Competency Framework - First Nations Health Managers ...€¦ · Draft Competency Framework developed December 2008 First Nations Health Managers Forum in Vancouver,BC July 2009 2006

CompetencyFramework

FIRST NATIONS HEALTH MANAGERSCOMPETENCY FRAMEWORKThe First Nations Health Managers Competency Framework has been developed by the First Nations HealthManagers Advisory Committee. It describes the competencies, and competency indicators of a First NationsHealth Manager in carrying out his/her work in order to assist First Nations Health Managers and their employ-ers in better understanding the complexity of the work. The aim is to provide First Nations communities andorganizations with a tool to help improve their awareness of the strengths and challenges of First NationsHealth Managers and assist them to focus on developing other competencies in themselves, as well as beingable to recognize these qualities in others.

ACKNOWLEDGEMENTS:The First Nations Health Managers Advisory Committee acknowledges the work of the File Hills Qu’AppelleTribal Council (FHQTC), which formed the foundation for this framework.

First Nations Health Managers Advisory Committee Members:Current members:Darlene Anganis (Paul), Membertou First NationDonna Metallic, Listuguj Mi’gmaq First NationDavid McLaren, Eagle Village First Nation KipawaAndy Wood, Four Arrows Regional Health AuthorityDoris Bear, Peguis First NationKaren Schmidt (Arnason), All Nations Healing Hospital and File Hills Qu’Appelle Tribal CouncilMary Carlson, Lac La Ronge Indian BandElla Arcand, Tribal Chiefs Ventures Inc.Laurette Bloomquist, Tla’amin Community Health Board Society

Past members:Roxanne Sappier, Tobique First NationArmand Jourdain Sr., Couchiching First NationMelody Genaille, Nisichawayasihk Cree NationChris Shade, Blood Tribe Department of HealthKeith Leclaire, Kahnawake Health ServicesCindy Thompson, Mohawks of the Bay of QuinteJeanette Watts,Nuu-Chah-NulthTribalCouncil

The First Nations Health Managers Advisory Committee also acknowledges the supportand contributions provided by the Assembly of First Nations (AFN) and Health Canada:Valerie Gideon (previously AFN), First Nations and Inuit Health, Ontario RegionRose Sones (previously AFN), First Nations and Inuit Health Branch, OttawaElizabeth Cook, Assembly of First NationsValerie Richer, Assembly of First NationsDebra Gillis, First Nations and Inuit Health Branch, OttawaLori Keith, First Nations and Inuit Health Branch, OttawaJanet Binks, First Nations and Inuit Health Branch, OttawaMarion Crowe, First Nations and Inuit Health Branch, OttawaSteven Phaneuf, First Nations and Inuit Health Branch, OttawaBeth Lewis, First Nations and Inuit Health, Atlantic RegionGloria Letendre, First Nations and Inuit Health, Alberta RegionSuzanne Pinsent, First Nations and Inuit Health, Alberta RegionKandice Terris, First Nations and Inuit Health, Atlantic Region

Table of ContentsVision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

Definition of a First Nations Health Manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2Objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2History of the First Nations Health Managers Competency Project . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

Introduction to the First Nations Health Managers Competency Framework . . . . . . . . .5Domains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

The Ten Domains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6Leadership and Governance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6Professionalism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7Advocacy, Partnerships and Relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8Human Resources Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9Financial Management and Accountability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10Health Services Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11Quality Improvement and Assurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14Cultural Awareness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Appendix AGlossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Appendix BReferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Competency Framework 1

Competency Framework

DEFINITION OF AFIRST NATIONSHEALTH MANAGERA First Nations Health Manager is someone who worksin a First Nation community or Tribal Council andhas the responsibility for the management of healthhuman resources, financial resources and healthprograms. They might also provide leadership anddirection around resource planning, change manage-ment, and health and social program delivery, theymay also be a manager of a community health facility,addictions treatment centre or health centre andhealth programs. Titles used to designate a FirstNations Health Manager include CEO, Health Director,Health Coordinator, Health Manager, Health andSocial Services Director and Executive Director. Thereare approximately 500 First Nations Health Managersin Canada.

