A domestic violence survivor loses her benefits if she stays with her parents for a tenth month. A person with a disability turns down a job offer because taking it means losing housing support. A senior is denied a taxi voucher to a clinic and ends up in a hospital bed at ten times the cost. This episode is about a system organized around rule-following rather than results — and what that looks like for the people on the other side of the desk.

How it All Broke Report

Kelly Lamrock Interview

How It All Broke Videos

Human Learning Systems as a method for Reimagining Government

Every year, government sets a budget for social programs. But almost nobody asks what those numbers are supposed to produce — or checks whether they did. This episode follows Lamrock's team as they ask the Department of Finance some very basic questions about its 2023 budget: what will this money do, for how many people, and how will you know if it worked? The answers — or the absence of them — will make you shake your head.  

How it All Broke Report

Kelly Lamrock Interview

How It All Broke Videos

In the 1990s, as a response decades of overspending, governments facing fiscal pressure made a deliberate choice: cap enrolments in health professions, reduce training spaces, limit billing numbers. The long wait times that followed weren't an accident. They were the plan — a way to slow demand without raising prices.  Thirty years later, we're still living in the system. This episode is about how we stopped planning for the people we need, and what that costs us now.

How it All Broke Report

Kelly Lamrock Interview

How It All Broke Videos

This is the episode that sets the stage. In 2024, Kelly Lamrock — New Brunswick's Child, Youth and Seniors' Advocate — released a report that asks a question most of us have been afraid to ask: what if the problem isn't the people in our systems, and it isn't the money, but the governance model itself? 

This series is built on that report, and this episode explains why it matters far beyond New Brunswick.

How it All Broke Report

Kelly Lamrock Interview

How It All Broke Videos

The Second Coming (Poem)

Meet the Advocate

In this episode, Kyla sits down with Dr. Brittany Ellis — an emergency physician with specialized training in geriatric emergency medicine — for a wide-ranging conversation about why Canada's emergency departments are in crisis, and why older adults are bearing the brunt of it.

Dr. Ellis walks us through the full patient journey: from an older adult struggling
to get home care in a timely way, to ending up in an ED hallway for days,
developing pressure ulcers within the first hour, experiencing delirium, and
leaving the hospital in worse shape than they arrived. It's a cascade of
failures across a fragmented system — and she breaks it down with clarity,
urgency, and a healthy dose of "delusional optimism."

Resources

• CIHI: Emergency Department Wait Times in Canada — Insights from a Health System Perspective
• CAEP Position Statement: Care of Older People in Canadian Emergency Departments
• What’s behind Canada’s Doctor Shortage?

Canada has expanded the legal options available at the end of life — but the conversations with patients and families haven't kept up.

In this episode, Kyla talks with Dr. Janine Brown, nurse researcher and PhD at the University of Saskatchewan, and Nabila Ashraf, public health researcher and Master's student in Aging Studies at the University of Regina. Together, they've been studying the social and political conditions that shape how Canadians navigate end-of-life decisions — from MAID to palliative care to the systemic gaps that make these conversations harder than they need to be.

We discuss  why good end-of-life care keeps hitting the same walls — and what it would take to change that.

If you work in healthcare, policy, or simply believe Canadians deserve better conversations about dying, this one is for you.

Resources

MAID Overview (Health Canada)

MAID Saskatchewan

Care Conversations with  Dr. Janine Brown

End of Life Conversations Research Paper

Advanced Care Planning Kit

Yellow Sleeve Program

End of Life Planning Guide and Checklist

Parliamentary Report on MAID and Mental Illness

In this episode, Kyla sits down with Dr Ginger Ruddy, a family physician and consultant with the Saskatchewan Medical Association, to break down what a patient medical home actually is, why the traditional fee-for-service model is holding us back, and what the future of primary care could look like for every person in this province. From Swift Current's same-day access model to the barriers of union integration and funding gaps, this is a frank conversation about the shift that's already underway — and what it will take to get there for everyone.

Also, tune in at the end for another Shift Shout Out where we highlight an innovation from a nurse practitioner in Toronto who is reducing falls in hospitals and long-term care facilities across Canada with her innovative technology.  

Resources

·      Crowfoot Family Practice, Calgary 

·      Advancing Patient Medical Home: Insights from Swift Current 

·      Saskatchewan Medical Association (SMA) — 

·      Innovation Fund 

·      HALO Article (October 2025)

·      UHN Inventor of the Year

·      HALO Website

In this episode, we sit down with Angela Sereda, a senior leader in Mobile Integrated Health (MIH) with Medavie West, to discuss the shift happening in paramedicine. Angela shares her 33-year journey from a high school athletic trainer to a leader in community-based paramedicine. We explore how paramedics are expanding their role from being a purely reactive 911 service to becoming a proactive, integrated part of the healthcare system—meeting people where they’re at with the services they need.  

If you enjoy this episode, please subscribe, share with friends and/or leave a review.  You can also follow me on Facebook and LinkedIn by searching @shiftpodcastcanada for more stories about transforming healthcare in Canada

 Resources & Links

Medavie Video

Promising Practice: Medavie Community Paramedicine (Report from Health Excellence Canada)

Medavie Integrated health

Medavie Integrated Care Facility Programs

Withdrawal Management

Hospital at Home (Vancouver)

In this episode, we explore an unlikely but powerful partnership between Terry Kostyna, a "get-shit-done" (GSD) entrepreneur and small-town mayor, and  Dr. Jacob Al Hassan, an academic researcher focused on health equity. Together, they discuss their work with the Health Quality Council’s "Thrive at Home" initiative, specifically focusing on how rural communities can innovate to provide sustainable transportation for seniors. From volunteer-run shuttles to specialized software, Terry and Jacob share how they are working to bridge the gap between research and action to ensure older adults can age in place with dignity.

Resources 

• Health Quality Council's Thrive at Home Initiative
• A Call for a Transportation Strategy
• Prince George's Social Prescribing Initiative
• Drive Happiness (Alberta)
• Gravelbourg Cares Shuttle

In this episode, I sit down with John Mortimer, a specialist in systemic service design and founder of Impro, to tackle a concept that is silently draining the resources and morale of our health care system: Failure Demand. John explains that much of the "spinning" felt by practitioners today—the feeling of running faster while staying in the same place—is the result of a system designed to manage the consequences of its own failures rather than meeting the actual needs of the person.

If you have ever felt that you or your organization is only as helpful as the rules allow, this conversation offers ideas for finding traction in the spin and eliminating the invisible drain of failure demand.

Resources

John’s Videos on YouTube 

 Buurtzorg Model 

Human Learning Systems