The Challenge
A province-wide initiative sought to improve how decisions were made on behalf of mentally incapable adults requiring support from the Public Guardian and Trustee. Multiple stakeholder groups were involved, including acute and primary care psychiatrists, senior executives, community teams, and provincial oversight bodies, yet roles, expectations, and processes were inconsistent across eight hospitals.
The inconsistency created delays, confusion, and escalating concerns from regulators. Without a unified, trusted process, patients in vulnerable circumstances were caught in a system that could not reliably or fairly advocate for them.
The Approach
A structured stakeholder engagement process was designed to bring clarity and alignment across the system:
- A comprehensive stakeholder analysis was completed and individuals were mapped on a Power Interest grid before the workshop
- High-influence stakeholders were engaged one-on-one in advance to surface concerns, gather insights, and build their commitment as workshop facilitators
- Global best practices were researched to anchor decisions in evidence
- During the workshop, participants aligned on purpose, validated the current state, identified root causes, and used structured problem-solving to design system-level improvements
- An Impact Effort grid guided prioritization of quick wins and longer-term changes
- Working groups developed a standardized operating process for Certificates of Incapability, which was piloted, refined, and implemented across all eight hospitals
The Outcome
The standardized process brought consistency, clarity, and confidence to a previously fragmented system. The Ombudsperson reported zero adverse comments following implementation.
The approach was subsequently adopted across all provincial health authorities, recognizing its clarity, consistency, and effectiveness as a model for the sector.