OBJECTIVEThe objective of this work was to develop aframework that describes the competencies, skillsand knowledge of a First Nations Health Manager incarrying out his/her work and to assist First NationsHealth Managers and their employers in betterunderstanding the complexity of the work. Thisdraft framework was presented at the First NationsHealth Managers Forum in January 2009, and thefeedback from the Forum has been incorporated intothis document. The aim is to provide First Nationscommunities and organizations with a tool to helpimprove their awareness of the strengths and chal-lenges of First Nations Health Managers and assistthem to focus on developing other competencies inthemselves, as well as being able to recognize thesequalities in others.

HISTORY OF THEFIRST NATIONSHEALTH MANAGERSCOMPETENCY PROJECTThe need for a First Nations Health Managers compe-tency framework was identified by the Assembly ofFirst Nations (AFN) and the First Nations and InuitHealth Branch (FNIHB). The AFN and FNIHB jointlydecided to establish a First Nations Health ManagersAdvisory Committee in 2006. The First Nations HealthManagers Advisory Committee was comprised of14 First Nations Health Managers representing allregions. Members were identified by First Nations andInuit Health (FNIH) regional offices and the NationalFirst Nations Health Technicians Network.

In 2007 a situational analysis and needs assessmentwas conducted by the First Nations Centre of theNational Aboriginal Health Organization (NAHO) togain a greater understanding of the role, experiencesand learning needs of First Nations Health Managersacross Canada. Based on this research, draft compe-tency domains were developed and presented toover 300 First Nations Health Managers at a FirstNations Health Managers Forum in March 2008 forfeedback and review.

Based on the positive feedback from First NationsHealth Managers, and their support for furtherdevelopment of the competency framework, the FirstNations Health Managers Advisory Committee identifiedthe requirement to further define the domains, describethe competencies within each domain and identifyhow the skills and knowledge of each competencywould be demonstrated by a First Nations HealthManager. A literature review of a number of health

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VisionFirst Nations Health Managers are leaders who honour, maintain and uphold inherent ways

of knowing while balancing management principles to bring excellence to their communities

and health programs.

and other domain leadership competencies, includ-ing those within a First Nations context,was firstcompleted to inform the framework development(see references). At the same time the File HillsQu’Appelle Tribal Council (FHQTC) was completingthe development of a competency framework forHealth Managers within their Tribal Council, in prepa-ration for the development of in-depth training.Thedraft First Nations Health Managers Framework wasthen presented at the First Nations Health ManagersForum to over 800 participants in January 2009.Thefeedback gathered at the Forum was incorporatedinto this final document.Thus, this framework wasdeveloped using a variety of sources, but most impor-tantly through the experiences shared by FirstNations Health Managers themselves.

The First Nations Health Managers AdvisoryCommittee feels this framework is the first step in along road leading to recognition of the pivotal role ofthe First Nations Health Manager in the First Nationshealth system.

How can this framework be used?The framework has a number of uses:

» It clearly outlines the complexity of the role of aFirst Nations Health Manager and will provideemployers and funders with a better appreciationof the scope of work;

» It provides First Nations communities with a valu-able tool to help improve their ability to retainand/or recruit First Nations Health Managers;

» It can be used by individual First Nations HealthManagers to assess their own knowledge andabilities and identify areas that they wouldlike to further enhance through formal orinformal training;

» It can be used by educational institutions or aFirst Nations Health Manager association ornetwork to potentially look at curriculum devel-opment that further supports the needs of ourcommunities by having trained leaders.

It is important to note that the framework is notmandatory, that it will not be used to judge the meritsof a particular health manager. It is a tool for your use.These competencies are standards of excellence forFirst Nations Health Managers to strive towards.


First NationsHealth Managers

Advisory Committeeformed

March2007


Forum inEdmonton, AB

July2008


Draft CompetencyFramework developed

December2008


Forum inVancouver, BC

July2009

2006

Timeline of the First Nations Health Managers Project

NAHO Nationalsituational analysis &

needs assessmentcompleted

March2008


Advisory CommitteeLiterature Review

December2008

AFNResolution

January2009

FNHMCompetencyFramework

Approved by FNHMAC

FNHM_Comp_Frame.qxd:Layout 1 9/2/09 11:12 AM Page 3


Cultural Awareness is at the centre of the wheel as it is an integral part of each component.

