CEO blog: 2019’s Healthcare Top 5

As we start the New Year here are the top 5 concepts that I think are going to be critical to meeting the enormous challenges for healthcare systems, organizations and leaders.

1) Trust

Holland Bloorview’s vice-president of programs and services Diane Savage shared the American Board of Internal Medicine Foundation (ABIM) “Trust Challenge” with me toward the end of 2018. The premise of the challenge is that in order to provide great health care teams must have a “stable foundation of trusting relationships.” If this rings true (and it does to me), then how can we as leaders in health care help to nurture and grow trust, in hospital leadership, in each other as members of teams, in the institutions that support us?

Edelman publishes an annual “Trust Barometer” which has demonstrated an erosion of trust in government, media, business and non-governmental organizations (NGOs). Most surprising is the rapid erosion in trust in NGOs with only half of the general population reporting that they trust NGOs according to the latest Canadian data.  What to do? Be clear about the change we are trying to make as healthcare institutions; share credible information grounded in evidence; and mobilize health professionals, researchers and healthcare leaders in public discourse.

We in health care have an advantage because healthcare professionals are trusted. Jane Sarasohn-Kahn (@healthythinker) shared a recent Gallup poll on Twitter looking at the most trusted professions in the US. Four of the top five are health professions with nurses at the top of the list.

But the medical profession has also been at greater scrutiny than ever for the way that relationships (and financial ties) can impact objectivity. One of the New York Times top health stories of 2018 was on conflicts of interest in medical research. How we manage the relationships for the credibility of our hospitals has been a key focus of efforts for the Toronto Academic Health Science Network over the past two years and Holland Bloorview will be advancing our efforts in disclosure and management of relationships this year.

 

2) Complexity

We have observed the increasing complexity of the clients we are seeing at Holland Bloorview over the past number of years. This is demonstrated by data we have on the proportion of our clients with multiple diagnoses, the increased medical acuity of many of our inpatients, and the proportion of our client families that are experiencing economic precariousness and other social determinants of health.

What we are seeing is consistent with what we know are the pressures on hospitals across the city and the province and has motivated initiatives such as Complex Care Kids Ontario (sponsored by the Provincial Council on Maternal and Child Health ) and Connected Care (created by SickKids and funded by the Toronto Central Local Health Integration Network), as well as the Kids Health Alliance , of which Holland Bloorview is a founding member.

A recent synopsis of two studies caught my eye with their special relevance to what we are requiring of our nursing professionals and the health human resource challenges of this increased patient complexity. As we know, complex children are being cared for not only in specialty hospitals but also in the community (home, school, other residential settings) where kids should be spending their lives. But we don’t yet have a truly coordinated high quality system of child and family centered care for this small but growing population.

Managing this level of complexity requires work at all levels of our hospital. Much of what we at Holland Bloorview think is required is contained in our No Boundaries strategy that asks us to personalize pathways for our clients, to use our research and academic mandate for rapid impact – to discover for action, and to connect the system in order that care can be more integrated. But I hear all the time from clinicians in particular that we aren’t as clear as we ought to be about how to make the No Boundaries strategy live in their work, and to support them with the quantity and complexity of their work.

 

3) Empathy

Marilyn Monk, Executive Vice President at SickKids recently tweeted a Harvard Business Review article that makes the case that for organizational change to be successful it has to be grounded in empathy. In other words, understanding the team’s perspective is critical to change that is sustainable and lasting. You can’t get insight without asking (and that means everyone) and creating transparency.

There are some great thinkers who have made empathy a focus in 2018. For example, on my reading list are Brian Goldman’s The Power of Kindness and Brené Brown’s Dare to Lead. In the waning days of 2018, I discovered Nathalie Martinek on Twitter (@NatsforDocs) who is writing about and working on “burnout culture and disconnected medicine.” I’ve also noticed that the concept of “moral distress” (the conflict between the “right” thing to do and scarce resources) which has been in the nursing literature for more than three decades is starting to be used in the context of medicine and I’m hearing a similar tone in conversations I’m having with professionals in the health disciplines I talk to at Holland Bloorview.

