About Facility Engagement

As an initiative of the Specialist Services Committee, Facility Engagement was created in 2014 to support medical staff working in facilities across BC to participate in health care planning and solutions.

It creates pathways to meaningful collaboration among medical staff and health authorities on shared priorities, ultimately to improve the delivery of patient care and clinical work environment.

• It brings clinical and organizational voices together to build relationships, open communication, and mutual understanding as a foundation for strong engagement.
• It creates effective processes, structures, and opportunities for solving problems, planning improvements, and making decisions together.
• It pays medical staff for their time to lead, manage, and participate in local and regional engagement activities with their health authorities – and to hire expertise to support them.

Engagement is defined as…

• A process for making better decisions that incorporate the interests and concerns of affected stakeholders and meets the needs of the decision-making organization. 
• An opportunity to strengthen relationships, share information, and build mutual understanding and consensus around shared priorities.

Two main groups are engaging:

1. Physicians and other medical staff, representing a voice for what is needed for patients:

• with a deep understanding of quality, safety, and efficiency of care delivery; initiators of clinical activities and decisions; and a central role in health system expenditures.

2. Health authority leaders and administrators working at local and regional levels, representing a voice for what is possible to achieve in the organization:

• with responsibility for operations, budgets, resources, people, teams, and infrastructure; and deliverables & accountabilities to health authority boards and government.

Participation in Facility Engagement is open to:

• All health authority facilities and programs with acute care beds
• Specialist and family physicians with privileges in BC facilities who are members of the medical staff and non-physician medical staff members (nurse practitioners, midwives, and dentists).
• Other physicians who are not members of the medical staff, such as community doctors
• Allied Health providers who are invited to participate by the MSA.
• Medical staff can participate in engagement activities ranging from leadership, to meetings with health authorities, to leading and implementing projects.
• Local medical staff associations (MSAs) manage engagement funds and local engagement activities on behalf of their members, and in partnership with their health authorities.

Facility Engagement participants (2016 – 2023/24)

• 76 active MSAs (most starting in 2016-17) in 6 health authorities
• 85 acute care facilities and provincial programs represented in 6 health authorities
• Northern Health: 17 MSAs & 17 sites
• Interior Health: 22 MSAs & 23 sites
• Island Health: 11 MSAs, 13 sites
• Fraser Health:  11 MSAs, 12 sites
• Vancouver Coastal Health (including Providence):  9 MSAs, 12 sites
• PHSA: 6 MSAs, 6 provincial programs (BC Centre for Disease Control, BC Cancer Agency, BC Children’s and Women’s Hospital, Concurrent Disorder Providers, Correctional Health Services, Forensic Psychiatric Centre)

Facility Engagement is part of BC’s Physician Master Agreement (PMA) between the Ministry of Health and Doctors of BC, and an initiative of the Specialist Services Committee.

• It was initated in 2014, in response to:
  • low levels of engagement and influence in BC’s health care system among physicians.
  • the need for effective structures, processes, and resources for physicians and health authorities to plan and make decisions together affecting patient care and the clinical workplace.

Doctors of BC, the Ministry of Health, and six health authority CEOs across BC signed a Memorandum of Understanding on local and regional engagement, committing to: Memorandum of Understanding (MOU) on Regional and Local Engagem

• Strengthen communication, relationships & engagement between facility-based physicians & health authorities through medical staff association structures.
• Increase meaningful physician input and involvement in health authority planning and initiatives that directly impact their work environment and patient care delivery.

The Specialist Services Committee is overseeing the initiative and distributing funding. Funding is administered through a physician society or alternative structure established at local sites.

The provincial initiative maintains flexibility for activities to be tailored to each facility at a local level, and/or regional level.

MSAs represent the voice of medical staff in BC hospitals and provincial acute care programs.

• Medical staff include physicians and surgeons, nurse practitioners, midwives, and dentists.
• Part of the MSA role is to oversee local Facility Engagement governance, funds, and engagement activities on behalf of their medical staff members, and in partnership with their health authorities.
• Physician Master Agreement negotiated funds and resources provided through Doctors of BC / Specialist Services Committee (SSC) support MSA engagement activities, with guidelines and goals for using the funds.
• MSAs are not governed or directed provincially by Doctors of BC / or the SSC. 
• Instead, MSAs exist under their health authority medical staff bylaws and rules with a mandate to provide a voice to the medical staff, promote and advance medical staff involvement in the provision and planning of medical services at their facilities, and to elect officers.
• MSAs and their health authority partners are supported in their engagement work by provincial Engagement Partners and a Facility and Community Engagement team at Doctors of BC.

FEI funding is provided through the Specialist Services Committee (SSC) to MSAs based on the number of acute care beds their facility or program supports  – with provincial guidelines, and with flexibility for local implementation.

• It pays medical staff members for their time to oversee, plan, lead, and participate in local and regional engagement activities, and to hire operational and administrative support.
• MSAs can optionally extend funding for participation in engagement to medical staff who are not privileged at the facility (such as community-based doctors), or Allied Health providers.
• The SSC Facility Engagement Working Group provides provincial oversight for the FEI.  It is comprised of Doctors of BC MSA physicians and Ministry and health authority representatives. 
• At the local facility level, funding is governed and managed by Medical Staff Associations (MSAs) for priority activities set out by medical staff, with flexibility to be tailored to each site.
• Some larger MSAs have set up non-profit physician societies to hold and manage FEI funds, while other smaller, unincorporated MSAs have their funds held and administered through the Facility Engagement Services Company (FESC).

To qualify for and receive annual funding, medical staff must have:

• A governance and a decision-making structure that will represent the doctors in the facility.
• The ability to receive, account for, and report on expenditures.
• General agreement to proceed with health authority representatives at the start of the process.

To find out if/how your site is involved, contact your medical staff president and/or local site administrator or e-mail engagement@doctorsofbc.ca

Examples of enhanced for new structures & processes include:

• MSA executive and working group meetings
• Participation of MSA executives or representatives at local and regional health authority meetings (e.g., medical advisory committees, quality of care)
• Local and regional MSA-health authority meetings and events to build relationships, share knowledge, successes and learnings, and co-identify and collaborate on shared priorities
• More physician and health authority leader dyads to align strategic priorities and work directly together on plans and initiatives
• Increased communications channels for communication and two-way feedback with members and greater transparency

Progress: emerging success factors (evolving, with more work to do)  

• Effective relationships and processes to solve problems together
• Physicians and health authorities contributing to mutual plans and decisions
• Improved patient care and the clinical workplace
• Physician influencing and leading system change

Increased engagement among medical staff

• Communication, collegiality 
• Collaboration for patient care across clinical areas and sites

Increased engagement between MSAs and health authority leaders

• Communication, collaboration & teamwork
• More relationships & progress with local medical leaders

Increased alignment of medical staff and health authority strategic priorities

• MSA/ Senior leader dyad partnerships and collaboration around shared priorities

Increased contributions to patient care with 1100+ Facility Engagement projects focus on patient care improvements/innovations.

Increased contributions to facility culture  (2023 Evaluation Survey)

• 66% of physicians agree or strongly agree that MSA/Physician Engagement Society activities has helped improve facility culture
• 72% of Health Authority medical and operational leaders strongly agreed/agreed: MSA/Physician Engagement Society activities has helped improve facility culture
• 63% of Health Authority medical and operational leaders strongly agreed/agreed: MSA/Physician Engagement Society activities has helped improve the delivery of patient care