Julia Hanigsberg, President & CEO of Holland Bloorview Kids Rehabilitation Hospital, explains how advocating for patients with disabilities and other marginalized groups informs her leadership at the largest children’s rehab hospital in Canada. Recognized as one of the country’s most powerful CEOs by the Women's Executive Network (WXN), Julia also discusses tech innovations that can help expand healthcare access, as well as her personal involvement in Holland Bloorview’s flagship fundraiser, Capes for Kids.
Title: Why Elevating Children’s Wellness is a Social Justice Issue
Guests: Julia Hanigsberg, President and CEO of Holland Bloorview Kids Rehabilitation Hospital
Host: Christine Parent, Associate Vice President, MEDITECH
Julia: Often the best changemakers are people who know how to do it with the team. It's not necessarily the lone person. It's someone who can bring people around them.
Christine: Welcome to another episode of MEDITECH Podcast. We're the leader in healthcare technology, empowering you to be a more informed healthcare consumer and provider. Hear the latest from our friends and colleagues in the U.S., Canada and abroad on topics we think you should know about.
Today, I'm joined by Julia Hanigsberg, President and CEO of Holland Bloorview Kids Rehabilitation Hospital located in Toronto. Holland Bloorview is the largest children's rehabilitation hospital in Canada, serving children living with a disability, medical complexity, illness, or injury. Julia is a champion for business effectiveness, cultural transformation, diversity, equity, innovation, and excellence. Recently, Julia was inducted in the Women's Executive Network, Canada's Most Powerful Women Top 100 Hall of Fame.
Today, we'll hear about some of the current initiatives at Holland Bloorview and discuss some of the challenges in the Canadian healthcare market. Welcome Julia, happy to have you join me today.
Julia: Thank you so much. It's a pleasure to be able to join you.
Christine: Well Julia, you've been recognized as one of Canada's most influential women leaders and the President/CEO of Canada's largest children's hospital. What are some current projects you'd like to share that are helping the lives of children in Canada?
Julia: Well, you know, it's hard not to focus a little bit on the past two years that we've been in. We're into year three of the pandemic, amazingly a lot of what we've been doing recently has been focused on children's health and well-being at this time. You know that the first year of the pandemic no one really paid attention to children.
I've got a colleague, Alex Bunter, the CEO of the Children's Hospital of Eastern Ontario, and he likes to say children may have been the least infected, but they may have been the most affected by the pandemic. A lot of what we've been doing recently has been to elevate attention on the impact of children's wellness, of what they've had to put up with over the past two years: things like masking, school closures, public health safety and making sure that in our governments and public policy makers, they're really focusing on the well-being of kids. So that's been a big part of what we've done with other leaders across children's healthcare in the country.
And then of course, we’re very focused on the work that we can do here at Holland Bloorview in improving the lives of children. Particularly, children with disabilities. Even at this time, when staff are facing so many challenges, they are always innovators and always creating new programs. I've got three new program proposals on my desk right now from our innovative staff. So there's lots to do to continue to advance children's health. Both here in our hospital and in collaboration with other health care leaders across Ontario and across the country.
Christine: So you certainly are transforming the lives of children in Canada and I love this next story that you're about to tell. Can you tell us about Holland Bloorview's Capes for Kids program and your personal involvement in wearing a cape yourself?
Julia: Capes for Kids is really fun. It's our flagship fundraiser and we just completed year six. The idea is that, instead of people sponsoring me to run a 5k or to do something like that, they sponsor me to wear a cape everywhere I go, and every meeting I'm in, for a full week in March. It is pretty hilarious because I've been in meetings where someone will say to me, “Julia are you wearing a cape?” And the answer is, well, yes I am and let me tell you why. So it's a great conversation starter. Of course, we're a hospital that cares for a lot of children with disabilities, so it's fully accessible. Anybody can participate in the fundraiser, and we're really excited this year to meet our annual goal of over 1 million dollars.
Christine: Congratulations, it's a great cause and I think I might don a quick cape for my next meeting.
Julia: So I’ve got to tell you, you feel great, you feel great with a cape, you know. It's one of those things everyone looks good in. Everyone likes to be a hero.
Christine: I agree and none more so than healthcare workers these days. I've also been noticing some other very impactful campaigns on your social media. Can you highlight a few of these for our listeners?
Julia: Yes, absolutely. So at Holland Bloorview, we're a hospital but our mission includes social justice for children and youth with disabilities and advancing the healthy and meaningful futures of all children, youth, and families. And one of the ways we do that is through our “Dear Everybody” campaign. The focus of that campaign this year is ableism. So, it's really an educational campaign. We want to make sure people understand the concept of ableism, as well as understand concepts like sexism and racism. We want them to understand that discrimination against people because of their disability is as serious as any other form of discrimination.