We are proud to have been the first hospital in Canada to implement the Schwartz Center Rounds® to enhance compassionate care, improve teamwork and reduce caregiver stress. There are also plans to increase access to the quality of engagement provided by Schwartz Center Rounds® with a “pop up” version for individual clinical teams.

How will we advance empathy while faced with system constraints?

 

4) Equity, Diversity and Inclusion

We are investing in equity, diversity and inclusion this year at Holland Bloorview. We know that part of the complexity in our clients’ lives is impacted by social determinants of health. We also wonder if there are clients that we are not serving as effectively as we could, or ways our programs could take equity, diversity and inclusion into consideration in design and delivery.

Research funders are requiring a greater degree of attention to equity, diversity and inclusion. We are rising to this challenge in our research institute.

We also are paying attention to equity, diversity and inclusion in the Holland Bloorview team. Do we at Holland Bloorview represent the diversity that we see in Toronto? We are in good company with the University of Toronto Faculty of Medicine, also deeply invested in this issue and finding ways to widen the pathways into medicine and other healthcare professions.

We want everyone who works at Holland Bloorview to feel comfortable bringing his or her whole selves to work – a critical part of the authentic culture of compassion that we know is also critical to providing child and family centred care.

We are grateful that we will have leadership in all elements of this important work at Holland Bloorview with our new Executive Lead of Equity Diversity and Inclusion, Meenu Sikand.

 

5) Wellness

All of these roads lead to the wellness of our team. I know from talking to colleagues across health care that burnout among healthcare professionals is one of our most pressing concerns. The Institute for Healthcare Improvement (IHI) describes the challenge this way:

With increasing demands on time, resources, and energy, in addition to poorly designed systems of daily work, it’s not surprising health care professionals are experiencing burnout at increasingly higher rates, with staff turnover rates also on the rise.

Burnout leads to lower levels of staff engagement, patient experience, and productivity, and an increased risk of workplace accidents. Lower levels of staff engagement are linked with lower-quality patient care, including safety, and burnout limits providers’ empathy — a crucial component of effective and person-centered care.

The IHI has developed a framework for improving joy in work emphasizing that systems change is what is needed not only to reduce burnout but to actually ensure high quality care.

Team wellness is a top priority for me and I’m excited that work has begun on our new No Boundaries people and culture plan – a plan that will be about “doing” rather than more “talking” (stay tuned on how members of the Holland Bloorview team will be engaged in this important work).

 

Conclusion

Whether it is a healthcare system or the team in any individual organization, hospital or community-based, wellness is mission critical. Let’s make 2019 the year we take our system and our organizational wellness to the next level.

Want to provide feedback on how we can take it to the next level? Email me at jhanigsberg@hollandbloorview.ca or tweet at me @hanigsberg. (For members of the Holland Bloorview team, come to my next CEO Coffee Chat. See HBConnect or stay tuned to your email inbox for HBConnect Weekly for timing and location details.)

_____

Julia
@Hanigsberg

CEO blog: Busting myths about Holland Bloorview (part two of a two-part series)

As mentioned in my last post, this one will focus on some myths and truths about Holland Bloorview (spoiler alert: there will be numbers!).

How do we share information?

Every summer we issue our annual Impact Report where we share some of the stories we are most proud of from the previous year from care, research and teaching and learning that demonstrate how we are making progress on our No Boundaries strategic plan and how community and donor support is advancing our work.

Our Impact Report also shares some of the key numbers that help describe who we are. I’m using this post to focus on these numbers and to do some gentle myth busting!

By dollars, Holland Bloorview is a $94M hospital. This makes us the smallest by funding (but certainly one of the mightiest by impact!) of Ontario’s academic health science centres, but there are many community hospitals that are smaller than us across the province.

 

Myth #1: “There are more management at Holland Bloorview than any other hospital!”

