Structured Chaos in a Messy System | John Yip

“hindsight is 20/20. You know, while we just talked about digital foresight, you know, hindsight is also part of foresight.”

“people think that the hospital is the healthcare system, and that's not true.”

“there's no more intimate place than your own home,”

“The staff are crying, and I want to just run away and hide. But you have to show leadership and the ability to provide calm, in, in the face of adversity.”

“One day left, a box of 10,000 masks showed up at our doors. It was life-saving.”

“But unfortunately, I think society has moved on. I haven't.”

“we'll do some of that and we'll do some little bit of Picasso, little bit of art.”

“But the, the sisters of St. Joseph's that founded our organization have this phrase of no margin, no mission.”

“You know, people call us the organi- the organization with a halo. sometimes I have a pitchfork with smoke coming out of my ears,”

“I had this mantra that you can find adventure or travel in your own backyard.”

“it's structured chaos. Like it's, yes, it's chaotic, but to drive change and reinvention, it does require chaos. But let's try to be structured about it.”

“Leadership is messy. It's not always clean. If it's always clean, then maybe you're not leading.”

“more recently, I am much more into data sovereignty as well as a country, given the geopolitical context of our time.”

“people call us the organi- the organization with a halo. sometimes I have a pitchfork with smoke coming out of my ears, but I think, most people know us as the, organization with a halo.”

“we also use the college to, bring refugees, into the country and give them meaningful work to be able to support the Canadian healthcare system.”

“the divisiveness That showed itself during the vaccines where the, the haves and the have-nots, people who had not gotten their first vaccine, were being pushed aside by those that wanted to travel and, try to get their second and third vaccines. So, at the expense of the vulnerable who still hadn't had their first vaccines.”

“I think the day or two days after, the streets of Toronto were empty, like just empty. And I have three or four set running routes from my house. But that day, for whatever reason, I was completely disoriented because there was no cars and I could just Jaywalk across the traffic lights, you know, busy corners, like very busy corners in normal times. But when there were no cars, I just felt disoriented. So I actually found myself three or four kilometers in the opposite direction from where I normally go, and I've never been there. And I went, wow, this is a really cool place.”

“But I think the biggest difference is some of the things that we worked on, Daniel, you may recall terminology that we used, like value as the custom, customer manager. So customers actually taking control of markets.”

“I'm also nervous as a father now with two teenage children and to see what they're going to go through and knowing that's going to be slightly different than what we went through for the last 25 years, that being the speed of change.”

“Well, my parents wanted me to do pre-med, but I did marine biology. Wow. Yeah, at Dalhousie, so, East Coast Canada and Halifax, Nova Scotia.”

“marine biology is based on systems. It's based on ecology, it's based on food supply and supply and demand, and that the natural world does have some order to it. If you take some of that thinking and apply it to other industries or sectors like healthcare, You can start to see the connections, you know, the web of stakeholders, the power dynamics, the demand and supply.”

“But having worked in healthcare for 30 plus years and working in some amazing organizations, there is something very unique.”

“But I think what I would say is, don't be so uptight, like, to my 2000 self. I was really uptight, really intense, and probably to my own detriment. So what I would say is, to my 2000 self, stay groovy,”

“And I think it's more taking a step back, watching things unfold, and then making small moves to be able to get to where your objective is instead of going full hard, all, a full bore, all out every single time.”

“Often, if you don't have a family physician here in Ontario, where we live, 2.5 million Ontarians do not have access to a primary care practitioner. So the default then is to go to the emergency room, for the most basic, non-life-threatening health issues.”

“I was very, pro-hospital early in my career, especially when I was working consulting. hospitals could afford the consulting fees, home and community organizations could not.”

“the difference being that there is longitudinal long-term relationships that are formed between the provider of health services and the recipient, versus when you go to the hospital, it's bedside, hopefully you're out in less than ten days, hopefully, or hours, and, and not months.”

“and there's no more intimate place than your own home, and so in order to provide the care, the great care that home and community providers provide, is to establish that trust and relationship because we are in your home.”

“So every day, we are, we operate in four provinces. we serve 25,000 patients a day, which accounts to millions of interactions over the course of the year.”

“We also have a accredited college, Daniel that, provides training to, personal support workers and healthcare aides, mostly to indigenous communities. And so, our graduates have, gone on to work in over 500 indigenous communities across the country.”

“So in Canada, we don't have a national health system. We have ten provinces and territories that operate healthcare in a very, as you said, distributed and fragmented way.”

“And, Gemba is go to where the work is being done. So I have spent two years, and I continue to do this, and it's quite a bit of effort, to visit all of our teams across the country.”

