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Message from the CEO, September 26, 2007


When I was first approached about the CEO position at Baycrest, one of the many things I did in considering the opportunity was to review the website and all of our brochures and publications that the search firm had sent me. While I certainly knew of Baycrest from my years of professional experience--in fact, I had presented at one of the early Rotman Research Conferences--the materials I studied conveyed a very clear message that Baycrest is both a proud and tremendously ambitious organization.

After meeting with over 1000 staff, families, clients and members of the community during the past two months, it is clear to me that the pride and ambition is deep rooted and well founded. The Baycrest family is not shy about talking about our strengths and also has some very clear ideas of where we need to put our focus in order to do better. In fact, what has impressed me is that it doesn’t make a difference what part of the organization a person works in, or what their specific role and responsibility, everyone shares the same view of what is special about Baycrest, and what we must preserve at all costs.

One very prominent theme I have heard is that we must focus our attention on the care and support we provide our clients and families and maximize the use of research to strengthen our care. You have told me that as an organization that aspires to be an international leader you think that we need to pay very close attention to our performance in all of our clinical care arenas, most urgently, in the Apotex and our hospital. And I agree.

In fact, as a result of feedback from our clients, families and staff it has became abundantly clear that there are immediate actions we can implement that do not need to wait for our assessment and action plan to be completed. Specifically, we need to dedicate more resources in the area of nursing. I have been most impressed with how many families and clients and members of our non-nursing staff from all across Baycrest have urged me to provide more support to our dedicated nurses so that they can provide more support to our clients and their families. As a result of this very thoughtful feedback we have made the decision to ensure that we have a Nurse Manager on every floor of the Apotex. Our Nurse Managers are critical to the overall functioning of our care delivery in the Apotex, and must be closely aligned and actively supporting the work that is going on at the bedside. I expect that the addition of three Nurse Managers in the Apotex will have a positive impact on the care we deliver as well as the operations of each floor.

Another decision that we have made is to hire a dedicated Nurse Recruiter in Human Resources so that we can maximize our efforts in this very competitive environment to attract the best possible nursing staff. We have felt the serious impact of the nursing shortage and this is clearly a challenge we must overcome.

As you know, successful, high achieving organizations continuously look in the mirror, validate their impressions and make adjustments such as we are doing through the additions in Nursing. The Research enterprise at Baycrest has done this for years through their regular External Reviews. On the clinical and administrative front we do undergo regular accreditation such as what we are preparing for now, however, that process measures our performance against set minimum standards not against world-class best practices.

The Listening Tour we are conducting with staff, and which the councils have participated in, is probably the most significant way we can look in the mirror and is clearly answering many important questions that will help to lay out our action plan. There are however, other questions being prompted from our discussions that we have not yet answered, and which are critically important given our high ambitions including:

  • How does our care delivery compare against best practices anywhere?
  • Are we making full use of our research activities to influence the best possible care delivery?
  • Are we collaborating effectively enough across all of our disciplines?

These are not easy to answer. You need expertise familiar with world class best practices in various areas of focus and an unbiased view--exactly the type of assessment Research has with their External Reviews. That's what has prompted us to approach four professionals whom we identified as at the leading edge of their fields and whom have tremendous experience. They have seen how it is done at the very best places in the world. We have asked them if they would do an External Review of our core areas of clinical care--the areas where we care for the frailest members of the community--the Apotex and the CCC Units. One member of the review team is a nurse, one is a geriatrician, one is a geriatric psychiatrist and one is a gerontological social worker. They have agreed to spend a couple of days at Baycrest observing and talking to people in addition to studying a lot of material in advance of their arrival. The geriatrician, Dr. Paul Katz and the nurse, Kathleen Hill-O'Neil will be here the end of September. The gerontological social worker, Judith Globerman and the psychiatrist, Dr. Ken Le Clair, will be here at the beginning of November.

What we are doing is essentially like hiring a personal trainer. A personal trainer is not your friend or your family member--and they are not someone you hire to look in the mirror and tell you how out of shape you are and discourage you. Instead, they are professionals who are able to assess where we are today and where we can be if we follow a game plan. As an organization that aspires to be an international leader, this is an important step for us to take now and periodically.

While this External Review team will be able to assess our clinical practices against the best in the world, they will not be able to answer all of the critical questions that we have identified during our discussions. There are two other important ones that are critical for us to consider as we look in the mirror including:

  • Are we using our limited resources effectively and efficiently?
  • Are we adequately using information/data to inform us about how we are performing to help us do even better?

We are currently sourcing a firm that will help us with these questions by doing a focused appraisal of efficiency and effectiveness, specifically in our administrative and support areas and to offer consultation on how we can strengthen our performance. Such an Infrastructure Review is critical in making sure that we are resourced appropriately and allows us to consider how we compare against like organizations. We intend to have this process done during November as well.

Once both the External Clinical and the Infrastructure Reviews are complete and we combine that data with what we have from the Listening Tour we are going to have a very clear understanding of our strengths, including where we are leading in the field. We will also know where we can do better. The goal is for all of the information to be synthesized and ready for review in December so we can have our action plan developed for implementation early in the new year.

It is that plan that will take us from being a very strong 'athlete' to Olympic caliber--perhaps the best athlete in the world.

Bill Reichman

Baycrest President & CEO