Myth-buster: We have only 16 people who are Directors or Senior Directors! We have 6 Vice Presidents who along with our Chief Financial Officer, our Chief Nursing Executive and the President and CEO of the Holland Bloorview Foundation, make up our Senior Management Team. Our overall management (managers and above) is only 5% of our total staff. 72% of our funds are spent on care and only 13% on administration.

That would make us among the leanest management teams out there especially when you take into consideration the complexity of our client population, that we serve the province (2/3 of our clients come from outside our Local Health Integration Network) and the fact that we are a teaching and research hospital with responsibilities to our trainees, learners and clinical supervisors!

We have just over 1000 staff with virtually a 50/50 split of full and part-time. Of this staff, a majority are physicians, nurses, members of health disciplines and family and caregiver support.

 

Myth #2: “When clinicians leave or retire they are never replaced!”

Myth-buster: Also not true! But I can understand where the misunderstanding comes from. Sometimes when a person leaves (happily we have incredibly low turnover) we consolidate their responsibilities with another position and even sometimes in a different area or clinic. Here’s an example of how this works:  clinician A who works part-time leaves and clinician B who also works part-time moves into a full-time role by the combination of two part-time positions. While in that scenario we have gone from two to one staff, we have maintained the amount of clinical resource (what is referred to as “full-time equivalent” or “FTE”).

So to be fair, a particular individual or team may feel like “their” person hasn’t been replaced, and the loss in expertise, knowledge, experience and camaraderie is real for them.

Fact: We work hard to fill vacancies in clinical positions even if that means we have to keep vacancies in administrative positions in order to ensure we have the money we need to fill clinical jobs. Retaining clinical capacity is always (and will always be) our top priority.

 

What IS absolutely true: 

Your work is getting harder and more complex. Even with the same amount of clinical resource available, there is more work and it is harder.

We are seeing more children and youth every year because the need just continues to expand and we doing everything we can not to turn families away.

The children we are seeing are more complex. 71% have two or more diagnoses. The number of rare conditions continues to expand as science progresses and diagnostic processes become increasingly specific. There were children with more than 2000 different diagnoses served at Holland Bloorview last year.

Children are also more complex because we are seeing them at a younger age. When I started at Holland Bloorview (just under four years ago) we rarely saw infants. We now routinely admit infants and very young children.

In addition, with the length of stay at acute care hospitals becoming shorter than it used to be, children arrive at Holland Bloorview with greater medical acuity than they ever have. That fact changes our required knowledge and capacity and we have worked hard to build that through professional development, training and new equipment.

The psychosocial needs of families are greater than they have ever been. What does this mean? For example:

• Half of our clients have a family income less than $50,000.
• Many of our clients are food-insecure.
• Sources of funding for equipment families need are dwindling.
• Waitlists for services (including those in the community or at other hospitals/service providers e.g. mental health) are long.
• Children and families are living with trauma.
• Parents (and other caregivers) are under relentless stress and sometimes appointments with Holland Bloorview care teams are where that frustration gets aired.

We are proud to extend Holland Bloorview’s care to some of Ontario’s most complex children and children and families across Ontario who need us most. But, that makes the work hard and it means fewer and fewer client visits are straight-forward and routine. It also means, that physicians and clinicians also live the pressure of never feeling like they are doing enough. I hear directly from clinicians that they frequently go home demoralized because they know that they haven’t been able to meet all the hopes and needs of the children and families they have seen that day. Fewer days end on an optimistic high note.

 

Myth #3: Children who come to Holland Bloorview receive extraordinary care and benefit from programs and services and work done by all of our teams that changes lives every day.

Oops, sorry, that one is true. And I could not be more grateful to every single person who has chosen to make Holland Bloorview the place to spend a career. These are not jobs they are callings and I am humbled to work alongside the Holland Bloorview team every day.

Best of the holiday season, and a safe, healthy and joyful 2019 to all.

_____

Julia
@Hanigsberg

CEO blog: Decision-making at Holland Bloorview (part one of a two-part series)

As the 2018-year comes to a close, I’m planning a two-part year-end set of posts to the blog (do you see how I am cleverly distracting you from the fact I didn’t post in November?).

