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Michele Smith - North Eastern Community Hospital

Michele Smith | Insights from Industry Leaders

Chief Executive Officer of the North Eastern Community Hospital, Governing Board Chair for the Far North Local Health Network.

Michele Smith is currently the Chief Executive Officer of the North Eastern Community Hospital. Prior to taking on this role in early 2018, Michele spent eleven years as the Regional Director, Eyre Far North Region, Country Health SA. Michele has a deep understanding and commitment to improving the health status of individuals and of population groups within this region and has strong networks across the Eyre and Far North area.

Michele recently sat down with Ccentric consultant, Michael De Santis to discuss her career. Some of the questions they discussed include:

  • What made you decide to study nursing?
  • What do you see the opportunities and challenges for the North Eastern Community Hospital over the next 5 years?
  • As your position as chair of one of the country’s LHN, similarly, what do you see the challenges and the opportunities?
  • How do you think digital health change the healthcare landscape in the coming years?
  • When you’re recruiting for a senior executive to join your team, what are the key attributes you look for in the person apart from their technical skills and background experience?
  • Diversity is becoming a prominent issue. How have you seen the companies and boards you are working with evolve and manage these issues?
  • What are the benefits of working in a board position?
  • What are your top tips for aspiring leaders?

The interview is also available as a podcast here.

What made you decide to study nursing?

I’d probably blame my sister. She bought me a little nurse’s outfit (with the little stethoscope and the little smock when I was really young), so I always knew that I was going to be a nurse. I then later applied to a number of hospitals when I finished school. Those were the days of hospital training, so I had the choice of either Mount Gambier or Queen Elizabeth Hospitals. I ended up going to Queen Elizabeth and did my hospital training, which was something that I had wanted to do my entire life.

I’ve continued to be a registered nurse and kept my registration for the last 33 years. I still do my CPD points every single year. I worked really hard to become a registered nurse, and I’m so proud to be a nurse; so it’s something that I’ve continued. It’s really helped as the wool can’t be pulled over my eyes by the clinicians because I stay up-to-date with clinical issues; which has really helped since stepping ‘over to the dark side’ and became a CEO.

What do you see the opportunities and challenges for the North Eastern Community Hospital over the next 5 years?

It’s probably not the North Eastern alone if I’m honest it’s the entire private healthcare industry. We’re all feeling the pain of families choosing to opt-out of private health insurance because their budgets are squeezed so tight. It’s a tough industry and it’s highly competitive; we are all trying to increase the activity that we get through our walls to keep ourselves commercial and keep ourselves viable. For the North-Eastern in particular, we are a values-driven organisation and a community hospital. We’re not for profit, we’re driven by human values rather than profit margins. But in saying that we also need to stay viable and commercially ahead of the game, being able to offer surety for our staff, our patients and our visiting medical specialists who rely on us to provide that local service for the community.

For the North-Eastern, the first piece of work that we did as an Executive Team and the board (I include the north-eastern board in the strategy), was to actually look at what the community is going to need from a clinical perspective over the next 10 years and we knew what we needed to become to satisfy the clinical needs of this community going forward. We did a big piece of modelling work a couple of years ago that told us what our growth areas were over the next seven years. Rather than build it and they come; we are actually targeting what we’re building. We are building what this community needs with their clinical presentations over the next seven years. That’s how we’re managing to develop ourselves going forward.

As your position as chair of one of the country’s LHN, similarly what do you see the challenges and the opportunities?

The challenges again in the public sector is money, there’s just never enough of it. Having said that, the budget is significantly more for the Eyre and Far North LHN. But we just need to make sure that the money is going to the right place, at the right time, for the right people and in the safest possible way. So, it’s a much more strategic role being on the board and certainly one of governance. It is absolutely a helicopter view of the largest geographical region in South Australia and the most remote as well. We’ve got two hundred thousand square kilometres of lizard to the acre country in terms of population that we have to make sure that they’re safe, they’ve got the essential services and deliver those services as close to home as possible.

The challenges are the same, but different. There’s always the challenge of money. But in the region the challenge is also the workforce. It’s really challenging to get especially a medical workforce out into the most remote LHN. We also really struggle to recruit doctors and have got a severe shortage of general practitioners in the region at the moment.

The days have gone where you’ve got your family doctor, had him all your life and he’s looked after your whole family for the last 30 years. Predominately they were all male GP’s back in the day. He was on call every day of the week, 365 days of the year and didn’t take his boat out because he was on call for the hospital and for the community. People don’t want to live like that anymore, they actually want to have a life. They want to do shared care, work within a supportive collegiate network and be supported by communities to be able to live their best life, as well as provide the best services and care. We need to look at how we do medical services in a different way for an isolated geography and support these young clinicians, that are coming out and making sure they get to live their best life. And also get to provide the care that they deserve to provide to the community without burning them out. We’re looking at all sorts of different workforce models at the moment to try to achieve that, but it’s not an easy fix and it’s going to take some time.

How do you think digital health change the healthcare landscape in the coming years?

