Can Canadian Health Care Learn from Past Mistakes?

If you're leading a health focused organization right now, you might be feeling a bit like Bill Murray in "Groundhog Day" – living the same challenges over and over. (It’s a great movie if you haven’t seen it!) As someone who works with health care leaders across Canada, I see both the frustration and the opportunity this creates. While we're investing billions in system improvements, we keep encountering familiar hurdles in surprisingly familiar ways.

At Reimagining Health Care Leadership, we polled our audience on the statement, “We know enough about ‘what went wrong’ in our health care system that we will not repeat past mistakes.” The results were quite conclusive, with 79.4 % not agreeing. (44.1% in disagreement and 35.3% in strong disagreement.)

Let's be honest: it's tough to watch your teams navigate challenges that feel eerily familiar to those you faced during past reforms, public health crises, and system changes. Whether it's wait time initiatives, primary care reforms, regulatory changes, educational curriculum modifications, or electronic health record implementations, many of you have that nagging feeling of déjà vu.

But this isn't about pointing fingers. It's about understanding why this happens and, more importantly, what you can do about it.

Why Do We Keep Dancing This Dance?

Several key factors contribute to this cycle:

• Institutional Memory Loss: With high turnover in leadership positions and retiring workforce, we're losing valuable organizational knowledge
• Time Pressure: The urgency to act often overshadows the need to review historical data
• Complexity Bias: We tend to seek complex solutions when simpler, proven approaches might work better
• Siloed Learning: Valuable lessons often stay trapped within individual departments, organizations, regions, or professions

Fortunately, these patterns are breakable. As my work with various health care organizations has shown, the key lies not in creating more elaborate processes, but in building simple, effective learning systems.

Breaking the Cycle: Practical Steps for Leaders

Create a "Lessons Learned" Infrastructure

• Establish a simple, accessible database of past initiatives and their outcomes
• Implement regular "history checks" before launching new initiatives
• Develop mentorship programs pairing experienced staff with newcomers

1. Embrace "Quick Learning Cycles"
   • Run small-scale pilots before full implementation
   • Document real-time feedback and adjustments
   • Share lessons learned across departments monthly, not yearly
2. Build Cross-Organizational Learning Networks
   • Partner with other health care organizations to share experiences
   • Create regular forums for inter-organizational learning
   • Develop shared measurement systems for common challenges
3. Simplify Documentation Think "one-pager" summaries instead of lengthy reports. Include:

• What was tried
• What worked (and why)
• What didn't work (and why)
• Key lessons for future initiatives

The Cost of Not Learning

The cost of repeating past mistakes isn't just financial – though that cost is substantial. It's also measured in staff burnout, missed opportunities for improvement, and slower progress toward better care. Every time we repeat a past mistake, we're not just wasting resources – we're potentially losing valuable team members who become frustrated with the lack of progress.

The Path Forward

The solution isn't more complex planning – it's better learning systems. I've seen organizations transform their approach by implementing simple, consistent learning practices.

The difference between those who succeed and those who struggle often comes down to how effectively they learn from the past. And you have something previous generations didn't: unprecedented access to data about what works and what doesn't.

The past isn’t just a story to tell – it’s a tool to use.