Christine Kilpatrick | Insights from Industry Leaders
CEO at Melbourne Health
Christine Kilpatrick is the Chief Executive Officer at Melbourne Health.
- What influenced your decision to move from medical management into hospital administration?
- What is the biggest challenge you’ve had to face in your career to date?
- How do you see the digital health space developing in the future?
- Diversity is becoming a prominent issue. How have you seen the companies and board that you are working with evolve and manage these issues?
- Who has inspired you the most in your career?
- When you are recruiting for a senior executive to join your team, what are the key attributes you look for in the person, apart from technical skills and experience?
- What are your top tips for aspiring leaders?
What influenced your decision to move from medical management into hospital administration?
I think the trigger was in the late 90s and early 2000s. I was appointed the chairman of the senior medical staff at the Royal Melbourne Hospital where I was working at the time as a neurologist. I’d been working as a neurologist for many, many years and was very happy in that role. But while I was the chairman of the senior medical staff, there are all ways you can take on that role. I took the opportunity to get to understand how the system worked and how the health system worked and I got quite interested. I could see there was more to the health system rather than just the doctor and the patient, which is a very important relationship of course, but I did get interested in the bigger picture.
In the early 2000s, there became an opportunity to take on a role as a divisional director, a part-time role. I took on the role that nobody really wanted to do and that’s how I got the role, that’s often how you get your first gig. I took that on, as well as continuing with neurology and I enjoyed it and was interested in it, so the opportunities really went from there. But I realised pretty early on in that phase that I didn’t want to be a divisional director forever and I didn’t want to be chief medical officer forever, which I went on to do, and that I’d like to be a CEO. I thought I had to fast track somehow, so I went off and did an MBA and then eventually I was appointed to the Royal Children’s Hospital and now back here at Royal Melbourne Hospital. It was a gradual thing, but it was a deliberate decision and I have no regrets. I always think it gave me two careers, so I think I’ve been fortunate in that sense.
What is the biggest challenge you’ve had to face in your career to date?
I think now is probably the biggest challenge I’ve ever faced, with COVID. Not so much today as it’s reducing in the amount of activity. Certainly, in the peak of it in late July/ early August we had a peak of COVID at our hospital. What was very distressingly was that we also had healthcare workers in the hospital, who were positive for COVID, and a lot of people who record to be furloughed. I think the furloughing of staff, being isolated for two weeks is much more dramatic than we would ever have thought, it has had quite a negative impact on their mental health and well-being. I found that very challenging. I had to manage the pandemic, but also facing up to it and managing the issue of the staff, which was quite distressing. Thankfully, it’s improving now.
I’ve had plenty of challenges in my career, but I’d have to say this pandemic has been the most challenging that I’ve faced. To manage it I think you’ve got to be resilient, agile and flexible. You need to be adaptable to the changes and able to cope with uncertainty because that’s what there’s been. We’ve had great advice from the department, but it kept changing and changing, not for the sake of change because new knowledge came out and in response, there would be new steps, policies and procedures put in place. It was and still is all-consuming in terms of volume of work. It’s that uncertainty which is difficult. You also need to bring the staff with you, they are the frontline workers who show up to work every day with uncertainty, in their own lives but also about the future and in the workplace. That was the challenge that we had to face. Our executives and I chose to be on site and to lead on-site at the hospital. Some people might be critical of that, but I couldn’t work out how I could expect staff to come to work every day if I wasn’t going to be there, that’s how I saw it. I think being visible and being about, although to a very lesser extent than we normally would be, I think was a clear message. I hoped that the staff would know we were with them and there to support them.
How do you see the digital healthcare space developing in the future?