It changes every day. We’re already firmly in the world of robotics in terms of acute surgery, the world of AI and electronic medical records. Love it or hate it, we’re in that digital world already. Some of the exciting innovation I’m seeing in the digital space is around data mining, this allows you to look at complex and significant datasets to come up with an outcome or a solution. It’s being used in the acute area for the care of deteriorating patients. It is a requirement for clinicians to come up with a pathway to look after and identify quickly deteriorating patients, which improves health outcomes at the end of the day. The data miner is basically a data set that’s collecting all the patient clinical information constantly and can alert clinicians to the fact that their patient is deteriorating quickly allowing the clinician to do a clinical intervention. It’s lifesaving stuff, not just something that makes it clinicians’ life easier and will save lives going forward into the future. I think that’s something that will be replicated across different clinical areas and functionalities in the next decade.

Similarly, in the residential aged care space, I’ve heard about the innovative pace of digital and data mining. For example, they can use the information of an aged care resident who’s non-communicative so far as to tell whether they’re experiencing pain judging on how their muscles are configured on their face. The clinician or the nurse can take a photograph of the patient’s face when they are at rest and comfortable and then take a photograph of the patient’s face if they think they might be experiencing pain. The software can then interpret how people use grimace in different ways and use their muscles in other ways, from this it can inform the clinician that this resident is in pain. Even though the patient can’t say hi, they can let the staff know that they are in pain because they can’t communicate. There are these tools coming out every day that are improving patient and resident clinical outcomes and then there’s the exciting space about human outcomes. In the aged care facility, there are things like virtual reality goggles, which can allow a dementia resident to climb Mount Everest in the virtual world, walk through the streets of Paris, go to their favourite piazzas or go dancing the salsa with their deceased loved one. It’s just amazing what we can do to help people live their best life, this area is just going to explode.

When you’re recruiting for a senior executive to join your team, what are the key attributes you look for in the person apart from their technical skills and background experience?

I’m going to look for cultural fit. Firstly, from the bigger picture, I’d need to make sure that the candidate was going to fit within the culture of the organisation as we are a values-based organisation.

Secondly, I would want to make sure that they’re the right that the right fit for our executive team. You need to make sure that you’ve rounded your team off. You need to have people with the right soft skills, your technocrats who are going to go through forensically analyse every piece of data and decision making, your strategic thinkers and your practical thinkers. We all need to bring our own authenticity into that piece. I will recruit two pieces of a jigsaw that are going to make an entire puzzle that’s going to work for the benefit of the organisation to drive it forward. It’s much more than merit, although merits plays a part of it.

Personally, I’m going to make sure that the teams diverse, so we don’t get stuck in a group-think environment. It’s not just about gender, it’s also about culture and LGBTIQ community. It’s about bringing some colour and flavour into the team. That’s not just in terms of employment, that is just in terms of how you bring a board together. How you do governance, how you make decisions, and how you embrace diversity in general.

Diversity is becoming a prominent issue. How have you seen the companies and boards you are working with evolve and manage these issues?

In various different ways. I can only really reflect on the North Eastern and on the health board. So perhaps I can bring my health board experience in. In health in general, from a gender diversity perspective tends to be quite balanced or overbalanced. There’s a big female workforce in health it’s just the way it is. Women are largely underrepresented when you get to the upper echelons of executive management is reflected in boards and governance in general across the public sector, private sector and certainly ASX listed companies. I jokingly say that there are more men by the name Andrew on ASX 200 companies than there are of women altogether. That sort of brings in the reality. I think our ASX 200 has finally hit a 30 percent benchmark for women on those boards, so that’s a step forward.

If we put gender aside for a minute and think about diversity in general, then then you can confidently say that Aboriginal people are underrepresented and need to be sitting at the decision-making tables, understandable desire for self-determination. LGBTIQ people are underrepresented, as are the disabled, as are the young. There are still all these groups and even if we get the gender balance right, we’re still not getting the rest and that they don’t share equal voice or representation. So, we’ve got a lot of work to do.

What are the benefits of working in a board position?

Blimey. Long hours and you’ve got to love it because you’re not going to feed your family on what you earn from being in a board position. My counsel to anyone considering being on any board is you have to be passionate about the board that you’re sitting on because some it takes a lot of time, communication and networking. It takes supporting your executive team and your CEO to help them succeed. You’ve got to crystallise that vision, if you can’t, you’ve got to give them the end game or they don’t know where they’re heading. As a board or as a CEO, you have to crystallise the end game for them. You also need to allow people to take their own pathway to reach it. So, don’t control them over how they’re going to reach the endpoint, let them take their own forks in the road and learn their own lessons and allow them the space to innovate. As long as they know the meeting points along the way and where we’re going to settle at the end, just let them get there in their own time. But you got to have the passion for the board and for the topic.

What are your top tips for aspiring leaders?

You’ve got to have the fire in your belly. If someone wants a job with me and they don’t have the authenticity to show me or don’t have the fire in their belly, regardless of merit and technical qualifications I’m just not even going to look at them. I’m going to look at the person who’s excited, who’s thinking outside of the square and would sit in the car wash with their laptop doing an email. I don’t care if I come in late so long as they are doing the work and helping us achieve the end game. These are the people I want to look at. I’m not going to look at your qualifications first unless it’s a clinical requirement.

Crystallise your end game, allow people to reach the endpoint in however way they want to reach it within the time frame that you set and don’t micromanage.

All podcasts are available on the Ccentric knowledge page here; including the latest podcast series “Insights from Industry Leaders” and series one, a combination of interviews with both healthcare and academia leaders.

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