The 2018 Leadership and Improvement Conference in Toronto brought together close to 300 healthcare leaders from Canada, the United States and Australia. Now in it’s 11th year, this event is well-established as a high-intensity source of practical know-how and inspiring stories of success.
Here are 12 key takeaways from Toronto 2018:
- Change in healthcare is now a given. There is no “business as usual.” This year’s opening presentation was delivered by Mark Hussey, executive vice president and chief executive office of Huron and Debbie Ritchie, corporate vice president of Huron and president of Studer Group. The theme was clear: Own your future or be disrupted by it. Healthcare leaders are living through unprecedented change in everything from information technology and clinical innovation to demographics and patient expectations. Hussey and Ritchie discussed how organizations can achieve and sustain improvement while simultaneously reinventing themselves. Daniela Lockhard, national director of Partner Development of Studer Group Canada, shared an approach to strategic planning called “dual transformation” that enables organizations to “beat disruption” by simultaneously growing their core business and developing innovative delivery models for the future.
- Technology alone is not the answer. We must understand the human-technology interface. Much of the change in healthcare is due to the accelerating flow of new technologies. Organizations at the leading edge are showing how successful technology adoption ultimately depends on “the human factor.” Lynne Mahony, coach leader of Studer Group Canada, showed how the flow of data on indicators such as patient experience becomes actionable when we understand the relationships to behaviours like rounding. Lu Sims, managing director at Huron, discussed how eHealth solutions will be optimized only when they match the expectations of patients and providers, and recognize the powerful computers we all have in our pockets. Bernard Leduc, chief executive officer of Hôpital Montfort, profiled the organization’s “strategic war room,” where the senior leadership team meets to assess key performance indicators. They’ve found that data, when combined with a culture of transparency, humility, ownership and collaboration, allow leaders to spot misalignment, identify solutions and develop strategies that drive results.
- Healthcare governance is evolving as organizations adapt to change and focus on safety and quality. Joan Dawe, a veteran Canadian healthcare leader, works with the Canadian Patient Safety Institute (CPSI) on a program that’s helping organizations develop governance to oversee safety and quality improvement. She discussed the critical role of governance in the transformations underway, and the importance of communication, education and engagement. “There has to be a trusting relationship between the Board and staff, and a mutual respect for these different roles,” said Dawe. Barbara Collins, president and chief executive leader of Humber River Hospital, added that “we need a sense of urgency in governance, a total commitment every day, starting from the Board and senior management.”
- “You can’t do 21st century medicine alone.” This message, from Jeff Morris, MD, a physician coach with Studer Group, was aimed at physicians but addresses fundamental principles of contemporary collaborative leadership. Dr. Morris sees physician leadership as a partnership with other key stakeholders. “Speaking with one voice and having a seat at the table is the currency for getting things done,” said Dr. Morris. He described a pathway to effective physician leadership that moves from physician selection and professional development to creating a supportive environment. Common barriers such as disconnected reimbursement models and perceptions that you can’t wear a “white coat” and a “suit coat” at the same time can be managed along the way. Dr. Morris also examined dyad and triad models that combine the complementary skills of physician and administrative leaders who share common goals but influence goal attainment in different ways.
- Successful engagement of staff and physicians is built upon trust. Several speakers identified trust as foundational to the engagement needed to drive sustainable improvement. Dr. Morris talked about openness and transparency as prerequisites for establishing the trust needed to engage physicians. Craig Deao, managing director at Huron and senior leader at Studer Group, spoke of common goals, a shared agenda and how “consistency is what starts building trust.”
Barbara Collins explained how transparency and consistency support trust-building even in complex organizations with unionized and non-unionized staff, noting that “standard work is fairer for all employees overall. It clarifies roles and how we work together.”
- Reducing workplace stress and anxiety is key to culture transformation. Healthcare leaders know that workforce stress and anxiety are critical barriers to successful change management, especially as organizations grapple with high turnover and staffing challenges. Solutions are found in the proven leadership principles embedded in Studer Group’s Evidence-Based Leadership (EBL) framework. Linda Deering Dean, president of Advocate Sherman Hospital, shared how leaders at her organization are creating a culture that reduces anxiety and increases confidence. Standard work and non-negotiable behaviours are a big part of this, along with modelling a positive, resilient mindset. She added that “an unexpected consequence of the safety journey is greater respect and the elimination of intimidation.”
- “What we have is not a knowledge gap. It is an execution gap.” This quote from Craig Deao captured a key conference takeaway about how there is no “silver bullet” to solve issues of underperformance. The multiple factors that drive sustainable improvement are understood and evidence-based; it’s possible to systematically diagnose the causes of underperformance and close the execution gap. Deao shared a list of reasons why organizational change doesn’t stick and underperformance resurfaces without standardized leadership accountability. Bernard Leduc of Hôpital Montfort, offered a chief executive officer’s perspective on execution. He talked about a highly collaborative approach to leadership and the importance of having the entire leadership team committed to modelling and monitoring evidence-based practices.
