Leadership in a Sea of Change

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

2. 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

3. Overview (cont’d)

4. 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

5. 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

6. 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)

7. 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)

8. 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)

9. 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

10. 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:

11. Human Resources Physicians Nurse practitioners Leadership Nurses Governance Human Resources Teachers Teaching assistants Leadership Governance Current Challenges (cont’d)

12. 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)

13. Current Challenges (cont’d) • Geographical Issues • Rural/urban divide • Hard to reach communities • Difficult to serve communities • Weather • Sustainability • Escalating costs

14. Current Challenges (cont’d) • Demographics • Population shifts • Immigration issues • Birth rates

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. “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

22. “ A leader takes people where they want to go; a great leader takes people where they ought to be!” • Jim Rohn

23. “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

24. Leadership responsibilities: • Chart the Course • Provide the Managers • Management Responsibilities: • Stay the Course • Manage the Culture & Climate • Provide Leadership

25. 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

26. Principles of Leadership (cont’d) • 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

27. 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

28. 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)

29. 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.

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

31. Lots of resources No deadlines No crises Stable environment Scarce Resources Pressure Cooker Multiple crises Changing, unstable environment Best of times ……….Worst of times

33. 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.)

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

36. “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

38. Communicate • Everything • All the time • In many ways

39. 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

40. Thank you