We also are promoting representation and inclusion of children, youth with disabilities. So it's everything in the media: what you know, who do you see in commercials, movies and TV, everywhere around us. And so, we're really excited about this. It's become a platform to engage corporate partners as well, to get them to sign on to what we've called the “Dear Everybody” agreement. That's an agreement where they promise that they will include people with disabilities to the proportion which they represent the population in all of their advertising. It's a really direct way that brands can support a new social justice mandate and help to create greater representations of people with a disability.
Christine: So what are the other key differences between your children's hospital and others in Canada?
Julia: We're a specialized children's rehabilitation hospital and we're the only one of our kind in Ontario and our province, as well as the largest one in Canada. So that means we're a post-acute hospital. We see children with a wide range of disabilities and medical needs for rehabilitation, and of medical complexity. So kids who are born with disabilities, kids who experience trauma, kids who experience changes in their function due to treatment or interventions, all spend time at Holland Bloorview.
It's a unique place because we have a specifically holistic view of the child. So of course, we have medical clinics and medical programs and inpatient beds and what you would expect in a hospital. But we also have pathways to employment programs. We're working to create opportunities for young people with disabilities to get those early employment and volunteer opportunities that will enable them to be more successful in the future. Also, because we serve a special population, we have a mandate for innovation. So as emerging issues arise, we're often the first hospital in Canada that will try to address that issue.
I'll give you an example from a few years ago. Young people, typically teenagers, adolescents with chronic pain were having to be sent to the U.S. for treatment because there was no program close by to care for them. So we, along with a couple of partner hospitals, went to our funder and said we'd like to create a program here so families that kids could stay close to home and get the treatment they needed. And our team went to the Cleveland Clinic and learned from that program and took the best from that program. We brought that back here to Toronto and now we've got a system leading program, which we call Get Up and Go. It is a two-week inpatient stay, two-week ambulatory stay, multi-disciplinary program that includes not only of course medication and management and therapy, but also mindfulness and exercise and all sorts of unique and multi-disciplinary and holistic ways to approach pain for kids. So there are lots of examples like that of novel programs that we help create in order to make sure that the kids who live in our geography are able to access absolutely the best care and what they need close to home.
Christine: Well it's obvious that Holland Bloorview definitely has a culture for innovation, and that obviously is through leadership. Congratulations on pushing these initiatives forward. What are some of the biggest challenges that are happening right now in the Canadian healthcare market, could you expand on that?
Julia: Well, I'd say probably the number one challenge is how do we “right size” our healthcare system for the needs we have. I think in all markets, we have seen that the pandemic has really shown a light on where the gaps are in care, and we've certainly seen that here in Canada. So we’re making sure that we have adequate services.
I know in Ontario, for example, we have 5,000 children waiting for surgery. Many of whom are now outside of the appropriate clinical window for that surgery, and that means in a child's life that they may not for a lifetime have the same function they would have had, had they gotten that surgery at the appropriate time. Let's say a child with scoliosis. We have patients here at Holland Bloorview with cerebral palsy who are in pain, need surgery, need those interventions and they can't get them for many, many months because of backlogs and waitlists. So that's something that's just not right.
It might surprise you to hear that on the Unicef scorecard, Canada ranks 30th of 38 countries. We think of ourselves as Canadians. We're very proud. We think of ourselves, as you know, as people who live in a great country, great lifestyle but that tells you there's a lot more we need to do. Too many children who live in poverty, too many children who don't have adequate access to care. We're a country that is densely populated across our southern border, the border we share with the United States. That means there's lots of parts of our country that are remote, northern, rural, where that care is hard to access. Of course like everywhere else, we are a system that faces health inequities based on race, for Black people, Indigenous people, people of color, trans people. We’re talking on Trans Visibility Day, so it's an important population to note. There is a huge amount of work to make our health care more accessible to everybody and of course that includes people with disabilities.
One of the things we've done specifically at Holland Bloorview is as part of a research institute, we have installed a new research MRI that is fully immersive, fully child friendly and fully accessible. We think it's the only one in Canada that is fully accessible to children with disabilities. Those are some of the challenges that our system is facing right now and those are things that we at Holland Bloorview are really passionate about.
Christine: What do you see as the key to building a great team at your hospital? And what is motivating your team right now?
Julia: Our team is so motivated by the children and families that we serve. I hear all the time that people love Holland Bloorview. I really think they love the kids and the families and that's what keeps them coming back every single day.
It's been a tough time. Before the pandemic, things had already gotten really hard. Now our team is facing burnout and exhaustion. I think a part of what makes our team so great is how much the team holds everybody holds each other up. People really care about their teammates. People really want to do well by each other. That's really important.
We're also really focused on our psychological safety. How can we make sure we're an environment where everyone feels safe to speak up against hierarchy, that's really important. We have joined Solutions for Patient Safety, which is a North American children's hospital patient and staff safety network. A big part of that work is around psychological safety.
