Managing Teams and Organizational Change in Not-for-Profits with Veronica Carroll

 

Providing welfare to those in need or what is called philanthropy is not as easy as it seems. Veronica Carroll, CEO of Children’s Health Foundation of Vancouver, points out that philanthropy is not just about donations and rich people giving their money to poor communities; it is more than that. Veronica says that donors do not just donate but also work with them hand in hand after the organization’s benefits are articulated. She shares how, as a leader, she keeps the board up to date with the projects and on the same path as the organization by showing an investment framework. Sharing her strong advice on being a CEO, she says you have to be prepared to be flexible all the time and understand how to get people to work collaboratively in a team environment.

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Managing Teams and Organizational Change in Not-for-Profits with Veronica Carroll

Our guest is Veronica Carroll. She’s the CEO of Children’s Health Foundation of Vancouver Island and the Chair of the Association of Health Philanthropies National Council in Canada. Welcome, Veronica.

Thank you. It’s a pleasure to be here.

For those who may not know about your journey, maybe you could tell us about your career path to date and how you came to be at the Children’s Health Foundation.

I’ve been in the non-profit sector basically my entire career, shortly thereafter out of university. I’ve worked in Ontario for the first twenty years of my career. In the last fifteen, out here in British Columbia. I’ve worked for grassroots organizations, international organizations, healthcare, disease-specific organizations and environmental groups. I’m a CEO of Children’s Health Foundation of Vancouver Island. I have a real love and understanding of what’s happening in healthcare, primarily in the philanthropic healthcare sector in Canada.

You’ve been in your role for almost three years, is that correct?

That’s right. Almost three.

You’ve got it all figured out.

There’s a lack of awareness about the prevalence of mental health issues for children and youth on the philanthropic side. Click To Tweet

It’s interesting. I have lovingly referred to our organization as a 92-year-old startup because over the past three years, we’ve gone through quite a number of changes. My role is to ensure that the foundation is best positioned to be able to manage what we do and that is attracting donor dollars to help us deliver healthcare services to families who have children with either health challenges and/or physical or mental health challenges as well.

One of the things I thought was really interesting in your background is that you have been the CEO of two hospital foundations. Those are places where donors have a clear sense or an intuitive sense at least of where their dollars are going, that they’re going somewhere within the four walls of the hospital. That’s not necessarily the case with the Children’s Health Foundation. How is your work with this organization different?

We were very much the traditional model where we were a foundation. It was a Queen Alexandra children’s healthcare foundation. We were site-specific. There was an acute center for children that our foundation was responsible for, a very traditional model. About eight years ago, the organization decided that we wanted to take on a broader, charitable purpose and our mandate expanded to Vancouver Island and the Gulf islands. Since that time, we’ve really looked at the community and how families are accessing support for the children in their home communities, as opposed to thinking that the healthcare is going to be delivered out of the acute center or out of any facility. Healthcare professionals and families need to get that support closer to their home communities. Since that time, we’ve looked at what does that look like and understanding from the health authority and certainly the Ministry of Health here in British Columbia, where we’ve been encouraged to look at regional programs and regional support for healthcare. That’s been quite an interesting journey from an administrative perspective.

I think that our board and myself, we’re definitely aligned with families. It’s less burdensome to be in their home communities accessing support. The model is shifting and while there might be great efficiencies from the health authority and/or the Ministry of Health from their perspective around these centers of excellence and for many things that work. If you’re talking about how do you help families manage perhaps not acute situations, health situations with their kids, but perhaps chronic situations and/or situations that they have to ensure they’re supporting their kids, to be the best at whatever age they will then be in living their life, whether it’s going to school or aspirations for post-secondary education. All of that is now I think dawning on people. Perhaps we don’t want to suggest that the only place that you can get healthcare support is in the acute setting.

Thinking back to your time in those acute care hospital foundations, do you find that the donors ask you different questions before they make a commitment?

Different questions, yes. When you’re in a hospital, you know the master site plan, taking a look at what is the health authority, how are they building that twenty-year plan for that facility, and the trends that they’re tracking, the demographics that they’re tracking, how is that shaping what’s actually being provided in those communities? When you’re in my shoes and the communities are asking how do we support families, as much as we possibly can and effectively, understanding that the more networked social services are, whether it’s taking a look at more of a wraparound service for families, how do we help communities do that?