It is now, but it’s going to be the absolute future. So interestingly, we had the privilege of putting an electronic medical record (EMR) on an enterprise-wide system across the Royal Melbourne Hospital, together with the Peter MacCallum Cancer Centre, the Royal Women’s Hospital and the Royal Children’s Hospital system. The four hospitals here in the precinct are now on the one system. There’s now communication about patients across the precinct, which is fantastic. We went live just at the peak of COVID, that was on the 8th of August. It was a very challenging time, but it was successful and is the big first big step forward in being a digital health service.
But I think digital has an enormous role and we’ve just seen it in the last few months through COVID. Some of the digital models of care, which I had hoped we would take on board, but we struggled to do before COVID, have actually just developed enormously. Telehealth is an excellent example of that, but I think there’s much more we can do. I think there’s home monitoring, home-based care, which is going to grow and supported by digital is going to be a big change in the way we deliver services, Not all services, of course. There are many patients who could be managed very safely, adequately, appropriately and probably in their best interest in their home rather than in the hospital itself.
I think the other thing is the use of digital, for meetings and for communicating with each other has worked remarkably well. What I’ve noticed is in our educational sessions, large information sessions with our staff and interactive sessions with managers and all staff, we’ve had much bigger numbers. It may be partly because of COVID and they feel they need to be connected, but they have been much more connected. I think people also feel safer on the digital platform, they can do it from their home, they can do for it wherever they might be, so it’s very convenient.
Multidisciplinary meetings with the clinicians have worked very well using a digital platform. We’ve had huge numbers attending grand rounds, whereas when it was physically, we never thought you could do it any other way except physically. So I think there are many ways that the digital platform is going to change how we deliver services and how we work together. Working from home, I’m sure will have a place. Probably not as much as it’s having at the moment, but I think it will absolutely have a constructive place for the working model going forward.
What role do you think EMR will play in forming models of care for patient safety and the quality of outcomes?
It’s early days and we’ve only been here for five weeks now, so we don’t have all that data yet. But what I do know is that from the EMR we can get a lot of data around the safety of care, which is much more than you could before.
Secondly, the program itself improves safety, because there’s a lot of decision support built into the program, so that improves the safety of patient care. There’s a lot of checks and balances about medication, which improves medication safety. They are processes which you can’t keep going until you address those, so that improves the safety of the care we give our patients.
The other is that it also tells us where the barriers are inpatient flow across the organisation, from the emergency front door to the back door into discharging. There’s a lot of waiting that happens at a hospital, which we know from audits. But to have the data in real-time, and to know what someone is waiting for if there is a waiting component and rather than progressing care when we just waiting for it to be able to move on with the care that we need to deliver. So identifying that and having the data, technicians like data, otherwise, it is just anecdotal. I think it can help us drive improvements. So I think it’s going to have a significant impact on understanding the business, understanding the flow and what systems we can put in place to try and improve the flow.
Diversity is becoming a prominent issue. How have you seen the companies and board that you are working with evolve and manage these issues?
I think everyone is trying to address, be mindful of, and see the advantages of acknowledging diversity and embracing diversity. It’s changed a lot in the last 20 years, and quite dramatically in the previous 10 years. The changes I think are that we are open about it and willing to address it. We acknowledge that the differences in all of us make us unique and make places like the Royal Melbourne Hospital such a wonderful organisation with ten thousand people. Many people are very different, some people are very similar, but they all bring a different aspect to the organisation.
But the other side is patients are diverse too. If we don’t have a diverse workforce, then we are going to struggle to be able to respond in an appropriate way to our diverse patient population. So, the needs of patients, the wishes of patients and what is important to a patient, is very different in one group than it is in another, ending individuals. I think as a profession and as a healthcare professional, I think we have struggled a bit with that. We struggle to understand that, but I think with a much more patient-centred approach, we are beginning to understand. We still have a long way to go, but I think we are starting to understand that much better.
Who has inspired you the most in your career?
It’s an interesting question. A couple of people who do come to mind, they’re actually both doctors who inspire me. I think they’re wonderful leaders and they’ve both come from being clinicians, one of them is a clinician-researcher, but into a very strong leadership role and making a big difference to Victoria in particular.