This first one will focus on decision-making at Holland Bloorview especially regarding budgeting (it is, after all, that time of year). The second one will focus on some myths and truths about Holland Bloorview (spoiler alert: there will be numbers!).  And to start off the New Year in January, I will focus on a subject particularly near and dear to my heart, the wellness of our team. Stay tuned.

All three of these of these posts are likely to be of greatest interest to our Holland Bloorview team and in the spirit of transparency – more information is always better than less – and I’m eager for your comments and questions!

As promised, this post will focus on decision-making at Holland Bloorview especially, but not only, regarding budgeting. This is what I sometimes hear:

“It’s impossible to understand how decisions get made in this place!”

This post is an attempt to help to clear some of that up.

There are other ways to better understand decision-making: ask your manager if there’s something happening on your team or in your department that you want to know more about; check out HBConnect (the Holland Bloorview intranet) where information on major initiatives can be found (e.g. Meditech EXPANSE, our health care information system); come to a CEO Coffee Chat and ask me directly!

But here are a few FAQs to help make it (hopefully) clearer:

 

How are money decisions made?

By now all departments will have completed their financial optimization and budget process and submitted the results to the Finance Department. Our Chief Financial Officer has brought preliminary numbers to the Senior Management Team to show us that all departments have met their savings targets (thank you – we know it wasn’t easy!).

[Why savings? Because the increases in funding we have gotten each year in the past few years while terrific, don’t keep up with inflation (the amount our costs go up). Stay with me!]

These departmental budgets also include new operating budget “asks.” Later, capital (e.g. equipment) requests will be brought to the Senior Management Team. Where operating and capital need exceed our funding (always), Senior Management Team is responsible for prioritizing.

This priority setting gets reflected in the annual Operating Plan, which is prepared to demonstrate alignment with our No Boundaries strategy. In other words, our activities in the coming year are shown organized around how they will advance the impact areas of our strategic plan: Personalize Pathways, Discover for Action, Connect the System (as well as our four enablers).

The Operating Plan pulls together financial requirements with priorities. In other words, are there things we want to stop doing, consolidate, start doing, or do differently? For example last year, a key priority was to develop a plan to transition medically complex and younger clients from specialist acute care (primarily SickKids) to Holland Bloorview for rehabilitation. This change (and the funding required to make it happen which we ultimately received from the Toronto Central Local Health Integration Network (LHIN)) had been developed by our Rehabilitation and Complex Continuing Care team with support of lots of other resources across the hospital before it made its way into the Programs and Services priorities and finally into the Operating Plan.

The Operating Plan is reviewed by the Quality Committee of the Board of Trustees  – to ensure focus on services, programs, safety and quality – and the Business and Audit Committee of the Board of Trustees – to ensure that it demonstrates financial responsibility and adherence to our Hospital Services Accountability Agreement (HSAA), which is our contract with the government for our funding. Then the whole thing goes to the full Board of Trustees

Aren’t you glad you asked?

 

What about equipment and IT?

Similar process for capital requests but Information Systems/Information Technology (IS/IT) equipment is reviewed by the Digital Health Strategy and IS Committee. This committee has been newly constituted this year and includes physician and health discipline representation as well as two family leaders.

The Senior Management Team also decides on equipment needs in line with the No Boundaries strategy and quality and safety (as well as lifecycle of current equipment). For example, last year some big approvals were for capital required for Meditech EXPANSE and new X-Ray equipment to replace an aging existing machine.

 

Where does the Foundation come in?

Great question! Much of what we do as the bread and butter of Holland Bloorview couldn’t happen without the generous support of our donors. Roughly $9M annually of donor dollars are spent on equipment (e.g. new inpatient sleeper beds – finally!), programs (e.g. therapeutic recreation, therapeutic clowns, parent education), the family support fund, and research (e.g. the new research MRI which will come to Holland Bloorview next year as part of the Bloorview Research Institute Growth Strategy) and innovation (e.g. No Boundaries Fund projects such as KneuroKnits anxiety reduction through knitting for kids with ASD). In addition there are generous endowments (donor funds which are invested to create an income stream), which fund particular research areas (e.g. named chairs/positions supported by targeted funding like the Holland Family Chair held by Dr. Nick Reed, the Bloorview Children’s Hospital Chair held by Dr. Melanie Penner, and the Chang Family Chair held by Dr. Tom Chau).

