As regular readers of this blog know, I have monthly “Coffee Chat with Julia” (last month was a summer “popsicle chat”) opportunities with the Holland Bloorview team.
Why? I know that I can lead better by deepening my relationship with my team. These informal chats help me to do that. To make effective decisions you have to have multiple sources of insight: evidence and data, plans, surveys, external reviews, etc. This is especially important to me as we close out year 5 of our current strategic plan “Leadership in Childhood Disability” and develop our strategy for the next 5 years. And we can’t forget that I am still in my learning journey at Holland Bloorview.
Now, with my second anniversary at Holland Bloorview in sight, I’d like to supplement the coffee chats with “Skip Level” meetings. No, there is no actual skipping involved (but I probably could be convinced…). These are meetings I’ll be scheduling with the people who report to my direct reports. In other words, my office will be reaching out to schedule ½ hour meetings with people who report to Judy Hunter, Golda Milo-Manson, Stewart Wong, Diane Savage, Ben Sybring, Tom Chau and Marilyn Ballantyne.
So what am I likely to ask during the meeting?
What’s one thing you love about Holland Bloorview (or your job)?
What’s one thing you wish were different (and how might you make it so)?
What should I know about you?
What would you like to know from/about me?
This kind of information gathering helps me do a better job of supporting the whole Holland Bloorview team and opens and sustains lines of communication. Listening to people within Holland Bloorview is a critical source of insight for me. And listening to as diverse a set of internal voices with different points of view will deepen that insight.
It’s pretty simple: Meet more people. Chat more with greater intention. Learn and reflect. And then, together continue to build on the boundless potential of our clients and families.
Shortly after I became President & CEO at Holland Bloorview Kids Rehabilitation Hospital, I started a regular Coffee Chat. We’ve scheduled them at different times of day and different locations in order to make it as convenient as possible for staff to join me for a drink and a chat. In some cases we’ve targeted particular groups with special outreach, e.g. we did a students’ coffee chat and we scheduled one on the 3rd floor with particular thought given to a time of day that would maximize nurses being able to attend.
So with another Coffee Chat around the corner (actually a “Popsicle Chat” in honour of the weather and locating the chat outdoors), I thought I’d share some of the FAQs about Coffee (Popsicle) Chat:
Who is invited? EVERYONE! Whatever you do at Holland Bloorview you are invited. Work at registration – love to chat with you. Researcher – yup. Admin assistant – yup. Physician – sure. OT? PT? SLP? Uh-huh. Nurse – You betcha. Ops manager – okey dokey. Environmental services – why not?! You’re probably seeing the pattern. Come one come all.
How many people usually come? It varies. I think it has ranged from 2 people to a dozen or so at a time. The numbers don’t matter – however many people come is the right number. I’m there for the hour.
What do you talk about? It depends. Sometimes when I have something on my mind I’ll raise a topic, e.g. about 6 months after joining Holland Bloorview I started to talk about and wanted feedback on my priorities. I used a Coffee Chat to elicit that. Sometimes the time of year dictates what’s on people’s minds, e.g. is it operating planning season? Are we working on the Quality Improvement Plan? It’s a group chat so who is in the room dictates the topics. Whatever is on your mind is what we’ll be talking about. Some memorable chats included aboriginal ways of knowing and equity, diversity and inclusion; workload and how do you give the kind of care you want to when there are so many kids who need therapy; what are some of the new things going on in the health care sector outside of Holland Bloorview; why do I use social media and how do I think it benefits Holland Bloorview; and lots of other things. Oh and one time Dr Flap and Nurse Flutter created a “Coffee Chat Song” (of course they did!).
How long does it last? I book Coffee Chat for 1 hour but no one (other than me) needs to stay that long. We’re all busy. Drop in and stay for a few minutes if that’s what you have. Stay for the whole hour. Come in and grab a coffee to go but at least stay hi.
Will I cause problems if I give the CEO my honest opinions? Sharing what’s on your mind is what this is about. I can’t learn unless I know what people really think and experience working at Holland Bloorview every day. And I can’t lead without being a learner and a listener.
Why do you do this? Okay so no one has actually asked me this but I bet some think it! I do it because it’s a great way for me to meet and catch up with people I don’t see every day. I like having a casual way to get a sense of what is top of mind particularly for frontline staff. I also want people to get to know me and feel free to ask me questions. Many do this in the hall or walking through spiral garden and that’s great too. And, well, I like coffee and it’s fun!
So that’s the 411 on “Coffee Chat with Julia.” Can’t wait to see you at one soon!
Holland Bloorview’s 2016 Sheila Jarvis Award Winners
Holland Bloorview Kids Rehabilitation Hospital’s June 13 Leadership Forum was on the topic of equity, diversity and inclusion. This had been planned months ago, but the discussion couldn’t have felt timelier having followed less than 48 hours after this weekend’s tragedy in Orlando, Florida.
