Restoring trust in Ornge

In January of this year, when I was approached to become interim president and CEO of Ornge, what I knew of the organization was only what I had read in the newspapers in the preceding weeks as the controversy unfolded. I understood that Ontario’s air ambulance organization, while undoubtedly providing a vital service, was lacking in transparency, accountability and operational integrity.  It was my job, as someone with more than 30 years in business and government, to help Ornge improve in these areas in an effort to rebuild the public’s confidence in the service.

It wasn’t until a few weeks later, however, that I was able to witness first-hand the challenges, the rewards and ultimately the importance of a first-class air ambulance system.

Shortly after 7:00 a.m. on a cold northwestern Ontario morning, I rode along with an Ornge crew, taking off from Thunder Bay in an Ornge PC-12 Next Generation (NG) airplane.  With two pilots and two paramedics on board, we landed in Kapuskasing to transport a patient from a small community hospital to a larger facility back in Thunder Bay which could provide a higher level of care.  Aside from the hard work performed by Ornge staff that morning, I was struck by the level of dedication at every stage of this patient’s care:  the doctors, nurses and staff at the hospital in Kapuskasing who prepared the patient for transport, as well as the local Emergency Medical Services (EMS) team who assisted Ornge paramedics in safely transporting the patient from our aircraft to the hospital.  It was a well-oiled machine that performed admirably for the benefit of this patient.

Though this story is hardly unique, it is one that has been lost in the headlines over the past months.

It hasn’t been an easy time to work at Ornge.  Our frontline staff has had to maintain focus on this day-to-day work through a media storm.  Yet we are taking the criticism directed at the organization seriously and are committed to making improvements.  The new senior leadership team and volunteer Board of Directors at Ornge have made considerable progress in addressing the most significant issues.  In doing so, we are keeping in mind a number of the lessons learned as we rebuild:

Never lose focus on your core business.  With Ornge no longer pursuing business opportunities outside of the province, we have a renewed focus on our mission:  providing high quality medical transport to critically ill or injured patients in the air or on the ground in the province of Ontario.  Every activity at Ornge – from the bases to the head office – is performed with this straightforward mission in mind.

Put your patients first. For patients and their families, air medical transport away from their home community can be a stressful and confusing prospect. While Ornge’s mission has always  been to place the care and safety of our patients first, we are now working to make understanding the transport process easier through our new Declaration of Patient Values and the appointment of a Patient Advocate to assist patients and their caregivers. We have also introduced a dedicated section on our website for our patients. Here they will find information about our compliments and complaints process, along with the results of our patient satisfaction surveys.

Listen to your employees. Under previous leadership, employees did not feel comfortable coming forward with their concerns. Not only are we now actively encouraging our staff to provide their input, this change in culture is starting to pay dividends. With the assistance of our frontline paramedics and pilots, we have developed an interim solution to issues with the medical interior of our AW139 helicopter, as well as plans for a permanent improvement.  We are engaging our Operations Control Centre staff in a quality plan that is improving our dispatch process.  In addition, we are developing a whistleblower policy to ensure there is a formal, independent process for employees to raise concerns without fear of retribution.

Engage your partners.  Relationship building has been a key theme at Ornge over the past few months.  I, along with members of our Board of Directors, have been working to support and enhance the relationships developed by our operations managers, by meeting regularly with hospital staff and management, representatives of Emergency Medical Services, the Ontario Association of Paramedic Chiefs (formerly the Association of Municipal Emergency Medical Services of Ontario), Central Ambulance Communication Centres (CACCs) and others from all over Ontario.  Ornge Board member Dr. Barry McLellan, CEO of Sunnybrook Health Sciences Centre, is leading a quality of care committee with a focus on patient safety.  To our stakeholders, I say:  we can’t do it without you.  We all have an interest in ensuring Ontario’s air ambulance system is functioning properly and efficiently and I welcome any and all feedback.

In the complex and heavily-regulated fields of aviation and healthcare, it is unrealistic to expect an overnight fix to many of the issues facing Ornge.  However, many longer-term improvements are well underway.  Pilot recruitment is a top priority as we continue to bolster our roster.  Ornge employs 10 more paramedics than we did at this time last year and we are still hiring.  We are improving our education programs so our paramedics can upgrade certification in a more timely fashion.  All of this is built on the foundation of an amended and improved Performance Agreement with the Government of Ontario which has led to much greater oversight and transparency.

And while all this takes place, our incredibly dedicated and committed front line and back office staff continue to work tirelessly to ensure our crews safely transport dozens of patients every day across thousands of kilometers.  It’s a service in which all Ontarians can take pride.