Meet Lori Marshall, an accomplished Healthcare Executive with a remarkable ability to drive success through collaboration. Recognized for her innovative and compelling strategic approach, Lori thrives on untangling intricate systemic challenges and fostering a unified vision. She is not only an esteemed mentor and guide but also highly appreciates the wisdom derived from shared experiences. Lori’s leadership is defined by unwavering integrity and setting a compelling example for others to follow.
In her role as a senior healthcare leader both within the industry and at Chatham-Kent Health Alliance (CKHA), Lori bears the responsibility of ensuring our commitment to the community, patients, and their families is upheld. This commitment is realized by cultivating an environment where both staff and physicians are motivated to excel, by effectively managing the entrusted resources, and by involving a wide spectrum of perspectives in shaping our strategies.
Let’s dive into the details of the visionary leader:
The Centre
Chatham-Kent Health Alliance (CKHA) is a 200-bed community hospital, serving the residents of Chatham and rural Kent including Walpole Island and Delaware First Nations. Formed in 2018, CKHA is committed to delivering quality and safe care at its two sites in Chatham and Wallaceburg.
CKHA collaborates with other partners to deliver care across its community. CKHA’s dedicated team is comprised of approximately 1,400 staff, 200 physicians and 200 volunteers. CKHA provides a full range of programs, services and specialties from internal medicine and surgery to women & children’s and critical care; it is designated a schedule one facility under the Ministry of Health and cares for tens of thousands of inpatients, outpatients and emergency patients annually. CKHA is equipped with state-of-the-art diagnostics and technology to support its varied programs.
CKHA’s vision: Together, growing a healthier community, underscores a movement to improving the population’s health. Grounded by its values “CKHA CARES” (Collaboration, Accountability, Respect, Excellence, Safety), CKHA commits to continuously improve the patient experience in partnership with patients, families and caregivers.
Advancing Equity, Diversity, Inclusion, and Anti-Racism
CKHA has made much progress recently in its Equity, Diversity, Inclusion and Anti-Racism (EDIAR) initiatives. In 2022, the center welcomed an EDIAR Executive Lead for the organization and introduced an EDIAR Committee. An inclusive health equity framework, work plan, and tools were developed – these form the foundation of CKHA’s EDIAR strategy. The center is in the process of implementing this equity framework to deliver culturally safe and friendly care to the diverse populations we serve.
Through the following initiatives, CKHA is seeking to reduce health inequities:
- Collection of equity data, specifically enhancing current sociodemographic data collection.
- Exploring an enhancement of the patient complaint process to include fields that allow for the self-identification of racial identity.
- Promoting health equity internally and externally through the development of the role of Executive Lead for Equity, Diversity, Inclusion and Anti-racism. The Lead has been focused on identifying and when able, delivering education to CKHA on health equity.
- Additionally, the Lead is establishing collaborative partnerships with local Indigenous and racialized leaders.
Adapting to Transformation
The landscape of healthcare and hospitals has undergone a significant transformation in recent years, diverging considerably from its state just a short while ago. Comparable to its counterparts across the Ontario province, CKHA has encountered its fair share of challenges concerning health human resources as it navigated through the pandemic. To tackle this issue, a series of recruitment strategies were devised. These strategies encompassed participation in local and provincial job fairs, the establishment of novel care provider extender positions like the Extern Program (financed by the Ministry of Health), and engagement in Ministry-backed tuition reimbursement plans for new recruits. The strategies for staff retention center around addressing the specific concerns pinpointed by employees, encompassing initiatives such as interdepartmental liaison programs, educational access, and acknowledgment programs. The organization’s upcoming focal point involves streamlining hospital tasks, with a focus on initiatives like virtual care. It’s acknowledged that resolving these matters is a gradual process, but the aspiration is to mold CKHA into an attractive hub for practice, employment, and volunteering. Recent times have also witnessed the emergence of staff and physician burnout as a pressing challenge in the healthcare system. In response, a medley of strategies has been put into motion. Some of these strategies were operational during the height of the pandemic, while others have now become standard practice. These include heightened resources dedicated to Infection Control and Prevention, augmented availability of the Employee Assistance Program (EAP) and mental health provisions, as well as the formulation of both staff recognition and wellness schemes.
