Leadership in a Sea of Change

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Leadership in a Sea of Change
Vickie Kaminski President CEO, Eastern Regional
Health Authority July 8, 2010
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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

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Overview (contd)
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Overview (contd)

• 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 Childrens Hospital Foundation

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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

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The Region (contd)

• 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. Johns
• (111 incorporated municipalities, 69 local
  service districts and 66 unincorporated municipal
  units)

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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. Johns to Edmonton, Fort
  McMurray)

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Population Changes (contd)

• 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 _at_ 1.30 (lowest in the country)

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Lines of Business

• Promote health well-being
• Facilitate programs services that promote and
  protect population Health help prevent disease
  and injury
• Provide supportive care
• Provide community-based support and continuing
  care, residential care options, home support and
  nursing home care.
• Treat illness and injury
• Investigate, treat, rehabilitate and care for
  individuals with illness or injury
• Advance knowledge
• Advance research, education and knowledge
  dissemination

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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

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Current Challenges (contd)

• Human Resources
• Physicians
• Nurse practitioners
• Leadership
• Nurses
• Governance

• Human Resources
• Teachers
• Teaching assistants
• Leadership
• Governance

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Current Challenges (contd)

• 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

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Current Challenges (contd)

• Geographical Issues
• Rural/urban divide
• Hard to reach communities
• Difficult to serve communities
• Weather
• Sustainability
• Escalating costs

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Current Challenges (contd)

• Demographics
• Population shifts
• Immigration issues
• Birth rates

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Current Challenges (contd)

• 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

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Leaders

• Leaders are not born. They are made. They are
  made just like anything else through hard work.
  Thats the price we have to pay to achieve that
  goal or any goal.
• Vince Lombardi

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Leaders (contd)

• 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

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Leaders (contd)

• Have a good understanding of human nature
• Are good communicators
• walk their talk
• Would never ask you to do something they wouldnt
  do themselves
• Are adaptable
• Exercise good judgement

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Leaders (contd)

• Arent 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

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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

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• 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

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• A leader takes people where they want to go a
  great leader takes people where they ought to
  be!
• Jim Rohn

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• When Noah heard the weather forecast, he said
  Build an ark!
• - thats leadership.
• When he got everyone on the ark he said Dont
  let the elephants see what the rabbits are
  doing!
• - thats management
• Unknown

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• Leadership responsibilities
• Chart the Course
• Provide the Managers
• Management Responsibilities
• Stay the Course
• Manage the Culture Climate
• Provide Leadership

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Principles of Leadership

• Know yourself and seek self improvement
• Be technically proficient
• Seek responsibility and take responsibility for
  your actions
• Make sound and timely decisions
• Set the example
• Know your people and look out for their well being

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Principles of Leadership (contd)

• Keep your employees informed
• Help your staff develop a sense of responsibility
• Ensure that work is understood, supervised and
  accomplished
• Train as a team
• Use the full capabilities of the organization

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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

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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)

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Culture and Climate (contd)

• 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.

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• A leader must be trustworthy and must be able to
• communicate a vision
• A manager must be steadfast and adept at changing

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Best of times .Worst of times

• Lots of resources
• No deadlines
• 
  
• No crises
• Stable environment

• Scarce Resources
• Pressure Cooker
• Multiple crises
• Changing, unstable environment

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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.)

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Great Leadership

• Challenge the process
• Inspire a shared vision
• Enable others to act
• Model the way
• Encourage the heart

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• I used to think that running an organization was
  equivalent to conducting a symphony orchestra.
  But I dont think thats quite it its more like
  jazz. There is more improvisation.
• Warren Bennis

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Communicate

• Everything
• All the time
• In many ways

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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

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• Thank you