Program overview :

EXTRA™ Cohort 19 (2024): Fellowship Teams

Canadian Health Leadership Network

Fellowship team

  • Dawn Thomas, Vice President Indigenous Health and Diversity, Equity and Inclusion, Island Health
  • Kelly Grimes, CEO, The Canadian Health Leadership Network
  • Reagan Bartel, Director of Health, Otipemisiwak Métis Government, Métis Nation of Alberta (MNA)
  • Steve Kovacic, Vice President, Chief Human Resources Officer and Reconciliation, The Good Samaritan Society

Project title: Listening and learning from Indigenous health leaders to create a culturally safe space that strengthens recruitment and retention

The Canadian Health Leadership Network (CHLNet) and its partners met with Indigenous health leaders to discuss their concerns and hopes for leadership in Canada’s healthcare system. The 2020 “In-Plain Sight” report stressed the need to increase Indigenous leadership roles and decision-making in both Indigenous health governance and the wider healthcare system.

In October 2023, CHLNet hosted a Listening Circle. The event aimed to explore how non-Indigenous employers can create culturally safe environments for hiring and supporting Indigenous health leaders. This project will build on those discussions to improve leadership practices at both system and organizational levels.

Central Interior Native Health Society

Fellowship team

  • Tammy Rogers, Primary Care Clinic Coordinator, Central Interior Native Health Society
  • Cassandra Mitchell, Clinical Development Coordinator, Central Interior Native Health Society
  • Emily Christensen-Sweeney, Client Safety and Community Engagement Coordinator, Central Interior Native Health Society

Project title: Implementing a culturally safe patient safety learning system to improve culture and client care

Central Interior Native Health (CINHS) understands the need for a patient safety learning system (PSLS) to meet professional standards and be accountable to the communities it serves. A PSLS will help track organizational learning and system changes needed to prevent medical errors.

CINHS provides safe, high-quality care to all patients, while ensuring a supportive and safe environment for staff and contractors. To better improve the system, CINHS aims to ensure workplaces and care settings are trauma-informed and culturally safe. They also expect partner organizations to follow the same standards.

This project strengthens accountability for both clients and staff by promoting fair and safe services. It also helps CINHS build leadership skills to handle complex changes, while keeping the focus on clients and culture.

CHU de Québec–Université Laval

Fellowship team

  • Stéphane Tremblay, Director of Critical Care, CHU de Québec–Université Laval
  • Sarah-Kim Dufour Bernard, Associate Director (Interim) – Logistics Department, CHU de Québec-Université Laval
  • Julie De Carufel, Physician Escort and Regulator Physician in the Quebec Aeromedical Evacuation Program (EVAQ), CHU de Québec-Université Laval
  • Jean-Thomas Grantham, Assistant to the Chief Executive Officer – Public Affairs, CHU de Québec-Université Laval
  • Sarah Déry, Assistant to the Director – Business Processes, CHU de Québec-Université Laval

Project title: Clinical culture and communication: Supporting reassuring aeromedical transfers to Nunavik

The Quebec aeromedical evacuation program (EVAQ) at the CHU de Québec–Université Laval carries outpatient medical transfers to specialist centres across Quebec, including Nunavik’s Inuit communities. The fact that these patients, who make up 19% of transfers, are often far from their family and community creates significant challenges. To improve quality of care, EVAQ proposes developing in-flight communication services that are sensitive to Inuit culture. Patients’ ability to speak their native language is critical to establishing a trust relationship with health professionals, and to obtaining culturally safe care.

The project aims to facilitate simultaneous interpretation and other modes of communication to empower patients as active participants in their care in accordance with the Inuit concept of pigunnasiarniq, which emphasizes the importance of competence and control over one’s life. The project also aligns with the objectives of Healthcare Excellence Canada’s 2022–2026 Truth and Reconciliation Action Plan by building partnerships with Indigenous communities to promote cultural safety in healthcare.

