Heather McPherson, President and CEO of Women’s College Hospital shares some of her thoughts and ideas about our hospital, our health system, her views on leadership and innovation, and the things that inspire her to create a healthier, more equitable world.
Reflecting on one year of WCH's COVID-19 response
March 11, 2021
Early last year, our lives were profoundly changed with the emergence of COVID-19. On March 11, 2020, the World Health Organization declared a global pandemic, and countries around the world began to quickly shut down and prepare for what would become an unprecedented year in modern history. Today as our nation marks a National Day of Observance to commemorate the more than 22,000 people in Canada who lost their lives to this deadly virus, we also reflect on the tremendous sacrifices you all made to respond in a time of crisis.
We know this year has been difficult. From personal losses and missed time with family and friends to pushing yourself to your outer limits professionally, you put the greater needs of our community above all else. And now, as we ask you to dig deep again and support vaccination efforts, you continue to show an unparalleled level of resilience. I know words will never be enough, but on behalf of Senior Leadership, our partners and the community, we thank you.
We have learned much so over the past 12 months. Not only about how to detect, treat and now vaccinate against the virus, but also about the depth of our collective commitment during times of need. As the world around us quickly changed – sometimes by the hour – individuals across Women’s College Hospital continually rose to the challenge and came together to innovate and reimagine care.
The list of all you have been able to accomplish cannot be captured in a simple email. Running an Assessment Centre, supporting long-term care residences when they were in dire need, going into shelters, congregate care and schools with mobile assessment teams, and most recently working with nearly 60 community partners to vaccinate front-line community healthcare workers are just some of the most visible achievements. Throughout this time, we kept our clinical services accessible to our community and pivoted quickly to virtual care. Our front-line response wouldn’t have been possible without the hundreds of people keeping their home units running and providing all the critical infrastructure support needed from infection prevention and control, labs, imaging and EVS to IT, finance, receiving, HR, communications and more. Each of you was critical. Next week in Connect and on social media, we will be sharing images from this past year to recognize and honour your work, commitment and dedication.
As we look towards the future, it is with hope. Our journey is not over, but with every vaccination we move one step closer to returning to the lives we once knew. For Women’s College, the sacrifices from the past year will not be in vain and we will build back better.
With tremendous gratitude,
Happy International Women's Day
March 8, 2021
International Women’s Day (IWD) has always held special meaning here at Women’s College Hospital. The foundation of the hospital rests upon the shoulders of courageous individuals who refused to accept the status quo and sought gender equality – and, in doing so, created a legacy that continues within our walls today. Every day, I find myself surrounded by so many amazing people who are committed to revolutionizing healthcare, and March 8 serves as an opportunity for all of us to come together to continue advocating for gender equity.
On this day, it is important to recognize the layered experience and complexities of gender diversity beyond a binary of women and men, recognizing gender is a much broader spectrum. Gender equity means that all persons, regardless of their gender, will enjoy the same status and respect in society; have the same entitlements to all human rights and healthcare; can take advantage of the same opportunities to make choices about their lives; and have the same amount of power to shape the outcomes of these choices.
In order to achieve true gender equity, it is also important to acknowledge that not all individuals’ experiences are the same. Many people are often overlooked and underserved because healthcare has traditionally not considered the impact of sex and gender differences – but we also know that ongoing systemic racism makes this health gap even wider for Black, Indigenous and people of colour. We know that many transgender women experience discrimination when trying to access basic healthcare and often wait decades for life-saving transition-related care.
In order to build a truly gender equal world, it’s our shared responsibility to make sure that all people —regardless of their ethnicity, religious beliefs, gender identity, sexual orientation or socioeconomic status—have an equal voice and are included. There is a lot of work to be done but I am so proud and honoured to spend each day working alongside so many allies here at Women’s College to challenge and address these barriers and advance our mission towards equity for all.
Last week, many of you shared your visions for a gender equal future – you wrote down your dreams for yourselves, your children and future generations. You described a world of equal opportunity without glass ceilings, a future where everyone has equal access to healthcare, a time that lets go of thinking of gender in binary terms – and so much more.
Seeing your collective vision for a gender equal future when I walked into the hospital this morning was so uplifting and a reminder what International Women’s Day is about. It is about all the people who stand-up each day to overcome different forms of inequity. It is about the people here at Women’s College Hospital who work to close the health gaps. It is about our patients and the diverse community we serve. And it is about our shared vision of a healthier and more equitable world for women and all individuals.
Wishing everyone a happy International Women’s Day!
Black History Month
February 1, 2021
February marks Black History Month, our country’s way of honouring and recognizing the work and sacrifices made by Black people in shaping Canada’s heritage, identity and development. However, Black History Month goes beyond reflecting on Black Canadians’ tremendous accomplishments and contributions to history. This is a time for acknowledging and understanding the lived experiences of Black Canadians that have shaped where we are today and taking an honest look at the past so that we can create a better future.
