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Part of Health data, research and standards

Hospital-based leadership

Restoring decision-making power to the front lines of Alberta’s hospitals.

Overview

Alberta’s government continues to make significant strides to refocus the health care system and improve care for all Albertans. This includes:

  • transitioning Alberta Health Services into a hospital service delivery provider
  • finding ways to decentralize the system from the zone-based leadership structure that has existed for many years

A one-size-fits-all solution does not work in the health care system – so Alberta is shifting to hospital-based leadership.

Hospital-based leadership means hospitals will have the flexibility to respond, freedom to adapt and authority to act. Giving decision-making powers to on-site leadership teams will empower them to hire the staff they need, manage resources and solve problems to meet the needs of the patients and communities they serve.

Improving our health care system

Alberta’s government announced plans to refocus the health care system in November 2023. Through engagements, a consistent message has emerged from patients, front-line health care workers and concerned Albertans alike about the flaws of the prior system:

  • Alberta Health Services’ current zone-based leadership structure is overly complex and bureaucratic.
  • It lacks the flexibility and responsiveness needed to effectively support facilities and staff – particularly when it comes to hiring, securing supplies and adopting necessary technologies.

The current zone-based leadership structure has led to system-level challenges that affect hospital efficiency:

  • Health care staff have shared that this centralized system takes too long to respond to local needs, which has resulted in issues such as hiring delays or difficulty purchasing supplies.
  • Duplicative management layers have led to confusion within organizations and among staff, and inconsistent and uncoordinated performance management mechanisms have led to a lack of accountability.
  • Excessive spending on regional infrastructure has led to increased and, in some instances, unnecessary operational costs.

Moving to hospital-based leadership means that the people who know their hospital, community and operational needs will be making decisions that are best for their patients, families and staff. There will be oversight across the system to ensure consistency but, overall, hospitals will have the flexibility to act quickly.

How it will roll out

Under a new hospital-based leadership model, on-site leadership teams will be responsible for hiring staff, managing resources and solving problems to effectively serve their patients and communities. While health zones will be eliminated, collaboration and integration between acute care sites will be facilitated through new regional corridors within the new decentralized system.

Performance management will be site-focused, with clear expectations set by Acute Care Alberta through a hospital-based management framework. Sites will be required to report to Acute Care Alberta based on established performance expectations.

As part of this refocusing effort, AHS will transition into a hospital service delivery provider. A review and redesign of AHS’ organization accountability and structural alignment will:

  • reflect a hospital/health care site-based operational structure
  • build local accountability that adheres to provincial standards
  • ensure leadership aligns with a new hospital-based design
  • ensure leaders have clear accountabilities and authorities
  • provide a clear process for performance evaluation and reporting against site-based accountabilities, including budget
  • align operations with health corridors to reflect how people access services

There will be standardized organization charts and role accountability summaries for all front-line staff and leadership positions for consistency across the system. These will be validated with front-line staff and leader engagement during the assessment process.

All hospitals will continue to follow provincial standards and guidelines. Acute Care Alberta will track performance across all sites to ensure consistency.

The new model will be launched on an interim basis in 2025 and will be adjusted based on results:

  • AHS leaders and health care workers will be consulted throughout the process to help identify what is working and what needs improvement.
  • Full implementation is planned for summer 2026.