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Leadership & Governance

Professionalism

Advocacy,Partnerships and

Relationships

Health Services Delivery

Quality Improvement & Assurance

Human ResourcesManagement

Financial Management &Accountability

Planning

Communication

CulturalAwareness

A competency is an observable and/or measurableknowledge, skill or behaviour that contributes to suc-cessful job performance. Competencies are intendedto provide a clear picture of the types of behavioursrequired in a particular job in order to support suc-cessful performance within an organization.

DOMAINSFollowing the results of the needs assessment andsituational analysis, key domains were identified andvalidated during the initial First Nations HealthManagers Forum in March 2008. The National FirstNations Health Managers Advisory Committeedefined 10 domains under which competencieswould be identified and described. The domainsprovide the broad areas that are consideredmost important in the role of a First NationsHealth Manager.

The Ten Domains:» Leadership and Governance» Professionalism» Advocacy, Partnerships and Relationships» Human Resources Management» Financial Management and Accountability» Health Services Delivery» Quality Improvement and Assurance» Planning» Communication» Cultural Awareness

The domains are listed in the order in which theyappear within the wheel.

Within each domain, there are Core Competenciesthat will further describe key skills, abilities,behaviors, attitudes and knowledge.

These core competencies will be demonstratedacross Competency Indicators and are describedthrough technical, interpersonal, and analyticalperspectives. These Competency Indicators demon-strate and describe the behaviors and abilities ofsuccess, provide examples of effective managementand leadership, and connect the domain to the com-petency through the various ‘lens’ of management.


Introduction to the First Nations HealthManagers Competency FrameworkThis framework begins to describe competencies of First Nations Health Managers – including

skills, abilities, behaviors, attitudes, and knowledge. First Nations Health Managers have

many competencies. This tool will increase our awareness of our own strengths and

challenges and assist us to focus on developing other competencies in ourselves, as well as being

able to recognize these qualities in others. These competencies are standards of excellence.


Competency Indicators1. Applies the mission and priorities of the

organization into regular practice.2. Facilitates others to establish a common vision,

goals and outcomes, and develops strategies toachieve them.

3. Establishes goals, deliverables, time linesand budgets.

4. Demonstrates trust-building communicationwith team members.

5. Resolves conflict in the organization usinginterest-based conflict resolution andmediation techniques.

6. Motivates and inspires staff to achievework potential.

7. Uses group decision-making methods topromote teamwork.

8. Conducts quality reviews of team projectsand guides the team through them.

9. Implements and sustains positive change.

10. Leads staff through stressful or unusualsituations and maintains positive morale.

11. Empowers staff to undertake their ownproblem-solving and organizationalimprovements.

12. Develops and maintains organizationalperformance standards.

13. Obtains constructive feedback from andprovides feedback to the team.

14. Builds constructive and supportive networksand relationships.

15. Maintains awareness of new informationrelated to job.

16. Gathers and analyses client feedback to informorganizational development.

17. Shares knowledge, tools and expertise tocontribute to capacity building.

18. Utilizes negotiation skills in health care delivery.

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The Ten DomainsLEADERSHIP AND GOVERNANCE

Within this domain, a First Nations Health Manager is a leader who focuses on leadership

and governance competencies that build capacity to improve performance and enhance the

quality of the working environment. They enable organizations and communities to create,

communicate and apply shared visions, missions and values.

Core CompetenciesThe First Nations Health Manager demonstrates:1a) Knowledge and abilities in leadership based on

values and a shared vision in planning and imple-menting programs and policies.

1b) Knowledge and abilities to facilitate and employa team approach within the community-basedorganization.

1c) The ability to build capacity within the organiza-tion and the community.

1d) The ability to guide and manage change,consistent with the vision and values ofthe organization.

Competency Indicators1. Identifies, acknowledges and analyses own

emotional responses to the histories andcontemporary environments of First Nationspeoples and offers opinions respectfully.

2. Engages in dialogue and relationship buildingwith First Nations peoples to improve healththrough increased awareness and insights ofFirst Nations cultures, and health practices.

3. Develops and applies codes of conduct andethics in the workplace.

4. Describes examples of ways to respectfullyengage with and give back to First Nationscommunities.

5. Acknowledges and analyses the limitations ofone’s own knowledge and perspectives, andincorporates new ways of seeing, valuing andunderstanding with regard to First Nationshealth practice.

