Markham Stouffville Hospital has undergone an extensive renovation and expansion transformation over the last five years. During this period, change became our new normal; and today, our programs and services can evolve in keeping up with the support required by our large community.

The physical metamorphosis was incredibly exciting and there was energy infused into the organization throughout the project as everyone worked to make the change a success.

On August 24, 2014, the project was done, the contractors were gone, the hoarding was taken down, and we went back to the singular business of being a hospital, not a hospital and a construction site. The change was welcome for many who had to wear two or more hats throughout the project.  We had nurses reading blueprints, front-line staff designing workflow and managers coordinating patient moves.  It was an excellent learning experience and, and while adding a substantial piece of work to everyone’s plate, it really allowed the whole team to be involved in the new building.

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The challenge became how to create a similar level of excitement and momentum in the absence of a project of this magnitude.  It was not easy for some who really felt the post-construction let down.  Their feedback told us that creating a new building, fitting up every room, ordering equipment, moving patients – was incredibly exciting.  But now, they have a sense of “what’s next”.  For others, they wanted the organization to go back to where it was before the project…a small, intimate, manageable and familiar work place where they knew everyone and knew every nook and cranny.

Fortunately, the emphasis of the Ministry of Health and Long Term Care (MOHLTC) and the growing community we serve gave us the “next project” – a focus on organizational efficiency, quality, and patient engagement.

We used the completion of the project as a great opportunity to take stock of what we did really well, where there were opportunities for change, how we could create formal partnerships to enhance our programs and services, and how we could contribute to the sustainability of the system through an enhanced focus on innovation and creativity.

We shifted our self perception so that we could see ourselves more as a partner in health care, developing plans to engage the community in our strategic plan and in the patient experience and not just talking to them about our construction project and our endless detours. We are maximizing the fact that our community has a high level of technology comfort as we reach out to engage them in our discussions.  We are visiting our community partners and inviting our community partners into our new facility so that they can become ambassadors with their patients on what it will be like to come to MSH for an MRI , CT or for surgery.

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We redesigned our organizational structure so that the focus on quality, strategy, human resources and patient experience were aligned.  We had long time leaders who stayed with us throughout the project to provide a successful transition; many of whom decided to take a well-deserved retirement following the project. To manage this change, we brought in new talent from other organizations so that we could have a fresh look at ourselves.

We shifted our meeting structures and our role expectations so that leaders had time to integrate their approaches to visibility, quality and staff engagement. Quality was already embedded in everything that we did as an outcome of our Leadership for Performance Excellence (LPE) work with the Change Foundation, but we used the project completion as a chance to push the reset button.  There are daily huddles around quality boards, a broader engagement in developing our improvement plans and a significant focus on quality in our strategic plan which has quality as our differentiator and partnerships and as our method of operations.

There was also the opportunity to look at our programs and services thoughtfully and to plan, from a strategic perspective, which programs would grow and when, and which programs had outgrown a hospital focus and needed a transition to our community partners.  We assessed what our community needed and how we could provide it more efficiently and are currently looking at our clinics to determine how we can maximize the specialist clinics to see more patients with a shorter wait time. We are also looking at easing the congestion in our emergency department and medical units through an avoided admissions focus and earlier discharges in a manner that that will have maximum benefit for our patients.

To keep pace with the City of Markham’s economic focus on innovation, we created a role of Chief, Innovation and New Ventures.  We need to find a way for entrepreneurs and community hospitals to understand one another.  It is my experience that entrepreneurs find hospitals resistant to their new ideas and hospitals find entrepreneurs naive about the complexity of patient care.  I believe that there is an answer somewhere in between these two perceptions and that must come together constructively and realistically for the benefit of the whole system.

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As staff, volunteers and physicians, we also had to get to know each other in a new way.  The greatly expanded facility put more physical separation between departments that had been cramped together in the past.  Everyone’s travel patterns have shifted and casual opportunities to connect have changed.  Many new faces have also joined us such that there are more new people than there are those who founded the hospital in 1990.  We now need to use this time to reconnect with the long-time staff and to allow the new staff to infuse us with new ideas and new energy.  It is engaging to hear the great ideas that our long-time and new staff can bring to a unit.

I am pleased to report that the post construction let down has turned into increased focus on our day-to-day operations and the energy that people had put into the construction project is now energy they are putting into expanding programs for our patients, finding new ways to work collaboratively across units, and enhancing our outreach to the community.

We are finding our new identity.  The challenges we have gone through over the past five years have helped us to define what our evolving organization can be today and in the future.   And we will not forget that this new identity will draw on our founding mission of “making it great” for all.

As the organization emerged from the project, I realized that at this point in its evolution, and in mine, it was time for a new leader.

We have grown and changed together and now it is time for both of us to go in a new direction – each with our new identities and both with the foundation of kindness that brought us together.