Over the past several months at Women’s College Hospital we have been working to deepen this very understanding. Working with our Black staff and physicians, through interviews and surveys, we have only just begun to get a glimpse into what it means to be Black at Women’s College and in the broader community. In the weeks ahead we will be sharing some of the preliminary findings of our work. First with those who participated, and then across the organization. I want to recognize the strength and courage it took for our Black staff and physicians to come forward and openly share their feelings and experiences. We know we have a lot of work to do in order to achieve a hospital environment that is free from anti-Black racism and that respects the worth and dignity of every individual. Our people, patients and community deserve better.
This letter to you marks the first time that we, as Women’s College Hospital, have recognized Black History Month. We should not have waited until 2021 to do so and recognize this is a humble step forward. As we deepen our anti-Black racism work, Black History Month activities will be planned by a committee that is led by those who identify as Black. This year, we will be undertaking several activities to signal our commitment for change.
It is in the spirit of learning and addressing anti-Black racism that we have asked Tenniel Brown to lead a discussion on anti-oppressive communications. We have scheduled the talk during a regular Town Hall meeting in hopes of increasing the number of people who are able to attend. Full details are coming shortly but for now I encourage you to mark noon on February 23 in your calendar and encourage all your colleagues to attend as well.
Our work to dismantle anti-Black racism and anti-Indigeneity will not stop here nor be confined to one month of the year. Today I reaffirm our continual commitment to moving forward, having the difficult conversations and creating positive and lasting change.
A Year-End Message
December 22, 2020
The year 2020 will have a unique place in history. A 12-month rollercoaster that had us pivoting both as individuals and healthcare professionals, together we encountered not only unprecedented challenges, but also unprecedented achievements. While this year will mean something different for each of us, personally I will remember the courage, compassion, dedication and innovation that helped Women’s College Hospital respond to one of the biggest healthcare crises of our lifetime.
Patient care has always been at the forefront of WCH. When we had to limit the care provided on site due to the pandemic, teams across the hospital quickly reimagined, retooled and responded. With unprecedented speed we pivoted and created innovative platforms to provide virtual care and launched COVID Care@Home. New clinical care pathways were introduced including non-touch abortions and virtual counselling, and new processes were quickly implemented to adapt to our new world. Within academics, our research teams began to look at the impact of COVID-19 on underserved communities to identify and shine a light on the gaps in care so that we could continue building a more equitable system.
WCH was one of the first hospitals in the downtown core to open a COVID-19 Assessment Centre. Driven by a commitment to equitable care, we also quickly formed mobile assessment teams to reach beyond our walls and deep into the community to support long-term care homes, shelters and schools and work alongside our partners to detect and stop the spread of the virus.
As new needs from our patients, community and healthcare system emerged, WCH staff, physicians and learners were always amongst the first to put up their hands and offer to help. Often taking on new roles in uncharted territories, we all came together to keep each other safe.
COVID-19 also helped shine a light on some of the deep inequities that exist within our healthcare system and the deeply engrained institutional racism that exists in our communities. Addressing anti-Black racism has been a priority for our hospital and I admire everyone’s willingness and courage to take on this deep examination of our systems, structures and ourselves to understand the challenges being faced and how we can best move forward together.
The successes we experienced this year responding to COVID were not coincidental. It is because we have a well-thought out strategy that is the foundation of all decisions. We made marked progress towards our goals of health equity, exceptional care experiences, an integrated system of care and innovation, and world-class research and education. It is this unified focus that guided us this year and will continue to guide us into the future.
As we look towards 2021, I do so with optimism. In part because of the promise of a vaccine potentially bringing an end to the pandemic, but mostly because of all the work that happens day-in and day-out at Women’s College. I firmly believe we have some of the best, brightest and most passionate people. Their relentless quest to reach higher and further in the name of a healthier and more equitable world will revolutionize care for our patients, their families and the entire system. They are the shining light of the future.
I want to thank all of staff, physicians, learners, volunteers and donors for their commitment this year. Words cannot fully express my gratitude and we extend our sincere thanks. I also want to acknowledge the family and friends that stood behind our staff and physicians and helped them be at their best. This year was tough on everyone and we know many sacrifices were made.
While the holidays will be a little different this year amongst restrictions and many healthcare and essential workers are on the frontlines, I do hope everyone has a chance to enjoy some time with loved ones. On behalf of the entire leadership team I extended wishes for a peaceful season filled with moments of joy.
Happy 2021 to you all.
Voices of Patients: What Matters to Us is What Matters to You
February 28, 2020
Listening. Really listening, engaging and partnering with patients is fundamental to improving and reimagining Ontario’s healthcare system. When we ask, patients consistently tell us that their biggest challenges are related to navigating the healthcare system as a whole. As care providers we are engaging patients as partners in their care and shared decision making every day. Yet we have often been trained to see each healthcare encounter by patients as an episode. Patients tell us they experience it as one journey, with many stops along the way. And so our focus as an ambulatory hospital reflects this desire to improve the experience of individuals as they move in, out of, and across the healthcare system over time.
