What is going to happen “after” MUSCO?
How far along are we in ensuring the continuity and sustainability of our efforts?
2025 will mark the Initiative’s last effective year, as the initial funding comes to an end. Although reflections on the future of MUSCO have been underway for several years now, discussions surrounding the sustainability of MUSCO projects and the prospect of an “after” for the Initiative have been more concrete and numerous over the past year. Several possibilities have been considered, notably at the most recent meetings of the Executive Committee (EC), to ensure that the accumulated expertise and spirit of collaboration endures beyond the initial funding, whether in a perspective of continuity or duplication.
For Sam Daniel, who joined MUSCO’s EC following his appointment as Director of the Department of Pediatric Surgery at McGill University’s Faculty of Medicine and Health Sciences (FMSS) in 2023, “the foundations of MUSCO’s house have been laid, now it’s a matter of continuing to build the walls and ensuring the continuity of this ‘construction’, which still needs time to be completed”. Convinced of MUSCO’s relevance, he believes that its current achievements form the basis for a solid follow-up to the Initiative.
What have been the thoughts of MUSCO’s collaborators? What efforts have been made to ensure a smooth transition of the projects and expertise accumulated over the past six years?
A consultation process involving key players
As the title suggests, a consultation process was initiated with over 50 collaborators from various hospitals, rehabilitation centers, community organizations, including front-line workers, families and patients. A wide range of expertise was mobilized to identify existing and unmet needs that a collaborative model like MUSCO could address:
This consultation process was initiated in connection with two avenues identified by several EC members as pressing needs in the community, and for which the Initiative’s achievements could be beneficial:
- The continuum of care in pediatrics for certain diagnoses and patients, beyond the time of surgery;
- The transition to adulthood and the issues faced by patients and their families during this transition.
Discussions during the consultation process enabled the MUSCO team to identify 16 major issues in the following three main categories of continuity: informational, relational and managerial.
Presentations of findings and current thinking to decision-making committees at partner centers
These issues and MUSCO’s preliminary results were presented to a number of decision-making bodies at the partner establishments, in order to continue discussions on possible directions to take – namely, the Directors’ Committee of the Shriners Hospitals for Children – Canada, the Operational Committee of the Montreal Children’s Hospital, and the Clinical Executive of CHU Sainte-Justine. The Advisory pole comprised of patient’s parents involved in the MUSCO governance also benefited from this presentation.
During these presentations, several points were raised repeatedly by the members of those various committees:
- The desire for continuity, so as not to lose what has already been achieved;
- Recognition of the importance of the work carried out, particularly with regard to the inter-institutional trajectory of patients in the pediatric context of partner centers;
- The importance of highlighting the benefits and efficiency of current actions;
- The desire to ensure the sustainability of these achievements.
“We can see that the needs are there and will continue to exist”, explains Sam, “What’s particularly interesting is that we’re starting to see the Initiative’s impact, both qualitatively and quantitatively. This is particularly true of projects such as the Inter-establishment Navigator (IEN) and the Patient trajectory continuous improvement project, which are beginning to show concrete results. These results and advances must be preserved. I also think that in the context of a program developed between our four establishments, the key is to demonstrate how we can reach the rest of the network and see how we can include other stakeholders we met during the consultation process”.
A business plan in the making
In light of the consultation process and the discussions within the EC, the MUSCO coordination team has been mandated to draw up a business plan by early 2025, which will include the results and lessons learned from the Initiative, as well as the directions desired by the establishments’ management.
This business plan will include collaborative achievements and cross-functional results, with an emphasis on smoothing the care trajectory, on the IEN project and the Patient Trajectory project. Opportunities for deployment and/or duplication will also be shared, with a financial projection. If duplication is envisaged, it will be necessary to validate the population and beneficiaries, the objectives, the governance and partners to be mobilized, the activities and key resources.
But whatever happens, for Sam, it’s a question of ensuring that the gains made are maintained: “Sustainability can’t be based on the business plan alone. We need to sustain the benefits we’ve seen now, and not lose the gains we’ve made! We need to ensure that what has been developed over the past six years is seen and heard, and that we find a way to maintain our collaborations”.
Submission for the Prix d’excellence du réseau de la santé et des services sociaux
In addition to the consultation process, the various meetings held within the establishments and the business plan currently being drafted, steps are being taken to raise the profile of MUSCO’s projects. The IEN project has been submitted in the Partnership category of the Prix d’excellence du réseau de la santé et des services sociaux. The Prix d’excellence recognizes the exceptional commitment and collaboration of network and community players, and highlight initiatives implemented in the field for the benefit of patients.
More specifically, awards in the Partnership category recognize institutions and/or community organizations “that have relied on partnership to improve living conditions for the population”. Reciprocity of partnership, mutual support, collaboration and positive impact on the quality of care and services offered to patients are sought. Reviewed and approved by the Initiative’s partner establishments, this application aims to raise the profile of the achievements made to facilitate the inter-center trajectory of patients.
As with Sam Daniel’s considerations, and those of the other members of the EC, for the future of the Initiative, one thing is certain: reflections on the “after” MUSCO must reflect the collaborative efforts deployed to date: they must be collectively driven and thought out for the benefit of all.