12

BOLDLY GO:
CHARACTER DRIVES
LEADERSHIP AT
PROVIDENCE HEALTHCARE

Presented by:
 Ms. Gharam Alawneh
 Ms. Asmaa Shaheen
 Ms. Haleema Alshehhi
 Mr. Ibrahim

Course:
Executive Master in Healthcare management
& Economics - EMHME -2019

EXTERNAL ANALYSIS - OVERVIEW

• Josie Walsh, was nominated as the CEO and President of Providence Healthcare in Toronto in
2011.

• She was the change leader who led the organization through a huge change and alteration asso-
ciated with global crunch in finance as well as financial health problem by virtue of her collabora-
tive leadership styles just within a span of four short years.

• Providence began consulting with the key stakeholders for their needs which depicted making
improvement of patient flow.

• Walsh had a new model in mind with regards to patient flow which would diversify the entire pa-
tient care and hospitals’ future.

• This resulted in a new pilot designing and then implementing it.

OUR LEGACY

“Ever since this institution was established… its work and usefulness
have continually increased, until it has risen from the small, almost
unknown refuge of a few old men to a home for the distressed of all
ages numbering 475.”

– Providence Annals, 1882

The Sisters of St. Joseph opened the House of Providence in 1857 on Power Street in downtown
Toronto to care for orphans, widows, immigrants and the homeless. Countless stories in our Annals
detail how the Sisters sought out the unmet needs of the city’s most vulnerable, without consideration

its capacity and at its peak, provided accommodation for 700 residents.

After a century of caring in downtown Toronto, Providence relocated to the city’s east end in 1962.
The new ‘Providence Villa and Hospital’ was built on farmland owned by the Sisters at the corner

In the decades that followed, Providence evolved in new and creative ways, building on its solid
reputation caring for older adults, and growing its expertise in rehabilitation, palliative care, long-term
care, as well as care for those with dementia.

Today, Providence is a leader in helping people access and receive the care they need. With the
support of our partners in acute care and the community, we work to return people home whenever

at Providence and at home.

While much has changed for Providence over the years, what hasn’t changed are the Core Values
enshrined in our promise of ‘helping people and healing lives’.

EXTERNAL ANALYSIS
–STRATEGY AND OBJECTIVES

STRATEGY OBJECTIVES

• Clear vision, calculated risk • Expanding the Outpatient
taking, and big thinking. program and service.

• Radical reengineering pro- • New designing of the re-
cess adoption. hab’s inpatient units via
design transformation.
• Implementation of manage-
ment tools and techniques. • Achieving excellency with
regards to patient care.
• Productive partnerships.

• Engaging high staff.

• Aligning the strategic aim
with the health service inte-
gration plan.

• Collaboration

• Change communication

• Accountability

PROBLEMS AND ISSUES

Global Financial crunch and
added pressure in Ontario’s
health care sector

Providence was at a deficiency
threat and pension plan at a stake.

Job Cut downs, lay offs, and closing
down of patient care units

Hospitals were held accountable for per-
formance and productivity and expected
to make budgetary balance.

Conventional solutions was not enough to
save the future of Providence health care.

INTERNAL CAPABILITIES –
FUNCTIONAL ANALYSIS

Rehabilitation
units (6),

palliative care
unit (1), and
clinic for
outpatient.

01

Adult FUNCTIONAL Cardinal
day care
program 04 ANALYSIS 02 Ambrozic
houses

03

Serving 5000
patients on an
annual basis

WHO WE ARE TODAY Providence Hospital
Cardinal Ambrozic Houses of Providence
Providence Healthcare is a leader in providing
rehabilitation, palliative care, long-term care and Adult Day Program
community programs in Toronto. We provide
care in three areas:

Providence Hospital
In our Hospital, we help adults of all ages rehabilitate after strokes, orthopaedic surgery,
lower limb amputations or other complex medical conditions generally associated with aging.

. Our Ambulatory
Services and Clinics promote ongoing recovery, healthy living, and sustained well-being to
people in the GTA and beyond.

Our Hospital also offers palliative care, helping people approaching the end of life by providing
state-of-the-art care in a supportive environment. We offer seven-day/week patient admissions,
as well as short-term respite admissions for palliative patients who require inpatient care before

Cardinal Ambrozic Houses of Providence
Our long-term care home, the Cardinal Ambrozic Houses of Providence, is home for each of
our 288 residents. With a focus on quality of life and the implementation of best practices,
the Houses provide the highest standards of comfort, care and safety for our residents.

Adult Day Program
In our Adult Day Program for people who live in the community with moderate to severe
dementia, we have the capacity to care for the most vulnerable clients, around the clock.

In addition, families and the general community have access to individual and group support,
as well as education resources through our Scotiabank Learning Centre.

INTERNAL CAPABILITIES –
ASSESSMENT OF
THE MANAGEMENT TEAM

Thelma Horwitz was the pro-
ject lead based on her capa-
bilities.

Dr. Peter Nord who contribut-
ed towards a key process im-
provement.

Beth Johnson worked close-
ly with Walsh to develop en-
gagement and communica-
tion strategies.

Josie Walsh the CEO the main
leader who headed the entire
change process.