At Women’s College Hospital we are committed to understanding what matters to patients and bringing these matters forward to realize meaningful change. As we were designing the programs and services that would be housed within our new hospital building, we engaged women from a diversity of communities to tell us what they wanted in a hospital and from their healthcare. Our Thousand Voices for Women’s Health project was unprecedented and gave us valuable insights, amplifying patient voices to ensure that decisions reflected their priorities.
In 2020 and beyond, it’s time to engage even more. It’s time for the next (r)evolution of patient engagement. Today, patients are more engaged in their own treatment options, more likely to do their own research and increasingly expect to be able to interact with their healthcare providers in the same ways they do with commercial brands. Multiple studies have connected higher levels of clinical outcomes to a focus on patient experience. In 2020 and beyond we can expect that patient engagement technology will move well beyond patient portal use into more specialized patient-centered tools. We can expect the introduction of advanced patient-reported outcome measures (PROMs) and patient reported experience measures (PREMs). Capturing measurements from the patient’s perspective, such tools can be used to more fully assess quality of care and impacts on health status and quality of life. And we can expect the voices and stories and experiences of patients to continuously inform design, care, research, innovation and education at Women’s College Hospital.
Last year our Experience Advisor Program was created in partnership with patients, families, caregivers and the community to share and reflect on their experiences at WCH and the healthcare system in order to improve healthcare experiences for everyone.
Experience Advisors have helped us shape and design care programs right from the start. When we set out to build Canada’s first publicly funded, hospital-based transition-related surgery program, we knew we needed to directly involve the community this program would serve. A group of individuals with lived experience were involved in a patient journey mapping that simulated a patient visit to the program from the moment they walked through the doors of the hospital, to check in on the unit, to the OR and post-operative care unit. The lessons we learned on this journey shaped aspects of the building itself such as washroom signage, ensured inclusive language was built into the electronic patient record and ultimately has contributed to positive experiences for thousands of future patients. One of our Experience Advisors, Kiera, who helped shape the program told me how valuable this experience was for her - she said that the trans and non-binary community is so diverse and it’s so important that they are involved in creating something like the TRS program, so that it can be shaped to meet their needs, whatever they happen to be.
Experience Advisors are now playing key roles on hiring committees at Women’s across all levels. Most recently, we partnered with patient experience advisors on the recruitment and hiring of three new senior leaders. In my view, their insights and contributions to our process and final candidate selection were instrumental in helping us find the best people for these critical roles. In speaking with them afterwards, they felt the same way. Vincenza, who participated in two of our search committees, said that being an equal partner on these hiring committees was a deeply gratifying experience and she felt respected and listened to. She thinks that WCH has taken patient centered care to the next level by including a patient on a hiring committee and that it is yet another example of how WCH is blazing the trail and revolutionizing care.
Meaningful, effective patient engagement is core to advancing our strategy. I’m excited and moved when patients share their stories with me. Some of the knowledge patients bring has been gained through the most painful of experiences and truly represents their generosity and compassion. To all those who take the time to fill out a questionnaire, participate in a study, communicate through clinicians or patient relations, or sit a committee with a willingness to share their wisdom in the hope it will improve care for others, thank you. What matters to us is what matters you.
A New Decade in Healthcare
January 31, 2020
Happy New Year! As we kick off this new decade, I am energized to see Women’s College Hospital deliver on our strategy in ways that disrupt, innovate and transform healthcare .
Digital transformation is happening across every sector of our economy, and all around us in the world of health care. It should mean that over time, more preventative, ambulatory acute care and chronic care will be delivered virtually “at home”, outside of the regular workday, by what is likely to be a more diverse set of providers. Emerging technologies will advance patient and provider convenience, experience and outcomes. And artificial intelligence (AI) and analytics will continue to enable healthcare breakthroughs. It’s predicted that over the next decade millions of emergency department visits will be reduced thanks to AI-enhanced virtual care. The speed at which healthcare technology is evolving is staggering and we are starting to see innovations that we thought were decades away already becoming realities.
With our launch of Women’s Virtual – Canada’s first virtual hospital – WCH is poised to lead this next generation of connected, collaborative and integrated healthcare platforms. Women’s Virtual will allow us to treat and care for patients in the setting most appropriate for them by integrating digital health tools - like e-consultation, online peer support groups, curated apps for the self-management of chronic disease and video visits - into WCH’s existing clinical areas. This will enable us to enhance our health services and ensure that patients get care in whichever way best addresses their needs, while at the same time enhancing the provider experience. Imagine a model of care where if a patient is invited to come in for a traditional in-person appointment, it’s because a face-to-face visit is the best way to address that person’s issue or concern. We will have an array of alternatives that can improve both access to care and integration of care.
One of the reasons we are so well-positioned to do this at WCH is our academic expertise in digital care. The Ministry of Health and Long-Term Care has designated WIHV (Women’s College Institute for Health System Solutions and Virtual Care) as the secretariat of the provincial Centre for Digital Health Evaluation (CDHE) with a mandate to evaluate new healthcare technologies to revolutionize care. In this role, Women’s College is well positioned at the forefront of digital health transformation in Ontario, partnering with organizations in the broader public and private sectors to test, evaluate and spread innovative models and tools across the province. Our staff, clinicians and scientists at WIHV and WCRI are experts in “what works” – and what doesn’t – when it comes to digital tools and virtual care. All that expertise is being channeled into the design of the Virtual Hospital. And all our staff, clinicians and patients will be invited to participate as Women’s Virtual starts to roll out in the coming months.
