The Reminder is making its archives back to 2003 available on our website. Please note that, due to technical limitations, archive articles are presented without the usual formatting.
Jonathon Naylor Editor From the outside looking in, Helga Bryant, interim CEO of the NOR-MAN Regional Health Authority, has her work cut out for her. She is tasked not only with helping to rebuild the organization's blemished reputation, but also with implementing 44 recommendations made by a provincially appointed review team. But drawing on years of experience in a range of executive health care positions, Bryant appears upbeat and confident moving forward. This week, The Reminder sat down with Bryant and NRHA Executive Director of Communications Corliss Patterson to discuss the state of affairs within NOR-MAN. REMINDER: How many of the review team's 44 recommendations have been implemented? BRYANT: Well, we're working on implementing different aspects of the recommendations. Some are shorter term, some can be completed much quicker, while some may well take a number of years to fully realize. By way of example, we're going to be very shortly naming a Vice-President, Medical Services. Then on the other hand there is a recommendation regarding transfer of the nursing stations from the province to the region. That will probably take a number of years as the process involves other organizations and jurisdictions. So it is fair to say that the recommendations will be (met on) a variety of timelines. There are also recommendations that extend beyond the jurisdiction of the region; in those cases we are looking to partner with those organizations or jurisdictions as of course our interests will be best served to move all recommendations forward. REMINDER: As of this moment, can you put a percentage on how far you are into implementing the recommendations? BRYANT: We're making progress on various review recommendations. For instance, meeting with you today, quite frankly, is an example of a community engagement strategy. See 'Engag...' on pg. 11 Continued from pg. 1 Community engagement; that will go on forever, because it's a new way of the organization "being" with its community. So those strategies will continue and will just be the way we've become Ð much more open, much more transparent. PATTERSON: In response to Recommendation No. 42, the board has engaged a governance specialist and will begin their work later this month. With regards to the NRHA Medical Clinic, recommendations around the clinic have either been implemented or are in the process of being implemented. BRYANT: I believe we've made progress on probably every one of (the recommendations); the recommendations are a significant aspect of our work. For instance, we just spent all day reviewing them again, going through them one by one; a plan has been made for every single recommendation. REMINDER: Taking into account that actions on some of the recommendations will always be ongoing, can you say when all of the recommendations will essentially be implemented? BRYANT: I would comment that within six months, progress will have been made on each of the recommendations. REMINDER: There has been a lot of criticism of the NRHA. How much of it is fair and what is not fair? BRYANT: That's, I think, the thing that we're trying to alter with becoming more engaged with our community, because the delivery of health care can be very challenging. We have not done a good job as a system in general Ð not just the NOR-MAN region Ð (but) the system in general has not always done a real good job in terms of communicating with the public, ensuring that the public learns as much as they need to know to ensure an understanding, to build their trust, to build their confidence. I worked in Winnipeg for a number of years, I worked in Brandon for many, many years before that. And it's always been a bit of an issue about how well health-care organizations relate to their public. Health care is very near and dear to the heart of Canadians. The public is very passionate about health care in Canada, so their need to know about the health-care system is different than it might be for some other organizations. And as a system, we can always improve in terms of our communication and openness. PATTERSON: Or promoting ourselves. We're not good at that. We seem to do the knee-jerk reaction when something bad happens, and that's what gets publicized. The good things never get publicized. REMINDER: The previous CEO, Drew Lockhart, is obviously no longer in his position. Are there any other staffing changes being contemplated within the NRHA? BRYANT: We are looking to implement the new positions as recommended in the review (Vice-President, Medical Services and a Chief Nursing Officer); that may result in some alterations to the organizational structure over the course of time. At this point, we are focusing on building a strong leadership team for the region. As an interim CEO, I am being cognizant of making changes that are contemplative and logical. As a permanent CEO is recruited, that person will bring new ideas and experiences to the organization. See 'Respo...' on pg. 12 Continued from pg. 11 Every new CEO, every new leader that comes in, wants to develop their team...but as an interim CEO I'm privileged to work with the team that is here and we're coming to know each other and we're coming to work together. It is clear to me that they all care about the region. Undergoing a review such as this is not easy; in fact, it has been a very difficult time for the staff and the board. REMINDER: How do you respond to the criticism that the NRHA spends too much money on bureaucracy when that cash should be funneled into doctors and nurses? BRYANT: Well we're certainly well below the benchmark in Manitoba for corporate costs. It's a $90-million organization. Every organization needs a leadership structure to appropriately manage the programs and the services. Given my experience in other organizations, the NRHA is not top-heavy; that's just my personal, humble opinion. You need to have a certain set of professional expertise managing an organization like this. For instance, we are grounded in service and program delivery; we need to have expert leaders that manage those programs and services. Financial expertise at a senior level is required. I have spoken of the need to ensure communication occurs internally and externally; particular expertise is required in that regard. A leader at the most senior level of the organization, a CEO, is required to lead the organization and carry out the mandate from the board. Given the accountability and responsibility of the region to meet the needs of our public, planning is a critical function and takes a particular competency set; we prepare and submit (to the provincial government) a health plan every year. Any new funding requests must be identified in the health plan and justified with data and rationale. The health plan is developed from a community health needs assessment, which is what our community tells us they need and what we know from health data around the health status of our community. So the community health needs assessment is the driver. It's all about what the community needs. That creates, then, the health plan which in turn is submitted to the (health) minister to identify the needs of our region. Funding allocations are based on the health plan. Given the need to balance needs and resources, requests in the health plan can at times take several years to be approved. People in our organization are our greatest asset; as an employer with some 1,000 staff, recruiting, retaining and supporting our staff is a critical function and again requires senior leadership. The communities we serve are helpful in our recruitment and retention efforts as it is the communities that create the (environment in) which our staff live and raise their families. Given the variety of expertise required, a senior leadership team must be comprised of these skill sets. So to say "is there too much bureaucracy?", there are a lot of administrative leadership tasks that have to be conducted, and it is our intent to be accountable in all areas of our responsibility. To that end, we need to employ people who are going to grab onto that accountability and make sure that things get done, and appropriately. REMINDER: Some patients allege they have been misdiagnosed by physicians. How are those complaints dealt with? BRYANT: We review each one; this is what we're doing now that I'm here. Every one gets reviewed by the right number of people, whoever that might be, depending on the nature of the complaint. And what we've been starting to do is to meet with the families and have a dialogue about, "Tell us about your experience and we'll share with you what we've learned and are we understanding it correctly?" I find that that works really, really well, to just sit down with people and have a conversation. Sometimes there are Ð and I relate it to my own nursing practise Ð many ways to get to the same end. And one practitioner can look at a case and make one assessment; another practitioner can look at a case and make another assessment, and they both might be not wrong. So it's to find the middle ground there and to just have the families understand what happened when they were in our system and just to try to enhance that understanding of the clinical care that they experienced. (The second part of this interview will appear Monday).8/19/2011
