General Information
Instructor(s)
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- Health Sector Management (c)
- Business Design (r)
Instructor Bio
Professor Brian Golden is the Sandra Rotman Chaired Professor in Health Sector Strategy at the Rotman School of Management, The University of Toronto, and The University Health Network. He previously served as Vice-Dean, Working Professional Programs, and Vice-Dean, MBA Programs. Professor Golden is the Academic Director for the Rotman School’s Sandra Rotman Centre for Health Sector Strategy. In 2006 he became founding Executive Director of The Collaborative for Health Sector Strategy, a policy, research and leadership development institute funded by the Ontario Ministry of Health. In his role at the Collaborative he was a member of the select advisory committee that led to the creation of Ontario’s Excellent Care for All legislation. He co-authored the province’s report on Primary Care Governance in 2011, and followed that in 2015 with a policy white paper on a new model of primary care: “Patient Care Groups: A new model of population based primary health care for Ontario”, based on his work while part of the Ministry’s Expert Advisory Committee on Strengthening Primary Health Care in Ontario. He also sat on the Ministry of Heath’s Hospital Funding Formula committee from 2012 to 2014.
From 2005 to 2010 Professor Golden was Board Chair of the Institute for Clinical Evaluative Sciences (IC/ES). He is former Board Chair of Rise Asset Development, a non-profit micro-finance organization providing business development loans for individuals with mental health and addiction challenges.
Among his published work are articles in The Canadian Medical Association Journal, The Strategic Management Journal, Healthcare Quarterly, Healthcare Papers, The Annals of Pharmacotherapy, Management Science, Clinical Oncology, Health Policy and The Harvard Business Review. Professor Golden’s article “Transforming Healthcare Organizations” in Healthcare Quarterly was that publication’s most downloaded article with over 160,000 downloads.
As an advisor and director of leadership development programs, Professor Golden has worked with a variety of organizations including Ontario’s Ministry of Health, Britain’s National Health Service, several Local Integration Health Networks, and hospitals including The Hospital for Sick Children, The University Health Network, Hamilton Health Sciences, London Health Science Centre, Sunnybrook Health Sciences Centre, The Centre for Addiction and Mental Health, The King Faisal Specialist Hospital, and Baylor Medical Center. His recent private sector executive education clients include Janssen-Ortho, Manulife, General Electric and Baxter International.
Among his teaching and education awards are Canada’s Ted Freedman Innovation in Healthcare Education Award and the Canadian Medical Association’s first Eureka Award for Innovation in Physician Education. He was the first business school professor to be inducted as a Fellow of the Canadian Academy of Health Sciences.
Target Audience
This course is open to all 2nd and 3rd year Rotman Students (i.e., post required cores courses) and is a required course in the Rotman School of Management’s Major in Health Sector Management. In the past few years an increasing number of students from the faculties of medicine, engineering and public policy have also found this course valuable. This course aims to improve your ability to formulate and implement strategy in the healthcare delivery sector. The course will help prepare students for leadership roles in healthcare management, the life sciences, insurance, government, entrepreneurship, venture capital, and health sector consulting.
Numerous guest speakers will participate in the course. They will be selected from a group of hospital CEOs, physician leaders, health care consultants, health care managers and senior government officials.
Guest Speakers from past years
- Matt Anderson (CEO, Ontario Health)
- Dr. Dante Morra, Chief of Staff, Trillium Health Partners (and Rotman Grad!)
- Dr. Tom McGowan, MBA, Founder Canadian Radiation Oncology Services (and Rotman Grad!)
- Lydia Lee, MBA, National Partner Digital Health, KPMG, (former Senior Vice President and Chief Information Officer, University Health Network)
- Jamison Steeve (Former Principle Secretary to Ontario Premier; Former Chief of Staff to Ontario Minster of Health)
Format
Currently the plan is to teach the course in a hybrid format, in the classroom as soon as possible, but until then on-line.
Class Schedule
This is an elective course that meets on Mondays and Wednesdays from 7:00-9:00 (March 7-April 13).
Course Mission
The healthcare sector is the single largest economic sector in the world —- approaching $8 Trillion annually. It is not only huge, but also among the fastest growing sectors in all industrialized economies. It represents the service and knowledge-oriented focus of the 21st century economy, and has significant and unique management challenges that have not been adequately addressed — in any jurisdiction on the planet! Virtually all observers agree that the aging population and increased patient demand for new services, technologies, and drugs are contributing to the steady increase in healthcare expenditures, but so, too, is waste. For instance, many types of medical errors result in the subsequent need for additional healthcare services to treat patients who have been harmed. A highly fragmented delivery system that largely lacks even rudimentary clinical information capabilities results in poorly designed care processes characterized by unnecessary duplication of services and long waiting times and delays. And there is substantial evidence documenting overuse of many services — services for which the potential risk of harm may outweigh the potential benefits.