Different questions, but I would say that donors are really savvy now and they understand that not everything needs to be the newest, biggest piece of machinery in an acute setting in a hospital. In fact, if you are able to build for example, youth hubs where you’ve got perhaps pediatricians coming, pediatric psychiatrists, psychiatric nurses and they’re coming into community, and there might be smaller communities, but they’re traveling to come into community at a regularly scheduled time and families know that they can access that support in their smaller community. What you’re able to provide for families is far more responsive and far more integrated into how they’re experiencing taking care of their families.

 

That’s really a powerful motivation for philanthropy and I think a good perspective for other leaders to follow that donors are willing to take that trip with you or make that journey with you if you’re able to articulate the benefit.

It is sometimes challenging to understand what impact. My question is always what does the data tell us about what’s actually happening in healthcare for children and youth who have the need to access healthcare services? Is it all about developmental disabilities? Is it about mental health issues? If it’s not, some of the older like cerebral palsy, some of the more commonly known disabilities, if that is in itself changing, then how do organizations like ours keep up and how do we talk about what’s happening for families to philanthropic leaders in communities? It’s very interesting.

In as much as mental health was stigmatized in general, in community, there was a lack of awareness about the prevalence of mental health issues for children and youth on the philanthropic side, with the exception of organizations that was their main bailiwick, but just in general. We’ve done a really big job at trying to educate our donors about how healthcare is and the healthcare issues that are affecting families is changing and how they need to now understand the impact of these new challenges for kids and youth.

That is a complex discussion to be having with donors. I’d imagine it also can be somewhat challenging to have that discussion with your board and to keep your board focused. How do you keep the board up to date on that and keep them on the same path as the organization?

We’ve looked at developing a framework where we say, “Here’s our investment framework,” where we want to be able to have a conversation both with service providers like the medical community, also donors who are going to enable the add-ons and the additional programs and services for families. We’ve looked at early child development, so zero to six, and then we have youth mental health. We have complex care. A number of issues going on for free, children and youth. We’ve looked at a framework like that and what we’ve tried to do is look at that’s our lens.

What we tried to say is, “How can we have the most impact within those areas and who’s doing what, how can we bring them together, convene community leadership in addition to the government? How do we act as a catalyst to ensuring that different parts of healthcare providers are talking to one another?” Many years ago, people didn’t think about how could schools or school districts play a part in children’s health. I do believe that this is now dawning on them that they have to play an active part ensuring that families are supported. If not, then they’re going to end up seeing a lot of the manifestation of some of the issues that perhaps we need to have support in. We’ve been very fortunate to have some great school district leadership on Vancouver Islands and I think you’re going to see that more and more.

That’s a really interesting connection. I wonder if you could tell us a little bit more about how you develop that investment framework and what was the role that the board played in putting that together?

The school districts should play a part in children's health. They have to play an active part ensuring that families are supported. Click To Tweet

We’ve been around for 92 years and so you can imagine how many times we’ve had to really take a look at what’s happening for families and what role do we play in terms of supporting the healthcare of their children and youth. I would say understanding that mental health was a big issue that came up for our organization about maybe six or seven years ago. We had made the decision that we were going to fund a youth mental health hub where we would provide long-term operating dollars for a number of partners to come together and act as a wraparound service for kids and their families. I think it was at that point that our board understood that strategically they have to be engaged in that level of conversation in the community. Taking a much more almost like a detective or a diagnostic perspective where they got curious about what was actually happening, who was doing what, what was working, what was challenging and they made a commitment.

One of the first things that I did when I came on board was I went out and I traveled their beautiful island and met with about 200 stakeholders. These were families with kids with health issues, disabilities, care providers, nurses, doctors, and understood what was going on. What was their experience in working with the healthcare system? As well, I asked them, “What do you believe our role is as the Children’s Health Foundation of Vancouver Island?” The feedback was so enlightening, to be able to share that with the board as a part of their strategic planning so that they have the same information that I did. As their staff person, I was totally equipped with the voice of the families and understood, we need to pay attention to rural and remote communities because they’re not accessing even a modest level of professional support.