INTERNAL CAPABILITIES
– VISION, MISSION, AND VALUES

VISION

• Helping People
• Healing People

MISSION

• Compassion
• Hope
• Healing

VALUES

• Life Sanctity
• Dignified Humanity
• Excellent service
• Social Justice
• Community
• Social Responsibility

INTERNAL CAPABILITIES –
STRATEGIC POSITION

Was chosen

02 as one of the three Dr. Peter Node 04
hospitals in Ontario became the

to make a representa- co-chair of Ontar-
io’s Rehabilitation
tion in the rehabilita-
Care Alliance
tion process in the

Province itself.

03

Providence Received an Josie Walsh
Healthcare got award of Gold got the leadership
recognition for quality healthcare award from Toronto
University, Institute
innovative workplace for Health Policy
transformation
05
01

ORGANIZING A FIRM Plan Implement
Steps of TbyD Stake holder engagement Space: 6 month unit renovation
Staffing: Staffing model to sup-
Design 1 3 4 port improved patient flow
Breakthrough thinking Process Changes: Implemented
2 29 process changes
Measure
Sustain 65
Evaluate
1. Bi-weekly metrics walk 7
around with all involved staff Spread
Spread to all hospital
2. Staff surveys units
3. Patient/caregiver surveys
4. Checkpoint weekly meetings
5. Performance board on unit
6. Project score card
7. Sustainment model

This shows the detailed steps of Transformation by Design in Providence Healthcare. The strengths of TbyD are totally a lot, it
can improve the services’ efficiency, it can save manpower, and it can save lots of cost. But the TbyD also have weakness, the
main weakness of TbyD is time, this plan is an actual long-term management plan, this plan was started in 2010.

ALTERNATIVE COURSES OF ACTION

1 Providence Healthcare is better to continue to ensure TbyD of operation, at the same time, trying to do backward in-
tegration is a pretty good choice. Backward integration for Providence Healthcare means trying to entry medical sup-
plies or pharmaceutical plant industries. The advantages of doing backward integration are that can reduce hospitals’
operating costs, it won’t lead to the shortage of medical resources too, and it can increase a huge amount of revenues
of the company.

The disadvantages are that the investment scale of doing backward integration will be too much, although it is related
to the hospital industry, but it still belongs to the new field, and doing backward integration will also need technical
support, current technical level of Providence Healthcare might not enough.

2 Providence Healthcare can try to form a training class, on management, attitude, communication skills and
nursing skills four aspects to train their employees. Each employee must get at least one training a month,
the training can be like once a week.

hospitals still belong to the service sector, so that let patients feel comfortable and convenient will be pretty
significance, and making patients feel like home should be our main goal.

3 Actually to establish a nursing college or school will be a great idea for Providence Healthcare. Establishing a nurs-
ing school cannot only bring Providence Healthcare a considerable income, also can improve the awareness of the
company and the hospitals. At the same time, this action plan still can bring a huge number of reserve talents for the
hospital and the company, a lot of graduates of the school will be proud of working in Providence Healthcare. The
weaknesses of this action plan are: firstly, to work with this plan, it needs a lot of investments; secondly, the profits of
the school might not too much; finally, the Educational qualifications certificate will be hard to get.

RECOMMENDATIONS

1. There are many things to put into
consideration when implementing
a new system into a business. For
Providence Healthcare, it was very
difficult now that they have been in
business for more than 160 years
now. After reading and analyzing the
case, it is certain that Walsh is a lead-
er and knows how to manage the
business. My recommendation for
Providence is to spend lots of time at
the beginning designing the project,
for it to be easier in the long run and
be a smooth implementation.

2. make a timeline with deadlines, for
the process of the project to be or-
ganized and professionally tackled.
Communication as a team is impor-
tant, making the change easier and
already foreseen for those in the
business. Last, building trust with
everyone will help employees and
customers feel safe.

IMPLEMENTATION

For change to be implemented as smooth as possible there
needs to be many things done in an orderly manner. The first
couple of years need to be dedicated to planning and design-
ing the TbyD project. Spending a reasonable amount of time
plotting the plan and making the design, will make it easier for
the whole team to work together and understand what change
might bring.
There is always risk involved when changing how things work
in the business, but with a focused team and enough time, risk
decreases.

IMPLEMENTATION

After having the plan thought out and the design, implement
both the inpatient and outpatient clinic. Once the clinics are
running, there needs to be careful analysis of the clinics. Provi-
dence Healthcare needs to measure the performance, and see
what changes need to be made. It is important for the team to
evaluate what has been done right and sustain the good work
towards a perfect outcome. Last, once the clinics are perfectly
running, and there is a profit then implement the system in all
hospital units.

Concluding Remarks

In conclusion, it is going to be challenging for the project to be implemented. With a leader like Walsh
and a team so motivated for high-performance, it is without doubt a project that is going to succeed. Af-
ter looking at the changes TbyD brought to Providence Healthcare, now one can see that hard work pays
off. TbyD helped Providence Healthcare balance its budget, as well as providing the highest quality care
for patients. Their annual admissions grew by almost double from 1,759 to 2,664, making it evident that
the change was much needed. Walsh demonstrates incredible leadership skills throughout the project.
Leadership was important along the way, reaching the final outcome as expected.

The End

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