Strongest Families is a 12-week distance treatment program for children with various mental health disorders and their families. The program was started in Nova Scotia in 2001 to address issues of stigma, lack of access to primary care specialists and difficulty of obtaining care, especially in rural areas. To meet these needs, the program utilizes long-distance communication methods such as weekly telephone meetings with trained personnel who are available days, nights and weekends, so access to care is easy and convenient for families. The founder of the program has already proven its efficacy in a major outcome paper that disseminated the supporting evidence to the research community. As chief executive officer of the Strong Families Institute, a federally registered not-for-profit organization, he and his founding partner, now chief operating officer, want to scale up the program to other provinces and eventually other countries, but they must get government ministries and other stakeholders on side in the interests of making mental health care widely available to the children and families who need it.
In January 2005, the vice-president of International Affairs at the Hospital for Sick Children in Toronto, Ontario, must decide how to respond to a request for proposal from the Hamad Medical Corporation of Qatar. In order to reach its global mission of “Healthier Children, A Better World,” the Toronto hospital, which had an international reputation for excellence in pediatric medicine, had established an arm called SickKids International. In addition, it was anxious to find new ways to recover from an operating deficit caused by the aftershock of the SARS outbreak. Hamad Medical Corporation, a major state hospital medical supplier in Qatar, was looking for international centres that would want to partner with it in the development of what it hoped would become the best children's hospital in the Middle East. The vice-president understood the enormous benefits that the partnership had to offer but recognized the need for a comprehensive strategy to mitigate all of the associated risks, such as the difference in cultures between Canada and Qatar, the pressure on the Toronto hospital’s staff to make the project successful and the uncertain political and business environment in the Middle East. Should she recommend to her executive team that they go ahead with their first international request for proposal?