Featured case: Can Hospitals do Health Promotion?
Making Hospitals a Place for both Care and Health through
Health Promotion

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The case

Who – the protagonist

Lauren Kitsman, Special Programs Manager for her local hospital.


Lauren’s role involved advising the hospital on how to integrate new and innovative programming into the hospital’s daily delivery of care.


A few months into her new role, Lauren was concerned by the pattern of patients being well enough to be discharged from the hospital, who would often return sicker than when they had left.

Attending a meeting with the hospital’s senior leaders, directors, and other stakeholders, Lauren questioned why they weren’t doing more for patients after they left, but the CEO responded by saying the funding wasn’t there for long-term chronic care or health promotion.

Undeterred after the meeting, Lauren set about searching the internet and reviewing literature to better understand if hospitals with health promotion approaches had been effective at improving patient care or reducing service delivery costs. Lauren knew attitudes needed to be changed.


It was autumn in 2017 when Lauren had the meeting with her colleagues.


Lauren’s hospital is based in the Canadian providence of Ontario.

Key quote

“If our patients don’t get the support they need beyond their short length of stay they will be back in hospitals – it’s a terrible revolving door.” – Lauren Kitsman, Special Programs Manager for her local hospital.

What next?

Lauren was sold by the health promoting hospital approach, which had been successful in a number of Canadian provinces, but she only had two weeks until the next executive meeting, to sell the strategy to the CEO. Lauren knew there would be opposition.

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Can Hospitals do Health Promotion? Making Hospitals a Place for both Care and Health through Health Promotion 
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Teaching note
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The author

Shannon Sibbald

Shannon discusses the need for public health cases, the debate healthcare encourages in the classroom and writing her first case.

Making the case for public health

Shannon said: “I teach in the Schulich Interfaculty Program in Public Health at Western University (Ontario, Canada) and we use case based methods.


“The challenge is there are not many truly ‘public health’ cases. While we can use a public health approach to teach a ‘business case’, I really wanted to have a case that spoke directly to the challenges and complexities of public health in practice.”

Lively discussion

Shannon added: “Our students are sometimes frustrated that there is not one ‘correct’ answer.

“Healthcare is highly politicised too, so much of the decision making in healthcare is a function of context and historical, and often political, factors. We have a diverse classroom, with students from around the world, with training in a multitude of fields that are not all health related.

“Cases like this one bring a lively discussion and our knowledge gained through the discussion is richer for it.”

the motivationThe motivation

She commented: “The story of ‘health promoting hospitals’ is all too frequent in healthcare. Money is ‘thrown’ at an issue, with not a lot of thought toward sustainability. We know that preventative care is the best approach to decreasing overall healthcare costs and improving patient well-being – yet still our system (and many systems around the world) focus on curative care.

“This case represents an ability to bridge curative and preventative. It’s a wonderful opportunity that has been tested and found great success around the world.

“I wanted to tell this story – in hopes of students (i.e. the next generation of leaders and change makers) learning about this reorientation of the health system, to see themselves in the shoes of the protagonist and to envision the change.”

Scholarship help

This case was written with the support of a Case Writing Scholarship from The Case Centre.

She continued: “The Case Centre’s requirement of teaching the case twice was really great. I tested my case with two different groups of students (one at undergraduate level, and one at professional masters’ level). The feedback from the class was helpful, but what was more impactful on the case was the reflection I did post-teaching. This made the case stronger with an overall better ‘flow’.

“The feedback from the Case Writing Scholarship reviewers was very valuable in helping tighten up the case and learning which parts to add too or take away from.”

Learning the case method

Shannon concluded: “It was a huge learning curve – I didn’t expect it would take so long. In the end, the time it took was well worth it.

“I enjoyed the process of creating a story. In academic writing, we are very factual and sometimes removed from our writing. The case writing allowed me to feel more a part of the process and the end product. I am proud of the work I did.

“I am already working on more cases – and have built in more time to test the case in the classroom.”

About the author

Shannon Sibbald is an Assistant Professor at the Western Centre for Public Health and Family Medicine, Western University.


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