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Vancouver Island Health Authority

The Vancouver Island Health Authority (VIHA) has integrated physicians into the management structure, with clinical programs being co-led by physician-administrator pairs. This was done as a leverage point to influence physician engagement in quality. The Chief Medical Officer (CMO) of VIHA is developing a physician leadership education program and building performance expectations into the contracts for clinical chiefs, to underscore, in his words that “quality has to be inherent in everything that you do.” Both the CMO and Health Authority Medical Advisory Committee (HAMAC) provide regular input at board meetings. The HAMAC Chair presents a regular report to the board, mainly focused on credentialing, disciplinary issues and bylaw revisions, with the aim of expanding time spent reporting on quality. However, these structural changes take time to accommodate to, and leadership alignment of medical staff structures with new board roles and expectations is ongoing. To build trust and communicate this new approach, the VIHA board, in the presence of Senior Management, meets with local physicians during each of their 3-day board meeting sessions, by rotating meeting locations around the region.