Thinking about Quality Improvement

Last year I signed up for updates from the Institute for Healthcare Improvement (IHI), the organization known for the Triple Aim framework. I have been learning about IHI’s impressive work and have appreciated the resources available on the organization’s website. This week I participated in an excellent webinar featuring Dr. Don Berwick, IHI President Emeritus and Senior Fellow, and Dr. Jessica Berwick, Internist, Beth Israel Deaconess Medical Center, discussing the topic Morality Matters: How to Reset the Mission of Quality Improvement.


Their starting point was a keynote presentation by Don Berwick given at IHI’s National Forum last December in which he had raised concerns about the tensions experienced in healthcare today arising from two eras: professional dominance in era one followed by a move to accountability, measurement and greater scrutiny in era two. He proposed steps to a third era – the focus of the February 18 webinar – with a plea to decrease excessive measurement among other steps (See slide 8 in the webinar slides). To move into a moral era, he outlined the need to recommit to the science of improvement, protect civility within healthcare and focus on the patient (“Listen, really listen”). Jessica Berwick offered commentary and examples from her current experience as a new internist and hospitalist in Boston. It was interesting to hear from this dynamic father and daughter team as they talked about what really matters and explored ways to overcome the challenges imposed by corporate entities and external systems. They stimulated my thinking about the importance of values to the quest of improving health and healthcare delivery.

Please see links to selected IHI resources:

A primer on the Triple Aim framework, history and application is found on the IHI Triple Aim Initiative page.

Audio recording of Morality Matters: How to Reset the Mission of Quality Improvement. (Feb. 18, 2016)

Video recording of Don Berwick’s IHI National Forum presentation (Dec. 9, 2015)

Highlights of 2015 by Nora Whyte

2015 marked a professional transition as my work with the Association of Registered Nurses of British Columbia (ARNBC) came to an end after close to four years of exciting and satisfying times during the organization’s development.

One of my personal highlights was collaborating with ARNBC colleagues Julie Fraser and Barb Reece on a presentation delivered by Julie at the International Council of Nurses’ Conference held in Seoul in June 2015. Our presentation – Developing Nurse Leaders: An Important Role for Professional Nursing Associations – outlined ARNBC’s experience in implementing strategies to support the development of emerging leaders through local networks and student engagement activities.

Dr. Sheila Tlou giving a plenary presentation at ICN Conference in Seoul.

Dr. Sheila Tlou giving a plenary presentation at ICN Conference in Seoul. Photo credit: ICN

It was a pleasure to follow the daily updates from the ICN Conference and to review presentation materials posted at a later date. See the ICN conference site for selected presentation slides on the theme of Global Citizen, Global Nursing.

Other highlights were speaking invitations during the fall including the opportunity to deliver opening greetings at the 25th anniversary celebration of the British Columbia History of Nursing Society in September – a wonderful event held at Hycroft in Vancouver and a great chance to see many friends and colleagues.

Networking at CNSA Regional Conference in Courtenay, BC. Oct. 2015

Networking at CNSA Regional Conference in Courtenay, BC. Oct. 2015


Meetings with students at North Island College and at the Western/Prairie Regional Conference of the Canadian Nursing Students’ Association (CNSA) were enjoyable times to talk with students, to learn about their interests and to observe student leadership in action. See my blogpost below dated Oct. 26, 2015.







Plans for 2016 include writing projects and continuing my consulting work in nursing and global health.

With my thanks to colleagues for your support in 2015 and best wishes for the coming year!

Nora Whyte

Nursing Leadership: Global Contexts and Connections

It was a great pleasure to meet with nursing student leaders at the Western/Prairie Regional Conference of the Canadian Nursing Students’ Association in Courtenay, British Columbia on October 25, 2015. The conference theme for this dynamic gathering was Inspire! Advocate! Unleash!

Graduate Students at Baba Farid College of Nursing, Faridkot, India

Graduate Students at Baba Farid College of Nursing, Faridkot, India

In my keynote address I explored aspects of the role of Canadian nurses as global citizens. Drawing on experiences and lessons learned through involvement in international partnerships, I shared examples of advocacy by nurses and their organizations in improving health and health systems. I highlighted current global contexts and connections for Canadian nurses including our strong link to a global nursing leadership community through the International Council of Nurses. An important new political advocacy context for nurses around the world is the launch of the United Nations Sustainable Development Goals, known as the Post-2015 Development Agenda.

My presentation slides posted here have links to references and resources for further exploration: Nursing Leadership CNSA Conference

Thanks to the conference planning committee for inviting me to speak and to all the student delegates for your interest and questions!

Nora Whyte

Sustainable Development Summit


The long-anticipated UN Sustainable Development Summit is taking place from September 25-27. For news and background, see the Sustainable Development Summit website.