As I usually do, I opened the Leadership Forum with remarks and this is the substance of what I said.
We are fortunate to be able to sit in this beautiful hospital building on lands that have belonged to First Peoples for thousands of years. Most recently these have been the recognized lands of the Mississaugas of the New Credit First Nation. Meegwetch. Thank you.
It is also June and that means Pride Month, so happy Pride to all of you! For those who observe, it is Ramadan. Ramadan Mubarek. And this weekend I participated in a session on Jewish approaches to disability and inclusion hosted by the Miles Nadel JCC in downtown Toronto for the Jewish holiday Shavuot. In as culturally diverse a city as Toronto and as culturally diverse a community as ours there is always a multitude of different celebrations and observances going on at any one time, something that always makes me feel very fortunate.
I don’t know who first shared with me the idea that we all carry around our individual (metaphorical) backpack. It might have been Holland Bloorview’s Louise Kinross or something I read in her wonderful BLOOM Blog or maybe I picked it up somewhere else. In our backpack we carry with us our experiences, our perspectives, our life choices, our culture and tradition, even whether getting the kids off to school this morning was smooth or WWIII! And as it is an invisible backpack, we can’t ever know what’s in the one that another person carries. But we know they carry it, and it affects who they are, what they say, how they react.
Today, we can expect many people’s backpacks to be heavier because of the act of hate and violence that happened this past weekend in Orlando. There will be clients, caregivers, family members, volunteers and staff who when they walk into our hospital today, will feel a bit less safe than they did on Friday. There will be other members of our community (clients, families, staff, volunteers, etc) who will feel like they will get more funny looks, more scrutiny today, because they look like someone’s idea of an “Islamic extremist.” Their backpacks will be heavier today, and in the days and weeks to come.
At Holland Bloorview our vision is a world of possibility for kids with disabilities. The way we frame and realize equity, diversity and inclusion for our organization will be in keeping with our DNA – our values, vision, mission and our belief in the strength, possibilities and optimism in our work with kids of all abilities. We are probably among the world’s experts on strength and resilience…taught by our clients and families.
Equity, diversity and inclusion is important every day, especially for an organization whose soul is in serving children who face being marginalized in so many aspects of their lives. Building a better, more inclusive, more just world for our children is important every day…especially today.
This year Holland Bloorview Kids Rehabilitation Hospital is celebrating an important milestone in our 117 year history – 10 years in our new state-of-the-art, accessible, child-friendly facility recognized by the International Academy for Design and Health as “an inspirational building…which speaks to a child’s right to participate in our society.”
We have come a long way since 1899 to become the largest rehabilitation hospital in Canada focused on improving the lives of kids and youth with disabilities.
Holland Bloorview Kids Rehabilitation Hospital’s therapeutic clown duo Dr. Flap and Nurse Flutter.
We take therapeutic clowning pretty seriously at Holland Bloorview (I couldn’t resist!). There’s science behind it and we’ve done research about its impact. When therapeutic clown duo Dr. Flap and Nurse Flutter are around, you can hear the laughter – from kids and employees – down the halls. Dr. Flap’s ukulele has provided the unofficial soundtrack for many of our events and Dr. Flap even recently held a 24-hour uke-a-thon in support of the therapeutic clown program.
In this blog as part of my Q&A series, I go behind the nose with Helen Donnelly, AKA Dr. Flap’s “supervisor” or our Senior Therapeutic Clown Practitioner, and she talks influences, heroes and the meaning of happiness.
1. What are you reading lately? What’s on your nightstand (or kindle!)?
James Herriot, It Shouldn’t Happen to a Vet. He’s a great humourous writer and it’s fun night-time reading!
2. Do you use any social media? Why or why not?
I’m addicted to social media; Facebook in particular. Being mostly self-employed over half of my business (teaching clown, performing in theatre and circus) results in people connecting with me in this way.
3. Who have been your biggest influences?
This is too huge a question! In terms of artistic, I’d have to say my master clown teachers, of ‘Mump and Smoot’ fame as well as a host of others (David Shiner, Bill Irwen, Lucille Ball, Laurel and Hardy, I could go on). In terms of the art of Therapeutic Clowning, aside from my partners in nose here, currently it’s a tie between our colleagues/past mentors in Quebec (JOVIA), Caroline Simonds of France (Le Rire Medecin) and many practitioners within Scotland (Hearts And Minds). So many awesome mentors out there. But if you were to ask me what drives in terms of Best Practice the big prize has to go to the kids, youth and teens we serve here at the hospital. They are the biggest influences of all, hands down.
4. What do you think your best quality is?
My sense of silly. Also my enthusiasm and drive.
