Structuring the design and implementation of leadership and teamwork for program management.

Health care providers throughout Canada are aspiring to improve how they manage their resources, while maintaining or improving the quality of patient care through more patient-focused, team-based approaches. Many of the current program management models being implemented in the field are designed to realize these aspirations. Yet they are actually opposing them because of a lack of clarity about accountability and authority. Working relationships (teamwork) within clinical teams, and between clinical teams, physicians, support functions and the senior management committee, have been vague. This lack of clarity in role relationships has created many problems. This article demonstrates how we attempted to solve some of these problems at the Royal Ottawa Health Care Group.