Alberta's healthcare at a crossroads (again)...

Alberta's healthcare system is at a crossroads.  Again.  This past Friday the current CEO of Alberta Health Services announced her resignation from a post she's held since May 2014.  In doing so, she placed the newly installed Board of AHS in the position of commencing a search for the 8th CEO in the 7 years of the existence of AHS.  Regardless of what opinions you might hold of the calibre of leadership provided to Alberta's health system in the past number of years I'm fairly certain that NO leadership text or framework would suggest that nearly annual turnover in the key leadership position in any organization would constitute best practice.

While there have been strides made in the functioning of Alberta's health system since 2008 you could be excused for not hearing much about progress given the machinations, political gamesmanship, and media coverage over the past number of years.  There is no doubt much to overcome and deal with given that Alberta is now touted to have one of the most expensive healthcare delivery systems in the country while at the same time seemingly delivering less than what is being achieved in other provinces.

What is equally disconcerting is that as the merry-go-round of healthcare leaders in Alberta has continued the import of those leadership changes through the lens of front-line staff and managers has become less and less evident.  The reality has become - and perhaps it always was - that those at the frontline just continue to do their jobs, attempt to provide service to their individual patients despite changes higher up the corporate food chain, and have generally become numb to a host of changes that are seemingly disconnected with their day-to-day challenges.

All that being said there are very real issues in Alberta's healthcare system as alluded to above.  Not the least of the solutions to these challenges will be the recruitment of a leader that can drive real, fundamental, inclusive and long overdue change in Alberta's healthcare delivery system.  I do not envy the challenge facing the new Board of AHS.  A number of worthy candidates may be out there but they may also be more than justifiably gun-shy given the shelf life and authority experienced by their predecessors.  A good leader - a great leader - required by Alberta's healthcare system will first have to be supported by the quality of governance that the AHS Board will have to bring to bear to this first and most critical decision of its tenure.

The AHS Board will have to take into account the impact of all that the healthcare system has been subjected to over the past 7 years of Alberta Health Services' existence - and appreciate that the challenges now in front of the organization also speak to what was gifted to it from previous "health reforms."  We have a system that has become increasingly bureaucratic and controlling, seeking to deal with past issues of lack of accountability through more comprehensive paperwork.  We have a system where creativity, innovation and risk-taking have never been more required, but yet are stifled by caution, fear and regulation.  "Rules" are multiplying ensuring that those who are motivated to make a difference can't while providing cover for those who are interested in preserving the status quo or their own positions.

Many healthcare providers - and perhaps patients and communities - would claim to be exhausted and cynical given all the change already experienced in the past decade.  Yet what is required given the circumstances of system performance (current and anticipated) is even more change.

How seriously this need for change is understood by the new AHS Board will be tellingly demonstrated by the process of recruitment and selection of the next AHS CEO.  Healthcare in Alberta needs a transformational leader, a leader in the spirit of Jim Collin's Level 5 Leader.  A leader who is fundamentally committed to the success of the organization as a whole - even at the expense of their personal success.  This is a leader that cannot be afraid to change out the old guard, to unfreeze old patterns of behavior and performance, to institute a true culture of accountability and responsibility, and sacrifice some sacred cows.  The Board and our government must be prepared to weather some noise as previous governments and administrations have not.

There are undoubtedly difficult and painful decisions ahead but if driven by a compelling vision of the future versus the (political) expediency of the past I am confident that healthcare professionals and public alike will be able to work through these challenges.  All the more so if they are an integral part of the discussion, decision-making and implementation decisions.

Paraphrasing Albert Einstein, "The definition of insanity is doing the same thing over and over again and expecting different results."  Going forward, the AHS Board will have to push itself to really think about the type of leader necessary to achieve far more extraordinary results for our healthcare system.  Does this extraordinary leader currently reside in Alberta's system?  I'm convinced they do not.  Our efforts will have to be more far flung and not just in a geographic sense.

The process and the decision by which a new AHS CEO is chosen this time around will send a huge signal about the type of values, expectations and culture that will be created over the next number of years.  Healthcare providers and professionals are watching intently - and maybe even cynically.  I hope they are not disappointed.  If we are to truly make a difference for the health of our province it really will be all about leadership.
______________________________

Greg Hadubiak, MHSA, FACHE, CEC, PCC
TEC Canada Chair/Executive Coach/Senior Consultant
hadubiak@wmc.ca

Helping leaders realize their strengths and enabling organizations to achieve their potential through the application of my leadership experience and coaching skills. I act as a point of leverage for my clients. I AM their Force Multiplier.

