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About The Restorative Leadership Symposium

The Restorative Leadership Symposium, hosted by the Ministry of Health, Health Quality BC and the BC Restorative Circle, brought together social sector leadership, with an emphasis on health leadership, to develop and enhance systems understanding of a Restorative Approach. The focus of the symposium was at the governance, executive and management levels but included discussions of preventing and healing from harms in clinical practices and dispute resolution processes.   

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Keynote Speakers and Panel Discussions

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What is a Restorative Approach? Why & How it Matters for Health Care

Jennifer Llewellyn opened the first day of the symposium with a presentation on ‘Cultivating Caring Leadership and Embracing a Restorative Approach’. Professor Llewelyn provided an overview of the theory of a Restorative Approach and why system transformation is needed, and shared learnings from her years of experience leading restorative processes.
Learn More and Watch What is a Restorative Approach? Why & How it Matters for Health Care
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Shifting Paradigms to Identifying & Responding to Harm in Health Care 

Kelly Smith presented on the benefits of a ‘Communication and Resolution Program’ and walked the audience through two case studies in the United States, one in a state-run hospital, and another involving a 10 hospital system, in which the implementation of restorative principles and a human-centered model of responding to harm had profound benefits for patients, staff, and healthcare system.
Learn More and Watch Shifting Paradigms to Identifying & Responding to Harm in Health Care 
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Panel Discussion: Understanding & Integrating a Restorative Approach

The panel brought together the patient, physician, and executive leadership perspectives to the topic of integrating a Restorative Approach into healthcare. The panel shared their personal and professional experiences of how the health system responds to when harms have occurred, emphasizing the need to bring humanity back into processes that are both dehumanized and dehumanizing. 
Learn More and Watch Panel Discussion: Understanding & Integrating a Restorative Approach
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Panel Discussion #3: Considering Legal and Legislative Spaces

The panel discussed a Restorative Approach in legal and legislative spaces, and brought forward diverse perspectives from the legal, medical, and finance sectors on how to move towards a just and restorative health system. The discussion highlighted barriers to a Restorative Approach in the current medical, legal, and regulatory system landscape, and steps that can be taken to move multiple sectors forward in unison to achieve systemic transformation.
Learn More and Watch Panel Discussion #3: Considering Legal and Legislative Spaces
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Patient Reflection: Bringing it All Together

Carolyn Canfield provided closing remarks for the Restorative Leadership Symposium that highlighted the centrality of trust in a Restorative Approach. Carolyn reflected on the social determinants of trust and the importance of cultivating and role-modelling good relationships in the workplace to gaining the trust of the patient.   Carolyn CanfieldIndependent Citizen-PatientAdjunct Professor, Dept of Family Practice,…
Learn More and Watch Patient Reflection: Bringing it All Together

Working Together to Adopt a Restorative Approach

The symposium attendees engaged in a live Thought Exchange, which is an online engagement platform in which they identified challenges and barriers, opportunities, and next steps that were discussed throughout two breakout sessions at the symposium. Key themes of the feedback highlight the multifaceted challenges and considerations involved in implementing a Restorative Approach, emphasizing the need for education, cultural humility, trust-building, and a shift in systemic attitudes and structures. The following is a consolidated summary of the feedback from the Thought Exchange, and from the Q&A sessions with panelists.

Challenges and Barriers  

  • Adopting a Restorative Approach is the transformation of a complex and adaptive health system that also involves significant changes to legal and financial systems, Health and Human Resources (HHR) practices, and cultural norms and expectations. It will require sustained change leadership and collaboration across the health, social, legal, and financial sectors. Power dynamics, risk aversion, and a lack of understanding of a Restorative Approach were identified as barriers to system transformation.  
  • Legislation, and/or the interpretation of legislation, specifically section 51 of the evidence act can prevent the sharing of knowledge, which is integral to a Restorative Approach. The challenges in collecting data on patient perspectives, and evaluating the impact and success of a Restorative Approach, were identified as key barriers.  
  • The application of a Restorative Approach as a resolution process is a lengthy and in-depth process that can place an added burden on an already strained workforce. Without adequate training and structural support, the misapplication of a Restorative Approach can exacerbate moral distress, systemic racism, and cause compound harms.  
  • A colonial mindset, and the inherently colonial structure of the healthcare system, were identified as a barrier to a Restorative Approach. The lack of awareness and understanding of Indigenous worldviews, a reluctance by some to prioritize cultural safety and humility, and a fear of the unknown is viewed as a contributing factor in the health systems’ resistance to change.   

Opportunities

  • The need for systemic improvements to patient safety & quality processes, as well as HHR and Occupational Health and Safety (OHS) concerns to improve worker wellbeing, has been acknowledged, and there is momentum for change by motivated actors from the patient, health care provider, legal, and finance perspectives.   
  • First Nations and Métis Nations and organization have paved the way for system improvements in cultural safety and humility and Indigenous-Specific Anti-Racism (ISAR), as exemplified in the In Plain Sight report and the FNHA & HSO Cultural Safety and Humility Standard. The alignment of a Restorative Approach with the principles of CSH and ISAR can be an asset in advancing both streams of transformational change.  
  • Decades of work in restorative justice underpins and the adoption of a Restorative Approach in healthcare, and it has been successfully adopted in multiple jurisdictions in the United Kingdom, United States, Aotearoa (New Zealand), and Australia, providing BC with principles, process considerations, and guidelines to adopt a Restorative Approach.  
  • The BC Health System is structured in a way that encourages collaborative action to work across traditionally siloed institutions. Multiple strategies and commitments in the healthcare system, such as the HSO CSH Standard and The Declaration on the Rights of Indigenous Peoples Act align with and can benefit from adopting a Restorative Approach.  

Next Steps for System Enhancement  

Systemic coordination to guide the adoption of a Restorative Approach is provided by the BC Restorative Circle. Next Steps from the Restorative Leadership Symposium implicate leaders from multiple social sectors and emphasize the need to align efforts across legal, financial, and health systems.  

  1. Maintain Momentum with Increased Inclusion and Collaboration
    • Partner and engage with First Nations and Métis Nation BC to understand and advance Indigenous perspectives on adopting a Restorative Approach to ensure that it is a culturally safe and appropriate approach to responding to the unique nature of colonial processes, systems of white supremacy, and Indigenous-specific racism. Focus on relational and trauma-informed approaches.  
    • The BC Restorative Circle to host follow-up events to the Restorative Leadership Symposium.  
  2. Support Capacity Development and The Prioritization of a Restorative Approach 
    • Support education, learning and development in collaboration with health system, education, and legal professionals, and patient partners. Develop learning resources including frameworks, principles, and ‘guardrails’ to guide the adoption of a Restorative Approach.  
    • Identify change leaders to role model cultural humility and restorative practices and champion a Restorative Approach.   
    • Prioritize a Restorative Approach with adequate resourcing for organizational change and capacity development at all levels.  
    • Support system learning through transparency, information sharing, and accountability throughout change leadership and change management processes.  
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See the Data Gathered Post-Event

This report provides an overview of the data gathered from the Restorative Leadership Symposium.

Restorative Leadership Symposium  – Summary Report

The Restorative Leadership Symposium  – Summary Report is coming soon.