Medical 'mayor'

By definition, the campus of the Health Sciences Centre is a city unto itself, with nearly 15,000 people working, visiting or staying there as a patient on any given day. That makes chief operating officer Adam Topp the "mayor" of Manitoba's largest hospital.

"I work for the 7,000 people who work here," says Topp, who is also COO of Grace Hospital and oversees regional programs such as diagnostic imaging, child health, clinical engineering, respiratory therapy and transport for the Winnipeg Regional Health Authority.

"The people who work here know what it is they need to do, so my goal is to make sure everyone can do their jobs to the best of their ability. That means creating an environment where they can take care of a patient without worrying too much about bureaucracy and red tape."

Topp came to HSC in the fall of 2008. Ever since, he has been working towards that goal as well as ensuring all staff feel appreciated, valued and empowered in their role in patient care.

"We have over 11,000 doors on our premises, so the locksmith we employ is just as important as the physician in ensuring that we function as a health-care provider. Regardless of their role, everyone here adds value to the patient experience and has a part in making HSC work."

Q: You've been working on a new vision for the hospital. How is that going?

A: We recently went through an intense, year-long exercise involving people from across the organization to create a new vision for HSC. What we came up with is Patients First, which is in line with the Health Regions Vision. It means that when a patient comes in here, we don't treat them just as a diagnosis. We don't treat them as the next scan that has to get done or the next procedure we have to do. We treat the patient knowing there is someone behind the diagnosis and we need to learn how to treat them appropriately. That goes beyond our health-care providers to include everybody who works here. We each have a responsibility to recognize that when a patient arrives, it's a stressful time in their life; they may need directions, need to know where to park, to get a coffee, to access health information, or even just to have a functional chair in the waiting room. Everybody on staff at HSC has a role to play in making that patient experience a valuable one. So far, staff feedback has been very positive. People are saying that Patient First is a wonderful thing to strive for and that they are very proud to be part of it.

Q: How do you ensure that the vision translates into how people are relating to one another?

A: We wanted to make the Patients First vision real and relevant to what we do here every day. So we identified five values that define our vision that we try to adopt in everything we do: caring, discovery, excellence, hope and honour. First of all, when a patient comes to us, they need to feel well cared for. They need to know we are talking to them as a person, not as a diagnosis. Secondly, medical research is a massive mandate for HSC, but to us, discovery is not only about science, but the discovery of how to improve outcomes, how to be efficient and how to treat our patients even better. We want to make sure we strive for excellence in all that we do, which is why we look at what we're doing, how we're doing it and if we can do it better. Hope is a long standing value at HSC. Although we can't fix every illness or injury, we can help you understand what your treatment options and potential outcomes may be and just work with people to come to terms with what they might be facing and to have the best experience possible. Honour may be our most important value. Personally, I try to be completely transparent in my discussions with patients and patients' families as well as staff. If we make a mistake, we need to admit we made a mistake. We need to treat people in an honourable way -- with dignity, with respect and with honesty. We always need to treat patients and each other the way we would want to be treated if the situation was reversed.

Q: Have there been any stumbling blocks to communicating this vision?

A: Patients First is intended to say that whatever we do here, we do with the patients' best interests in mind. That can make treatment more difficult because it puts you in a grey zone -- what's right for one patient is not necessarily right for another. Part of our challenge is tailoring the patient's experience to the treatment they need while we continue to manage a very busy environment. We know that the patient volumes we experience don't always allow us to put the patient first every time. For example, emergency visits at HSC went from 90,000 in 2008 to 106,000 in 2010. So the service volumes are placing incredible pressure on our system. While we should take 30 minutes to talk to you about the issue you're dealing with, we may only have 15 minutes before we need to get to the next patient.

Q: What are some of the other people challenges you face in managing this unique workplace?

A: We operate within a highly-scrutinized environment. This means that we have to be accountable for every dollar we spend, especially dollars spent on things that, at first blush, may not seem to have an impact on patient care, such as staff development and appreciation.

The fact is though that both of those do result in better patient care and the amount we spend on them is small. We are working hard to create a better and more respectful work environment, whether it is through making more welcoming team rooms and green spaces, or ensuring management is more accessible so that staff feel comfortable bringing forward concerns without fear of retribution. I believe that if you can give people the right environment, they will work better and stay longer.

Q: What qualities do you look for in the leaders and future leaders you hire at HSC?

A: The first thing I look for is someone who can solve problems with understanding and with emotional intelligence. When they're dealing with a challenge, the first thing they must ask themselves is what the impact will be on the patient. I want people who can handle a stressful environment with enough compassion and tenacity to recognize how their decisions may affect patients. I also want someone who is willing to challenge me. I try to surround myself with people who are much smarter than I am so the last thing I want is someone who says yes to everything I come up with. Likewise, they can't take criticism personally. Our senior management meetings are filled with healthy and respectful debate, and I think that's the best environment to be in. If you think something isn't working, speak up. If you think something can be done better, let's talk about it.

Q: Is there a particular mentor in your past who taught you important lessons in leadership?

A: I would have to mention Tom Closson, the former CEO of the University Health Network in Toronto and the current president of the Ontario Hospital Association. We worked together when I was VP at Sunnybrook Hospital. Tom led by example and the most important thing I learned from him was the value of being honourable and straight-up honest with people. It's a two-way street. As a leader, I never want to be caught off-guard or find out about something long after the fact, and at the same time, I have an obligation to make sure people know what I'm thinking about when it comes to the future of the organization. Tom taught me the importance of that as well as the value of integrity. If you lose your integrity, you not only lose credibility, you lose your leadership potential. So I try to emulate what I learned from Tom in everything I do and live up to being an honourable and honest leader each day.

-- With reporting by Barbara Chabai

John McFerran, PhD, F.CHRP, is managing director of Boyden Global Executive Search. He can be contacted at jmcferran@boyden.com.

Republished from the Winnipeg Free Press print edition March 26, 2011 H1