CHU de Québec–Université Laval

Fellowship team

  • Marie-Michèle Fontaine, Director of Human Resources, CHU de Québec-Université Laval
  • Magali Chevallier, Associate Director of Human Resources – Prevention and Manager Experience, CHU de Québec-Université Laval
  • Audrey Gagnon, Medical Director, CHU de Québec-Université Laval
  • Anne Gignac, Associate Director of Technical Services, CHU de Québec-Université Laval
  • Marie-Hélène Gilbert, Full Professor, Department of Management, Faculty of Business Administration, Université Laval

Project title: Improving manager experiences for patient benefit

The CHU’s development project has determined that the key to its path to the future is putting both patient AND healthcare worker as its stars to steer by. We believe that achieving our mission of providing the people of eastern Québec with cutting-edge healthcare and services requires us to focus on directly connecting patients to our 18,000 workers, including our managers, to impact health and drive change.

Consequently, we hope to influence the value chain by improving manager experiences, which will directly impact employee experiences and improve patient experiences. Through their leadership, managers play a critical role in the health network. However, they also deal with risk factors that can affect both their own health and their ability to be a positive influence. Our objective:

Leverage changes to managers’ working conditions to improve employee experience and patient experience.

Human resources leadership has conducted a diagnostic process in recent months to accurately document the situation and find potential solutions. Work-life balance and challenges onboarding, integrating and supporting new hires over the first two years have been identified as major reasons why our managers leave. Our project aims to positively affect these aspects to improve our retention rate and benefit patients.

CHU de Québec–Université Laval and CIUSSS de la Capitale-Nationale

Fellowship team

  • Philippe Paquin-Piché, Director of Flow – Patient Flow and Business Processes, CHU de Québec-Université Laval
  • Marie-Pierre Fortin, Co-Head of the Geriatrics Department, CIUSSS de la Capitale-Nationale and CHU de Québec
  • Natalie Cauchon, Alternate Level of Care Assistant – Service and Organizational Mandate Pathways, Multidisciplinary Services Office, CIUSSS de la Capitale-Nationale
  • Isabelle Lévesque, Assistant Director of Professional Services and Medical Affairs – Medical Coordination, CHU de Québec-Université Laval
  • Julie Berger, Assistant Director of Flow, Professional Services and Professional Affairs Department, CHU de Québec

Project title: EXTRA journey – Seniors

The aging population is creating significant challenges for healthcare systems worldwide. In Canada, the number of adults aged 85 and older is rapidly growing and will triple by 2046. In the Capitale-Nationale region, this demographic transformation is forcing healthcare organizations, like the CHU de Québec-Université Laval and the CIUSSS de la Capitale-Nationale, to review their strategies to guarantee equitable access to care. One strategy involves improving the flow of care pathways for seniors by integrating patient-reported health indicators to better meet patients’ needs and support their self-reliance.

Under the EXTRA Project, we propose a regional combined clinical/administrative flow governance for seniors. Its aim is to actively engage with patients and their loved ones using Patient-Reported Outcome Measures (PROMs) to optimize care pathways between the CIUSSS de la Capitale-Nationale and the CHU de Québec-Université Laval. PROMs shed light on the patient experience and thus promote better interactions between patients and clinicians. This project is specifically focused on seniors aged 85 and older who visit the emergency room for falls and, using operational governance that includes a variety of actors from both institutions, advocates for patient-side decision-making. This shared operational governance will help support and guide patients and their caregivers more effectively through their episode of care by working to meet their specific needs.

CISSS de Chaudière-Appalaches

Fellowship team

  • Julie Perron, Associate Director of Logistics, CISSS de Chaudière-Appalaches
  • Valérie Lapointe, Director of Quality, Assessment, Performance and Ethics, CISSS de Chaudière-Appalaches
  • Binta Diallo, Associate Director at the Department of Quality, Assessment, Performance and Ethics, CISSS de Chaudière-Appalaches
  • Annie Lavigne, Department Head – Centre of Expertise in Organizational Development, CISSS de Chaudière-Appalaches
  • Josée Soucy, Director of Human Resources, CISSS de Chaudière-Appalaches

Project title: Performance management and continuous improvement: Keeping it simple in a complex environment

This project aims to improve coaching for managers by developing their performance management skills. More specifically, it aims to develop a useful, efficient and sustainable method for hands-on support. We hope to boost skill development for middle managers and generate a positive impact on their ability to assess their environment and better manage employee performance. The issue is at root: how do we improve their ability to take in information, make decisions and solve problems on the ground? How can they integrate simple, accessible foundations of continuous improvement and performance into their day-to-day work?

Will developing processes for and competence in reading their environment via a process of hands-on learning help support them in developing performance management skills? How do we keep this simple, concrete and useful in day-to-day work? Those are the questions our project addresses.