As these innovations mature and evolve they will help our providers offer better care to all. The ethos of our organization remains grounded in health equity and as we move forward, these game-changing ideas and technologies must help us address gaps in care for underserved and poorly served populations. This will require that we forge new and robust alliances with community, health organizations and industry to advance innovation in ways that keep equity top of mind. It has been predicted that half of all healthcare delivery organizations will ally with organizations like Google, Apple and Amazon in their clinical diagnostic and treatment processes over the next decade. We must always ask to what end? At WCH the endgame will require improved healthcare and technologies that benefit high-needs and marginalized individuals and communities.
A new Integrated Care for Vulnerable/Marginalized Women Network coordinated by WCH is one example of how our strategy lends itself to this blending of equity and innovation. This model brings together 18 partner healthcare organizations and community partners. We share the aim of creating integrated services and improving access for marginalized women across the GTA, and we are committed to collaborating and working more closely together so that services for those women will not feel as fragmented as they have. The partners in this Network will focus on improving healthcare pathways to and from shelters to reduce unnecessary emergency department visits, avoid premature discharge from care and consider how the social determinants of health, like housing, employment, gender and race, impact health and wellness. I’m incredibly proud of our role in the city in which we are challenged to shift our thinking and our services in ways that meaningfully address gaps in care related to sex, gender and the broader social determinants of health.
Healthcare in the 2020s will evolve at a staggering pace. Women’s College Hospital will radically reshape and modernize the delivery of health care in Canada for a healthier and more equitable world.
December 6, 2019
Digital technology has transformed our lives in a short period of time. We shop online, bank online and communicate online. Technology has disrupted many sectors and healthcare is no exception. Under Ontario Health’s new vision for the healthcare system, organizations and providers are encouraged to incorporate digital approaches and technology-enabled models of care to enhance the system and modernize the delivery of care.
As part of our commitment to innovation and continual improvement, Women’s College Hospital (WCH) is launching Women’s Virtual – Canada’s first virtual hospital. We are re-imagining how healthcare is delivered, using technology to create a hospital where traditional face-to-face care is used when that is the best way to meet a person’s needs – and when other kinds of care can be as good or better, we have those options available. This work is starting in our Mental Health and Surgery programs, and over time will be expanded across other clinics and services.
Women’s College Hospital is already among the leaders in developing and evaluating digital healthcare innovation, so we have the insights and expertise to forge this new path. The research and evaluation work of WIHV, our WCH Institute for Health system solutions and Virtual care, has yielded insights about the importance of starting with care redesign, rather than starting with technology, to get the models right. Our Women’s Virtual team is working with departments across the hospital to imagine how tools such as e-consultation, video visits, asynchronous messaging, online groups and more can fit into our existing clinics. The goal is to ensure these tools are implemented in ways that have real benefits for our patients, our clinicians and our health system.
Incorporating virtual care into our existing programs and services aligns with our focus on providing truly equitable and accessible care. Technology-enabled care can improve access for people who face barriers getting the services they need, like people living in rural or remote communities, shift workers, new moms, frail seniors, and people with physical disabilities, to name a few groups.
Beyond easing access to care, virtual care can also help alleviate system-wide issues, such as avoidable emergency department visits, hospital admissions and wait-times for appointments with specialists. One such example is our hip and knee replacement surgical program. By providing patients with an app they can download on their own device that securely provides relevant treatment information, as well as immediate access to their surgical care team, we can allow patients to go home the same day after their surgery and recover safely in the comfort of home. If we are able to spread innovative models like this across the province, in-patient hospital beds can be saved for acutely ill patients who need them most.
For the many patients living with chronic conditions, virtual care can provide further support in managing their disease on a daily basis. For example, online learning modules and digital coaching designed with the specific individual’s needs in mind, provide patients and their caregivers with additional tools and education, helping them stay healthier at home and out of the hospital.
Through Women’s Virtual we will also be able to provide just-in-time advice from our specialists to Long Term Care facilities by using video visits between our AACU (Acute Ambulatory Care Unit) and the staff in these Long Term Care homes. This is another example of how we can prevent frail seniors from being transferred to the emergency department.
Digital health tools can also improve integration within the system and breakdown silos of information between health providers and healthcare organizations. Our model of eConsultations and eReferrals allow physicians, nurses and other care providers to connect with each other more easily to match patients with the right services more quickly.
Women’s Virtual is a highly innovative initiative that will allow us to leverage technology in service of a healthier and more equitable world. Through Women’s Virtual we will make virtual care a part of our day-to-day patient care in a sustainable and scalable way.