One person is Ewan Wallace, the CEO of Safer Care Victoria. Ewan was an obstetrician, I’m not sure if he still practices obstetrics anymore now. But he was an obstetrician, a researcher, but he was mainly a clinician. He obviously had a clear idea about what high-quality care was all about, and what we should be doing to deliver high-quality care. He’s now come in as the leader of Safer Care Victoria and I think he’s done a wonderful job translating that into a language which is much better understood and appreciated by clinicians, particularly in the medical profession. So that is a wonderful thing that he has done for our state, and for the patients that we look after. So, I admire what he has done and continues to do.
The other person is Sharon Lewin, who is the inaugural Director of the Doherty Institute. Sharon is an infectious diseases physician, and I’ve known her for many years. I remember her as a registrar, then as a consultant and later as a researcher, of course. Through a number of leadership roles, she’s now the Director of the Doherty Institute, which is a collaboration between the University of Melbourne and the Royal Melbourne Hospital. She has managed to bring groups together, much greater than the sum of the parts if I can put it that way. Sharon’s enabled them to flourish and to make an enormous contribution, particularly through COVID, but even before that. I think she has an ability to bring out the best in people, to acknowledge the contribution of individuals and groups. And also, really to harness the energy of people to produce great work and communicate it to the public, politicians and leaders. That’s a real skill with infectious diseases and what the work at the Doherty Institute is all about. They are two leaders that I admire that come from a medical background and I think have done great things.
When you are recruiting for a senior executive to join your team, what re the key attributes you look for in the person, apart from technical skills and experience?
The technical side is not easy, there are lots of people who can do that side of things. But there are probably two other elements that I think are important, and therefore I consciously look for.
One is to think about, how this person will fit in within our executive team. You bring an executive in, not just to be the technical person. Of course, they come with a set of skills in a particular area you need. But they also have an equally important role as being a member of the team and the leadership team for the organisation. So if they just come with the technical skills and not the ability to fit into the team, not to be homogenous and the same, but to work well as part of the team and take on a leadership role. Not just in their portfolio, but a leadership role within the organisation then I believe it’s not going to work.
I always think about that and I always have because you can try before you buy. You have to try and sort that out and make a good decision. That’s something I’m very, very conscious of. The other is to make sure that they’re always thinking ahead and are creative or innovative. So thinking differently, always thinking ahead and always trying to improve to do things even better because we know this job is never done. These are the two aspects that I think are important.
What are your top tips for aspiring leaders?
First of all, don’t be in a rush, sometimes you meet young people and they are always worrying about leadership and how do I become a leader. They tend to focus on that upward progression before really getting the basics right. So I think don’t be in a rush, that depends on what stage of your career you are in of course. But take your time.
The second tip is if you’re a clinician, to be a clinician leader and go into management as I have, you don’t need as much clinical work as I did. But to have a very good base of clinical work before you go into a management role is a good thing. I think you get credibility that way. It’s important that you genuinely understand the challenges that healthcare workers have and the complexity of working in health. Some frontline work is excellent, a substantial amount is good.
Then the next tip is to be brave and take that next step when it’s the time. I contemplated doing an MBA and contemplated going to management for quite a while before I ever did. I said what if I fail, that wouldn’t be any good. I should have been braver and wish I had got going somewhat earlier. That’s a regret, would life be different, I don’t know. But in retrospect, I think I left that too late. So there can be two extremes in that sense.
Take on a role that maybe sometimes you might think of like a rollercoaster. You might say I really want to do that one, but it might be the one that’s being offered to you. That’s what that was my first step, I took the role no one else wanted and then went on from there.
So, don’t be in a rush. Having said that, be brave and take the next step when it’s time. Get some clinical work under your belt, if that’s what you have as a background. Finally, don’t be afraid to take on the role that no one else wants, because you may well do very well and it’ll be a big stepping stone.