The highlight of the opening day was captured in a statement released on Sept. 25:

A bold new global agenda to end poverty by 2030 and pursue a sustainable future was unanimously adopted today by the 193 Member States of the United Nations at the start of a three-day Summit on Sustainable Development.”

There will be many commentaries in the coming weeks following adoption of a new development agenda. A pre-summit statement from the International Council of Nurses offers a global nursing perspective.


Summer Reading: Sustainable Development Goals

As a keen observer of global health trends, I have been following recent discussion about the formal conclusion of the United Nations Millennium Development Goals (MDGs) this year and the launch of a new era framed by Sustainable Development Goals. National governments, international agencies, the private sector and civil society organizations have participated in drafting the new goals in advance of the UN Summit in September 2015.

Schoolchildren in Punjab, India

Known as the Post-2015 Development Agenda, it will be a single development framework to encompass three dimensions: social, economic and environmental goals. This proposed new Agenda with 17 goals builds on important work over the past decade on climate change, global financing for development and social determinants of health, among many other major issues. See the UN Sustainable Development Knowledge Platform for background documents and media releases.

Commentaries by some organizations and individuals have highlighted concerns about gaps in the framework and lack of implementation strategies; however, it’s anticipated that this final draft will be endorsed after years of political negotiations to arrive at this stage. It’s worth noting that a technical review of the 169 targets is underway by teams of experts.

All 17 goals relate to better health in the broadest sense; there are also specific health goals and targets worth a close review. The push for universal health coverage–the topic of recent global health systems efforts–is a major focus in the new framework.

In this final year of the MDGs, the World Health Organization issued a fact sheet in May 2015 with an overview of results on each of the health-related goals and targets. The fact sheet highlights achievements in specific targets for reducing child mortality; improving maternal health; combating HIV/AIDS, malaria and other diseases; improving access to safe drinking water and sanitation; and provision of access to affordable essential medicines in developing countries.

The final draft document developed in preparation for the September Summit is entitled Transforming our World: The 2030 Agenda for Global Action:

7603Final draft outcome document UN Sept Summit w letter_08072015

Posted by Nora Whyte

July 16, 2015

2014 in Review

2014 was marked by numerous opportunities to meet, exchange ideas and learn with my colleagues and to make a change in my role with the Association of Registered Nurses of BC (ARNBC).  During the course of the past 12 months, I have moved from being interim executive director to interim policy lead and, by year end, to senior consultant, nursing leadership.

I attended stimulating meetings and conferences throughout the year, the first being the annual Quality Forum hosted by the BC Patient Safety and Quality Council. The highlight was a presentation by Robert Francis, who led the public inquiry into the Mid Staffordshire National Health Service Foundation Trust in the UK. The audience heard some of the inside story through his description of meeting with patients, families and the brave whistleblowers who insisted that the systemic organizational failures be made public and acted upon. I have continued to follow the story as others have been writing about the issues that came to light and the changes underway as a result of the Francis Report.


BC Nurses at CNA AGM and Convention
June 2014

ARNBC Booth at CNA AGM and Convention 2014

ARNBC Booth at CNA AGM and Convention Winnipeg










Another important event was the annual meeting and convention of the Canadian Nurses Association in Winnipeg in June, where I was part of the team from British Columbia. Highlights included meeting nurses from across the country, observing the proceedings during the AGM, being present for the installation of Karima Velji as CNA President–and saying a fond farewell to outgoing President Barb Mildon–and holding a great breakfast meeting with the Steering Committee for the newly formed Manitoba RN Network.

Meeting of ARNBC Board and Staff with members of the Steering Committee, Manitoba RN Network in Winnipeg


Ms. Charanjit Kaur and Mr. H.C. Rawat
From Baba Farid University of Health Sciences
Visit to UBC, Vancouver – June 2014


The University of British Columbia School of Nursing in Vancouver, Canada and Baba Farid University of Health Sciences in Punjab, India have continued their partnership to advance nursing research and to strengthen hospital nursing practice through continuing education. I have enjoyed my ongoing role during the past few years as a member of the partnership advisory committee.

Visits by faculty members of both institutions continued in 2014 as they worked on joint initiatives through the support of the two universities and the Canada India Education Society.  I was pleased to reconnect with colleagues from India for an informal dinner during their visit to Vancouver in June.

These personal connections with colleagues always stand out as high points of the year as a source of inspiration and ideas for my work…to be continued in 2015.



Nora Whyte

December 31, 2014

International Collaboration for Community Health Nursing Research

Temple in Seoul

The International Collaboration for Community Health Nursing Research (ICCHNR) and the Korean Academy of Community Health Nursing are hosting the next conference to be held in Seoul in August 2015.