As the hospital designed to keep people out of hospital, this is the next step in Women’s College Hospital’s evolution as a leader in healthcare innovation. I believe that virtual care will allow us to further improve the services we offer and enhance the care experience for our patients, their families, clinicians and hospital staff.
Healthcare and Climate Change: What Can We Do?
October 31, 2019
Climate change has been identified as the 21st century’s greatest threat to global health. And like many other sectors, healthcare delivery contributes to this growing problem. Canada’s healthcare greenhouse gas footprint ranks 21st in the world – behind countries like the USA, Belgium and Japan. Internationally, health system leaders are setting new and ambitious plans in place for a healthier future.
A 2017 Health Canada poll found that 79 per cent of Canadians accept that global warming is happening, but only a little more than half think it’s a health risk right now. Between 2030 and 2050, climate change is expected to cause roughly 250,000 additional deaths per year, from malnutrition, malaria, diarrhea and heat stress. Vulnerable populations are particularly at risk, including the poor, the elderly, the young, those who are chronically ill and those living in vulnerable geographic areas like the North.
So if climate change is one of the greatest threats to population health this century, we need to think about what we can do to reduce some of these risks. Health systems and hospitals have an important responsibility to develop smart strategies and solutions to mitigate and reduce greenhouse gas emissions, to adapt to shifts in patterns of illness related to climate change and to lead by leveraging social capital for collective action.
At Women’s College Hospital (WCH), we’re working to be a more environmentally friendly organization. Our hospital building is Leadership in Energy and Environmental Design (LEED) Gold Certified, which means we’ve incorporated environmentally sustainable construction practices and an energy efficient design. An example of this is our green roof, which helps with water retention and management.
In addition, we developed a Sustainability Plan to identify ways that our organization can reduce energy consumption and the amount of waste we send to the landfill on a monthly and annual basis. We are integrating the principles of sustainability and sound environmental practice into all functions and operations within our hospital. Our aim is to reduce our environmental footprint at WCH. To do this, we’ve implemented a series of actionable strategies to minimize our greenhouse gas footprint and we’re committed to adding to this list every year. To reduce paper use, we’ve installed new printers with default double-sided printing. To minimize energy use in our building, we’re working in partnership with Black and McDonald, our building management company, to make necessary changes. To reduce the use of bottled water, we are installing more filtered water stations throughout the hospital. To implement an organics recycling program, we’re introducing the use of organic bins in our lobby and in staff lounges. On an annual basis, we will produce a sustainability report that measures year-over-year results of our initiatives. There’s a lot we’ve done and even more we need to do, but I’m proud of the strides we have made to shrink our hospital’s carbon footprint.
Locally, WCH has joined the other academic hospitals (Toronto Academic Health Sciences Network) and the University of Toronto’s Centre for Sustainable Health Systems to create a community of practice who will collaborate on shared quality initiatives that will add momentum to implementing change.
Climate change isn’t tomorrow’s problem. For the health of our patients, our communities and our world, we need to take accountability and action today.
Reproductive Rights: We’re Not Done Yet
September 30, 2019
We are fortunate to live in a country where sexual and reproductive healthcare rights are ingrained in law – it’s been 50 years since contraception was legalized in Canada and just over 30 years for abortion. However, we can’t take for granted the progress that has been made. In most places around the world – including many developed countries – reproductive freedom is still a major health issue and we only need to look south of the border to know that reproductive health rights for many people are precarious.
There have also been more recent advancements. In 2017, Health Canada approved the use of Mifegymiso, also known as the abortion pill – a global, gold standard of care that has been available throughout Europe for decades – with the intention of increasing accessibility to safe, effective medical abortion, particularly in rural and remote communities where hospital and physician services can be difficult to access. However, there were many onerous prescribing restrictions that were mandated for Mifegymiso - specialized physician training, mandatory ultrasound and requiring patients to take the first dose in the presence of their physician - as well as complicated dispensing practices, so this slowed the uptake of Mifegymiso and did little to improve access. Although these barriers have since been removed, the usage rates of Mifegymiso continue to vary considerably from province-to-province and are still limited, particularly in community care settings.
Physicians at our Bay Centre and scientists at our Women’s College Research Institute were instrumental in the Canadian approval of Mifegymiso. In less than two years at our clinic, approximately 55 per cent of all abortion care is now done medically rather than surgically.
As early adopters who believe in its efficacy and safety, clinicians from the Bay Centre are also training and supporting community primary care physicians in rural communities including Thunder Bay, Sudbury and Orillia through e-consults and telemedicine to increase their understanding and confidence while growing their capacity to prescribe Mifegymiso to their patients. Next they are turning their attention directly to patients in rural communities to provide abortion care using Mifegymiso using virtual care and digital health tools.
Although in Canada, on the surface, it might seem like access to abortion care is readily available for people who want to exercise their legal right to make decisions about their sexual and reproductive health, you don’t have to dig very deep to truly understand that for many this still isn’t the case. Geographic, financial and cultural factors play a large role in a person’s ability to access the care they want and need.