6. Provides an orientation of the health programsto new leaders and community memberswhen needed.


2 PROFESSIONALISMWithin this domain, a First Nations Health Manager is a leader who lives and embraces

the Seven Teachings of trust, respect, honour, honesty, humility, courage and truth with

competence and integrity.

Core CompetenciesThe First Nations Health Manager demonstrates:2a) Knowledge and awareness of self and others

to perpetuate the Seven Teachings in thework place.

2b) The ability to stay current on, and incorporatenew health services and management informa-tion to ensure quality services are provided tothe community.

2c) The ability to ensure community healthprograms and services are founded on a codeof ethics.


Competency Indicators1. Identifies and builds effective partnerships with a

variety of First Nations, non-governmental andgovernmental agencies to achieve mutual bene-fits in addressing health issues.

2. Utilizes a variety of public relations and commu-nications skills such as presentations, negotiation,mediation, and collaboration to achieve organi-zational goals.

3. Integrates community-approved traditionalhealth practices and resource people in additionto other health professionals.

4. Demonstrates an understanding of the inter-jurisdictional relationships in health service delivery.

5. Recognizes and participates on selectedcommittees that can improve community-basedhealth services.

6. Advocates for healthy public policies and serv-ices that promote and protect the health andwell-being of individuals and communities.

7. Recognizes the political supports available andknows when to utilize them.

8. Advocates for positions in facilities, like hospitals,that can liaise and share cultural aspects withhospital staff, Aboriginal patient navigators andportfolio holders.

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3 ADVOCACY, PARTNERSHIPS AND RELATIONSHIPSWithin this domain, a First Nations Health Manager is a leader that advocates, fosters and

nurtures partnerships and strengthens and sustains relationships to improve the health of

our communities.

Core CompetenciesThe First Nations Health Manager demonstrates:3a) Knowledge and abilities to collaborate with both

health care professionals and para-professionalsin the provision of effective First Nations healthcare delivery.

3b) Knowledge and abilities to use skills to create andsustain partnerships.

3c) Knowledge and abilities to advocate for healthypublic policy and services that promote, protectand enhance the health and well-being of indi-viduals and communities.

3d) Knowledge and ability to appropriately motivateand mobilize individuals, community, and partners.

Competency Indicators1. Establishes a communication and feedback

system that keeps everyone informed whilemaintaining confidentiality where appropriate.

2. Organizes and divides workload and tasks.3. Develops human resource management plans.4. Maintains awareness of Canada Labour Code,

human rights and privacy legislation, and scopesof practice.

5. Develops, updates and enforces personnelpolicies and procedures.

6. Allocates time and financial resources totraining and development opportunities forself and employees.

7. Provides guidance and coaches employees toachieve or surpass performance standards.

8. Facilitates staff to participate in decision-making.9. Conducts performance appraisals of staff at

least annually.10. Applies disciplinary procedures for staff infrac-

tions as needed.11. Develops an organizational wellness plan.12. Encourages First Nations people to seek

health careers.13. Ensures orientation to the organization and

its partners.


4 HUMAN RESOURCES MANAGEMENTWithin this domain, a First Nations Health Manager is a leader who is able to effectively

recruit and retain qualified staff that help to meet the needs of the community.

Core CompetenciesThe First Nations Health Manager demonstrates:4a) The ability to assess human resource needs of

the community-based health organization.4b) The ability to strategize and create human

resource management plans.4c) The ability to recruit and select qualified

employees.

4d) The ability to train and supervise staff andboards to achieve organizational goals.

4e) Knowledge and abilities to mentor and coachhis or her staff to promote professionaldevelopment.


Competency Indicators1. Develops budgets using a structured budget

preparation process.2 Identifies who should be involved in budget

development.3. Demonstrates understanding of funding

arrangements and categories.4. Adheres to expenditure limitations for each

program funding component received from thegovernment and other sources.

5. Monitors financial statements and comparesto budget.

6. Takes appropriate action to deal withunexpected variances so budget is balanced atyear end.

7. Understands and uses the income statements,balance sheets and changes in financialposition statements for decision-making andfuture planning.

8. Develops and implements procedures torecord transactions.

9. Maintains awareness of the accounting systemused by the community.

10. Monitors and manages contracts.11. Communicates budget monitoring information

and can defend rationale for budget items tointerested parties and the governing authority.

