17. NOW – No One Waits – Transformational change from push to pull (panel)

During a remarkable large-scale initiative that became No One Waits (NOW), 2500 staff, physicians and Patient Experience Partners at Bluewater Health worked together to reduce their time to inpatient bed from 9.8 hours to a low of 3.5 hours over 18 months. As the work continues, the target of two hours to transition a patient anywhere within the hospital draws closer.

This panel will bring together three key leaders: a vice president, a project manager, and a nurse leader, to share key steps along the journey, with specific reference to how they fit the selected change frameworks of Kotter and Bridges. Throughout the discussion, presenters will discuss how building coalitions was vital for communicating, identifying, testing and implementing solutions.

Presenters will discuss this ambitious change initiative from the repeated surges in demand for hospital care and the acknowledgment that “This is not sustainable!” Three perspectives will be offered about key steps on the change journey: choosing a change framework; building engagement; developing specific priorities and goals; the importance of senior leader sponsorship; and navigating chaos. Presenters will reflect on the emotional challenges encountered along the way: how to gain the trust of staff, and reassure them that accountability to processes is supportive, not punitive.

The transformation journey, developed to transition patients quickly and safely to the right place of care, will be shared, including: creating a flex culture to match demand; implementing collaborative models of care for greater flexibility; using technology to improve patient flow; improving the efficiency of admission, transfer and discharge and leveraging community support to prevent hospital visits and reduce length of stay. Panelists will also make reference to steps in the change management journey itself. As a result, this panel presentation will be of interest to anyone who is contemplating a major change management initiative.

Vital lessons learned will be shared, including: the importance of putting staff and patient experience at the forefront, as they are interconnected; assuming positive intent: the approach needs to be supportive of staff, not punitive; time spent on the front line listening and understanding barriers was invaluable; and the LEAN philosophy was demonstrated as true: those who do the work know what improvements are needed.

Panelists will finish up addressing the future: the continuation of this change initiative; how it has set Bluewater Health up for success as it approaches the changes inherent in a shift to Ontario Health Teams; lessons that can be applied to wider system change, and how others can learn from their experience.


Kim Kraeft – Bluewater Health

Laurie Zimmer – Bluewater Health

Paula Riley – Bluewater Health



Julie Acker – Bluewater Health

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