We can do something about that because there are models that we can look at, we can implement and encourage donors to want to do and support that. It’s been a journey over the last three years in empowering the board. We have a sub-committee that’s called Community Investment and we look at how we fund through our donors, various initiatives, relatives to the framework that I was mentioning before. We evaluate every year and we take a look at what is our return on investment, what have we enabled and what have we prevented? A lot of the social benefit comes in health promotion and ensuring that people are trying to change the trajectory for kids in youth early on so that they don’t have to be a teen or late teen, early adult and they’ve never seen anyone or much of what would have been helpful for them earlier in their life.

Looking back over that and talking to 200 families across the island, is there one or two that really stand out to you that you refer back to, at least in your own mind, as you go about doing this change management at your organization?

It’s interesting because you want to make sure that you’re not assuming that the words that you use and how you think about what you’re talking about is the same for families across any jurisdiction. Everybody’s coming in and accessing it from their own perspective. I would say in the more northern parts of our islands and understanding many of the first nation communities that you have to take boats, planes and whatnot, and travel extensively to access support. You want to make sure that you are providing them with enough information for them to be able to make good decisions around what support they need and not just assuming that we’re offering this clinic. We’re going to measure it by how many families come to it. We have to find a way to make sure that it’s culturally safe, that we’d been as most welcoming.

We’ve created no barriers to entry and that we get out there, speak the way in which makes people feel the most of these and the less stigmatized. Many families will not access support for their kids, not because they don’t love their kids because there’s shame there, the stigma. As you educate even the caregivers in terms of the language that they use, how they approach the communities and the families that would benefit most from their love and their care for children, our northern communities and our first nation communities are the ones that struck me as being very vulnerable. I think that donors and philanthropic leaders want to respond to that. They need that connection because those stories are heartfelt.

That’s a pretty strong north star for both you personally and for the organization. I want to change topics now and focus a little bit on your work as Chair of AHP. From that perspective, what do you see changing in healthcare philanthropy right across Canada?

 

In many respects my colleagues and I talk about how our work is influenced by the political up and down elections the different initiatives that various governments put in place and then four or eight years later, you have to change and explain that to donors. I think from a healthcare perspective, certainly, my colleagues who are responsible for facilities would say, “It gets challenging when you’re going from this was the priority under one government to now it’s something else.” You have long-term legacy support for major initiatives within the facility only to have that either we send it, changed or delayed. I would say we see a lot of that. Primarily where you have great changes in the way that the health authorities are, organize and how they administer the dollars. It’s interesting, we’ve asked donors to really come along on a journey.

Every time we’re faced with a government change, whether it’s Ontario, the East Coast or out here in BC, I think that the donors understand now. Perhaps when they’ve talked about we’re going to bring in a MRI or a CT or whatever the case may be, that there is also a chance. If the project doesn’t get completed within a four-year term of a provincial government, that it could actually falter. I think these larger donors look to us to really have a good understanding of what is actually achievable. How do we want to encourage supporters to enable the acute centers to do the work that they need to do? As well, we will have to be cognizant that things might change. It has changed, the relationship that we’ve had with our supporters.

It is one of the things that I always love doing my own work and working in healthcare, is that you do get to see the very best of people often at their worst. The donors, their families or patients and their families are very willing to understand changes when they’re presented. As long as it’s clear that they’re still going to be able to have the same impact with their gift, whether it’s, “Let’s do a program instead of do an MRI,” that’s a little harder to do. I’ve always found that donors have been very willing to make that trip with you if you can articulate the final impact or the net impact that their giving will have.

One of the things that I’ve talked about in some of my leadership talks has been encouraging people to think about what type of community you want to live in. That’s the potential, obviously for philanthropy. If what you do as you’re partnering with other organizations and you’re partnering with other government departments or ministries, you can shape communities for many years. If that’s what you care about is, at the end of the day, what type of community you want to live in, then I think we’re up to take a longer perspective, which is much more helpful.

It’s more compelling to most donors. With your perspective on working with colleagues across the country, one question I’d like to ask people on the Discovery Pod is, “What would you change?” If you could change one thing about the social profit sector, what would you point your magic wand at?