12. Compares budget and actual expenditures andmakes the required program adjustments.

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5 FINANCIAL MANAGEMENT AND ACCOUNTABILITYWithin this domain, a First Nations Health Manager is a leader who is able to demonstrate

competence in financial management and ensure accountability to the community,

Chief and Council and/or Health Committee/Board and funders.

Core CompetenciesThe First Nations Health Manager demonstrates:5a) Knowledge and abilities in following and

implementing Generally AcceptedAccounting Principles.

5b) Knowledge and abilities to ensure efficient andeffective financial management of healthprograms and services.

5c) Knowledge and abilities in planning, reportingand decision-making in a transparent manner inalignment with organizational objectives torelevant stakeholders.

Competency Indicators1. Demonstrates knowledge about the history,

structure and interaction of health care servicesat local, provincial/territorial and national levels.

2. Applies the components and concepts ofprimary care and public health.

3. Incorporates communicable disease control,surveillance, and risk management approachesrelated to health service delivery.

4. Demonstrates knowledge about the history,structure and interaction of public health andhealth care services at local, provincial/territorial,national, and international levels.

5. Plans strategically to achieve improved popula-tion health based on relevant socialdeterminants of health and knowledge ofconcepts such as health status of populations,inequities in health, health promotion andprotection, and disease and injury prevention.

6. Uses research to inform health policies andprograms; while recognizing the strengths andlimitations of available data used as key indica-tors of Canadian First Nations health.

7. Coordinates and prepares a Community HealthPlan based on community needs, priorities andcore program activities.

8. Engages First Nations populations as partners toidentify and acquire information on health issuesand needs; incorporating concepts of commu-nity development and ownership.

9. Identifies and utilizes First Nations communitysupport structures in health care provision.

10. Incorporates into organizational policies andapplies relevant provincial, federal and FirstNation legislation relating to privacy and accessto information, health, and the environment.

11. Creates or participates in multi-disciplinaryteams delivering health services.

12. Informs clients of the health programs availableand reasons for provision or non-provision.

13. Describes successful approaches that have beenimplemented to improve the health of FirstNations peoples, locally, regionally or nationally.

14. Understands the factors that influence thedelivery and use of health services utilized byFirst Nations.


6 HEALTH SERVICES DELIVERYWithin this domain, a First Nations Health Manager is a leader in understanding the

components of health services, responding to community health concerns and planning

for emerging health needs.

Core CompetenciesThe First Nations Health Manager demonstrates:6a) Knowledge and abilities to assess current health

topics of concern (or areas) using a First Nations‘determinants of health’ approach.

6b) Knowledge and abilities to use evidence andresearch to influence health policies andprograms on a local, regional and national level.

6c) Knowledge and abilities to apply leading conceptsrelating to First Nations health care delivery.

6d) Knowledge and abilities to recognise, value andincorporate First Nations perspectives in healthservices development and delivery.

6e) Knowledge and abilities to actively participate inthe developing, implementing and evaluating ofresponses to health emergencies.


Competency Indicators1. Implements quality improvement processes

within and between programs.2. Guides the team through quality reviews.3. Identifies risks to program success and develops

plans to mitigate.4. Assigns roles and responsibilities for staff and

contractors based on assessments of theirstrengths and limitations.

5. Ensures each program has processes in place forconsent for care; including adults, children, andvulnerable community members.

6. Describes quality improvement and assuranceplans to clients, staff, partners and thecommunity.

7. Creates and implements policies and processesthat promote client safety.

8. Communicates to client and their families theirrights, responsibilities and roles.

9. Receives client complaints, coordinates the fol-low up investigation, and responds appropriatelyaccording to policy.

10. Strives for excellence in the delivery of healthprograms and services.

11. Fosters and employs a healthy work environment.

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7 QUALITY IMPROVEMENT AND ASSURANCEWithin this domain, a First Nations Health Manager is a leader who is able to integrate

ongoing quality improvement and assurance as a foundation.

Core CompetenciesThe First Nations Health Manager demonstrates:7a) Knowledge and abilities of the key elements and

processes of continuous quality improvement.7b) Knowledge and abilities to identify, manage

and/or mitigate risks.

7c) Knowledge and abilities in the application ofrelevant provincial, federal and First Nationlegislation and its impact on programmingand services.