“we created a policy called SE Flex, which varies by business unit, but we have shed a lot of office space and allowed our teams to work where they feel they're most productive, but also encouraging frequent and scheduled planned team meetings so that we don't lose that human Connection.”

“Post COVID, I'm recruiting nationally. And so we have leaders from, right across the country. In fact, there's of our leadership team of nine, only three live in the GTA. So the point being to ensure some national cohesion, our leadership needs to be national.”

“There's a special sauce within SE Health that binds a, a service coordinator in Victoria, BC to a nurse practitioner in St. John's, Newfoundland. And, there's an unwritten code of, hey, you're here to serve.”

“We were founded 118 years ago, out of St. Michael's Hospital in downtown Toronto, which was to provide free postpartum care to new mothers and their children who could not afford to pay.”

“we do have an impact venture fund we're about to launch, and so we're quite excited about that, where SE Health is the anchor investor to support, Canadian entrepreneurs, around living well, caring well, and aging well.”

“But the, the sisters of St. Joseph's that founded our organization have this phrase of no margin, no mission. So in order to fulfill our social mission, which is to serve older Canadians and vulnerable Canadians, we need to generate a margin.”

“if we are consistently good for twenty-five thousand interactions, then I think the financial benefits will come out of it. I think good quality of care, you focus on that, good things will happen, financial and non-financial.”

“in our domain, what we do is all about social responsibility. It's not a token checkbox thing for the board or shareholders. We don't have any shareholders. Our board's volunteer board, we don't pay our board.”

“And so my previous role in another not-for-profit, it was called Kensington Health, located in downtown Toronto in the heart of Kensington Market. we did operate one of the city's larger, long-term care homes, so 350 beds.”

“And I remember going up to the floor We're all masked up. We have two weeks of masks left. The staff are crying, and I want to just run away and hide. But you have to show leadership and the ability to provide calm, in, in the face of adversity.”

“And that's when I decided to say, hey, if I do it, then I'll have no qualms about asking our staff to put themselves at risk. And remember, early days, we didn't really know what this was. amazingly enough, thirty people signed up. I worked on the floor as a residential aide for a good six months.”

“So within 24 hours, we had hired 20 family members on a temporary full-time contract, did a four-hour crash course in training, and managed to shore up some of our COVID floors and non-COVID floors. Amazingly enough, almost all the 20 donated their wages back to the organization.”

“but the willingness to try something, explore it, compelled the organization to take a chance. And as a result, in the end, we came out of the pandemic, less scarred than I think we would have been had we not tried some of these things.”

“Well, sadly, I think society has forgotten about our, older Canadians. So out of the pandemic, there were significant policy changes that has made the long-term care home sector a lot better, at least in Canada.”

“But the playbook on how to implement the change management, the, adoption, the clinical adoption of these digital tools remains pretty standard. and what we're doing at Estee Health is, surprise, surprise, not according to the playbook.”

“AI is just the fancy label to, decision-making, smart computing, data, and using data, in this case, for good.”

“is to have a skunkworks lab, so-called in the basement, puts a bunch of smart people, to experiment in a safe way. So don't use real personal health information, use scenarios that we know well, clinical scenarios like falls, which happened to a lot of frail older Canadians.”

“but I do feel the greatest opportunity around data isn't the banking industry or manufacturing, it's healthcare.”

“So for us at SE Health, part of our strategy is to be a health intelligent company, is we are sitting on a mountain of data that we don't do anything about it. So what can we do to accelerate health and wellbeing for older adults?”

“And so inspired by this professional runner named Ricky Gates, and he made a YouTube video. He ran all the streets of San Francisco in 50 days. Now, I'm not that fit and don't have that time. San Francisco is really hilly, but I decided to run every street of Toronto.”

“So for five plus years, I have Not run the same route. And so, to date, I've run all the streets in the town of Collingwood, town of Blue Mountain, but new streets keep being added when there's development.”

“I'm pleased to say that three of those, WhatsApp chat group members, who I'll call my friends, have actually run the entire city. It took them three years, but they have run the entire city.”

“By having set patterns, my three or four routes I used to do, and then getting that changed completely, where I actually haven't run the same route since then, is I actually found my neurons, my brain getting completely rewired.”

“To the chagrin of our leadership team that think it's chaos, and I have coined this, and I tell our team, it's structured chaos. Like it's, yes, it's chaotic, but to drive change and reinvention, it does require chaos. But let's try to be structured about it.”

“But if you acknowledge that, that that's part of leadership, that it's messy, that it's a grind, and it's chopping wood, then when you hit those breakthroughs, those breakthroughs give you that, the amplitude is massive. But if you think that that's what leadership is all the time, then the lows are super low.”