The theme for the 6th international conference is Knowledge Translation in Community Health Nursing Practice: Health Promotion through the Life Span.

As a longtime member, I have attended some of the past conferences organized by ICCHNR, held in various locations around the world. Each one has provided great networking, knowledge exchange and inspiration. The conferences offer an opportunity to learn about research in community contexts and  to explore new developments in the field of community health nursing practice and policy. This one will be held at the Seoul National University Cultural Centre. A venue map is available on the conference site along with the preliminary program. Members of the Korean Academy of Community Health Nursing will provide a warm welcome to all. Site visits to public health and health promotion centres will be offered to delegates (see registration form for details).

Posted by Nora Whyte

Updated December 31, 2014.


Highlights of 2013

This past year saw many positive developments in our work to build a provincial nursing association in British Columbia. The Association of Registered Nurses of BC (ARNBC) celebrated its third anniversary in 2013 and held its second annual meeting. Through a partnership with the College of Registered Nurses of BC, ARNBC has a secure future as we enter 2014. Last month we moved into a new office space on Creekside Drive in Vancouver’s False Creek area where we are so pleased to have a permanent home.

View from New ARNBC Office

ARNBC’s achievements included establishing an innovative Network Leads Program that began as a pilot initiative in the first half of the year and grew into an ongoing program with nurses and nursing students throughout BC taking on roles as ambassadors for the Association. Network Leads are demonstrating success in reaching out to their own unique networks in their communities, workplaces and schools of nursing. They share their experiences and alert the ARNBC staff and Board to emerging issues or needs for support.  Monthly meetings provide a mechanism for staying connected and updated. The Network Leads Page is a good starting point for anyone who is interested in finding a Network or in volunteering as a Network Lead.

Our social media presence grew steadily during the past year as more people used these platforms for engagement with their colleagues. It is fascinating to observe the interest generated by blog posts, as noted in this year-end article.

ARNBC is proud to be a member of the Canadian Nurses Association—2013 brought opportunities to voice perspectives from BC during the annual meeting in Ottawa in June and throughout the year with our president’s participation in the CNA Board of Directors.

Looking back on the year with its challenges and highlights, I am grateful for the opportunity to continue to work closely with remarkable nurses in British Columbia and with leaders in local and national nursing organizations.

Posted by Nora Whyte, Interim Executive Director, ARNBC

News from India: Launch of Dhahan Village Improvement Project


Visit to Dhahan Village, Punjab


Two years ago during a visit to India with colleagues from Canada, we spent an interesting afternoon touring Dhahan village in rural Punjab and meeting with community members. We learned about concerns with lack of sewerage treatment and observed issues with open ponds and garbage in this otherwise beautiful rural setting.

Last month the Canada India Education Society (CIES), in conjunction with the Dhahan village council and the Punjab state government, announced the Dhahan Village Improvement Project.

Dhahan Village 2011



Elements of the project will include a sanitary sewer system, improvements in the water supply, and installation of solar street lighting. The project also has an educational aspect aimed at raising awareness about community practices that will help maintain the overall environment of the village and its surrounding area. It is such a great example of people coming together to implement changes that will make a difference to public health and the environment.

Please visit the CIES website to view a video on the project.

Congratulations to all the partners involved in getting this initiative underway!

Nora Whyte

A Landmark Year

English Bay, Vancouver, BC
October 2012

2012 was a landmark year for the Association of Registered Nurses of BC (ARNBC). We began by launching an extensive consultation with nurses around the province—a process that forged many new connections and generated ideas for a strategic plan for the organization. In the spring we held our first Annual General Meeting and election of new board members.

In June it was a thrill and an honour to participate in the Canadian Nurses Association (CNA) Annual Meeting and Biennial Convention in Vancouver. ARNBC was recognized for developing a new provincial nursing association and was formally named as the jurisdictional member for British Columbia of the CNA. We have arrived! The presence of BC nurses was evident: Our voting delegates presented and debated resolutions, many nurses served as volunteers, we connected with delegates from across the country through our exhibit table and social events.

It has been exciting to witness increased student engagement in ARNBC this past year, particularly through student-initiated events and projects to promote awareness of the role of a professional nursing association. Students are signing up for our distribution list and are connecting via social media. During the fall of 2012, Board members gave presentations to students and faculty members in four BC schools of nursing and at the Canadian Nursing Students’ Association Western Conference held in Vancouver in October.

Reflecting on the past year, we faced typical challenges in our organizational development and we’re well aware of the work needed to build and sustain a new association from the ground up. I want to thank everyone who has supported our efforts by coming out to events, engaging through social media and by writing and commenting on our Blog. The ARNBC Blog has become the centrepiece of our social media presence and a forum for dynamic exchanges on policy issues—please visit often and offer your comments.