On June 14, 2017, I received a recognition from Ontario Minister of Labour Kevin Flynn for leading the successful delivery of the Workplace Violence Prevention in Health Care initiative. The recognition was for the project itself, its complexity, its scope, and the fact that it produced what it was designed to produce.
I want to use this moment not to talk about the recognition, but to talk about what the project actually demanded. Because the gap between what large-scale government projects look like from the outside and what they require from the inside is significant. And it is a gap that rarely gets discussed honestly.
The Scope No One Sees
The Workplace Violence Prevention in Health Care Leadership Table was a joint initiative between the Ontario Ministry of Labour and the Ministry of Health and Long-Term Care. These two ministries had not collaborated on a shared mandate since the 2003 SARS crisis, when Justice Archie Campbell’s commission found that discord between them had contributed to systemic failures that cost lives.
Fourteen years later, the challenge was different but the stakes were comparable. Fifty-six percent of all lost-time injuries from workplace violence in Ontario’s hospital sector were among registered nurses. The healthcare system was the most dangerous workplace in the province for violence. Not construction, not mining, not manufacturing.
The initiative brought together 23 Leadership Table members co-chaired by two Deputy Ministers: Sophie Dennis from MOL and Dr. Bob Bell from MOHLTC. Behind that table sat unions, hospital associations, nursing organizations, patient advocates, researchers, and regulators. In total, 108 people participated across the Leadership Table, Advisory Committee, and four Working Groups.
What Complexity Actually Looks Like
The word “complex” gets used loosely in consulting. This project earned it.
Every recommendation had to survive scrutiny from stakeholders with fundamentally different mandates. The Ontario Nurses’ Association cared about enforcement and worker protection. The Ontario Hospital Association cared about operational feasibility. Patient advocates cared about care quality. The Chief Prevention Officer cared about systemic standards. Two ministries with historically different cultures had to align on shared deliverables with real accountability.
My role as Lead Consultant was to design the structure that made consensus possible. That meant building the logic model that connected every activity to measurable outcomes. It meant managing two parallel workstreams that produced 34 deliverables across two phases. It meant developing an implementation plan with 166 key items, each with identified owners, timelines, governance structures, and KPIs. And it meant facilitating a process where every party, regardless of their institutional interests, could see their mandate reflected in the final recommendations.
The Leadership Table produced 23 consensus recommendations. Not majority-vote recommendations. Consensus. Every member signed on.
Why This Matters Beyond the Project
The recognition from Minister Flynn was meaningful because of what it represented: a project that could have stalled at any number of points actually delivered. The ministries that the SARS Commission had criticized for discord found a way to collaborate. The stakeholders who had every reason to disagree found a way to align. And the 400,000+ healthcare workers across Ontario got a framework, not just a report, designed to protect them.
Workplace violence subsequently became the first mandatory indicator in hospital Quality Improvement Plans for the 2018/19 fiscal year. Legislative amendments to the Occupational Health and Safety Act were advanced. The tools developed through the initiative remain in active use across the province.
These outcomes did not happen because the project was simple. They happened because the project was designed to produce them, with governance, accountability, and a process rigorous enough to hold 108 people aligned over sixteen months.
That is what delivering complex government projects actually requires. Not good intentions. Structure.
References
- Ontario MOL/MOHLTC (2017). Workplace Violence Prevention in Health Care: Progress Report. workplace-violence.ca
- Ontario Government. Workplace Violence Prevention in Health Care: Guide to the Law. ontario.ca
