Making sense of recurrent boom and bust cycles in Canadian public health systems.

Abstract

Public health systems undergo recurrent "boom and bust" cycles, also described as panic and neglect. Given such turbulence, we argue that Canadian public health workers, institutions, and systems would benefit from more spaces for sensemaking and policy capacity. This commentary shares observations on these public health cycles. It builds on specific concepts and frameworks from the disciplines of organizational development, health policy, public health sociology, political science, and public administration. It contends that holding organizational spaces for sensemaking is possible and useful for at least five reasons: (1) it may help public health workers contend with the complex dynamics underlying their daily work, (2) fortifying policy capacity (particularly analytical competences) can be a stepping stone in the process of becoming better learning organizations, (3) discerning common patterns or helpful strategies to better cope with change likely paves the way for more efficient and better-adapted solutions, (4) creating spaces for sensemaking may lead to innovations in public health decision-making, such as more meaningful citizen participation and greater staff involvement, (5) securing sensemaking spaces while maintaining day-to-day operations is feasible, even in the midst of major reforms.