UBC Theses and Dissertations

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UBC Theses and Dissertations

Innovation in a public health unit Lugsdin, James Gordon


The impact of introducing a new program into a public health unit was examined by introducing a lifestyle program, named HHA-PRHU, into the Peace River Health Unit in British Columbia. The program was initiated without sanction or direction from the Central Office controlling all the health units of the Ministry of Health of British Columbia in order (i) to investigate the fate of local innovation in health care delivery; (ii) to establish the impediments to such innovation; and (iii) to determine ways to remove organizational obstacles in their paths. The lifestyle program HHA-PRHU used the Health Hazard Appraisal method. This method is a popular major tool in the delivery of prospective medicine, a branch of medicine which stresses prevention. The urgent need in the community for such a lifestyle program was demonstrated. An analysis of the organizational design of health units showed that they are not designed to foster innovation. Furthermore, it was shown that local initiative in health units is difficult to accomplish unless, during the planning process, consideration is given to political bodies and to the Central Office. The evaluation of the impact of HHA-PRHU on the Peace River Health Unit was based on observations and perceptions of the Director of the Health Unit, and its staff. These observations confirmed that a new program is not readily incorporated into a public health unit when introduced at the local level. Methods of successfully introducing new programs originating within a health unit were explored. These methods include ways of restructuring, as well as making better utilization of, the existing administrative design.

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