Challenge

The Nuclear Waste Management Organization (NWMO) was established as a requirement of the Nuclear Waste Fuel Act to develop a long-term management strategy for used nuclear fuel in Canada. In current practice, once nuclear fuel products are removed from reactors, they are safely stored at licensed facilities located where fuel is produced. However, long-term planning requires the development of a safe and secure storage and transportation system for these products.

After the NWMO conducted a three-year collaborative study with over 1000 citizens, Adaptive Phase Management (APM) was identified as a suitable management framework, as it incorporated a high level of flexibility and adaptability into the decision-making process. In 2007, the federal government approved the APM approach and gave the NWMO the mandate to implement it. The NWMO’s next task was to engage citizens in designing a site selection process for “an informed and willing community” to host the management facilities in a deep geological repository. The goal was to ensure that the implementation of the APM accurately reflected their values, concerns and expectations at every step of the way.

Approach

To continue and strengthen its dialogue with Canadians, Ascentum collaborated with NWMO to design, implement and report on two daylong dialogues with members of its Citizens’ Panels (recruited from community-engaged opinion leaders). Ascentum also collaborated on the design of five Public Discussion Groups to engage a broader cross-section of citizens on this issue.

Results

The two Citizens’ Panel Dialogues engaged over 60 participants, with representation from each of the four provinces involved in Canada’s nuclear fuel cycle. Additionally, each of the five Public Discussion Groups brought together 14 to 18 randomly recruited citizens from different cities across Canada.

The engagement process revealed a number of shared values and expectations between the Citizens’ Panel and Public Discussion Groups, even though their experience and degree of familiarity with the issue varied. Both groups generally agreed that the proposed guiding principles and the site selection process were fair and appropriate. Importantly, participants provided the NWMO with many valuable ideas for refining and strengthening these processes, and clarifying the reference documents.

Additionally, participants felt very positively about their dialogue experience. Feedback through written evaluations revealed that all participants either agreed or strongly agreed that they enjoyed participating in the meeting; and that the facilitators were effective in promoting reflection and constructive, respectful dialogue. The dialogues contributed to the final site selection process for the identification of a willing and informed host community. The dialogue reports can be found on the NWMO website http://www.nwmo.ca/

Share Your Story, Shape Your Care community online dialogue

Northwestern Ontario is a unique place with a special set of health care challenges.  People living in the region have poorer health than anywhere else in Ontario, and have the furthest to travel to access health services.  It’s a population of a few hundred thousand people spread across an area the size of France.

The North West Local Health Integration Network (LHIN) manages how heath services are delivered and knew they needed to listen to and involve local communities in setting a care plan for the future.  That’s why they decided to work with Ascentum.  The resulting partnership led to Share Your Story, Shape Your Care – a game-changing online engagement initiative that received the International Association for Public Participation (IAP2)’s inaugural Innovation of the Year award for 2009.

Ascentum built a suite of online and in-person tools to involve local patients, health care workers and stakeholders.   These included an online deliberative Choicebook™, a stories and ideas sharing platform and a creative community Conversation Guide to empower people to host their own dialogues on local health care solutions at home, at work or in their neighbourhoods.

By the time Share Your Story, Shape Your Care had ended, the LHIN had:

• Heard from over 800 people across Northwestern Ontario
• Learned more about patients’ and health professionals’ experiences with the health care system
• Identified clear public values and priorities for the future of local health care.
• Gathered 100s of new insightful ideas on how to provide services differently and more effectively

Share Your Story, Shape Your Care allowed the North West LHIN to develop a health services plan that more closely reflected the values of local communities and their health care needs.

And, it further enhanced their reputation as a government agency that listens closely to public views and gives them close consideration when making tough decisions.

Choicebook
The Choicebook was an interactive experience that allowed participants to provide informed perspectives on key issues, through facts, scenarios and background information. It collected by qualitative and quantitative data that was straightforward and highly accurate.

Stories/Ideas
This tool allowed participants to share their own experiences and their own solutions directly with the North West LHIN.  People could also choose to make their story or idea public, posted in near-realtime after review for appropriateness.

Conversation Guide
This tool was designed to foster small participant-led and organized group dialogues in communities across Northwestern Ontario, with simple steps to send the results back to the LHIN.  Different participant and facilitator versions helped people run moderate their own conversations, even if they had never done so before.