Transparency is really important in our organization and I think we've actually gotten better and better at that. Making sure that all of our people understand how decisions get made, and what the factors are. We're transparent when we get it wrong, we admit our mistakes, and try to correct them as quickly as we can. And we do that through things like a weekly email that I send to all the thousand plus staff at Holland Bloorview. And virtual town halls every couple of weeks. We're always seeking the advice of the entire team because we know we'll do better by listening to our team and also through family leadership.
We've got an extraordinary number of family leaders. People who are volunteers, who are committed to making Holland Bloorview the best, safest place for their children. There's no major initiative we do that doesn't have family leader involvement.
I'll say also that of course our team is affected by the things within the walls of Holland Bloorview, but they're also really affected by the things going on in the outside world. And I don't know about you, Christine, but I’m feeling that the world is very heavy these days. Canada has the largest Ukrainian population outside of Ukraine and Russia. So I've got lots of people on my team who have close family and friends who are directly impacted by the Ukraine conflict. And of course, conflicts in other parts of the world, Ethiopia, Sri Lanka you know, there's a relentless list of what's happening in our international community. And that really impacts a place like ours as well. We really try to be sensitive to that, to all the impacts on people's lives and what we can do at Holland Bloorview to help to mitigate some of that. To give members of our team what they need, to do the work that they're so passionate about.
Christine: Well said. I do think that there is a heaviness now in the world, and you said rightly that it influences everyone. Are there any new IT initiatives your organization is working on that you want to mention? How is technology helping to support your inclusive care goals?
Julia: There's so much. Like I said, even a tired team at Holland Bloorview is an innovative team. So there's a lot going on for a technology perspective. Maybe I'll start with the end of your question first, which is how are we leveraging Expanse to assist us in some of our health equity work.
I'll give you a really, what seems like a very straightforward and simple example. We recently turned on the feature for pronouns in Expanse. And that means that individuals' pronouns are right there in the health record for the clinician to see, so that person doesn't have to explain their gender identity every time. That's great, you know, it's a great example of when you change something in the system, it's just changed for life. The patient doesn't have to keep coming back and telling you over and over again.
Of course, we have really leveraged virtual care to new degrees over the last couple of years, and technology is making a big difference there. We're also looking at how to capture race and ethnicity data in Expanse, in order to be able to make the association between patient safety and health equity.
So I mentioned Solutions for Patient Safety before, the North American safety network we're part of. One of its new priorities that we're really excited about concerns health disparities. You find out things that you wouldn't imagine, like that hospital-acquired conditions (CLABSI and central line-associated bloodstream infection) have a higher incidence among Black patients than among white patients. We need to know about these things. We need to have the ability to collect the data to make those associations, so we can make change. Then there are other technology initiatives we're really excited about. For example, working on the interoperability of our system, with the systems at other children's hospitals. Of course, children move between organizations and so if we can make that process as seamless as possible for them and their families, then that's really going to help.
And then I think about healthcare and the fax machine. How is it that we still rely on the fax machine? I think, thank goodness for us, or those companies would definitely be out of business. We're just launching e-referrals. It'll be a climb because, of course, every provider who refers will also have to get on the e-referral platform, but that's fully integrated into MEDITECH Expanse and that will save a lot of work for our teams as well. Time that they can use for much better purposes. I have to mention cyber security because it's on everybody's mind. It's equally on our mind and the team is doing lots of work in that regard as well.
Christine: So Julia, this has been such a pleasure speaking with you today and I can see how your passion, your empathy, your innovation, your spirit and just overall leadership really has moved your organization forward. Really health care in Canada.
We always end with our final question, something fun to learn a little bit more about Julia. You mentioned Capes for Kids and anyone listening, I might actually show up to a meeting in the near future with a cape, so I apologize. I want to hear from you: what's your definition of a hero and also do you have a favorite superhero?
Julia: Oh my goodness, favorite superhero. That's a great question. Well, I guess my definition of a hero is someone who makes transformative change. Often the best change makers are people who know how to do it with a team. It's not necessarily the lone person. It's someone who can bring people around them. That's what I think of as a hero.
I would have to say that my current favorite superheroes are Batman and Catwoman. That's because this year Robert Pattinson and Zoe Kravitz did a public service announcement for Capes for Kids to support us in this year's campaign. We were just really delighted to be able to partner with them and Edward Media. So yeah, definitely those two are the tops of my list.
Christine: Oh that's fantastic. We'll make sure to get a link to that with this podcast as well. I'd like to thank you, Julia, for joining us today.
Julia: It's been such a pleasure. Thank you so much for inviting me on and for your leadership at MEDITECH and creating this kind of voice for healthcare leaders.
Christine: Thanks for tuning in. Stay informed and subscribe to MEDITECH podcast. Be sure to check out our resource page for links from this episode. We'll talk to you next time.