Competency Indicators1. Develops processes for long and shorter term

organizational and community health planning.2. Undertakes community assessments and

asset mapping.3. Incorporates and integrates key components of

strategic planning such as vision and missionstatement development, SWOT analysis, issueidentification, strategy development, implemen-tation and innovation.

4. Develops desired outcomes or goals andperformance indicators.

5. Facilitates strategic, operational and programplanning with staff.

6. Links individual workplans and staff performanceto strategic plans.

7. Involves staff and relevant community membersin strategic planning process.

8. Develops and implements strategic and opera-tional plans.

9. Communicates the plan and its progress to rele-vant stakeholders, including the community.

10. Collects, analyzes and applies informationincluding data, concepts and theories.

11. Makes evidence-based decisions.12. Prepares reports that align with plans.13. Conducts program and plan reviews and makes

recommendations for policy and program devel-opment; and updates/revises strategic planas necessary.


8 PLANNINGWithin this domain, a First Nations Health Manager takes a leadership role in planning,

implementing and evaluating policies and programs based on evidence and relevance to

community health needs and plans. This includes ongoing operational and strategic planning.

Core CompetenciesThe First Nations Health Manager demonstrates:8a) Knowledge and abilities in strategic and opera-

tional planning.8b) Knowledge and abilities to gather, analyze and

apply research principles and information.

8c) Knowledge and abilities in programdevelopment, implementation and evaluation,maximizing available resources and basedon plans.


Competency Indicators1. Selects appropriate methods for communication

topics and audiences.2. Prepares and makes presentations to Health

Committee, Board and/or Chief and Counciland organizations internal to and outside ofthe community.

3. Initiates working relationships andcommunicates with organizations within andoutside of the community that can support andcomplement the health organization.

4. Facilitates meetings and informationsharing activities.

5. Listens and addresses concerns and issuesexpressed by the staff, community members andother key stakeholders (document if required).

6. Translates complex health care issues to commu-nity members in the language appropriate to theFirst Nation community.

7. Maintains confidentiality and privacy principleswhere appropriate as it relates tocommunications, data entry and storage, andrecords/document management.

8. Prepares communication documents andchooses an appropriate medium.

9. Writes concise, well organized reports for stake-holders (program, annual, funders).

10. Develops and enforces appropriate informationstorage and management systems and polices.

11. Keeps current on technological tools.

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9 COMMUNICATIONWithin this domain, a First Nations Health Manager is a leader who is able to effectively

exchange ideas, opinions and information with different audiences.

Core CompetenciesThe First Nations Health Manager demonstrates:9a) Knowledge and abilities to perform a range of

communications activities with individuals,families, groups, communities, staff, colleagues,and internal and external programs andorganizations.

9b) Knowledge and abilities to implement a commu-nications strategy within their community.

9c) Knowledge and abilities to work with computersand necessary software applications and report-ing systems to manage, monitor and report ontheir program data.

Competency Indicators1. Utilizes understanding of community and family

histories and decision-making to respectfullyengage in health planning and providinghealth services.

2. Incorporates traditional approaches and proto-cols as instructed by community (i.e. Elder andtraditional healer involvement).

3. Ensures cultural safety for patients and families isapplied in policy and practice.

4. Establishes a positive therapeutic relationshipwith First Nations patients and their families,characterized by understanding, trust, respect,honesty and empathy.

5. Identifies the centrality of communication in theprovision of culturally-safe care, and engages inculturally-safe communication with First Nationspatients, families and communities.

6. Addresses population diversity when planning,implementing, adapting and evaluating FirstNations health programs and policies.

7. Applies and respects culturally-relevant andappropriate approaches with people fromdiverse cultural, socio-economic and educationalbackgrounds, and persons of all ages, genders,health status, sexual orientations and abilities.

8. Knows the protocols with respect to approach-ing the Chief and Elders.

9. Knows the protocol for healing processes andrelated activities.

10. Describes types of First Nationshealers/traditional medicine people and healthcare professionals working in local First Nationscommunities and how they are viewed inthe community.

11. Demonstrates how to appropriately enquirewhether a First Nations patient is takingtraditional herbs or medicines to treat his or herailment and how to integrate that knowledgeinto his or her care.


