Transforming a health care system: managing change for community gain.

The research undertaken describes a regional health authority's approach to managing a shift away from acute hospital care towards more community-based, health promoting service orientations in line with new legislated responsibilities. It builds on earlier research of province-wide efforts to create new ways of organizing work within new regional health authority structures. The initial study explored "what matters most", to managing the restructuring of Alberta's health care system and identified ten variables as critical to the transition to regionalization in Alberta. Four were seen to be pre-requisites to effective change: sustaining political will; pacing; resourcing; and, committing to change. Six others were described as continuous process variables; leading; communicating; informing; learning; planning; and, adjusting. This case study looks closely at the operation of these variables in a specific change process within the wider context of the Alberta health reforms.