A noteworthy predicament revolves around ensuring that patients are placed in the appropriate bed and care setting within a suitable timeframe. This concern has been tackled through the Time to Inpatient Bed Project, which zeroes in on the duration required to transition an admitted patient from the Emergency Department to a designated bed. A collaborative effort has been instigated to detect gaps in the patient flow process and enhance the caliber of care dispensed. Recent statistics reflect an achievement of the target time in over 90% of cases, showcasing tangible advancements in this domain.
Turning the Tide
When Lori assumed her position at CKHA, the organization was operating under the oversight of Provincial Supervision. In 2016, the former Erie St. Clair Local Health Integration Network recommended to the Ministry of Health and Long-Term Care the appointment of an investigator to ensure the public’s confidence in the governance model for hospital services in Chatham-Kent.
Subsequently, a Provincial Supervisor was designated to address the recommendations stemming from this investigation. Lori commenced her role in early 2017 and collaborated closely with the Provincial Supervisor to execute these recommendations until his departure in March 2018. Following this, a new Board was appointed to the organization. The presence of substantial financial challenges during that period necessitated a significant restructuring of the hospital’s operational framework. This undertaking held paramount importance, but it also presented formidable difficulties for all stakeholders at CKHA during that phase.
In the lead-up to the period of Provincial Supervision, both the morale of the staff and the trust of the public in the hospital had undoubtedly been affected. Throughout Lori’s inaugural year as President and CEO at CKHA, concerted efforts were directed towards revitalizing morale and trust through a diverse range of strategies. Transparency emerged as a pivotal element during this period, a principle that continues to be deeply ingrained as a core value. Presently, the organization relishes an improved financial standing overall, displays a steadfast dedication to construction projects, and has achieved the highest level of accreditation bestowed by Accreditation Canada. The organization is steadfastly aligned with its mission, vision, and values, evident in its day-to-day operations.
Exemplary Accreditation and Advancements in Patient Safety Initiatives
CKHA’s commendable efforts have yielded remarkable recognition, as it achieved the esteemed “Accreditation with Exemplary Standing” designation from Accreditation Canada for the entirety of 2022-2026. Further underscoring its commitment to excellence, the institution successfully met accreditation standards for its specialized domains of stroke care and medical laboratory through distinct evaluations conducted within the same year. These accomplishments stand as a resounding testament to the unyielding dedication of CKHA’s collective team, including staff, physicians, volunteers, and patient advisors, all of whom have fervently championed the cause of patient safety and the maintenance of high-quality care standards.
In the area of patient safety, a series of strategic initiatives have significantly contributed to the realization of these remarkable goals:
- Promotion of a Just Culture: The cultivation of a culture that perceives incidents as valuable learning opportunities, spurring improvements in both systems and processes when they occur.
- Electronic Incident Reporting System (RL6): A streamlined mechanism that empowers staff to directly report incidents in a timely manner, ensuring prompt follow-up. Moreover, this system facilitates summary reporting to the Board, enabling comprehensive trend analysis and the identification of key avenues for enhancement.
- Sharing Safety Reports: The dissemination of safety reports, offering insights into learning opportunities for various departments, transpires during cross-functional Quality and Safety Program Councils. Furthermore, CKHA’s dedicated Professional Practice team actively disseminates these improvements throughout the entire organization.
- Quality of Care Reviews: These comprehensive reviews involve all individuals directly engaged in patient care situations. Their purpose is to meticulously examine critical incidents and other serious patient safety occurrences, with the aim of comprehending the root causes, the reasons behind them, and the potential system or process modifications that can prevent the recurrence of similar incidents.
