Leadership in a Sea of Change

Vickie Kaminski

President & CEO, Eastern Regional Health Authority

July 8, 2010

Overview

Eastern Health:• The largest integrated health authority in Newfoundland

and Labrador

• Serving a regional population of more than 293,790

• Offering the full continuum of health and community services, including public health, long-term care, community services, hospital care and unique provincial programs and services

Overview (cont’d)

Overview (cont’d)

Budget: 1.2 Billion

Employees: 12,834

Credentialed Staff: 720

Volunteers: 3,500

Foundations:

• Burin Peninsula Healthcare Foundation

• Discovery Healthcare Foundation

• Trinity Conception Placentia Healthcare Foundation

• Healthcare Foundation

• Dr. H. Bliss Murphy Cancer Care Foundation

• Janeway Children’s Hospital Foundation

The Region

Geographic Catchment Area:

• The province of Newfoundland and Labrador east of (and including) Port Blanford

• The Avalon, Burin and Bonavista Peninsulas, as well as Bell Island

• Approximately 21,000 Km2

The Region (cont’d)

Settlement patterns:

• Tied in large part to the cod fishery

• Small communities scattered predominately along the coastlines of the Peninsulas

• Includes capital city of St. John’s

(111 incorporated municipalities, 69 local service districts and 66

unincorporated municipal units)

Population Changes

• Lowest immigration rates in the Country (homogeneous group)

• NL Population Trend (1996 – 2006) 8% decrease

• Expect significant increases in 65-74 year age group & over 75

• Demographics impacted by long distance commuters (direct flights, St. John’s to Edmonton, Fort McMurray)

Population Changes (cont’d)

• Avalon Peninsula increased by 2.5% (2001 – 2006)

• Burin Peninsula decreased by 8.9% (2001 - 2006)

• Clarenville – Bonavista decreased by 5.4% (2001 – 2006)

• Birthrate @ 1.30% (lowest in the country)

Lines of Business

1. Promote health & well-being – Facilitate programs & services that promote and protect

population Health & help prevent disease and injury

2. Provide supportive care– Provide community-based support and continuing care,

residential care options, home support and nursing home care.

3. Treat illness and injury– Investigate, treat, rehabilitate and care for individuals with

illness or injury

4. Advance knowledge– Advance research, education and knowledge dissemination

Current Challenges:

Access to Care

• Specialists• General Practitioners• Hospital beds• Specialized procedures• Expensive Drugs• New Procedures• EM$

Access to Education

• Busing• School amalgamations/closures• New teaching technology• Curriculum

Current Challenges (cont’d)

Human Resources

• Physicians• Nurse practitioners• Leadership• Nurses• Governance

Human Resources

• Teachers• Teaching assistants• Leadership• Governance

Current Challenges (cont’d)

Continuum of Care

• Alternative housing• Appropriate housing• Home care/home support• Day hospitals• Convalescent care palliative care

Continuum

• Board integration• Provincial testing• High school success rates• University preparation

Current Challenges (cont’d)

• Geographical Issues

• Rural/urban divide

• Hard to reach communities

• Difficult to serve communities

• Weather

• Sustainability

• Escalating costs

Current Challenges (cont’d)

• Demographics

• Population shifts

• Immigration issues

• Birth rates

Current Challenges (cont’d)

• Pubic Expectations & Demands

• Immediate or timely access

• Fully funded

• Evidence-based care (good results)/new teaching techniques

• Transparency

• Disclosure

• Choice

• Privacy protection

• Wise use of tax dollars

Leaders

“Leaders are not born. They are made. They are made just like anything else… through hard work. That’s the price we have to pay to achieve that goal or any goal.”

Vince Lombardi

Leaders (cont’d)

• Are made, not born

• Embark on a never-ending process of self study, education, training and experience

• Are influenced by their beliefs, values, ethics & character

• Understand themselves, their strengths, weaknesses

• Inspire trust and confidence by what they do and then what they know

Leaders (cont’d)

• Have a good understanding of human nature

• Are good communicators

• “walk their talk”

• Would never ask you to do something they wouldn’t do themselves

• Are adaptable

• Exercise good judgement

Leaders (cont’d)

• Aren’t afraid to correct inappropriate behaviour

• Recognize the value & benefits of informal leaders in the organization

• Recognizes that power makes them a “boss”; the success of their employees makes them a “leader”

• Have a sense of humour

Leadership

• Strong, not rude

• Kind, not weak

• Bold, not a bully

• Humble, not timid

• Proud, not arrogant

• Humour without folly (witty, not silly)

• Reality and truth, not fantasy and lies

“Leaders instill in people a hope for success and a belief in themselves and the organization. Positive leadership encourages and empowers people to accomplish their goals.”

George S. Patton

“ A leader takes people where they want to go; a great leader takes people where they ought to be!”

Jim Rohn

“When Noah heard the weather forecast, he said “Build an ark!”

- that’s leadership.

When he got everyone on the ark he said “Don’t let the elephants see what the rabbits are doing!”

- that’s management

Unknown

Leadership responsibilities:

• Chart the Course

• Provide the Managers

Management Responsibilities:

• Stay the Course

• Manage the Culture & Climate

• Provide Leadership

Principles of Leadership

1. Know yourself and seek self improvement

2. Be technically proficient

3. Seek responsibility and take responsibility for your actions

4. Make sound and timely decisions

5. Set the example

6. Know your people and look out for their well being

Principles of Leadership (cont’d)

7. Keep your employees informed

8. Help your staff develop a sense of responsibility

9. Ensure that work is understood, supervised and accomplished

10.Train as a team

11.Use the full capabilities of the organization

Leading vs Managing

• Managers ensure goals are met

• Managers monitor employee productivity

• Managers accept responsibility for accomplishing certain goals for organization

• Leaders make employees want to achieve high goals

• Leaders help employees see the big picture; define the vision

Culture and Climate

Culture:

• Rites, rituals, “the way we do things here”

• Formed by the founders, past leadership, current leadership, crises, events, history and size

(Newstrom, Davis 1993)

Culture and Climate (cont’d)

Climate:• The “feel” of the organization

• Individual and shared perceptions

• Short term phenomenon created by the leadership

• Determined by what people believe about what occurs in the organization

• Directly related to the leadership style based on values, attributes, skills and actions, as well s the priorities of the leader

• Cannot easily change the culture but everything a leader does affect the climate.

A leader must be trustworthy and must be able to

communicate a vision

A manager must be steadfast and adept at changing

Best of times ……….Worst of times

• Lots of resources

• No deadlines

• No crises

• Stable environment

• Scarce Resources

• Pressure Cooker

• Multiple crises

• Changing, unstable environment

Good News

• These issues are not unique nor are the people experiencing them.

• Issues are similar coast to coast, and in some cases, continent to continent.

• Shared circumstances across disciplines (i.e. health, education, etc.)

Great Leadership

• Challenge the process

• Inspire a shared vision

• Enable others to act

• Model the way

• Encourage the heart

“I used to think that running an organization was equivalent to conducting a symphony orchestra. But I don’t think that’s quite it; it’s more like jazz. There is more improvisation”.

Warren Bennis

Communicate

• Everything

• All the time

• In many ways

Leadership

• Leaders must convey a strong vision, have a clear sense of direction, act ethically and earn respect (US Army 1983)

• Managers: must be, know, do and evaluate

Thank you