One of our strategies will be rooted in the principle of learning to learn: using principles of adult pedagogy and applying a method that focuses on experience and self-regulation. A method that needs to adapt to various management contexts within the same organization, rather than a single, unchanging magic recipe. This is a sizable challenge, but our improvement project could yield significant results for organizational performance. 

CISSS de la Montérégie-Centre

Fellowship team

  • Jennifer Chaloux, Assistant to the Director of hospital services, emergency, operating rooms and general front-line services component, and department head of the mobile outreach clinic, CISSS de la Montérégie-Centre
  • Geneviève D’Aoust, Associate Director of vaccination, screening and samples, CISSS de la Montérégie-Centre
  • Gaby Farand, Regional coordinator, Infectious diseases, threat management and environmental safety sector, CISSS de la Montérégie-Centre
  • Anne-Lou McNeil-Gauthier, Physician specializing in public health and preventive medicine, environmental and occupational health team, CISSS de la Montérégie-Centre
  • Hawa Sissoko, Regional department head, Infectious disease, threat management and environmental safety sector, CISSS de la Montérégie-Centre

Project Title: Déstig-MADO: A compassion-based model for supporting patients with notifiable diseases throughout their care and services pathway and the potential impacts of stigmatization

The proposed project stems from the observed fact that patients with a notifiable disease (ND, or MADO in French) often experience stigmatization. NDs, of which Québec has approximately 60, are a population health hazard and may lead to problems such as potential epidemics. NDs require control measures such as screening, vaccination, isolation at home and contact tracing (LSP, 2024). Stigmatization arises when differences are labelled and negative stereotypes applied to people, creating a distinction between “us” and “them” (ASPC, 2022). Such stigmas can lead to worse access to healthcare, worse health outcomes and lower quality of life for patients (Marra et al., 2004).   

Furthermore, although public health authorities oversee investigation into cases of NDs and coordinate follow-ups, there is no efficient and integrated care trajectory with all partners in the health network and community to ensure full and local care for ND patients and their contacts in Montérégie. This means that patients’ treatment, health and quality of life is less closely monitored, in addition to creating a great deal of back and forth between various partners. It can even delay protection measures from being put in place, endangering population health. A centralized, personalized approach has also been shown to reduce the delay in intake and increase treatment adherence (Abebe et al., 2020).   

The core hypothesis of the proposed project is that patient experience can be improved, and that stigma can be reduced and mitigated by providing people with NDs and their contacts with a personalized, compassionate, integrated, centralized and community-based trajectory of care that includes a model for supporting patients experiencing stigmatization. The project is divided into four parts: 

  • Part 1: Setting up a compassionate, integrated and centralized care trajectory at the CISSS de la Montérégie-Centre.
  • Part 2: Co-creating a patient care and services pathway based on actual needs, including the co-development of a model to support ND patients and their contacts experiencing stigmatization.
  • Part 3: Strengthening community-based management that considers patients’ social and cultural contexts.
  • Part 4: Consolidating community partnerships.

Lessons learned would be transferrable to the entirety of Montérégie as a second phase of the project (regional public health mandate and responsibility, sharing experience through issue tables and regional coordination) as well as elsewhere in Québec and for other populations whose care experience is impacted by stigmatization.

CISSS de la Montérégie-Est

Fellowship team

  • Christiane Ouellet, Director of Hospital Coordination and Flow, CISSS de la Montérégie-Est
  • Geneviève Leblanc, Associate Director of Hospital Coordination and Flow, Hôpital Honoré-Mercier, CISSS de la Montérégie-Est
  • Mélissa Paradis-Lapointe, Associate Director, Direction du soutien à l’autonomie des personnes âgées [Support for independent seniors department] – Housing Component, CISSS de la Montérégie-Est
  • Julien Girard, Director of Quality, Assessment, Performance and Ethics, CISSS de la Montérégie-Est
  • Valérie Leblanc-Dominguez, Associate Director of Professional Services for Hospital Flow, CISSS de la Montérégie-Est

Project Title: Using a CO-5 command centre to improve the flow of care for seniors, both in-hospital and outpatient

Montérégie-Est’s over-75 population is on the rise (+68% by 2036), leading to a surge in demand for health and social services. This increase in the senior population is particularly noticeable in our hospitals (+30% beds by 2036), our CHSLDs (+100% beds by 2036) and our home care (+100% new clients by 2036).  