To learn more about this project, please contact us.

Engaging Canadians in a Dialogue to Set the Goals for a Pan-Canadian Mental Health Strategy: Stakeholder Dialogues and Online Public & Stakeholder Consultation

The Challenge

In 2007, the federal government, in collaboration with provincial and territorial governments, announced the creation of the Mental Health Commission of Canada – an organization mandated to be the catalyst for the development and implementation of a mental health strategy for Canada, one that will ultimately lead to a deeply transformed mental health system.

Canada’s lack of a national mental health strategy is in part  a result of our constitutional reality: health care and social services are largely the responsibility of provincial and territorial governments. Given this fact, the Commission though tasked with leading the creation of a mental health strategy for Canada, does not have the authority to implement or evaluate it. Consider therefore the Commission’s challenge: the creation of a consensus-based framework to guide the implementation of a comprehensive, pan-Canadian strategy for mental health promotion, prevention and treatment… while working within the parameters of  Canada’s complex constitutional context and history, and given a vast array of competing interests for limited resources.

The Approach

As it embarked on this journey, the Commission felt it was critically important to engage as wide a range of people as possible, including: people living with mental health problems and illnesses, their families and caregivers, mental health service providers, researchers and policy experts. It also wanted to connect with  people who are concerned about mental health issues, whether or not they are currently involved with the mental health system.

To this end, Ascentum collaborated with the Commission to design and deliver a series of 15 regional stakeholder dialogues, along with a parallel online consultation process open to all individuals and organizations with an interest in this issue:

Regional dialogues

Ascentum designed, facilitated and reported on 15 full-day dialogue sessions, which brought together a diverse mix of individuals and stakeholders, including two sessions dedicated to delving deeper into the specific perspectives, needs and concerns of Canada’s Aboriginal peoples (through their national leadership) and of health and social/community services professionals (through their national professional associations).

These dialogues were designed to provide participants with an opportunity to learn about the proposed strategy Framework (which outlined 8 proposed goals for the strategy) in plenary and small groups, and to provide concrete feedback on what they liked, were concerned about and wanted to change/add to the Framework. The facilitators also used electronic voting keypads to test agreement with each proposed goal and with the Framework as whole  at the beginning and end of the day, to measure shifts in perspectives. A summary of the day’s discussion was posted on the Commission’s blog at the end of each session.

Innovative online participation website: public and stakeholders

Ascentum developed and hosted a customized participation website on its dialoguecircles.com platform. First, an online workbookTM provided a brief overview of the Commission’s proposed Framework and allowed participants to react to each goal through a mix of close-ended and open-ended questions. The online workbook also included pre- and post-test questions to measure shifts in views on the 8 proposed goals as a result of completing the online workbook. Members of the general public and representatives of stakeholder groups completed the same online workbook to facilitate a comparative analysis of their respective perspectives.

Second, each audience was offered the opportunity to provide “free form” qualitative comments -  in the form of personal stories and ideas for members of the public and more formal comments and suggestions for stakeholder organizations. Public participants could choose to register or participate anonymously, and could elect to share their stories and ideas on the website for other visitors to read or submit them for analysis only.

Participation Website: Online Workbook:

Participation Website: Shared Stories

The Results

Over 450 people, from coast to coast to coast, participated in the Commission’s Regional Dialogues, between January and April 2009. In addition, over 1,700 members of the general public and 300 stakeholder groups availed themselves of the opportunity to share their views with the Commission online between February 11 and March 31, 2009, completing some 1,800 online workbooks and providing over 465,00 words of comments (just a few pages short of “War and Peace”!). Moreover, in their evaluations of the process, the majority of participants expressed their willingness to remain engaged in the Commission’s work moving forward.

The Commission’s commitment to active listening was demonstrated by the extent to which it revised the final Framework document to reflect the weight and direction of public and stakeholder input: the Framework document was substantially modified to reflect what they heard, including the insertion of a vision statement, a reframing of the goal statements, the redefinition of key concepts and the elimination of one goal. Most importantly, as it engages in the most difficult portion of this journey – defining HOW to achieve the goals set out in the revised Framework – the Mental Health Commission of Canada can leverage the relationships and trust it has begun to build through this process  – all with a view to catalyze the change hoped for by the one in four Canadians who live with or have experienced mental health problems and illnesses.