Decisions on how the annual donor support is spent are made by the Senior Management Team (SMT) through the annual grants process. Grant fund requests are made on a template, VPs review all the grants coming through their areas to make sure they represent the most important priorities, the whole bundle gets reviewed by me, and then the full “ask” comes to SMT. Once we have decided which among the grant requests the hospital will ask be funded, I sign off on the package and it goes to the Board of Directors of the Foundation for approval. The Foundation will only fund something that has been identified by the hospital as a priority.

The Foundation President and CEO also looks at the Senior Management Team approved equipment needs and will fundraise for a significant proportion so we can purchase more through donor support then our capital budget each year would make possible (thank you donors!).

More questions on donor funding, how you can help generate more of it, or anything else about community support? Stop Sandra Hawken our terrific Foundation President and CEO in the halls, chat with any of her great team or join the staff philanthropy champions group.

 

I have a great new idea, how do I get it funded?

If it is something that will help to personalize pathways, give us an edge in discovering for action or connecting the system and you can do it for less than $5000 it is perfect for the No Boundaries Fund. This is a fund that members of the Holland Bloorview team can apply to. Check out HBConnect (Holland Bloorview’s intranet) for more information.

Not every new idea requires new money. Doing things differently to make our organization better and to enhance the care and services we provide is always top of the agenda. But it isn’t always clear where to go with those ideas. If your idea doesn’t fit the No Boundaries Fund requirements talk to the relevant manager or if you aren’t sure talk to a VP or come chat with me and I’ll help to steer you in the right direction.

 

Okay, those are decisions about money, but what about other decisions? How do they get made?

The answer is … it depends. Lots of decisions are made locally. Of course clinical care decisions are made by physicians, nurses and clinicians as part of their everyday responsibilities. Managers and Directors make decisions for their areas and the VPs make decisions in the portfolios for which they are responsible (most often in consultation with colleagues across the hospital). “Final” decision-making typically (but not always) resides with the Senior Management Team, and ultimately, on matters of governance, with our Board of Trustees.

There are committees such as the Medical Advisory Committee that have a number of sub-committees that ensure safety and quality. These committees for example review incidents and determine whether and how they could be prevented and take steps to do so working with practice councils and our Quality, Safety and Performance team. Policies regarding care, quality and safety are approved through this mechanism. The Medical Advisory Committee reports into the Quality Committee of the Board of Trustees every month.

The Family Advisory Committee sets goals every year and then works with Programs and Services leadership to coordinate how to achieve them. For example last year one of the Family Advisory Committee goals promoted by our Chief Nurse Executive was the creation of Family Communication Whiteboards for inpatients.

The Digital Health Strategy and Information Systems Committee make recommendations to the Senior Management Team on how to enhance the use of technology at Holland Bloorview.

Academic and research priorities are set by the Teaching and Learning Institute and the Bloorview Research Institute in annual plans and budgets that go to the Research, Teaching and Learning Committee of the Board of Trustees.

Sometimes important and strategically aligned (i.e. supporting No Boundaries) ideas come directly to me. For example this year we launched Canada’s first Autism ECHO, a very important initiative to build healthcare provider capacity where there is huge client need across the province. This was “pitched” to me, we decided as a Senior Management Team that it was a very important, impactful and strategically aligned idea and put our support behind the team creating a proposal that was ultimately funded by the Government.

 

Is that it?