- Leading organizations are tackling the challenge of high reliability with discipline and an uncompromising culture of safety. Linda Deering Dean acknowledged that “the safety journey in healthcare is still relatively new” and that “sustaining safety initiatives over the long term is the hard part.” Advocate Sherman Hospital is posting significant wins – the elimination of catheter-associated urinary tract infections (CAUTIs) for 18 months is one example – but hard work on the disciplined execution of mandatory practices is ongoing as leaders push toward a goal of zero adverse patient events by 2020.
Chris Judd, director of pharmacy, and Amanda Thibeault, director of professional practice at St. Joseph’s Health Care London, described a program to eliminate wrong-drug-wrong-patient medication errors. Positive identification of staff, patients and medications was implemented beginning in 2013. Since then, results have shown significant reductions in incidents, but a small number of errors persist. Reiterating a key conference theme, Judd noted that “technology isn’t the answer to everything. It comes down to the relationship between people and technology.” St. Joseph’s is refocused on changing culture to make it safe to discuss errors, to support staff as they implement technologies, and to solidify norms of rigour and discipline.
- Healthcare organizations can deliver more with less. Barbara Collins made a compelling case that “our high reliability and efficiency agendas are the same.” Humber River Hospital has been combining safety, quality and efficiency priorities by standardizing and streamlining processes and focusing on never events. Recent proof of the impact on resource utilization is the ability to open 23 beds at no additional cost. “We can shift money around to grow,” explains Collins. “And we don’t have to be downsizing.”
Two experienced Studer Group coaches described processes that enable organizations to do more with less. Carol Manson McLeod, coach at Studer Group Canada, reviewed published research confirming how key tactics like rounding cut costs by reducing turnover, errors and accidents. Rachel Johnson, coach specialist at Studer Group, showed how a systematic approach to care transitions helps patients return safely to their post-acute settings with far fewer readmissions.
- Choose wisely. These simple but profound words of advice were explored in detail by Mitch Hagins, former general manager of Studer Group Canada, in a talk on sustaining healthcare excellence. Delegates were reminded that a prerequisite for leadership is relentless and disciplined execution as it sustains results over the long term. To be successful you must choose where to be relentless so that organizational resources are focused clearly on top-priority goals. “It’s not about how much you do,” according to Hagins. “It’s about the choice of what you do.”
- If you are not getting the results you would like, look in the mirror. This provocative statement was the title of a presentation by Eric Hanna, president and chief executive officer, Arnprior Regional Health. It highlighted a key conference theme: leaders go first. Eric Hanna has been leading an EBL journey for eight years, and his talk on the real-world practicalities of reducing variation and sustaining results focused on how leadership teams build a shared commitment to organizational goals and model key behaviours each and every day. A quote from Paulo Coelho was used to capture the approach of Eric Hanna and his team: “The world is changed by your example not by your opinion.”
- “No matter what is happening in your life, the circumstances will never be the reason you can’t succeed; they are the reality in which you must succeed.” This nugget of inspiration was one of many offered by Studer Group Coach and Speaker Kris Ann Piazza, who suffered a childhood spinal cord injury that left her a quadriplegic. She overcame adversity, built a successful life and career, and now helps individuals move their lives and careers forward while empowering and inspiring their teams. At the core of her approach is recognizing the opportunity we all have to develop resilience. “It’s all about mindset,” according to Piazza, “Don’t let the things you can’t do stop you from doing the things you can do. You get a second chance every time you take a breath. You can either hold it in and do nothing out of fear, or exhale and use it to make a difference.”
This year’s Conference provided an opportunity for many delegates to learn firsthand about the combined strengths of Studer Group Canada and Huron. Delegates were welcomed by Bonnie Cochrane, general manager of Studer Group Canada. Mike Heenan, assistant professor at McMaster University and Studer Group speaker, served as emcee for the two-day event. Feedback from delegates highlighted the value of peer-to-peer networking.
The tactics and strategies shared by leaders at the Toronto Healthcare Leadership and Improvement Conference serve as a reminder that healthcare leaders who think, plan and act differently can improve performance today while transforming our organizations for tomorrow.
2018 Award Recipients from Canada
The Healthcare Leadership and Improvement Conference in Toronto recognizes outstanding and inspiring leadership in Canadian healthcare.
Three Canadian healthcare leaders were the first recipients of the Living Values Award, recognizing performance that stands out as a demonstration of a partner’s values and creates strong sustained results that have positively impacted one or more of the partner’s pillar goals:
- Mayda Timberlake, RN, BHA, manager, Emergency Services, Humber River Hospital
- Vicky Florio, RN, GNG(C), director of care, Norfolk Hospital Nursing Home
- Deb Gibson, RN, BSCN, CPMHN(C), director adult ambulatory services, coordinated access, assessment, treatment and rehabilitation programs, St. Joseph’s Health Care London
The Living Values Award was introduced in honour of Mitch Hagins, who led Studer Group Canada through it’s first dynamic decade and continues to demonstrate ‘living our values’ in all that he does.
Dr. Bernard Leduc, chief executive officer, Hôpital Montfort, will be inducted into the Fire Starter Hall of Fame at this years What’s Right in Healthcare® conference, August 21-23 in Nashville TN. This is the highest award for excellence given by Studer Group. It recognizes leaders who, through their dedication and passion, guide and support an organization's commitment to excellence while keeping the true spirit of their organization alive and flourishing.