5. What’s your main fault?
My enthusiasm and drive (go figure!).
6. What do you appreciate most in your friends?
Unconditional acceptance of my quirks and a beautiful sense of the silly.
7. What’s your favourite thing to do?
Toss-up between clowning (in healthcare, circus or theatre) and hiking/bird-watching.
8. If you hadn’t ended up doing what you do what would you be?
Oh, I come from a long line of teachers; I’m sure I would have wound up in the school system. As it is, I do teach theatrical clown outside here and therapeutic clowning techniques here, so teaching followed this fool after all!
9. What is your idea of perfect happiness?
I tend to shy away from this word as I’m not quite clear what it really means…it can be a feeling, that is fleeting in my view. But I think it would have to be that there would be no longer any need for Therapeutic Clowns in healthcare. So I guess I’m hoping one day to be out of a job? Wait….hang on Julia!!
10. What is your greatest fear?
To be out of a job (see above!) or to lose my funny perspective of the world (kind of the same thing!).
11. Which living person do you most admire?
My partner, who is both my director and the love of my life. He has healthcare struggles of his own and endures them with such dignity and humour.
12. What is your most treasured possession?
The first clown nose I was ever given, upon ‘graduating’ from my first clown workshop. It hangs in my office and stares at me…it’s a bit creepy…(no, it’s not!)
13. What do you consider your greatest achievement?
The path I’m currently on in healthcare.
14. What do you like the most about working at Holland Bloorview?
Being inspired to put my best effort forward and challenge myself and my colleagues to meet and exceed global standards. Sounds so geeky but it’s really true; it’s also true that countless colleagues continue to support my vision and help me find ways to get there…so a big shout out to all of you!
15. How did you end up working at Holland Bloorview?
My former colleague Jamie Burnett, who succumbed to a brain tumour in 2011, scouted me out. He and I knew of each other’s practice when I was working at SickKids back in 2004, so in 2007 when he heard I was looking for a change he snatched me up! It was a historical and beautiful union. We were a great contrast to each other (hence, a fine duo). I miss him every day.
16. What would surprise people most about your job?
How much ‘office’ work comes with the territory. I think most (outside this hospital) assume we just kind of sludge in, get dressed up, wander around, finish and leave. They would likely be surprised to learn only half of our time is spent ‘in nose.’ I think there is an opportunity for further education about this (nudge nudge say no more!)
17. Your greatest hero?
There are countless examples of true heroism here at the hospital, beyond the kids. I can cite hundreds of parents and clinicians who would easily fit this bill! I often say there are hundreds of documentary films just waiting to be made to tell their story…(idea?)
Payton, a client, with Dr. Evdokia Anagnostou, co-lead of the Autism Research Centre and senior clinician scientist in the Bloorview Research Institute.
Awareness days are important opportunities to draw attention and build knowledge about a particular group of people. By pausing on a particular day we can create a window for increased opportunities to learn, teach, celebrate, and build greater inclusion and opportunity where there is stigma and inequality.
In the lead up to this year’s World Autism Awareness Day on April 2, there was a social media storm on an issue that I thought had been put to bed once and for all. What created the attention were actor Robert De Niro and the Tribeca Film Festival’s decision first to show, and then pull, a discredited scientist’s film showing what is now known to be a thoroughly debunked link between vaccination and autism.
Parents of children who are on the autism spectrum (like Mr. De Niro) are justified in wanting to use whatever platforms are available to them to promote social inclusion and equality, as well as to enable rich dialogue about the causes of and interventions for autism. People who have autism and their families need to be listened to and be empowered to take the lead in identifying the key questions and defining for themselves the identities they wish to shape.
However, they need help to find credible information. The most important response to misinformation and the sometimes dangerous actions it spawns is high quality science. Services and treatments based on the best evidence will yield results for the about one in 68 children who have autism and that’s why research is one of the most important ways to impact the lives of kids with autism and their families.
This month and beyond, I want to invite you to celebrate kids who have autism and their families in your communities. We know and our guided by the experiences of many such families at Holland Bloorview and we believe the greatest impact we can have is through research, specifically the ground-breaking work of the scientists and clinicians affiliated with the Autism Research Centre under the leadership of Dr. Evdokia Anagnostou and Dr. Jessica Brian. Whether looking at social inclusion, early intervention, drug therapies or technology to build on the strengths of and enhance the lived experience of kids with autism (and other neurodevelopmental disorders), research is making a difference now and is the key to making a difference in the future.
Dr. Melanie Penner, a developmental pediatrician and scientist in our Autism Research Centre, recently shared her passion for making a difference in the lives of kids with autism and their families in a video by the Ontario Medical Association.
At Holland Bloorview, we want to continue to accelerate knowledge in this area, which is why we are working to build support for the creation of the Dr. Stuart D. Sims Chair in Autism. This research will aim to improve quality of life for kids with autism and their families. To find out more or how you can help click here.