As the CEO of a hospital that has been an advocate for reproductive health for 136 years, and Chair of the Board for Planned Parenthood Toronto, I have spent a considerable amount of time thinking about these disparities and how we can work to fix them. Lack of access to reproductive and sexual healthcare is most prevalent among people from marginalized communities who are disproportionately effected by the social determinants of health. Geographic access also poses a barrier for those who are required to travel for hours to reach their nearest clinic because their community does not have the resources to support them. So as we are developing solutions to meet people’s healthcare needs, it is imperative to take into account not only their clinical needs, but also the stigma and societal barriers that can have an equally significant impact on their ability to be healthy.
A New Era of Sex and Gender in Health
August 26, 2019
Women’s College Hospital is a long standing leader in sex and gender in health. Throughout history we have uncovered, advocated and worked to improve the significant population-level health inequities that exist simply on the basis of sex and gender. Recently, we have seen more conversations about sex and gender officially enter the mainstream, and, whether it be through social media campaigns like #MeToo, heated debates about health and wage gaps for women, or embracing gender neutral bathrooms and pronouns, we are undoubtedly in the next sex and gender revolution. We will continue to be at the forefront of this revolution in health research, education and clinical practice, as well as leading the way in shaping our own organizational environment and culture.
Together, we have done critically important work highlighting and addressing how healthcare and health research for men and women differ. Did you know that up until as recently as the 1990s, women were not included in most health research? Or that women are more likely than men to experience serious mental health issues, yet they are three times more likely than men to experience barriers to accessing care. Sex and gender influence our risk of developing certain diseases, how well we respond to medical treatments, and how often we seek care. The more we understand about how sex and gender affect health, the more we can do to improve health and well-being for everyone.
But the health gaps between men and women don’t tell the whole story. Growing recognition of diverse gender identities is not only changing public policy but pushing healthcare and health research to be more inclusive of previously unheard voices—including those of transgender, non-binary, and Two-Spirit individuals. We know that even today, trans and gender diverse people are typically not included in health research and continue to face barriers to accessing healthcare.
Our society, and perhaps especially the health sector, likes to sort by checkboxes: male or female, gay or straight, single or married. However, growing numbers of people don’t fit into these boxes. Being at the forefront of sex and gender in health means transforming and evolving beyond our traditional binary world views. Gender-transformative approaches are improving the way we design, implement and scale-up novel health interventions. Women’s College Hospital has been working toward a world where sex and gender – all genders – are integrated as key considerations across healthcare, research and its applications.
Women’s College Research Institute (WCRI), promotes the use of SGBA+ (sex- and gender-based analysis plus) across all health research; acknowledging that both biology (sex) and society (gender) influence our health and well-being in distinct yet interrelated ways. The ‘plus’ in SGBA+ points to the many other social determinants like stable employment, safe housing and food security that can impact a person’s health. These ideas are at the heart of the work our team of WCRI scientists are doing; from research design to measurement, analysis and implementation. We know that health research that includes sex and gender is more scientifically rigorous and responsive to the diverse health needs of people in Ontario, across Canada and around the world.
A focus on best clinical practice, specialized care and training of health professionals are all essential components to advancing the health of women and gender diverse people. Alongside our many other world-class clinical programs, we are the first public hospital in Canada to offer a transition-related surgical program that will increase access to medically necessary surgical procedures for transgender people. As a component of our strategy, we are hard at work to establish a new Sexual Health Centre that will be focused on addressing sexual and reproductive health gaps for women and gender diverse people.
We continue to coach and train our physicians, staff, learners, and volunteers to deeply understand and consider sex and gender as vital to health and well-being. We continue to investigate and address biases in the structure of our clinics, forms, electronic medical record systems and aspects of our physical environment, like access to all-gender washrooms, in order to ensure a safe and welcoming care experience for everyone who visits our hospital.
To achieve our bold vision to revolutionize healthcare for a healthier more equitable world, we will continue to push boundaries. This is who we have always been and I am incredibly proud that this is who we still are today.
It’s All about the People
July 29, 2019
It’s hard to believe that four months have already passed since I became President & CEO of Women’s College Hospital (WCH). It’s been the most energizing four months of my career and I have learned so much. Many of you know that I like to listen, learn and see firsthand what is happening across the organization and beyond our walls – I’m naturally curious about what people are doing, what they are thinking and how they are feeling. Our people are our most important resource and it is important to me that our teams appreciate and share the meaning and purpose of their work. A positive work environment strengthens the delivery of high-quality care to patients and creates the right conditions for innovation and ideas to grow.
So, in these first four months, I’ve hit the ground running to try to better understand what is motivating our people to deliver on the new strategy, where are they facing barriers, and how might we support and engage them more. This has meant many one-on-one meetings, team and departmental visits, leadership walkarounds and my personal favourite, a new monthly Coffee & Catch-up Session where I invite 15 people from across the organization to meet informally with me to share their ideas and inspirations. I have met with more than 300 people and I’ve heard about all the ways teams across the hospital are hard at work putting our hospital strategy - Healthcare Revolutionized - into action and creating positive change. Here are just a few things that people who work at Women’s College Hospital say matter to them:
"Patients matter. That is why we come in to work and give our best every day. But we know we will never see every patient. So what is different here is that communities and citizens also matter. We bring them into how we are delivering care and services."