To ensure that the services we offer align with patient needs, our organization recently deployed a command centre with operational, tactical and strategic levels in order to support patient flow throughout the care journey, both upstream and downstream.  

To improve care for patients 75 and over, both in the hospital and in outpatient settings, we are aiming to reduce the average length of stay (ALS) by 5%. For a short-term care facility with 800 beds, a 5% reduction in ALS means a 5% increase in capacity. The current ALS for patients 75 and over is 15.2 days. For the emergency department, the ALS with hospitalization is 34.9 hours. 

To achieve our objective, we are drawing on our multidisciplinary team and our command centre to coordinate our work. Our improvement project aims to streamline the work of our command centre so that it can sustainably support our objective and enable us to respond to our patients’ growing needs.

CISSS de la Montérégie-Ouest

Fellowship team

  • Ysabelle Marleau, Associate Director of DI-ASD-PD Programs, CISSS de la Montérégie Ouest
  • Isabelle Papineau, Director of Youth Programming and Public Health Activities, CISSS de la Montérégie Ouest
  • Johanne Fleurant, Director of Research, Innovation and Learning, CISSS de la Montérégie Ouest

Project Title: Optimizing telework: A practical guide for management at the CISSS de la Montérégie-Ouest 

Our organization is grappling with a significant difficulty: we do not have any guides, decision aids, eligibility criteria, or concrete indicators for managing and evaluating telework performance. This shortcoming hinders both employers and employees in their ability to effectively manage, assess and improve telework and make the best possible use of it. 

Data on telework at the CISSSMO for 2022–2023: 1,278 telework requests the departments of disability programming (391 requests), mental health and addiction (221) and youth programming and public health activities (146) have received the greatest number of requests. The departments with the smallest number of requests are housing for seniors (7), technical services (8) and communications (21). 

Significant increase in requests between 2021–2022 and 2022–2023. The number of requests was even higher in the same two departments. Category 4 staff (professionals) telework in larger numbers. CUPE union employees (para-technical, care aide, trade and administrative staff) are the next highest, at only a third of the number of professionals. Executives telework in significant numbers as well. In total, 68% of teleworking employees work remotely for less than 50% of their week, 21% for work remotely over 50% of the time, and 10% work remotely full-time. 

Below are the hypotheses and initial observations that spurred the proposal of the FORCES project: 

  • Lack of evaluation methods: Managers do not have clearly defined methods for evaluating the performance of teleworking employees.
  • Granting criteria: The choice to grant telework privileges is not based on criteria linked to performance or appropriateness. The primary considerations are ones such as a lack of desk space or staff retention during a labour shortage.
  • Lack of in-depth analysis: Telework is seen as a perk or a recruitment or retention strategy, but its actual impact on performance remains little studied. An in-depth analysis of its usefulness in connection with required duties and staff capacity to meet the requirements of their work contracts is needed, but managers have largely not conducted such an analysis.

Evaluation criteria similar to those for in-person work: Performance evaluation criteria for telework do not seem to be tailored to the specific context of telework but are the same as those used for in-person work. 

Adaptability of telework: It is essential to determine whether telework is suitable for all employees and all types of work. Some tasks are better suited to telework than others.  In the current context of reforms to the healthcare system, it is critical to explore best practices in telework management and evaluation.

Our objective: Enable informed decisions about telework, based on performance and appropriateness criteria, to yield the best results for the organization.

CIUSSS du Centre-Sud-de-l’Île-de-Montréal

Fellowship team

  • Julie Darveau, Director of Nursing, CIUSSS du Centre-Sud-de-l’Île-de-Montréal
  • Laurence Sauvé-Lévesque, Senior Nursing Advisor, Professional Practice Component, CIUSSS du Centre-Sud-de-l’Île-de-Montréal
  • Laurence Chaput, Senior Nursing Advisor, CIUSSS du Centre-Sud-de-l’Île-de-Montréal
  • Myriam Lalonde, Senior Nursing Advisor, Critical Care Component, CIUSSS du Centre-Sud-de-l’Île-de-Montréal
  • Maggie-Audrey Gaudreau Gauthier, Executive Advisor, Surgery Component, CIUSSS du Centre-Sud-de-l’Île-de-Montréal

Project title: Transitioning to patient-based funding to meet the needs of the population

Like many agencies around the world, the Ministère de la Santé et des Services sociaux is increasingly turning to patient-based funding (PBF). This payment model links outcomes, population health and the cost of interventions to respond to health needs.

