Shift: Conversations on Changing Canadian Health Care

KDA Consulting
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Welcome to Shift! A podcast dedicated to exploring ideas, projects, practices, and policies that are reshaping the future of health care in Canada. Each episode delves into the dynamic world of health care innovation, featuring insightful discussions with leaders, thinkers, policymakers, researchers, and direct care practitioners who are driving change and finding solutions to enhance health and health care. My mission is to illuminate the challenges and celebrate the ideas that are changing Canadian health care. From ground-breaking technologies and policy reform to grassroots initiatives and patient-centric approaches, we aim to uncover the stories behind the progress. Join me as we navigate the complexities of health care transformation, inspire meaningful conversations, and foster a community committed to improving health outcomes for all Canadians.  Whether you're a health care professional, policymaker, or simply curious about the future of health care, Shift provides the insights and inspiration change makers need to stay informed and engaged.

  1. 4d ago

    Reimagining Home Care - The Buurtzorg Way

    What happens when you stop managing nurses and start trusting them? In this episode, Kyla sits down with Jos de Blok — the Dutch nurse-turned-founder of Buurtzorg, the neighbourhood care organization that rebuilt home nursing in the Netherlands around self-managing teams instead of hierarchy. Jos started as a community nurse in the 1980s, watched that model get dismantled when the system shifted to task-based, regionalized care in the '90s, and spent the next two decades building something better. In 2006, Jos and a colleague founded Buurtzorg (Dutch for “neighbourhood care”) on a simple idea: if you give nurses real autonomy, keep the back office as small as possible, and build trust instead of surveillance into the system, both quality and cost will take care of themselves. Ten teams became hundreds within a few years. Today Buurtzorg employs roughly 15,000 people across the Netherlands — and the country's total volume of home care delivered has dropped by half, even as outcomes improved. Jos and Kyla talk about what nurses lose when hierarchy and task-based care takes over, why he believes multidisciplinary teams are often treated as a solution when they should be a last resort, and what it would actually take to bring a model like this to Canada. It's a conversation about trust, autonomy, and what becomes possible when a health system is built around relationships instead of routines. Resources & Links How Buurtzorg Works Buurtzorg in action (video) - •     Buurtzorg International — official site •     Jos de Blok's personal website •     Buurtzorg Nederland — Wikipedia overview •     World Economic Forum: “Buurtzorg — The Dutch word that could revolutionize healthcare” •     Corporate Rebels: The 7 Self-Managing Team Roles of Buurtzorg •     Academic case study: “Buurtzorg Nederland: A Global Model of Social Innovation, Change, and Whole-Systems Healing” •     Euronews: “Buurtzorg — the Dutch proximity health care revolution” •     The 90% Code

  2. Sep 1

    Season 2 Premiere: The Race to Save Medicare from Privatization

    To open this new season, Kyla sits down with retired registered nurse and author Cathy MacNeil to talk about her book Dying to Be Seen: The Race to Save Medicare in Canada. Over fifty years in the system — bedside nursing, ICU, hospital administration, and long-term care management — Cathy watched Canadian Medicare go from a hard-won, world-admired achievement to a system she believes is being deliberately dismantled. They trace the story from Tommy Douglas and the birth of Medicare in Saskatchewan, through the devastating cuts of the 1990s, to today's privatization pressures in provinces like Alberta and Nova Scotia — and close with Cathy's concrete ideas for what governments and individuals can do about it.   Resources & links   -       Book: Dying to be Seen: The Race to Save Medicare in Canada by Cathy MacNeil, or through the FriesenPress bookstore -       Film: Bitter Medicine, Part One: The Birth of Medicare — National Film Board of Canada documentary on the 1962 Saskatchewan doctors' strike and the founding of Medicare -       Canadian Health Coalition -       Canadian Doctors for Medicare -       Friends of Medicare (Alberta) -       BloodWatch.org  -       Cathy MacNeil on LinkedIn

  3. Aug 17

    The Centre Cannot Hold Summer Series Finale: Funding the Crisis, Starving the Solutions

    This is the episode where all five flaws converge. When you don't plan your workforce, don't budget for results, follow rules instead of outcomes, and never track data — you end up funding the emergency and starving the prevention, year after year, until the safety nets all break at once.  How it All Broke Report Kelly Lamrock Interview How It All Broke Videos

  4. Aug 10

    The Centre Cannot Hold Summer Series: Little data, less analysis, no follow-up

    This episode is about what happens when governments collect data but never act on it, measures inputs but never outcomes, and substitutes the phrase "we are committed to continuous improvement" for an actual plan. How it All Broke Report Kelly Lamrock Interview How It All Broke Videos

  5. Aug 3

    The Centre Cannot Hold Summer Series: The Operation Was a Success but the Patient Died

    A domestic violence survivor loses her benefits if she stays with her parents for a tenth month. A person with a disability turns down a job offer because taking it means losing housing support. A senior is denied a taxi voucher to a clinic and ends up in a hospital bed at ten times the cost. This episode is about a system organized around rule-following rather than results — and what that looks like for the people on the other side of the desk. How it All Broke Report Kelly Lamrock Interview How It All Broke Videos Human Learning Systems as a method for Reimagining Government

  6. Jul 28

    The Centre Cannot Hold Summer Series: The Budget Was Met, The Problem Wasn't

    Every year, government sets a budget for social programs. But almost nobody asks what those numbers are supposed to produce — or checks whether they did. This episode follows Lamrock's team as they ask the Department of Finance some very basic questions about its 2023 budget: what will this money do, for how many people, and how will you know if it worked? The answers — or the absence of them — will make you shake your head.   How it All Broke Report Kelly Lamrock Interview How It All Broke Videos

  7. Jul 20

    The Centre Cannot Hold Summer Series: Wait Times are a Feature, Not a Bug

    In the 1990s, as a response decades of overspending, governments facing fiscal pressure made a deliberate choice: cap enrolments in health professions, reduce training spaces, limit billing numbers. The long wait times that followed weren't an accident. They were the plan — a way to slow demand without raising prices.  Thirty years later, we're still living in the system. This episode is about how we stopped planning for the people we need, and what that costs us now. How it All Broke Report Kelly Lamrock Interview How It All Broke Videos

  8. Jul 13

    Introducing “The Centre Cannot Hold" Summer Series

    This is the episode that sets the stage. In 2024, Kelly Lamrock — New Brunswick's Child, Youth and Seniors' Advocate — released a report that asks a question most of us have been afraid to ask: what if the problem isn't the people in our systems, and it isn't the money, but the governance model itself?  This series is built on that report, and this episode explains why it matters far beyond New Brunswick. How it All Broke Report Kelly Lamrock Interview How It All Broke Videos The Second Coming (Poem) Meet the Advocate

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About

Welcome to Shift! A podcast dedicated to exploring ideas, projects, practices, and policies that are reshaping the future of health care in Canada. Each episode delves into the dynamic world of health care innovation, featuring insightful discussions with leaders, thinkers, policymakers, researchers, and direct care practitioners who are driving change and finding solutions to enhance health and health care. My mission is to illuminate the challenges and celebrate the ideas that are changing Canadian health care. From ground-breaking technologies and policy reform to grassroots initiatives and patient-centric approaches, we aim to uncover the stories behind the progress. Join me as we navigate the complexities of health care transformation, inspire meaningful conversations, and foster a community committed to improving health outcomes for all Canadians.  Whether you're a health care professional, policymaker, or simply curious about the future of health care, Shift provides the insights and inspiration change makers need to stay informed and engaged.

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