"At WCH we do change well. Change is never easy but we have a special ability to appreciate and embrace continual improvement and innovation – and this is what the health system requires."
"Inclusiveness matters. This inclusiveness extends across our teams and programs to our shifting patient population. This is an organization that lives the values of equity, diversity, and inclusivity."
"Being part of an organization that has the courage to reimagine the way care is delivered is amazing. That we will lead the way in virtual care is exciting and it really feels like WCH is living and leaning into the future."
I heard common themes about what excites people most about our strategy; resoundingly people talked about virtual care, innovation, equity and partnerships – tied together to impact our communities and patients we care for.
I also took the opportunity to ask people why they stay at WCH and in almost every conversation people told me that the culture here is why they stay. The culture they describe is one of respect, inclusivity and a feeling of ‘family’. As a leader, and on a personal level, these are wonderful things to hear, and I also know there is always room for improvement. People believe we can make WCH an even better place to work with more opportunities for professional development and clearer lines of communication across teams. This feedback is consistent with what we learned in our 2018 Engagement Survey.
We have taken all of this information – anecdotal feedback, our survey results and best practices – to create our new People Strategy. Our People Strategy is our commitment to our staff, clinicians, scientists, learners and volunteers. It provides focus and direction for creating support systems and programs that will help everyone contribute their very best to WCH and realize their full potential at work. Research has shown that hospitals whose staff and clinicians feel engaged and empowered lead to better health outcomes for patients.
Our People Strategy has five areas of focus:
- Total rewards
- Human capital planning
- Equity, diversity and inclusion
- Leadership and talent development
Each of these areas have distinct goals, objectives and measurable outcomes. As we finalize the programs and tactics within each area of focus, there will be additional opportunities to provide feedback and share your thoughts.
As a leader, I deeply believe in the power and promise of people. At WCH, we are fortunate to have exceptional teams providing exceptional care. Healthcare is all about people – whether we are clinicians, frontline staff or in administration – we are all here, doing our best each day to support patients and make our hospital and health system better for everyone.
What I’m Learning about Indigenous Healthcare
June 25, 2019
June is Indigenous History month and June 21 was National Indigenous Peoples Day – a celebration of Indigenous Peoples’ culture and heritage. This date was chosen because it corresponds with the summer solstice, the longest day of the year, and because for generations, many Indigenous Peoples’ groups have celebrated their culture and heritage at this time of year. The day celebrates the unique heritage, diverse cultures and outstanding achievements of Indigenous Peoples from across the country. So, for my blog this month, I’d like to share what I am learning about Indigenous communities and how we thoughtfully shape our organization to better meet the health needs of Indigenous Peoples.
A few weeks ago, I had the honour of participating in my first Indigenous Ceremony. Alongside Marilyn Emery, members of the Indigenous health team and community members, I took part in a traditional Bundle Ceremony lead by Senator Constance Simmonds. The ceremony was meant to celebrate Marilyn’s work with and support of the Indigenous community throughout her time as President & CEO of Women’s College Hospital and recognize my new leadership and our ongoing commitment to create an inclusive and accessible healthcare environment for Indigenous patients, staff, physicians, learners and volunteers. The bundle now resides at WCH – a meaningful symbol of this connection to community and our commitment to Indigenous health.
This ceremony was one of many firsts for me as I continue to learn about Indigenous communities, traditions and right to healthcare experiences so vastly different than what has occurred through history. We can do better. We must do better.
Canada’s Indigenous community has been underserved and poorly served by the healthcare system for too long. So, in collaboration with Indigenous communities, we are committed to implementing Wise Practices for Reconciliation, where programs to meet specific community needs will be developed. Wise Practices for Reconciliation means we are signaling that our hospital is a safe space – we’re doing this through the installation of Indigenous art, by including books and articles in our health sciences library written by Elders and other experts in Indigenous healing and by offering a place for people to smudge before their appointments. You will also start to see Indigenous health content on our website, in our new patient handbook and in this year’s annual report magazine. Starting in July, there will be an Elder in Residence one day per week. Indigenous healthcare is one example of how we’re putting our health equity strategy into action and improving care and the care experience for Indigenous communities.
I also want to acknowledge the recent release of Reclaiming Power and Place: the Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls. The report outlines 231 recommendations that must be acted upon to put an end to the sustained and ongoing genocide that is happening in this country. I encourage everyone to read the full report.
Through our Education Department, we are also offering a new online learning opportunity called the SAN’YAS Indigenous Cultural Safety Program. The course offers eight modules designed to provide training and information about Canada’s Indigenous communities for healthcare providers to improve patient experience and health outcomes. I recently completed the course and one thing that stood out to me was the impact of intergenerational trauma on Indigenous Peoples. It reinforced for me the importance and need for Trauma Informed Care as a key competency across our organization.