10 CULTURAL AWARENESSWithin this domain, a First Nations Health Manager is a leader who recognizes the value of

knowing traditional and cultural teachings which includes honouring ancestral knowledge

and incorporating inherent ways of knowing to improve health.

Core CompetenciesThe First Nations Health Manager demonstrates:10a) Knowledge and abilities as they understand the

traditional and community role of decision-making – at the individual, family, and commu-nity levels.

10b) Knowledge and abilities to understand the limi-tations of one’s own knowledge and acceptsand incorporates new ways of respecting andunderstanding with regard to First Nationshealth practice.

10c) Knowledge and understanding in interactingwith First Nations health care workers and com-munities by applying the Seven Teachings oftrust, respect, honour, honesty, humility,courage and truth.

10d) The ability to ensure that culture is an integralpart of health care.


GLOSSARYAdvocacy: Interventions such as speaking, writing oracting in favour of a particular issue or cause, policyor group of people.

Code of ethics: A set of standards, rules, guidelinesand values that govern and guide ethical decisionsand behaviours in an organization.

Collaboration: A recognized relationship among dif-ferent sectors of groups, which have been formed totake action on an issue in a way that is more effectiveor sustainable than might be achieved by a singlehealth sector acting alone.

Culturally relevant: Recognizing, understanding andapplying attitudes and practices that are sensitive toand appropriate for people with diverse culturalsocioeconomic and educational backgrounds, andpersons of all ages, genders, health status, sexualorientations and abilities.

Competency Indicator: Indicators provide examplesof how competencies can be demonstrated.

Determinants of health: Definable entities thatcause, are associated with, or induce healthoutcomes.

Diversity: The demographic characteristic of popula-tions attributable to perceptible ethnic, linguistic,cultural, visible or social variation among groups ofindividuals in the general population.

Ethics: The branch of philosophy dealing with distinc-tions between right and wrong, and with the moralconsequences of human actions.

Evaluation: Efforts aimed at determining as system-atically and objectively as possible the effectivenessand impact of health-related (and other) activities inrelation to objectives, taking into account theresources that have been used.

Evidence: Information such as analyzed data, publicresearch findings, results of evaluations, prior experi-ence, expert opinions any or all of which may be usedto reach conclusions on which decisions are based.

Governance: The process whereby societies ororganizations make important decisions, determinewhom they involve and how they render account.

Health planning: A set of practices and proceduresthat are intended to enhance the efficiency and effec-tiveness of health services and to improve healthoutcomes. This important activity of all health depart-ments commonly includes short term, medium-term,and long-range planning. Important considerationsare resource allocation, priority setting, distribution ofstaff and physical facilities, planning for emergenciesand ways to cope with extremes of demand andunforeseen contingencies, and preparation of budg-ets for future fiscal periods with a feasible timehorizon, often 5 years ahead, sometimes as far aheadas 10 or even 15 years.

Health policy: A course or principle of actionadopted or proposed by a government, politicalparty, organization, or individual; the written orunwritten aims, objectives, targets, strategy, tactics,and plans that guide the actions of a government oran organization.

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Appendix A

Health program: A description or plan of action foran event or sequence of actions or events over aperiod that may be short or prolonged. Moreformally, an outline of the way a system or service willfunction, with specifics such as roles and responsibili-ties, expected expenditures, outcomes, etc. A healthprogram is generally long term and often multifac-eted, whereas, a health project is a short-term andusually narrowly focused activity.

Health promotion: The process of enabling peopleto increase control over, and to improve their health.It not only embraces actions directed at strengthen-ing the skills and capabilities of individuals, butalso actions directed towards changing social, envi-ronmental, political and economic conditions so as toalleviate their impact on public and individual health.The Ottawa Charter for Health Promotion (1986)describes five key strategies for health promotion:build healthy public policy; create supportive envi-ronments; strengthen community action; developpersonal skills; and re-orient health services. (A publichealth system core function.)

Health protection: A term to describe importantactivities of public health—in food hygiene, waterpurification, environmental sanitation, drug safetyand other activities—that eliminate as far as possiblethe risk of adverse consequences to health attributa-ble to environmental hazards. (A public health systemcore function.)

Human resource plans: Strategy for matching thesize and skills of the workforce to organizationalneeds. Human resource planning assistsorganizations to recruit, retain, and optimize thedeployment of the personnel needed to meet busi-ness objectives and to respond to changes in theexternal environment.