However much the healthcare delivery marketplace environment may resemble a business environment, careful analysis reveals that healthcare organizations are considerably more than mere businesses. Peter Drucker tells us that hospitals, for example, are the most complex form of human organization we have ever attempted to manage. This complexity derives from, among other things, the confluence of professions (e.g., medicine, nursing, social work, pharmacy, nutrition, accounting, engineering, and physical therapy), numerous stakeholders with competing claims, perspectives and time horizons, underdeveloped information technology, and the incomplete knowledge of medicine.
This course aims to provide a framework for appreciating and managing this complexity. The course was originally designed around the key challenges identified by The Institute of Medicine’s influential report Crossing the Quality Chasm (2000). That report noted the need to address the following challenges in healthcare (btw: all of these challenges still exist):
- Redesign of care processes based on best practices;
- Use of information technologies to improve access to clinical information and support clinical decision making
- Knowledge and skills management;
- Development of effective teams;
- Coordination of care across patient conditions, services, and settings over time; and
- Incorporation of performance and outcome measurements for improvement and accountability
Course Scope
The healthcare sector is the single largest economic sector in the world —- approaching $8 Trillion annually. It is not only huge, but also among the fastest growing sectors in all industrialized economies. It represents the service and knowledge-oriented focus of the 21st century economy and has significant and unique management challenges that have not been adequately addressed — in any jurisdiction on the planet! Virtually all observers agree that the aging population and increased patient demand for new services, technologies, and drugs are contributing to the steady increase in healthcare expenditures, but so, too, is waste. For instance, many types of medical errors result in the subsequent need for additional healthcare services to treat patients who have been harmed. A highly fragmented delivery system that largely lacks even rudimentary clinical information capabilities results in poorly designed care processes characterized by unnecessary duplication of services and long waiting times and delays. And there is substantial evidence documenting overuse of many services — services for which the potential risk of harm may outweigh the potential benefits.
However much the healthcare delivery marketplace environment may resemble a business environment, careful analysis reveals that healthcare organizations are considerably more than mere businesses. Peter Drucker tells us that hospitals, for example, are the most complex form of human organization we have ever attempted to manage. This complexity derives from, among other things, the confluence of professions (e.g., medicine, nursing, social work, pharmacy, nutrition, accounting, engineering, and physical therapy), numerous stakeholders with competingclaims, perspectives and time horizons, underdeveloped information technology, and the incomplete knowledge of medicine.
This course aims to provide a framework for appreciating and managing this complexity. The course was originally designed around the key challenges identified by The Institute of Medicine’s influential report Crossing the Quality Chasm (2000). That report noted the need to address the following challenges in healthcare (btw: all of these challenges still exist):
- Redesign of care processes based on best practices
- Use of information technologies to improve access to clinical information and support clinical decision making
- Knowledge and skills management
- Development of effective teams
- Coordination of care across patient conditions, services, and settings over time
- Incorporation of performance and outcome measurements for improvement and accountability
With these challenges in mind, this course provides an overview of the central issues in the management of healthcare organizations and healthcare systems. This includes developing a working knowledge of the key facts about our healthcare system. Some of the issues we will examine are unique to the Canadian context (e.g., the role of government), and others transcend jurisdictional boundaries (e.g., stakeholder relations). The topic areas to be covered in this course may shift in emphasis from time to time, based on current debates in the health sector. In a typical term we will address topics such: as understanding the Canadian health sector (with comparisons to systems in other industrialized countries); comparing and contrasting various integrated healthcare delivery systems; the role of professions vs. occupations in healthcare organizations; the unique challenges of managing multiprofessional organizations, knowledge creation, management and diffusion in healthcare organizations; patient-centred care; issues related to patient safety and quality improvement; and managing change and transformation in healthcare organizations and systems.
The course will not directly explore two important segments of the health sector — medical devices and bio-pharma. However, students who wish to work in these industries will need to have a strong working knowledge of the healthcare delivery sector, which this course provides.
Evaluation and Grade Breakdown
| Component | Due Date | Weight |
|---|---|---|
| Class Contribution and Participation | Ongoing | 20% |
| Learning Journal 1 (Classes 1–6) | TBD | 10% |
| Learning Journal 2 (Classes 7–12) | TBD | 10% |
| Comparative Systems Paper (2 Person Group) – approx. 10 pages | TBD | 30% |
| Individual Paper | Due approx. one week after class | 30% |
Required Resources
- Case Packet
- Regular scanning of articles in the on-line journals available from Longwoods Publishing http://www.longwoods.com/
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