It is very important to me to continuously learn about the diversity of communities of patients we serve and ensure we are finding new ways to best meet their unique healthcare needs. I invite you all to join me in expanding our knowledge and developing our resources. It is critical that we listen and learn from Indigenous Peoples – we need to get this right. We may not always have all the answers immediately, but by working and learning together, we will make our vision of a healthier, more equitable world a reality.
How WCH Fits into the New 'Ontario Health' Structure
May 27, 2019
A few people have asked me about what’s going on in the Ontario health system and how does WCH fit in. So I want to share a brief overview on how the system is evolving.
There is much transformation underway in Ontario and there are many new structures and policies being implemented by our provincial government. Within healthcare, the MOHLTC (Ministry of Health and Long-Term Care) introduced The People’s Health Care Act, which aims to create a simpler, more efficient system by connecting and strengthening local healthcare services, and focusing on the needs of patients, families and caregivers.
This new structure includes the creation of a province wide “super agency” called Ontario Health. This agency will be responsible for overseeing Ontario’s healthcare system and for supporting all health services across the province. The former CEO of the TC LHIN (Toronto Central Local Health Integrated Network) – Susan Fitzpatrick – was appointed as the interim CEO of Ontario Health. Susan has been leading health system transformation in the central Toronto area for some time and this new provincial model is very much aligned with what has been happening in central Toronto.
Under the Ontario Health agency there will be a number of Ontario Health Teams (OHTs) who will organize and deliver the healthcare services within their local communities. Each OHT will be made up of various health providers including hospitals, physicians and home and community care organizations that are part of the same geographic region. These OHTs will have full responsibility for managing all the clinical services and healthcare budgets for their region. The schematic below shows all of the parts of the system that are included in OHTs:
In order to form an OHT, healthcare organizations within the same geographic region had to partner and submit their joint application and there are many criteria that need to be met in order to form an OHT. The first OHT applications were submitted on May 15th and there will be ongoing calls for more OHTs over the next few years until the entire province is covered.
WCH has been working with our healthcare partners and the TC LHIN to ensure that we are aligned with this new health system structure and that we can continue to provide the much-needed services we are known for and that meet our strategic priorities. Central Toronto is a complicated geographic region within this model because there are many hospitals in this region. So we have been working with the leadership teams of those hospitals to create a solution to this challenge. Also, we have been asked to lead a group of organizations that support women to see if we can improve care for some of the most vulnerable women in Toronto through the creation of an integrated delivery network. We had our first meeting last week and this is an exciting opportunity for us to work together in a new way with our partner organizations to improve healthcare delivery for the women in these marginalized communities.
I have been at many meetings with other hospital CEOs and government leaders over the past several weeks to ensure we are actively engaged and strongly positioned for our future. Our role in supporting primary care, improving access to specialty care and leading in virtual care is proving to be an important part in the system. We have had meetings with groups of organizations who have submitted applications for OHTs but have not signed on at this point. We have more due diligence to do in order to fully determine our optimal role.
Some of what we do at WCH is caring for our community, some is caring for our immediate neighbourhoods and some is caring for the province. This all needs to be considered in our path forward. There are many options to consider and I will keep everyone updated as our role in the system evolves.
My Next Chapter at WCH
April 29, 2019
It has been almost one month since I took on the role of President and CEO here at this wonderful hospital. And even in just these first few weeks, it has already been a stimulating and inspiring experience.
One of my goals is to encourage open communication and dialogue across this organization and to stay engaged in and connected with all our teams, programs and leaders. One way I will do this is by publishing a monthly blog post where I will share some perspectives and ideas from the various conversations and initiatives that I am a part of.
So here goes…my first blog post!
Although I am new to the role of CEO at Women’s College Hospital, I am not new to the hospital. I’ve had the privilege of working in different roles and leading numerous teams here for many years, most recently, as the EVP of Patient Care and Ambulatory Innovation. So I now have the exciting opportunity to use all the experience and knowledge I have gained in the past to help shape the future of WCH.
One of the aspects that has struck me as I begin this journey, is that even though I am very familiar with many people and programs here, being in this new role means that I am listening, hearing and seeing things in a different way than I did before. And it’s been incredibly interesting to hear people’s insights on the prospects they see ahead of us.
Last week I hosted my first “Coffee & Catch-up” meeting. These are monthly meetings that I’ll be having with groups from across the hospital to share ideas, ask questions and get to know new people. I also started having “CEO Team Visits” with different departments to learn what they’re working on and how they’re putting our “Healthcare Revolutionized” strategy into action. And I’ve been so impressed by the passion and sense of hope I’m seeing, especially people’s commitment to innovation and their desire for us to take calculated risks and forge new paths to improve our health system and developing healthcare for the 21st century.
Healthcare in Ontario is in a tremendously interesting place. Our government is building a new model for our system and we are strongly positioned to take advantage of the opportunities that this will present. I am energized by the potential that lies ahead for WCH and by the incredible chance I have been given to lead us there. I look forward to embarking on this new chapter and working together with you to create new possibilities for us all.