Color me Jaded...

This morning (November 9, 2015) we have reports of systematic cheating on the part of Russia related to its track and field teams.  In a devastatingly critical report, a World Anti-Doping Agency panel accused the Russian government on Monday of complicity in widespread doping and cover ups by its track and field athletes and said they should all be banned from competition — possibly even next year's Olympics in Rio de Janeiro — until the country cleans up its act.

To some degree this is earth-shattering news.  Even more so if, in fact, the relevant worldwide bodies in charge of athletics actually move to banish Russia from international competition for the foreseeable future.  For most of us, however, I have to believe that we are less naive than that particularly given the historically "robust" nature of some Eastern bloc competitors over the years and our own history of fallen idols in amateur and professional sports in the last number of decades.  Ben Johnson going from Canadian hero to goat within a matter of hours.  Lance Armstrong moving from iconic athlete to obfuscation with Oprah to being stripped of his accolades and awards.  And the list of professional athletes being suspended by their leagues for use of performance enhancing drugs is nigh on endless.  On a larger administrative scale we have the ongoing scandal with FIFA and the awarding of their events.

So color me jaded...Sports of almost any nature other than the efforts of my 5-year old on the soccer pitch have increasingly left me cold and skeptical.

But what does this have to do with business or leadership?  Well in many respects - or in all respects - sports has become a business like any other.  And as a result, we have seen, like any other business, that the ends justify the means.  For far too many athletes and business leaders success can be justified and must be justified at any cost.  As in sports and as in business the key has been in just not getting caught in the impropriety that we assume or know that all of our other competitors are engaged in.  For a current business example look no farther than the current crisis engulfing Volkswagen which has not only had dramatic consequences for the company, its executives and its shareholders but is sending ripples of doubt and despair over the automotive industry and German brand value as a whole.  This, of course, follows on other large scale leadership failures like Enron and Lehman Brothers in the past decade. 

Locally, the provincial government of Alberta has recently initiated new steps to promote transparency and integrity in compensation to those who receive payments from the pubic purse. The proposed legislation extends disclosure to 157 boards, agencies and commissions under the Alberta Public Agencies Governance Act, including Alberta Health Services, Travel Alberta and all post-secondary institutions.  Compensation paid to board members of these bodies will be disclosed, regardless of the amount.  Employees of these agencies, boards and commissions including Covenant Health, AHS and all post-secondary institutions are included, if they make more than $125,000 a year.  Again, like legislation, rules and regulations instituted after Enron, Lehman Brothers, Ben Johnson, or Lance Armstrong, this provincial effort comes as a result of transgressions of past leaders...for which all taxpayers will now foot the bill for extended rules, regulations and reporting.

Yet for all the effort everyone puts in to legislating a higher level of ethics and integrity in sports, business and the public sector we continue to have scandals like Russian track and field, Volkswagen, and public sector perks that defy reality.  Why?  At one level it is clear that the perceived or actual rewards of dishonest or unethical behavior still outweigh the potential and penalties of being caught.  There is also a perspective that holds that "everyone is doing it" so it would be naive and idiotic to not try to compete by any means necessary to stay in the race.  Finally, it is also clear that some business leaders, athletes and public sector leaders still perceive themselves as too smart or clever to be caught.  To some extent history bears them out.  Like an arms race, the escalation in tactics of trying to create a level playing field seem to be in constant catch-up mode to those who would seek a competitive advantage.

The moral of this story for me is that you can't legislate ethical behavior.  And as with the implications of the Russian doping scandal, it is clear that no individual athlete - or leader - circumvents a system of expectation and legality without help.  The mentality that got us systematic cheating on the scale implied in Russia, with FIFA, and Enron also explains how public sector leaders have - and will continue to - circumvent rules designed to promote transparency in compensation.

Until such time as we hold ourselves to a collective level of responsibility and are prepared to and act in the best interests of shareholders - public or private - I can guarantee you brand new, shocking stories of impropriety next year.  
______________________________

Greg Hadubiak, MHSA, FACHE, CEC, PCC
TEC Canada Chair/Executive Coach/Senior Consultant
hadubiak@wmc.ca

Helping leaders realize their strengths and enabling organizations to achieve their potential through the application of my leadership experience and coaching skills. I act as a point of leverage for my clients. I AM their Force Multiplier.