Lesson #2: How do you know? Or what should you know?

February 23, 2023

I often get asked, how do we at the Foundation know we are tackling the right problem with the right solution. The truth? We don't. The world is full of uncertainties and there is no shortage of "problems to tackle", just look around your home, neighbourhood or scroll through the newspaper.

Instead, we begin with those things we know, or rather should know. We know our mandate is to invest in initiatives that stand to improve the quality of life for people in BC. Ambitious, I know. From there we settled on working across three sectors we believe are fundamental building blocks of our society and access to which should be a fundamental human right. Those sectors are healthcare, education and social services, or in our vocabulary the sectors of care.  We then defined the aging population as our current priority. And lastly we say we want to see a fundamental shift in policies, practices, relationships, power dynamics and deeply held norms and values. Okay, still ambitious I admit, but with clearly defined direction.
What we focus on next is understanding, in great detail, the day to day circumstance of the aging population, especially those more likely to regularly need the institutions and services of those three sectors.  We allow for their lived experience to dictate what matters the most, to them and therefore to our work. For example, prior to Covid-19 pandemic, we spent weeks in long-term care homes understanding what it is like to be a resident in a publicly funded care home. News flash, not great. What did we learn mattered most to people living in such circumstances? Their independence. The ability to make simple choices such as what food to eat, when to take a bath and who to socialize with and when. Shocking right? But our system has repeatedly denied them those choices for the sake of efficiency and risk-management practices.
Because our work is across three sectors that are mandates of our Provincial government we also watch closely their leadership. We applaud their commitment to invest in and improve long-term care in our Province. The COVID-19 pandemic had laid bare all that  needs to shift in long-term care  and it is good to see public leadership that recognizes that we need to and should do better. Without government as an active participant, systems change is impossible to achieve, certainly not in the sectors we are speaking of.
Once we’ve gathered the first hand experience,  assessed the opportunity window for systems change, we focus on those working on the front lines. Their daily experience gives them a unique insight in what needs to change. Often, those on the front lines already have informal work-arounds for the systemic barriers. We can all agree, that removing the barriers would be much preferred.  We ultimately fund those on the frontlines to make the change happen and support them every step of the way. And they can’t do it alone it is a collaborative partnership of a range of stakeholders that can lead to big shift in systems. It is a long, complex, non-linear work and often excruciating. Which is why it requires a commitment to work together towards the same goal.
If we can agree on that commitment we can find a way through. It might not be the best, the most polished or even the first solution we envisioned. And yet we will make it through with better suited systems for the current era.
 As for long-term care, we hope the socio-relational model of care becomes THE STANDARD of care. You can learn more about the Foundations work to transform long-term care here!
You should know :
…your mandate and values.
…what are the real experiences of real people your solution is trying to “solve for”.
…which organizations are doing good work.
…where is capacity for the big job of systems change.
…if there is an opportunity window for a bigger system shift.
There is no such thing as  “the RIGHT problem” or “THE solution”. There is your commitment to put in the work together with your partners.
All my best,

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