Leaders play an essential role in transforming our healthcare system – and can learn a great deal from one another about this important job. For 20 years, the EXTRA: Executive Training Program has been supporting healthcare leaders and organizations across Canada to develop stronger leadership skills and improve quality and safety standards in their organizations.
Initially launched in 2004 by the former Canadian Health Services Research Foundation (CHSRF), the EXTRA program continued with the Canadian Foundation for Healthcare Improvement (CFHI) and now with Healthcare Excellence Canada (HEC).
Since its inception, more than 645 individuals have completed the bilingual, team-based leadership development program. These alumni form a powerful community who have leveraged the knowledge and capacity they developed through EXTRA to address complex challenges in their organizations.
The EXTRA program allowed us to develop our leadership skills and create synergy within our departments to achieve a common goal. The work we did, the things we learned, the discussions and team meetings we had – it all helped to strengthen our relationships and establish a clear position of frontline care within our organization. “
—Program alumnus
How it works
EXTRA participants, or fellows, work in groups of three to five leaders that include people with varied professional backgrounds as well as lived experience. A mix of in-personal and virtual learning formats is used, such as workshops, coaching sessions, site visits and webinars. This combination of approaches prepares fellows to drive lasting change.
Celebrating two decades of impact
For the 177 organizations who have participated in EXTRA to date, the program has a demonstrable impact on driving meaningful improvements across Canada's healthcare systems:
- Advancing Leadership: Since 2004, over 645 leaders have completed the EXTRA program, enhancing their capacity to address complex challenges within their organizations
- Driving System-Wide Change: A recent cohort reported that 83% of improvement teams achieved measurable enhancements in patient and resident health outcomes through their quality improvement projects.
- Creating Sustainable Solutions: Participants have implemented initiatives leading to significant outcomes, such as a 50% reduction in emergency room visits for 70% of frequent emergency department users.
- Strengthening Cross-Sector Collaboration: Teams have successfully improved communication flows between hospitals and community services, fostering better integration and patient care continuity.
Project spotlight: Collaboration in Quebec
Two teams from previous EXTRA cohorts, Centre hospitalier universitaire de Québec Université Laval (Cohort 15) and CISSS de Chaudière-Appalaches (Cohort 13), worked on reducing the logistics workload among nurses to improve care and patient experience. Both teams are now collaborating to sustain, spread and scale their improvement projects. This cooperation has strengthened access to a wide range of resources, including technology, funding and strategic partnerships. In this way, collaboration between two healthcare institutions becomes a driving force and key to success, offering transformative potential for improving access to care. Promising results include:
- 1.9 clinical hours liberated for every hour of logistics support provided
- more time spent with patients
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increased satisfaction of patients, families and providers
EXTRA improvement projects have also led to new programming at HEC. Our Appropriate Use of Antipsychotics (AUA) approach, which supports long-term care homes to safely deprescribe antipsychotics for people living with dementia, was first identified through EXTRA. We then partnered with long-term care homes and provinces across Canada to spread the approach to hundreds of long-term care homes through a series of national and provincial collaboratives.
We continued to build upon the AUA approach with our Sparking Change in the Appropriate Use of Antipsychotics Awards Program, which provides relevant resources, coaching and financial award opportunities to up to 500 teams in long-term care settings.
Recognizing excellence in health system improvement
To honor outstanding achievements, the EXTRA program sponsors two awards in each graduating cohort: the Naimark Fellow Award is an individual award recognizing professional excellence among health system leaders in Canada, and the Rochon Award is a team award presented to the EXTRA fellowship team whose improvement project will best improve population health and demonstrates early readiness for spread.
Award spotlight: Crisis intervention
The Centre intégré de santé et de services sociaux de la Montérégie-Est team (Cohort 17) won the 2022 Rochon Award for the project that will best improve population health and that demonstrates readiness for spread. The team worked with patients, providers and community organizations including the police, to design innovative crisis-intervention services adapted for the diverse populations they serve. Promising results include:
- 25 percent of crisis intervention services done closer to home and community
- 8 to 10 percent decrease in non-urgent hospital visits
- reduced average time of police intervention
- more than 90 percent provider, partner and staff satisfaction
Join a Legacy of Leadership
Ready to elevate your leadership and create a lasting impact on the healthcare system?
Applications for EXTRA Cohort 20 are now open! Apply by June 18, 2025, and be part of this transformative program.