The goal of PBF is accessibility and equity of access. Nursing-specific clinical indicators will be developed and used for classification of PBF models, to allocate funds based on each patient’s care and service's needs, above and beyond diagnosis at hospitalization. The specific biopsychosocial characteristics of the CCSMTL’s patient population require a tailored approach to achieve the best possible health outcomes, such as an urban health approach modified to suit the population's socioeconomic circumstances. Promoting health and disease prevention is of foremost importance for empowering patients and their families.

The evidence shows that PBF’s efficiency as a funding model rests on the granularity of classification of hospital stays. This is because the classification system must be an accurate representation of the care and services provided and the characteristics of the patients who receive it. Nursing staff play an undeniably crucial part in achieving objectives for improving performance and clinical appropriateness. It is clear that PBF, in parallel with field of practice optimization, provides a window of opportunity for identifying essential nursing-specific indicators for institutional performance.

Covenant Health

Fellowship Team

  • Melanie Doiron, Project Manager, Professional Practice, Clinical Learning, Libraries and Student Placement, Covenant Health
  • Vanessa Elliot, Senior Director, Community Health Centre, Covenant Health
  • Michelle Stone, Senior Practice Lead-Clinical Workforce Planning - Professional Practice, Covenant Health
  • Melissa Sztym, Corporate Director, Professional Practice, Clinical Learning, Libraries and Student Placement, Covenant Health
  • Kelly Stark, Senior Director Operations - Ambulatory Programs & Rehabilitation Medicine, Covenant Health
  • Karen Macmillan, Senior Operating Officer Acute Care Services, Covenant Health

TITLE: Enhancing Workforce Efficiency Through Innovative Care Models

Covenant Health, like jurisdictions worldwide, is facing a health workforce shortage. To address these challenges, two emerging trends have shown promise: models of care and optimal scopes of practice. Both approaches have demonstrated workforce efficiencies and improved patient outcomes. Models of care outline how services are delivered and by whom, across a patient’s journey through the healthcare system. This approach helps streamline the delivery of services to ensure that care is provided effectively and efficiently. Optimal scopes of practice explore opportunities for practitioners to maximize their practice and identify where task sharing and shifting can be used to enhance care delivery. This optimization can also be expanded to include unregulated healthcare providers and caregivers, broadening the potential workforce and improving service delivery.

Covenant Health is launching its primary care strategy, including the opening of a new Covenant Wellness Community in 2025. This will be Alberta’s first community-based wellness hub providing integrated health and social supports. The project team plans to leverage a care process framework to develop an optimized model of care in primary care and in-patient services settings. Identifying these needs will enable Covenant Health to address workforce difficulties, improve access to care, and ensure high quality patient outcomes.

Nova Scotia Health Primary Health Care (Provincial)

Fellowship team

  • Katie Heckman, Director, Primary Health Care, Chronic Disease Management Clinical Network, Nova Scotia Health
  • Ashley Harnish, Director, Primary Health Care and Family Practice Central Zone, Nova Scotia Health
  • Michelle Robinson, Professional Practice Leader-PHC, Department of Interprofessional Practice and Learning, Nova Scotia Health
  • Grayson Fulmer, Senior Director Medical Affairs, Nova Scotia Health
  • Dr. Aaron Smith, Provincial Medical Executive Director, Nova Scotia Health

Project title: Strengthening leadership and governance in primary care

Nova Scotia Health (NSH) is working to change how primary care is delivered, moving from stand-alone clinics to a model called health homes and health neighborhoods. In this new model, primary care leaders will need to work more closely within the organization and with outside partners to improve patient care and offer more meaningful services.

Currently, the leadership and management structures at NSH were designed for the old model, which has led to differences in how clinics are run. Some clinics are more efficient than others. As part of the transformation, there’s an opportunity to improve how clinics operate by strengthening their leadership and structure.

This project will create and test a framework for healthcare homes, with the goal of standardizing both clinical and administrative leadership. This will support multidisciplinary care teams and improve access to care and health outcomes for patients.

