Redesigning public sector community care delivery at massive scale

How we co-created a new model of community and mental health care for ~3 million people


Clarity of Direction

Clarity of Action


The Ontario government agency coordinating community and mental health care for ~3 million people living in Toronto was legislated to integrate 170 partner agencies delivering front line patient care into a new, centrally controlled Ministry of Health entity. This monumental change in approach to community care could lead to massive disruption. The Ministry of Health wanted to take a co-creative approach with all stakeholders to build the 5 year strategy for what the future would look like as an integrated entity.


Strategic Framework & Vision

Working with a cross-functional leadership team that encompassed administrators, patient/advocacy leaders, government leaders, physicians, and allied frontline healthcare providers, we developed a strategic framework encompassing the key pillars for future services delivery across the scope of community care. We also co-created a shared vision of the ideal future integrated care model that all stakeholders collectively aspired to achieve.

Massive Scale Co-Creation

To build the actual content of the strategic plan, we designed and facilitated a massive scale co-creation program for 250+ participants. Patients were trained to lead small group discussions on dozens of relevant topics.  Each small group included physicians, nurses, administrators and other patients, ensuring that cross-stakeholder needs, barriers and enablers were integrated into the discussion. Stakeholders were able to design the elements they wanted to see implemented in their future centrally-controlled community care ecosystem.

Strategic Narrative & Communications

Following completion of the co-creation, the strategy was further refined and integrated into the Ministry’s 5 year plan. Communications were developed for public dissemination, including policy documents and a website for general population awareness and use.

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Immediate Endorsement

Following widespread appreciation and buy-in across stakeholders for the approach taken for the initiative, the new model for community care was endorsed by the Ministry of Health and fast-tracked for implementation (24 month planning process was accelerated by one year).

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