PODCAST: What would make you feel confident that VCH has got your back?

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Mary Ackenhusen | September 25th, 2014

“I think ‘Provide the Best Care’ means so much to so many different people… it depends where you are right? And we have to remember, everybody is not a bed-side nurse in hospital or a bed-side care aide.”

That’s part of my discussion with Laurie Dawkins, which is the first segment in this first edition of True North Now–an audio magazine podcast. I invite you to listen, or read the transcription below, and then join the discussion by posting your comments or questions below. Thanks for tuning in!

In this edition:

  • What does ‘providing the best care’ mean to you (CEO Mary Ackenhusen) at 2:15
  • Redesign of the clinical teaching unit at VGH (interviews with staff) at 6:00
  • iCough initiative in Richmond reduces pneumonia (Elan Nattrass interviewed) at 8:28
  • Health Connection Clinic on the North Shore (patients and staff interviewed) at 10:35


20 Min. 8 Sec.

You can also download this podcast to your device: › Download MP3 file



LAURIE DAWKINS: As we sit down to talk about True North goals and Providing the Best Care, is there something that springs to mind for you personally, like you have a vision in your head of ‘this is what it looks like if we get there’?

MARY ACKENHUSEN: Well, when I think Provide the Best Care, it means so much to so many different people… it depends on where you are right? And we have to remember, everybody is not a bedside nurse in a hospital or a bedside care aide or in mental health in community, you know you’re an accountant… what does provide the best care mean? Well it means you know, how you bring forward those numbers to support the managers and the clinicians that are trying to do the best they can in terms of improving the quality of care within their budget. So that’s providing the best care for maybe a support person. Providing the best care if you’re in a hospital might be making that family feel really important in the process.

LAURIE DAWKINS: Is there one thing—one or two things—that we as a group need to focus on over the next six months to try to advance the goals? Is there anything we should be making a tangible effort to do differently or more of?

MARY ACKENHUSEN: There’s no one thing, so it’s maybe one concept and that’s really empowering everybody to feel comfortable that they can bring forward those ideas and actually start to action them or to work with their leadership or their colleagues to try to action these good ideas. The small ones and the big ones. And that’s probably one of the biggest challenges in an organization of this size with the bureaucracy that we have… with the history that we’ve had… is how do you create that freedom that people want to do that and that they feel comfortable doing that.

LAURIE DAWKINS: I think that is something that people struggle with. They find themselves part of numerous redesigns and I’ve heard it said you know they’re fearful going in… they want to contribute to a better workplace but they’re also fearful… ‘what if I’m leaned out of the process along the way’ you know.

MARY ACKENHUSEN: Right, and I think that’s one of the things very much in the front of my mind is: how do we make it safe for people? Because you shouldn’t ever feel that you’re redesigning yourself out of a job. That said, to survive and to thrive in current health care, you need to be adaptable. So, not adaptable like ‘I[m going to be moving out of VCH’ but adaptable that ‘I’m going to have the skills and I’m going to have the confidence that I’m going to be taken care of and that when I redesign to create better care, the best care, that I’m going to have a really great job at the end of this and it might not be the same job I have now, but that’s OK, because I’m open to learning new skills, I’m open to working with new teams, I’m open to that because I can understand where that’s getting us. And that’s True North.

LAURIE DAWKINS: Thank you, I think that’s always  the elephant in the room. People are afraid to talk about it.

MARY ACKENHUSEN: I would be very interested to hear more about it and I know there’s an opportunity with this podcast that people can write back in and kind of talk about their comments.  I am very interested in: What creates safety for you as an individual? What would make you feel confident that VCH has your back and that you want to give everything to move VCH and health care forward? What would that take?



Got a question or comment?

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More VCH News Radio

Listen to the rest of the September 2014 edition of True North Now.





About the Author

Mary Ackenhusen
email iconmary.ackenhusen@vch.ca  

As president and chief executive officer of Vancouver Coastal Health (VCH), Mary Ackenhusen leads the largest academic and tertiary health authority in British Columbia. She is passionate about engaging staff and physicians across VCH in building new models of health care that have potential to be more cost effective and better allow all of us to be more productive, to the benefit of patients and their family members. Mary is an advocate for constructive, two-way communication and through the Up for Discussion blog, invites all members of the VCH community to share their comments, questions and new ideas. View all posts by Mary.

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7 comments on “PODCAST: What would make you feel confident that VCH has got your back?

  • Mike Gix says:

    Hi Mary,

    In your interview you had supportive words for staff who feel angst related to service change and redesign. You encouraged us to trust our adaptive abilities, reminded us we can equip ourselves with new skills, and you expressed confidence we can all arrive at the other side of change with great jobs, if not always our current ones.

    At my worksite, valued team members who work in support roles are being contracted-out. We are told this is because of unfunded positions in other areas of the service, and that cost savings from our program are needed elsewhere. This not only impacts deeply the soon-to-be-displaced individuals, but it is also quite demoralizing to the team that remains. We worry that the change will diminish a key therapeutic aspect of our milieu, and will negatively impact care. Our team rallied and communicated our concerns “up the chain” to senior management. Sadly, we learn that the contracting-out decision was made on the strict basis of projected cost savings. Clinical impacts were not considered, or were deemed insignificant.