The project will focus on:

  • Setting up key management and leadership structures at the clinic level.
  • Developing clinical and administrative best practices for operating procedures.
  • Defining performance indicators and procedures for data entry and reporting, so health homes can be actively managed by their leaders.
  • Creating a plan to grow and improve leadership and management development for NSH primary care leaders.

Nova Scotia Health

Fellowship team

  • Kathy Spurr, Senior Strategist, Quality and Patient Safety, Nova Scotia Department of Health & Wellness
  • Danika Woodburn, Director, Provider Supports, One Person One Record
  • Lindsay Bertrand, Chief Clinical Information Officer, One Person One Record
  • Erin Gisborne, Director, Clinical Standardization, One Person One Record
  • Michelle Helliwell, Director of Policy, Nova Scotia Health
  • Natalie Cheng, Medical Site Lead, Dartmouth General Hospital, Nova Scotia Health

Project title: Using a computerized clinical decision support system to reduce hospital-acquired pressure injuries

Healthcare systems around the world have gone through huge digital changes and one of the biggest is the use of electronic health records (EHRs). EHRs have made it easier for healthcare providers to follow clinical guidelines, reduced medication errors and increased awareness of patient safety.

Nova Scotia’s health system will soon introduce a new clinical information system called One Person One Record. This system will actively work to monitor and prevent harm in hospitals. A key feature is the clinical decision support system (CDSS), which helps doctors and nurses by alerting them to possible safety risks, like pressure injuries.

Even though CDSS can improve patient safety, it hasn’t been widely used because of challenges in healthcare culture. This project plans to combine CDSS with other quality improvement efforts to help prevent pressure injuries in patients.

Nova Scotia Health

Fellowship team

  • Phương Nguyễn, Network Leader, Planning, Development & System Performance Integrated Access and Flow Network, Nova Scotia Health
  • Amanda MacDonald Green, Physician, Primary Care, Nova Scotia Health
  • Graeme Kohler, Interim Director, Integrated Access and Flow Network, Nova Scotia Health
  • Andrea Muenster, Senior Director, Care Coordination Centre, Nova Scotia Health

Project title: “Health beyond hospital”: addressing access and flow challenges to improve care for patients on discharge

Efficient patient flow through the health system is essential for improving access to care. Nova Scotia hospitals are dealing with more patients coming in than leaving, which affects their ability to provide timely care.

Nova Scotia Health (NSH) and the provincial government are working on new strategies to stabilize health and social systems, provide timely care for Nova Scotians and address these patient flow issues. A new program called “Health Beyond Hospital: Integrated Discharge Hub” (HBH) is being put in place. This initiative aims to improve patient flow, enhance patient experiences and bring together the different agencies involved. It follows NSH’s strategic direction and builds on the government’s Action for Health plan.

The project will set up a governance structure and focus on improvements at specific sites. The HBH governance structure will be formed through agreements between NSH and government agencies. Best practices for shared governance will be studied and recommendations will be made to a steering committee to help guide the work. This will include processes like conflict resolution, problem escalation and better coordination between different geographic areas.

A partnership called the Care Coordination Centre (C3) will also be created and the team will work alongside a government partner. Currently, the C3 team only works with NSH and Emergency Health Services. By co-locating with other partners, the project will break down patient flow barriers and improve collaboration.

The Good Samaritan Society

Fellowship team

  • Candice Christenson, Vice President and Chief Clinical Officer
  • Cheryl Sarazin, Vice President and Chief Quality Officer
  • Scott Chubbs, Director, Capital Management and Maintenance
  • Kellie Stajer, Director, Clinical Services
  • Crystal de Jong, Program Liaison

Project title: Reimagining the small home model to enrich the lives of residents in care

The Good Samaritan project aims to rethink the current small home model that has been in use for many years. The goal is to expand and strengthen the “being and belonging” philosophy, showing a commitment to improving quality while enriching the lives of residents in care.

For the West Village project, the model will include small homes within a larger care facility to maintain cost efficiency. The care model will have small neighbourhoods of 14 residents in each pod, with four pods per floor, using the Good Samaritan being and belonging model of care.

This updated small home model will focus on resident-centered, culturally safe care and improving the experiences of employees, residents and their families. It will also include recreational and rehabilitation activities.

The key parts of the model will explore design, philosophy, services, staffing, funding and care approaches. Current model examples include the Green House and Butterfly models and dementia villages.