CKHA rebuild shows progress

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After seven months of reorganization, the top overseers at the Chatham-Kent Health Alliance are changing gears.

Rob Devitt, the provincially appointed supervisor of the CKHA, will focus on the bigger picture of governance after spending months working with interim CEO Ken Deane on overhauling leadership positions at the alliance, and reworking the administration of business.

Deane, on the other hand, is heading home to London.

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Both changes are in no small part due to the hiring of Lori Marshall as CEO and president, as well as filling other top administrative positions.

Deane in fact is working from home for the near future before sliding out of the picture.

The two led a recent press conference with local media, and looked back on progress made at revamping the alliance. Devitt admitted the overhaul has been pretty staggering.

“All executive leadership is new. There is a new set of physician leaders,” he said. “In my 30 years in health care, I can’t think of a time or an organization where there’s been that scale of turnover in leadership.”

The fresh start, and overall changes made in procedures by Devitt and Deane appears to be paying off, according to an assessment by a third party. The alliance commissioned consultant firm KPMG to conduct an internal control framework assessment recently. It compared the state of the alliance in key areas at the time Devitt and Deane took control to what it was like just last month.

The report showed their starting point was littered with problem areas, such as failing to exercise oversight responsibility, enforce accountability, evaluate operations, and communicate internally and externally.

The study showed solid progress by February.

Devitt said the leaders at the hospital today all have a local history, something he believes is really important in order for them to understand the unique issues the alliance faces.

In terms of being open and frank, Devitt stressed that people must understand the reality the alliance’s plans.

“Two campuses, two emergency departments,” he said. “People keep asking me when one is closing. They’re not.”

Wallaceburg will not lose its hospital, he said, nor will it lose its emergency department.

In fact, another announcement by the alliance earlier this week reinforces the latter, Devitt said. The alliance announced on March 21 it was adding additional respiratory services to the Sydenham District Hospital. A registered respiratory therapist will work out of the emergency department.

“This is indeed great news for our community. We cannot over emphasize the importance of RT services and quality care,” said Dr. Dennis Atoe, family and ER physician, in a release. “I want to thank everyone involved for their work, time and effort towards these initiatives. We are looking forward to an improved working relationship between the Sydenham and Chatham sites and the communities we serve.”

Last week, the Ontario Health Coalition released its survey results of Chatham-Kent citizens and what they want from the alliance, including the retention of both hospital locations and emergency departments. Devitt stressed those issues were already addressed.

He added the alliance also asked an outside expert in to work on ways to strengthen how the Chatham and Wallaceburg emergency departments work together.

Despite the open forums and transparent efforts, Devitt said there are still skeptics out there.

“It will be a while before some people believe there will be a difference.”

Seeking input from the public won’t be limited to the urban parts of Chatham-Kent either. Devitt said the rural health advisory committee is shaping up, as interviews are booked for the second week of April, and he his hopeful the committee will meet later that month or in early May.

As well, the alliance is posting for a new position, chief of rural health.

Devitt said while a great deal of progress has been made, some people expected an overnight revolution at the alliance.

“In health care, a revolution usually means corners are cut,” he said. “We can’t do that. We’ve got to do it in a very methodical way.”

He believed the process is paying off.

“What has occurred in seven months is pretty remarkable. People have really pulled together,” he said. “We have a long way to go yet.”

Deane said the changes have helped liberate staff, as they realized they are open to be creative and innovative and can express their thoughts without fear of repercussion.

Stabilizing finances remains a priority for the alliance, but Devitt said it’s a one-sided problem.

“We don’t have a revenue problem; we have a spending problem,” he said, adding the alliance has teams looking at how it can bring spending in line with hospitals of similar size around the province.

Next up for Devitt is focusing on corporate and governance structure, including board recruitment and training. He said the KPMG results show him that “some of the fundamentals of governance were missing” under the previous structure.

“All boards were duplicitous in the financial direction of the alliance. That got us into this state. We don’t want to revert to that.”

The old structure had three ways board members were elected/selected. Deane said St. Joseph’s board was selected by the London Health Care Society, while the Sydenham board members were voted in by people who paid $5 to be part of the voting group, and the Public General members were voted in by the current board.

“I need to do more analysis,” Devitt said. “The model here is one of a kind.”

But Devitt said he can’t work on that element until he finalizes the corporate structure.

Regardless, three boards and two hospitals remain problematic and won’t be repeated.

“The boards’ successors must be focused on what’s best overall, not just for one building,” he said. “We are located in two communities; we are a regional hospital. We need to reflect the geography of the community.”

Devitt stressed the future hospital board must continue to look at the big picture at all times.

“Boards are in place to set direction and vision; to tell management what they can and can’t do,” Devitt said. “When a board gets mired in the minutiae, management can abdicate responsibility and ‘delegate up.’”

He added the board must be independent of administration, adding a dose of “healthy skepticism” is needed.

Once a new board is in place – and he said there is no set timeline for this – Devitt believed someone should be tasked to coach or mentor the board, “just to ensure the old culture doesn’t wash back in.”

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