    With the pace and scope of recent changes, it does not surprise me that staff at various levels of VCH experience apprehension and misgivings about redesign and about what tomorrow will bring. Even when changes don’t involve job displacements or cuts to client services, we hear from our colleagues about increased workloads, heightened acuity, increased pressure to close files, and on, and on. These conditions surely take a toll in terms of morale, job-related stress, and staff burnout. At the minimum, many of us are left with that persistent feeling of suspenseful dread, wondering when “the next shoe will drop”.

    In your interview you stressed the importance of staff feeling safe and empowered to bring forward and action our good ideas, to help create the conditions in each service that will result in “the best care”. Sounds like a challenge to us all to become workplace advocates and activists. This advocacy call is one I believe people at all levels of VCH will accept. Indeed, many staff have been innovators and effective advocates for their clients, patients, and services over long careers.

    What would help me feel confident that VCH has my back? For starts, I would sincerely like to hear you and other senior leaders speak about your understanding or embodiment of the duty of advocacy. I don’t mean advocacy in the global sense, in the community at large. I mean advocacy before the powers-that-be, to secure adequate resources for our health services. How do you see your duty, or not, to advocate strongly at the VCH Board, at the Ministry of Health, and at the Legislature, for the funding, infrastructure, programs and permissions that staff require to actually “provide the best care”? I ask this question in the context of this year’s VCH budget increase of 1.7%, a figure deliberately less than half the projected rate of increase in the cost of providing care.

    Is there an example you could share from your work life where you were the squeaky wheel, the sore thumb, or the Oliver Twist character who goes to the front of the workhouse dining hall and asks the austere master, “Please sir, I want some more”? I’m not trying to put you on the spot or make you “toot your own horn”, but the more specific you can be, the better, and the more reassuring it will be for me, and likely others.

    Thank you. Sincerely,

    Mike Gix

    • Mary Ackenhusen says:

      Hi Mike

      Thanks for having the courage to express your thoughts – I really appreciate the open dialogue.

      As you have indicated healthcare always needs more money – the growth in demand is around 6% per year, but as you know, in VCH we are receiving much less than that in terms of annual increases to our budget. This year was the lowest ever increase for VCH at less than 2%. However, even with these small increases that we and the other health authorities are now receiving, the percentage of the BC global budget consumed by health has grown over the past five years from around 43% to 48% – at the cost of other important government services. While health has received smaller than normal increases, other social services such as education, MCFD, parks, etc. have actually seen reductions. The concern facing for all western governments is that with the slow growth of our economies (especially since the 2008 crash), we can no longer afford our current healthcare system – at least in the way it is delivered today. It is too expensive. And if we did continue to increase spending without an expectation of performance, it would be at the cost of badly needed infrastructure, social services, etc.

      The good news is that many credible organizations and researchers believe that we waste up to 40% of the dollars spent in healthcare – meaning we don’t get value for these dollars due to inefficient processes, redundancy, overuse of acute care, etc. IHI (Institute for Healthcare Improvement) and Kaiser Permanente are two well-known organizations that have data to support this assertion. Now while I don’t necessarily believe VCH is full of waste, I do believe we still have room for improvement. So rather than advocate for more money, I believe our best strategy is to redesign the system to do more with less. I believe it is totally possible. The biggest challenge, however, is that the best healthcare is delivered by people, and people need to be engaged and valued to deliver great healthcare, even while we are undertaking redesign. My goal is to create an environment where staff can feel “safe” in this new world of change. Hence the question, what does this look like to you – what would make you feel safe and engaged in this path forward?

  • Ian says:

    The big question of your discussion is “What would make you confident VCH has got your back?” As a frontline staff member who has suffered through many changes I don’t feel fully supported, due to the amount of changes made with little to no consultation with those impacted by the changes. I have offered solutions, yet they go nowhere with no explanation. So: respect given would be returned.

    • Mary Ackenhusen says:

      Thanks for the feedback on the ongoing need to consult with the folks who do the work, consider the solutions that are offered, and then give transparent feedback on what is being implemented. As you know, this is not a natural part of our leadership culture in every area of VCH, and this is what we’re trying to change. I appreciate hearing how it is in your workplace, always, letting us know what you’re feeling.

  • Jan says:

    is there a way of having this podcast in writing? I do not have time at work to listen to 20 min but can scan something written faster

    • Thanks for the comment Jan. We do transcribe the shorter Straight Talk segments, but not the longer True North Now magazine–it’s just too much text. We’ve provided a download link in case you want to download the podcast and listen to it later.

    • Laurie Dawkins says:

      Hi Jan,
      thanks for your interest in the podcast! While transcribing the whole 20 minute
      show would be really time consuming and yield way too much text for easy online
      reading, we are happy to meet you half way. The Communications team have transcribed the first part (posted above) of the show where Mary talks about what “Providing
      the Best Care” means to her, along with the question she poses about what it
      might take to engage others in this work. After you’ve had a chance to scan the transcript, we hope you’ll rejoin the online discussion
      with your thoughts on what Mary has to say. And remember, since the blog lives
      outside the firewall, if you are truly keen you can listen to the podcast any
      time you want, from wherever you want, one whatever device you want!

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This is the place for discussion, debate and collaboration on issues and ideas that advance engagement with VCH’s strategic True North goals and objectives. It is not just for executives, but the tone of this stream is tailored to those serving in a leadership role or those who have interest in the “why” behind organizational priorities.