Like other awareness days, World Autism Awareness Day is an important opportunity to celebrate, awareness-raise and fundraise for all different kinds of organizations. I hope it encourages everyone to continue to teach and learn throughout the whole year!
Navigating health care can be tough. It can be even more challenging for kids with disabilities and complex medical care needs and their families. The care ecosystem for kids and youth we see at Holland Bloorview is complex and includes therapy and rehabilitation services, home care and in-school supports, care in family doctor and pediatrician’s offices, and often in acute care hospitals.
Dr. Eric Hoskins, the Minister of Health and Long-Term Care, released a consultation paper in late December that proposes changes in the governance and delivery of health care services to improve care coordination and access for people across the province. At its core, Patients First: A proposal to Strengthen Patient-Centred Health Care in Ontario sets out a vision to evolve the way care is provided to put “patients” at the heart of care networks and improve their ability to find the care they need, when they need it.
How does the Government want to achieve these goals?
Currently, 14 Local Health Integration Networks (LHINs) across the province have oversight for local acute care, long-term care, community services, and mental health and addiction services. The Ministry of Health and Long-Term Care is proposing that LHINs also oversee other parts of the continuum of care, including:
Primary care. These are the people we might more typically think of as family doctors and (in some cases) the teams they work in. The aim is to continue to improve access to primary care and ensure primary care providers can effectively connect their patients to other parts of the health sector. Currently, other than the Ministry, no organization oversees primary care.
Community and home care. Community Care Access Centres (CCACs) manage the delivery of home and community care in Ontario (including in schools) and are currently accountable to the LHINs. Under the proposal, LHINs would gain direct responsibility for service management and delivery of home and community care. CCAC boards would no longer exist.
Public health units. The LHINs would take over accountability of public health units and the allocation of Ministry funding and work closely with the Medical Officers of Health in each area. Public health services would still be managed at the municipal level.
Also under the plan, smaller sub-regions within each of the LHINs would be created and would lead the integration of community and home care with primary care. For example, within the Toronto Central LHIN there are five sub-LHIN regions proposed.
What I’ve heard at consultations
The Ministry asked patients, families, providers and care organizations to provide feedback about the proposal in January and February. In the various consultations I’ve attended and been briefed on, I’ve heard excitement about a vision for better integration across the continuum of care (hospital, doctors offices, home, community). However, I’ve also heard concerns about how provincial programs and specialty programs including pediatrics and rehabilitation fit into this vision, whether there will be new dollars associated with this transformation and how the critical issue of caregiver burnout will be addressed. I’ve also heard questions about the capacity of the LHINs to take on new care delivery responsibilities, where health equity and social determinants of health (e.g. poverty) are being accounted for and how successes are going to be maintained and strengthened.
Families at Holland Bloorview consistently tell us that kids needs do not neatly fit into government ministry borders, they don’t want their kids to be seen first and foremost as “patients” and they need better coordination and navigation to help access the array of existing services. They have also asked how Patients First and the work underway under the Special Needs Strategy will come together to make real improvements for kids with disabilities and their families.
What do kids and their families need from Patients First?
It would be hard to disagree with the overall and high level vision the Ministry has set out in Patients First: better service integration and coordination and putting patients at the centre of care. I commend Minister Hoskins and his team for their commitment to transforming the experience of care and, ultimately, the outcomes of care for all Ontarians.
What are missing in the proposal are kids and families. Quality care from pre-birth throughout childhood is critical to ensuring our kids and youth become healthy adults with the greatest opportunity, best lives and widest societal participation.
We know intuitively as parents and caregivers, and based on evidence as health care providers, that children are not mini-adults. The Government needs to thoughtfully plan to address the unique care needs of kids and their caregivers. Needs that include school supports, mental health care, the coordination between primary care providers and specialists, specialized technology and equipment, seamless transitions to adult services and, in particular for kids with complex needs, support navigating and accessing therapies and services including those that aren’t available in local communities.
Holland Bloorview partnered with CHEO, McMaster Children’s Hospital, Sick Kids and Kingston General Hospital on a coordinated response to Patients First. We proposed that any visionary redesign to health services include a distinct approach for improving children’s health and development and that the Ministry draw on the extraordinary expertise in pediatrics available in this province to help develop a strategy that puts kids and families at the centre.
Holland Bloorview is here to help. Drawing on the insights and experiences of our young patients and their families, specialized research conducted by scientists in the Bloorview Research Institute and clinical expertise, we look forward to informing improvements for kids and families to ensure the best experience and outcomes and optimal health and well-being for kids as they reach their full potential throughout their childhood and into adulthood.
What are your ideas for putting kids and families first in Ontario’s health care?