Research Article

Building a Comprehensive System of Services to Support Adults Living with Long-Term Mechanical Ventilation

Table 2

Organizational structure characteristics.

Oversight CommitteeOperations Management CommitteeTransitional care teams

Leadership(i) Organization leaders
(ii) Strategic
(iii) Vice presidents or senior directors
(iv) Chair and Vice-Chair model
(i) Organization leaders
(ii) Operational
(iii) Clinical directors, program managers
(iv) Co-Chair model
(i) Clinical leaders, operational leaders, and clinical specialists with direct client/patient responsibilities
(ii) Chair changes with case being addressed

Leadership attributes(i) A systems thinker who is able to build consensus among participants and flag strategic issues
(ii) Excellent meeting management skills
(i) An operational leader who is able to build consensus among participants and flag operational priorities
(ii) Excellent meeting management skills
(i) A clinical/operational leader who is able to problem-solve and engage senior leaders in the solution as needed

Membership(i) All member organizations(i) All member organizations(i) People within the “circle of care,” family members and client/patient

Physician leadership(i) Respirologist(i) Respirologist (i) Physician involved on a case specific basis

Decision-making(i) By consensus(i) By consensus(i) By consensus

Support roles(i) Administrative support donated by Chair’s agency
(ii) Project management support
(i) Administrative support donated by Co-Chair’s agency, shared
(ii) Project management and decision support for performance reporting
(i) Supported by lead organization for a particular case

Terms of reference(i) Yes; defines mandate, role & responsibilities(i) Yes; defines mandate, role, and responsibilities, reporting to the Oversight Committee(i) No; but process flow maps have been created to guide decision-making processes
(ii) Escalates system issues to the Operations Management Committee

Level of organizational commitment(i) High
(ii) CEO has signed off on a Memorandum of Understanding; reinforcing continuity as individuals change
(i) High
(ii) Participants involvement is supported and sanctioned by their organization
(i) High
(ii) Participant involvement is supported and sanctioned by their leaders