No! There are lots of committees and groups that promote change and new actions at Holland Bloorview. There’s the Equity, Diversity and Inclusion Committee, the Social Committee, the Evidence to Care Committee and the Human Resources Council, to name just a few. There is BRITE (the Bloorview Research Institute Trainee Executive) and an emerging council looking at integrating learning opportunities across the hospital building on work in the Teaching and Learning Institute, strength-based nursing and Organizational Development and Learning. There is a brand new (and our first!) affinity group that is a grass-roots initiative of staff interested in LGBTQI2S issues.

Have ideas about this (or anything else?) then come to one of my quarterly CEO Coffee Chats to share your thoughts!

_____

Julia
@Hanigsberg

CEO Blog: What is an occupational therapist? Guest bloggers answer questions and bust myths about their work

Pictured here is  Jennifer Crouchman, occupational therapist and guest blogger, with Gabriel, a Holland Bloorview client.

Guest bloggers: Christie Welch, Carling Robertson, Jennifer Crouchman and Susan Fisher

For part of our celebration for occupational therapy (OT) month this October, Julia is sharing the blogosphere to shine a spotlight on OT and the many roles occupational therapists play at Holland Bloorview.

What are occupational therapists?

Occupational therapists are regulated health professionals. They help people do the things that are important to them. For children and parents, these are everyday things that children engage in at home and at school, like writing, eating, learning to walk, playing with friends, or going to the washroom.

Occupational therapists look for the fit between a person’s skills and the demands of their environments. They work with children to increase skills and to reduce barriers in the environment, so that children can participate at maximum levels. An OT may recommend equipment to help with positioning and mobility, exercises to help strengthen muscles, games or toys to help with social skills and visual motor co-ordination, or calming activities to help with sensory regulation. OTs also support teens and young adults to get involved with early work experience opportunities such as volunteering, high school co-ops and paid summer jobs.

Occupational therapists at Holland Bloorview

At Holland Bloorview, occupational therapists are just about everywhere! You can find OTs at all of our locations, doing a variety of things from direct therapy, prescribing equipment, running education groups, doing research and acting in leadership roles. We also have OTs working out in the community – in kids’ and youths’ homes, schools and childcare centres.

Who are occupational therapist assistants?

Occupational therapist assistants (OTA) work under the supervision of OT to enhance treatment goals. This may be through 1:1 therapy or group therapy with or without the presence of OTs.

Occupational therapy myth busting

Because occupational therapists have such a wide scope of practice and because they work in so many different settings, it can be hard for people to understand what occupational therapy is.  Occupational therapists often have to bust myths about occupational therapy.

Myth #1: Occupational therapy is all about helping people find jobs

Actually, occupational therapists help people reach goals in any area of their lives. This sometimes includes work-related goals. Also, OTs believe that various forms of work are health promoting and so, might use work-based activities as therapy!

Myth #2: Occupational therapists work just in pediatrics

Occupational therapists work with people across the lifespan.

Myth #3: Occupational therapy is all about minimizing disability

Occupational therapists work with people to reach a variety of goals within and outside the context of disability (some OTs work exclusively in ergonomic design for instance). Just because someone has a disability does not mean they need OT, and when people do have a disability, they can work with an OT to achieve goals in many ways – sometimes by changing the environment, daily schedules or accessing new technology or equipment.

Myth #4: Occupational therapists work just on “arms and hands”

Occupational therapists are holistic in their views of people. They consider physical, mental and spiritual well-being and are trained to support people in a wide variety of ways.

About the guest bloggers

Christie Welch has been an OT at Holland Bloorview since 2003. She recently took on the role as lead for the early learning and development programs. Christie’s favourite part of being an OT is the versatility it affords her in terms of practice contexts, intervention approaches and job roles. Christie hopes to become more involved in leadership and research. She is set to complete a PhD in Rehabilitation Science in December 2018.

Carling Robertson has been an OTA within the youth employment programs at Holland Bloorview since 2015 and part of the brain injury rehabilitation team (BIRT) inpatient team since 2016. Carling’s favourite part of being an OTA is how every day is different which allows her to constantly learn new things while building therapeutic relationships with many different clients.

