Shared accountability and stakeholder engagement pave path to success

When I arrived at York Central Hospital a little over a year ago, the hospital was in the midst of a major transformation. The health care team had just completed a 100-Day Action Plan to address a significant budget shortfall – the hospital was facing a projected deficit of approximately $12 million that year. The Action Plan was designed so the entire organization could move quickly and responsibly to reduce costs, increase efficiency and improve accountability, while ensuring quality and safety.

At the end of the 100-Day Action Plan, we made tremendous progress and were on track to achieve a balanced budget. We quickly realized there were significant lessons which could be applied going forward. With a number of milestones and goals ahead, it was important to look at the tactics and strategies which had driven recent achievements. York Central is now on a sustainable financial path and on track to balance its budget for the second consecutive year. A growing sense of pride and ownership is spreading across the hospital. How did we accomplish such a momentous goal and more importantly, how can the lessons learned be applied to future initiatives, such as our capital development project to build a new hospital in Vaughan?

One of the main lessons from the Action Plan was the importance of having a clear and specific focus. In the past, the hospital was attempting to balance too many competing priorities. As a result of this insight, York Central launched its Wildly Important Goals (WIGs). WIGs are the top organization-wide priorities and areas of major focus for the year; they help to drive key initiatives such as capital planning and improving patient satisfaction. Achieving the WIGs resulted in major breakthroughs for the hospital and made a significant difference to our patients.

Consistent and clear communication is another key tactic we wanted to focus on moving forward. During the Action Plan, we recognized the importance of engaging stakeholders early and continuing this dialogue. Since then, we have continued to share our WIGs, progress reports and other key updates with our entire health care team, the community and other local partners. By operating in an open and transparent manner, we are building positive and mutually beneficial relationships.

Given York Central’s expanded mandate to plan, build and operate a new hospital in Vaughan, creating a major regional health system for Southwest York Region, it is critical to have the capacity to consistently and predictably deliver on key organizational objectives. Having received approval to tender the new hospital in Vaughan in 2014, it is essential for structures, processes and systems to be in place today to ensure the project continues to move forward efficiently and effectively.

With the high level of community interest in the future hospital in Vaughan, we want to give our stakeholders as many opportunities as possible to share their thoughts and hear updates on the plan. One major component of this project is branding the new health system to more effectively communicate our expanded two-hospital mandate; we plan on launching our highly anticipated new brand this spring.

The ultimate success of our brand depends on the ability of our staff, physicians and volunteers to live the commitments and values through every interaction with our patients, their families and our community. This is why we began our project by engaging our staff, physicians and volunteers. Through focus groups, workshops, forums and surveys, members of our health care team have been able to share their thoughts and provide feedback on our new brand.

For the branding initiative to thrive, involving our partners throughout the planning stages is critical. With a wide variety of stakeholders including residents, elected officials, the Ministry of Health and Long-Term Care, the Central LHIN, municipal and regional partners and local service providers, sharing information in a consistent and transparent way has generated support for our development project.

For our external stakeholders, we held community meetings in both Richmond Hill and Vaughan to share the details of our capital planning project. We also held focus groups in both communities to find out what healthcare meant to them and how it related to their sense of community. We implemented an innovative, two-phase Brand Lab to encourage participation in the development of our brand.

In addition, we had meetings with key opinion leaders, including elected officials, local Chambers of Commerce, donors and members of our President’s Advisory Council to elicit feedback on the new brand. By encouraging stakeholder involvement in a variety of ways, we increased support for the project with staff, physicians, volunteers, community members and our other partners. Given the rapid pace of our project to date, we will continue to use these tactics to ensure we proceed through the next stages with the same level of engagement.

The Action Plan also identified several enabling tactics, including Lean Process Improvement Events and “5S” Events. These tools were very constructive during the Action Plan and have the potential to benefit other initiatives, such as achieving our WIGs and planning for future hospital in Vaughan. By looking at best practices from other sectors, we were able to identify opportunities for efficiency, new ways of completing tasks and strategies to improve patient and staff satisfaction. More importantly, front-line staff are engaged and accepting of looking at new ways of delivering services or organizing care. This will be fundamental as we start to articulate how the new hospital will function, well before an architect is asked to design space. By identifying how tasks are completed and the ideal model for work spaces, we can design the new hospital to support maximum efficiency and best practices while continuing to deliver excellent patient care across the two sites.

The staff at York Central consistently make measurable and sustained improvements in short time frames as a result of Lean Process Improvement Events. These events involve all of our healthcare team and help to ensure accountability at all levels, which also factors into their success.

The hospital continues to hold “5S” events, where staff create a high performance and safer environment by going through each of the event steps: sort, set in order, shine, standardize and sustain the results. Both 5S and Lean Process Improvement Events ensure supplies are in the right place at the right time, increasing pride and ownership of workspaces and allowing everyone to gain a better understanding of their roles and responsibilities within the health care team.

While the projects depicted in this article may not appear to have many similarities on the surface, the tactics required to achieve success have many parallels. Communicating early and frequently with our stakeholders increases support and helps identify opportunities and challenges. By sharing accountability at many levels, ownership of a project is enhanced, often leading to better outcomes. As a result of our efforts to date, I am confident York Central is on a positive path for achieving all its future goals, including increasing capacity in the right ways to meet the growing needs of the community.