Information: Facts, ideas, concepts and datathat have been recorded, analyzed, and organizedin a way that facilitates interpretation andsubsequent action.

Investigation: A systematic, thorough and formalprocess of inquiry or examination used to gather factsand information in order to understand, define andresolve a public health issue.

Leadership: In the field of health, leadership relates tothe ability of an individual to influence, motivate, andenable others to contribute toward the effectivenessand success of their community and/or the organiza-tion in which they work. It involves inspiring people tocraft and achieve a vision and goals. Leaders providementoring, coaching and recognition. They encourageempowerment, allowing other leaders to emerge.

Management plan: Management plan usuallyincludes objectives, goals, standards and guidelines,management actions, and monitoring plans.

Operational planning: Describes short-term ways ofachieving milestones and explains how, or what por-tion of, a strategic plan will be put into operationduring a given operational period.

Partnerships: Collaboration between individuals,groups, organizations, governments or sectors for thepurpose of joint action to achieve a common goal.The concept of partnership implies that there is aninformal understanding or a more formal agreement(possibly legally binding) among the parties regard-ing roles and responsibilities, as well as the nature ofthe goal and how it will be pursued.



Population health assessment: Population healthassessment entails understanding the health of pop-ulations and the factors that underlie health andhealth risks. This is frequently manifested throughcommunity health profiles and health status reportsthat inform priority setting and program planning,delivery and evaluation. Assessment includes consid-eration of physical, biological, behavioural, social,cultural, economic and other factors that affecthealth. The health of the population, or a specifiedsubset of the population, can be measured byhealth status indicators such as life expectancyand hospital admission rates. (A public health systemcore function.)

Primary care: Primary care includes assessment,diagnosis, and treatment of common illnesses gener-ally provided by family physicians and nurses andmay include lay health personnel.

Public health: An organized activity of society to pro-mote, protect, improve, and when necessary, restorethe health of individuals, specified groups, or theentire population. It is a combination of sciences,skills, and values that function through collectivesocietal activities and involve programs, services, andinstitutions aimed at protecting and improving thehealth of all people. The term “public health” candescribe a concept, a social institution, a set of scien-tific and professional disciplines and technologies,and a form of practice. It is a way of thinking, a set ofdisciplines, an institution of society, and a manner ofpractice. It has an increasing number and variety ofspecialized domains and demands of its practitionersan increasing array of skills and expertise.

Seven Teachings: Trust, respect, honour, honesty,humility, courage and truth.

Strategic planning: An organization’s process ofdefining its strategy, or direction, and making deci-sions on allocating its resources to pursue thisstrategy, including its capital and people.

Surveillance: Systematic, ongoing collection,collation, and analysis of health-related informationthat is communicated in a timely manner to all whoneed to know which health problems require actionin their community. Surveillance is a central featureof epidemiological practice, where it is used to con-trol disease. Information that is used for surveillancecomes from many sources, including reported casesof communicable diseases, hospital admissions,laboratory reports, cancer registries, populationsurveys, reports of absence from school or work,and reported causes of death (A public health systemcore function).

Wellness plan: Providing a safe and supportiveenvironment for the organization and itsemployee’s health.

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REFERENCES:Aboriginal Financial Management Standards,Certified Aboriginal Financial Management NationalCompetency Standards, Aboriginal Financial OfficersAssociation of Canada (AFOA), 2006

Core Competencies for Public Health in Canada, Release1.0, Public Health Agency of Canada, September 2007

Core Competency Project for First Nations Community-Based Health Managers, File Hills Qu’Appelle TribalCouncil (FHQTC), March 2008

First Nations, Inuit, Métis Health Core Competencies,A Curriculum Framework for Undergraduate MedicalEducation, Indigenous Physicians Association ofCanada, February 2008

The Pan-Canadian Health Leadership CapabilityFramework Project: A collaborative research initiative todevelop a leadership capacity framework for healthcarein Canada, October 2007


Appendix B

Notes

Notes

WWW.FNHEALTHMANAGERS .COM

Documents

Competency Framework - First Nations Health Managers ...€¦ · Draft Competency Framework developed December 2008 First Nations Health Managers Forum in Vancouver,BC July 2009 2006