- Frequent Huddles: Regular huddles convened across units and departments prioritize patient and staff safety as central discussion points. Notably, as the CEO, Lori takes an active role in attending these sessions on a rotational basis, facilitating direct insight into any concerns that might impact quality and patient safety.
- CKHA’s Quality Utilization Review Committee: This committee, involving physician and administrative leaders from diverse sectors of the organization, rigorously evaluates overall performance. In addition to sharing best practices, this platform serves as a resource for seeking guidance, assistance, and advice to further progress in specific areas.
Revolutionizing Healthcare
CKHA’s digital transformation journey is evident through its role in the late 2020 launch of a regional Health Information System (HIS). Despite the pandemic, CKHA demonstrated commitment and precision in this major clinical transformation. The new HIS replaced an outdated system, ensuring secure electronic documentation, accurate drug administration, fewer duplicate tests, quicker access to patient records, and an improved patient experience. CKHA stands out as one of 16 Canadian hospitals achieving EMRAM 6 or higher digital maturity levels, highlighting its dedication to innovative healthcare technology.
Resilience and Collaboration
CKHA’s strong partnerships within the Chatham-Kent Ontario Health Team (CKOHT) were notably evident during the onset of the COVID-19 pandemic. Collaborating closely with partners and the community, we established a field hospital (which fortunately remained unused), orchestrated community-wide COVID-19 testing, and introduced a community COVID-19 Vaccination Clinic in collaboration with CK Public Health and Chatham-Kent Emergency Management Services (EMS). Moreover, CKHA’s team extended staffing assistance to local Long Term Care Homes during significant outbreaks.
In response to the substantial postponement of non-urgent surgical procedures during the pandemic’s initial waves, CKHA’s formulated and executed strategies to mitigate care delays. Its Surgical Renewal project yielded remarkable outcomes, addressing the procedural backlog stemming from the pandemic. Notably, CKHA surpassed pre-pandemic surgical volumes, performing 8,900 cases in 2022/23, marking the highest figure in the past five years.
Collaborative Excellence
CKHA is proud to be a signatory member of the Chatham- Kent Ontario Health Team (CKOHT). Through this partnership, the center has been given the opportunity to collaborate and engage with CKHA’s community partners. The CKOHT’s shared goal is to achieve the best health and well-being together. Recent collaborations with its CKOHT partners include shared priorities such as reducing ambulatory sensitive conditions/avoidable Emergency Department visits. One recent collaboration the CKHA team is very proud of is its Withdrawal Management Service. Mental health and addictions needs have risen, particularly over the course of the pandemic. CKHA’s Withdrawal Management Service provides a supportive environment to enable safe withdrawal from substances and initiation of follow-up addictions treatment. Lori states, “Along with our partners, we worked quickly to establish this 10-bed service at our Chatham Site to respond to this pressing need. Successful completion of the project required partnership and support from many stakeholders including the Ministry of Health; the municipality of Chatham-Kent; Chatham-Kent Health Alliance Foundation; the United Way of Chatham-Kent; and the Canadian Mental Health Association Lambton- Kent.”
View on Future of Healthcare Delivery
Lori highlights the significance of CKHA’s Virtual Based Care project as a standout initiative this year. This project signifies CKHA’s transition towards offering care through virtual channels within the inpatient framework, with potential future expansion beyond the hospital setting. She adds, “We’re also very engaged in a building project for our Wallaceburg Site and so engaging with our community to further that design will be a focus for the coming year.”
Wisdom for Emerging Leaders
Lori’s counsel to budding leaders’ centers on nurturing curiosity. Frequently, upon assuming leadership positions, there’s a tendency to believe that one must possess all-encompassing knowledge or possess the ability to make challenging decisions. However, by actively engaging with others, lending an ear to their insights, and drawing inspiration from their innovative thinking, you unlock a realm of possibilities that may have otherwise eluded you. This advice encourages an open-minded approach that can unveil uncharted horizons, extending beyond what you might have initially envisioned.
