The de Gaspé Beaubien Foundation

EDUCATION

Investing in the Management of the Public Health System

Image © Lumisculpt Productions.

Image © Lumisculpt Productions.

A summer afternoon at the Centre de Santé et de Services Sociaux (CSSS) des Sommets in Sainte-Agathe-des-Monts in the Laurentians. The meeting room is at capacity. All personnel not on emergency duty are present. Director General Yves Lachapelle checks his watch one more time. Two physicians are still missing. He is anxious to share the news he brings, but he understands why they are late. The three residences for seniors, three CLSCs and one hospital he manages are spread over 80 km on either site of the resort town of Mont-Tremblant. Summer roads are packed with city dwellers seeking a respite from the heat.

Facing him are people he has come to know well and to work with towards a common goal. His staff of course, but also Professor Alain Rondeau and Luc Bélanger-Martin from HEC Montreal, the landmark school of management for the Quebec business community. To their right, Dominique Monchamp, Executive director, and Phillipe and Nan-b de Gaspé Beaubien, co-chairs of the de Gaspé Beaubien Foundation. Not long before, these were strangers to Lachapelle, as uncertain as he about the success of their common project. But now, everyone is satisfied with a job well done.

The road has been long and bumpy. Lachapelle recalls viv.idly his first meeting with Nan-b and Philippe de Gaspé Beaubien six years earlier. This philanthropic couple could see that the public health system was struggling to meet the ever increasing demand from citizens in their communities. They had made a decision to help the CSSS in their own neighbourhood. People close to them said: “Have the de Gaspé Beaubiens lost their minds?”

Lachapelle recalls how weighed down he felt at the time by the health reforms in Quebec which had put him in a difficult management situation. His personnel were also suffering, and experiencing an abnormal turnover rate. W hat the Foundation was offering was something new and unheard of: private participation in the improvement of existing management methods. Unexpectedly intrigued, Lachapelle had decided to jump in.

The Foundation, convinced it was on the right track, though on new ground, immediately looked for expert advice. Alain Rondeau remembers: “With the de Gaspé Beaubiens we met with all staff in small groups. From the professionals to the support people. Their first reactions were negative. Many were asking themselves why have these philanthropists come here, if not to try to manage the institution their way?”

But the Foundation’s goal was exactly the opposite: it wanted CSSS staff to become more involved in finding solutions to the institution’s problems. This was highly risky. It would have been much easier for Nan-b and Philippe to buy sophisticated medical equipment or to contribute to a building. But they knew that this sort of investment could lead to limited or no progress at all.

“We were interested in the human beings at the heart of the organization, says Philippe de Gaspé Beaubien, not the fact of having contributed financially to the acquisition of some machine.”

The HEC team drew up a plan that would answer the needs both of management and of physicians, all of whom wished for improved collaboration in order to achieve their objectives. One major hurdle remained. The Foundation was bringing to the table the operational tools of the private sector: project-based management, deadlines, and specific actions to undertake in order to achieve stated objectives. The CSSS on the other hand followed a continuous process management model, answering daily to an ever evolving demand for services.

At the first meetings in 2007, participants could sense the tension in the air. Instead of looking for solutions, staff raised issues, many related to their respective roles in the health system. There was distrust of the CSSS leadership and this family foundation that seemed to want to help, but might have some hidden motive. There was however a beacon on the horizon for everyone: the shared goal of ensuring access to, continuity, and quality of health services to patients. The de Gaspé Beaubiens proposed that all work together toward a shared goal of excellence: to execute well on every task and to make the CSSS des Sommets an employer of choice.

Over time, everyone got to know each other and how to work together. Trust came with mutual respect and commitment to a close-knit relationship between partners for the long term. Significant sums of money were invested. From the start, the Foundation had made its support conditional on the CSSS chipping in an equal amount (by the end of the project, the Foundation and the CSSS will each have contributed $600,000). In addition, the leadership and staff of the CSSS, the Foundation and the HEC team all contributed much personal time and engagement.

Returning his thoughts to the meeting room, Lachapelle smiles broadly. The last two physicians have arrived. As he opens the meeting, he can relax. Today marks the beginning of the final phase of the project: the launch of a new co-management model between medical and administrative staff. But first, the DG wants to share with everyone the key results of the project so far: in three years the institutional deficit has been brought down to zero; workplace absenteeism is going down steadily; and there has been a sharp drop in the number of visits made by a group of repeat clients of the CSSS who were absorbing a substantial fraction of available resources. None of these results would have been possible without the intervention of the de Gaspé Beaubien Foundation.

Through its involvement with CSSS des Sommets, the de Gaspé Beaubien Foundation has introduced a new role for effective philanthropic action, which it describes as the “social intervenor”. The social intervenor invests personal time and effort to bring about social change. This approach favours continuous interchange with a community or institutional partner in an atmosphere favouring mutual trust and respect. The social intervenor fosters capacity building through introduction of governance tools such as project-based management, account.ability, expert consulting services, and significant investment to bring about more flexibility.

The de Gaspé Beaubien Foundation is eager to transfer what it has learned to other philanthropists and foundations to encourage them to become social intervenors in their own communities, particularly in the public health system where a proven model can be applied.