I was given the opportunity to lead a large regional cancer program. This was quite a bit beyond my previous experience, a couple of stations above what I had done before. And the first job was to lead the transfer of this program from one organization to another. There were quite a few unhappy people. My mentor, who was my new boss at the time, came to visit me early on as I settled into the role to see how I was doing. He said to me as he left that meeting: “If you ever need my help, you know you can just pick up the phone. …I don’t expect a call.”
To some that might be seen as a heartless sink or swim directive. But for me, it was the opposite and it gave me an immediate lift; this person had trust and confidence in me that I could do this job and do it well. And that feeling is something I strive to instill in the people I lead.
The memory of that management moment came to mind recently when I saw the work of two mid-level employees at Cancer Care Ontario.
Each year we bring together the hospital CEOs and regional vice-presidents who are responsible for quality in our regional cancer programs to discuss progress against the Ontario Cancer Plan, our roadmap for quality improvement in the cancer system in Ontario. Cancer Care Ontario works with hospitals, doctors and other healthcare professionals to develop and implement the plan. As you can imagine, these meetings often involve lively debate around the pace of change and the challenges hospitals and providers face to improve quality in an environment of rising need for health services amid financial constraints.
One of the projects we discussed at the meeting was health system funding reform, which is changing the way hospitals are funded from global budgets where a lump sum is provided with few strings attached, to per-patient funding where the funding is tied to the quality of care provided. Cancer Care Ontario plays a central role in this health system funding reform, in the areas of cancer and chronic kidney disease. (Cancer Care Ontario oversees payment for and quality of services for chronic kidney disease as well as cancer). Changing the way hospitals are funded is complicated and difficult to implement. It’s a big job.
At this key stakeholder meeting, the task of presenting the ins and outs of the funding model to this senior group of executives was not assigned to me, or to a vice-president, or even to our director responsible for this work. Instead, it was entrusted to the two staff who had been responsible for much of the technical work behind the new funding models. These were the people who knew the details most intimately and who could answer questions in the most meaningful way.
My best management moment was spent sitting and watching. I sat there, silent and proud, while my two colleagues gave a truly excellent presentation, and then expertly handled questions from the hospital CEOs. A complicated subject had been distilled to a clear and concise picture for some of our most important partners. And they clearly understood the implications and expectations that would be placed on them. After the meeting, one of the hospital CEOs told me how unusual, but refreshing it was to see more junior staff being given the opportunity to present such challenging and strategically important material, and at such an important forum. He also said what an outstanding job they had done.
We have about 850 employees at Cancer Care Ontario. Our success depends on every one of them being able to strive to do outstanding things. The two staff who presented at this meeting are helping to transform and improve healthcare in Ontario. They are representative of our future leaders.
This idea of having trust in our employees’ ability to deliver excellent results, to enable them to stretch themselves and occasionally to allow them to make mistakes is at the heart of this story, and a key quality for leadership.
Michael Sherar is president and chief executive officer of Cancer Care Ontario (@CancerCare_ON), a provincial government agency that manages the quality of services and patient care for those with cancer or chronic kidney disease.
