeholders were informed and involved in the change initiative (by, for example, providing updates during managerial meetings and including stakeholders in completing gap analyses.)
• supporting Best Practice Champions in leading best practice guideline (BPG) implementation alongside the BPSO Steering Committee.

As a result of the change team’s work to build a core leadership structure, they were able to tailor the implementation of BPGs toward daily clinical problems relevant to their direct support professionals. This increased recognition of and support for their change initiative.

To learn more about CWSDS’s BPG implementation journey, watch their 38-minute webinar: Collective Strength in Action: How to Promote and Implement Best Practice Guidelines. 

In Quebec, Canada, community groups and researchers participated in a network using social movement approaches for the Kahnawake Schools Diabetes Prevention Project. In the early phase of the social movement, the network supported capacity building and collaboration of the community members. As the movement evolved, the network strengthened alliances among the community members and their shared decision-making. It also supported the program’s expansion to more children. At the conclusion of the project, the network supported the emerging leadership of the community partners (Tremblay et al., 2018).