Jennifer Crouchman has been an OT in various roles at Holland Bloorview since 2012. She has held positions on the transitions, recreation and life skills and specialized orthopedic and developmental rehab (SODR) inpatient teams; and is currently part of the writing aids service. Jennifer’s favourite part of being an OT is the opportunities to be creative in developing individualized solutions and strategies with clients and families to increase their participation in everyday activities.

Susan Fisher has been an OTA at Holland Bloorview since 1997. She has held positions in integration education therapy (IET), specialized orthopedic and developmental rehab (SODR) inpatient teams, brain injury rehabilitation and currently inpatient seating services. She is also using her skills to develop the new position within Holland Bloorview of preventative maintenance technologist. Susan’s favourite part of being an OTA is the opportunity to work with many different populations across the hospital.

CEO Blog: Dear Everybody campaign challenges perceptions about disability

Nobody wants to see their child, sibling or friend left out or picked on for being themselves.

Yet kids with disabilities often face whispers, staring, exclusion, name-calling and bullying.

Young people with disabilities are two to three times more likely to be bullied than kids without disabilities and one study found that 53 per cent of kids with a disability have zero or only one close friend.

The shadow of disability stigma doesn’t disappear as young people with disabilities get older.

Median incomes for Canadians with disabilities are 34 per cent (almost $10,000) less than the incomes of Canadians without disabilities.

Many individuals with a disability who want to work face barriers to employment: one-third say they have been denied a job because of their disability, and 24 per cent say they have been denied a job interview.

This data, as well as the stories we hear first-hand from the thousands of children, youth and families served by Holland Bloorview Kids Rehabilitation Hospital, are the reason that we have recently launched the second year of our Dear Everybody campaign.

Dear Everybody is a national movement created in partnership with kids and youth to raise awareness about disability stigma.

Disability stigma is the negative and unfair beliefs or assumptions we make about people who have disabilities. And stigma has an impact on almost every facet of life: friendships, school, employment, law, policy and more.

So the time for change is now.

Read my full column on Toronto.com.

_____

Julia
@Hanigsberg

CEO Blog: Harnessing creativity and risk-taking for impact

The stereotype we are all familiar with is that hospitals are risk-averse and rigid. Indeed, when entrusted with individuals’ health and safety, our appetite for risk is low. Further, healthcare is one of the most complex systems in existence, more complex than banking, manufacturing, or education. Why? At least in part because the various combinations of care, activities, events, interactions and outcomes are virtually infinite (Braithwaite, J., BMJ (2018;361:k2014)).

So how do we get past our risk-averse tendencies and bring about change amid this complexity? A big part of the answer is embracing an innovative mindset. The challenge is how do we, as health care leaders, create an environment where the amazing ideas our staff, physicians, clients, and families have are harnessed into actions that make a positive impact and help us more effectively deploy our resources?

Read my full column in the August issue of Hospital News.

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Julia
@Hanigsberg

CEO Blog: Danforth Strong, Toronto Strong

This week has been a tough one with the unthinkable shooting on the Danforth, compounded by equally heartbreaking gun violence across so many of our neighbourhoods and the van attack only a couple of months ago. Learning that one of the victims, 18-year-old Reese Fallon, was going to study nursing at university in the fall hits many of us at Holland Bloorview particularly hard, as did the news that victim Julianna Kozis was only 10 years old. We will be flying our flag at half-mast over the next week.

This week, and every week, I encourage all of our Holland Bloorview staff members to check in with colleagues and teams to offer support and remind each other that immediate mental health resources are always available through our Employee and Family Assistance Program. Our program provider, Morneau Shepell, has also set up a crisis support line for anyone in the community in need of emotional support in relation to this event. The number is 1-844-751-2133 and is open 24/7.

Empathy and kindness are top-of-mind as we think about all of the many families, neighbours and friends touched by this tragedy. We are so fortunate in our city to have such incredible first responders and colleagues in trauma centres and communities that rally in times of deep need. We continue to prove over and over again how resilient and compassionate we are in this city.

We will always be Danforth Strong, Toronto Strong.

_____

Julia
@Hanigsberg