Children’s Hospital of Eastern Ontario: Michel Bilodeau, President and CEO

by HCE Exchange on January 17, 2011

The Children’s Hospital of Eastern Ontario is never referred to by its full name. Everyone in the region knows what CHEO is; an institution in its own right, one of the few stand-alone pediatric hospitals in Canada. The 36 year-old hospital has 167 beds and the largest pediatric emergency room in the province with about 57,000 emergency room visits per year. CHEO is a full teaching hospital associated with the University of Ottawa. It serves Eastern Ontario, Western Quebec, Eastern Nunavut and parts of Northern Ontario.

Today’s Patient

“Like everybody else, we face the changing landscape of our own patients,” says Michel Bilodeau, President and Chief Executive Officer of CHEO. “They get all kinds of advice before they arrive here. We have a tradition  of taking care of everything, but for the youth—certainly the adolescents—they want to take care of themselves and they arrive here with lots of preparation.”

Forums such as Twitter and Facebook are being used for communication and providing patients with access to those forums is important, as well. “We provide them, when they are here, with access to internet to keep the contact with their friends,” Bilodeau says. Catering to their need for knowledge, the children’s portion of the CHEO website includes a virtual tour of the surgical suites, as well as stories and games to teach kids about the human body and hospital terms and procedures.

Human Resources Considerations

The management of human resources has also undergone significant changes. “When I started in hospitals thirty-three years ago,” says Bilodeau, “the average age of a nurse was 24. Now, it’s almost 50. We have an aging workforce. We have shortages in physicians, in respiratory therapists, and in several other professions. One of our main challenges is in the recruitment and retention of specialists.”

The size of CHEO’s catchments’ area makes competition with other regions for specialists difficult. Population is denser elsewhere, which means salaries are higher and volume of activity is greater. “There is more potential for research in other regions, so we have positions that we’ve been unable to fill for several years,” says Bilodeau. “That’s obviously creating difficulties.”

An Old Strategic Plan with New Emphasis

In the four years that Bilodeau has been with the organization, he has focused on moving from a family type management philosophy to more of a business model approach. “CHEO wanted to be everything to everybody,” he says. “Now we’ve established priorities and we’re trying to involve all levels of leaders, both physicians and non-physicians, in the identification of those priorities.”

They are focusing research activities, for instance, on areas where they can lead, or at least be among the best. Genetics is one example. The hospital already has the provincial newborn screening program and is the site for the Ontario perinatal surveillance system (now Born Ontario). That’s an area where they are already more advanced, so putting extra emphasis on this area is a sure way to become a leader in the field.

Another shift is in rethinking CHEO’s regional role. Traditionally, all services have been provided within the hospital’s own four walls. “We started, two years ago, to discuss and negotiate with our colleagues in other hospitals throughout the region to try to support the development of children and youth services in the various sub-regions of eastern Ontario,” says Bilodeau. “A first successful project has been  in emergency where we have trained the staff and physicians in all the hospitals in our region in several protocols and clinical pathways.”

Rather than having children transported long distances because the individual hospitals don’t have the expertise, CHEO has worked with training the staff of each emergency room so that patients can be treated on location. “They have a direct link. They can contact our physicians by phone if they have problem. We have also established computerized linkages to allow them, for example, to have calculations of the exact dosage of medication that they need.”

Children and Youth are the Future

“Although they don’t consume as many health care dollars as the elderly, the fact that we focus everything on the aging population is problematic,” says Bilodeau. “Right now it seems that Ontario is moving toward rationing healthcare because we don’t get enough funding. Services to children are threatened because the volume is small in comparison to adults. When you look at things from a global perspective, 100,000 adults have a specific problem and only 500 children, so some services may be at risk.”

“Problems that are not resolved during childhood will become serious health problems in adulthood. My main concern is about our capacity to continue to develop services for children and youth. I don’t know how it’s going to evolve over the next couple years, but it’s going to be a concern.”

-by T.M. Simmons

The Children’s Hospital of Eastern Ontario is never referred to by its full name. Everyone in the region knows what CHEO is; an institution in its own right, one of the few stand-alone pediatric hospitals in Canada. The 36 year-old hospital has 167 beds and the largest pediatric emergency room in the province with about 57,000 emergency room visits per year. CHEO is a full teaching hospital associated with the University of Ottawa. It serves Eastern Ontario, Western Quebec, Eastern Nunavut and parts of Northern Ontario.

Today’s Patient

“Like everybody else, we face the changing landscape of our own patients,” says Michel Bilodeau, President and Chief Executive Officer of CHEO. “They get all kinds of advice before they arrive here. We have a tradition of taking care of everything, but for the youth—certainly the adolescents—they want to take care of themselves and they arrive here with lots of preparation.”

Forums such as Twitter and Facebook are being used for communication and providing patients with access to those forums is important, as well. “We provide them, when they are here, with access to internet to keep the contact with their friends,” Bilodeau says. Catering to their need for knowledge, the children’s portion of the CHEO website includes a virtual tour of the surgical suites, as well as stories and games to teach kids about the human body and hospital terms and procedures.

Human Resources Considerations

The management of human resources has also undergone significant changes. “When I started in hospitals thirty-three years ago,” says Bilodeau, “the average age of a nurse was 24. Now, it’s almost 50. We have an aging workforce. We have shortages in physicians, in respiratory therapists, and in several other professions. One of our main challenges is in the recruitment and retention of specialists.”

The size of CHEO’s catchments’ area makes competition with other regions for specialists difficult. Population is denser elsewhere, which means salaries are higher and volume of activity is greater. “There is more potential for research in other regions, so we have positions that we’ve been unable to fill for several years,” says Bilodeau. “That’s obviously creating difficulties.”

An Old Strategic Plan with New Emphasis

In the four years that Bilodeau has been with the organization, he has focused on moving from a family type management philosophy to more of a business model approach. “CHEO wanted to be everything to everybody,” he says. “Now we’ve established priorities and we’re trying to involve all levels of leaders, both physicians and non-physicians, in the identification of those priorities.”

They are focusing research activities, for instance, on areas where they can lead, or at least be among the best. Genetics is one example. The hospital already has the provincial newborn screening program and is the site for the Ontario perinatal surveillance system (now Born Ontario). That’s an area where they are already more advanced, so putting extra emphasis on this area is a sure way to become a leader in the field.

Another shift is in rethinking CHEO’s regional role. Traditionally, all services have been provided within the hospital’s own four walls. “We started, two years ago, to discuss and negotiate with our colleagues in other hospitals throughout the region to try to support the development of children and youth services in the various sub-regions of eastern Ontario,” says Bilodeau. “A first successful project has been in emergency where we have trained the staff and physicians in all the hospitals in our region in several protocols and clinical pathways.”

Rather than having children transported long distances because the individual hospitals don’t have the expertise, CHEO has worked with training the staff of each emergency room so that patients can be treated on location. “They have a direct link. They can contact our physicians by phone if they have problem. We have also established computerized linkages to allow them, for example, to have calculations of the exact dosage of medication that they need.”

Children and Youth are the Future

“Although they don’t consume as many health care dollars as the elderly, the fact that we focus everything on the aging population is problematic,” says Bilodeau. “Right now it seems that Ontario is moving toward rationing healthcare because we don’t get enough funding. Services to children are threatened because the volume is small in comparison to adults. When you look at things from a global perspective, 100,000 adults have a specific problem and only 500 children, so some services may be at risk.”

“Problems that are not resolved during childhood will become serious health problems in adulthood. My main concern is about our capacity to continue to develop services for children and youth. I don’t know how it’s going to evolve over the next couple years, but it’s going to be a concern.”

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