I would encourage people to look at other agencies, other charities or non-profits that are delivering similar services to perhaps the same clientele and find ways to come together, to think about sustainability from a different, less competitive but much more service-oriented. I would like to think about the mergers and acquisitions that happen in the for-profit sector. If you take a benevolent eye to, “How could we do the same?” and in the social services or non-profit sector, then I think there’s real benefit to not necessarily eliminating duplication, but to understand, “What are some of the other programs, organizations, services which we’re serving are accessing? Is there a way for us to work together?” I think increasingly for many non-profits, and maybe this has always been the case, but I do think, we all have to answer it at the end of the day to the declining number of donors who are giving more, “Is there a way for us to be smart about how we offer the work that we do and how we solicit the support that we do to do that work?” I’m looking forward to doing that for our own organization.

Here at the Discovery Group, we’ve worked with a number of organizations on merging and coming together. What strikes me every time is that it’s so frequently an emotional connection to the founding mission or the founding value proposition that can get in the way of long-term partnerships or formal mergers. I think if we can find a better way or a different way of speaking a new language of talking about organizations coming together, they could see it happening a lot more often and to the benefit of the sector in general, the people that those organizations serve.

Healthcare philanthropy is influenced by political ups and down. A change in government can mean changes in priorities. Click To Tweet

I think so too. I would agree.

I want to go to your own personal leadership style. As somebody who’s been CEO in three organizations, I’m curious, looking back, how your approach as a leader has changed over those roles.

I don’t think you ever fully figure it out. Maybe that’s what I’ve learned most over the last fifteen years is what you thought was true may in fact not be true. That’s a humbling position to be in. I would say that I ask a lot of stuff. In as much as I’m a super achiever, these are the people that I do tend to surround myself with. It becomes a lot of understanding of how to get them to work collaboratively in a team environment where they are just as excited about their colleagues’ success as they are of theirs. Understanding what is a team dynamic and how can we facilitate tough conversations, honest conversations, but that we’re in it.

We’ve got skin in the game, you’ve got the support of your CEO, there’s going to be rough patches, but we’re going to do this together. It’s helping them see that vision. I think back on my past and I don’t think that I had that team approach quite nailed down. I was doing one-off like, “Let’s support your director of development or your director of communications and they’ve got their development plan and who are they as people?” All of that is still true, but the layer on top of that is the team. The team must succeed and that we all owe it to one another to support one another. We are not going to hit it out of the park in the way that we all dream if we do not figure out how we coalesce as a team.

That’s not how everybody works. How do you handle or have you handled it in the past when you’ve had team members who put the I in the team?

I can’t discourage people from being super achievers because you want to encourage everybody to bring their best selves to work. It’s just the destructive elements that you have to dampen. You must find other outlets and/or you have to ask people to self-select off the team. Somebody said it great, how do you get eagles to fly in formation if it doesn’t happen? We all look for the superstars because we need great people to do the work that we want to do.

Your emphasis on team ownership and your team approach is probably the closest anyone can get to having eagles fly in formation. A number of readers are people who want to be CEOs one day. What advice would you give to someone who was just applying for their first CEO job?

 

Be prepared to be flexible. Be prepared to learn and be curious about how you might best move forward. Do surround yourself with people that you respect their opinions. Find people who are capable and competent, much more so in particular areas than you. Always ensure that you lead by example and that you do value trust, transparency, integrity. Those are big words but they’re easy to live. Every single day you have to show up and practice that stuff. When you practice that stuff, then people give you assignments that will draw on all of those positive things where you really are trying to make a difference in your community. People do look at you as you live those values and they entrust you with greater responsibility and then people work tirelessly to help you make those things come true.

You make it sound like a pretty good gig.

I wouldn’t be anywhere else. I love it.

I want to go over three things that you shared with us that I think are relevant to anyone, whether they’re a social profit leader now or a social profit leader to be. The first was that donors are getting savvier and that we can trust that they’ll join us in the changes in our organization if the value proposition is compelling and they could see the role of their philanthropy. It’s a great reminder for all of us. The second piece that had me nodding and smiling was, what does the data tell us? What are we going to do differently as a result of what we know from the data? That’s something that I think that follow through on asking the hard questions and then actually changing the services with the fundraising approach of the organization is really important. The final thing that I think we should all take away from this, whether we’re in the social profit sector or not, is that part of the role of leadership is to be thinking about the type of community that we want to live in and the people that we want to surround ourselves with. Thank you very much for sharing those great ideas with us.

I’m happy to do so.

Thank you for being a part of this.

You’re very welcome. That was lots of fun.

Important Links:

• Children’s Health Foundation of Vancouver Island

About Veronica Carroll