Working between two large entities – academia and the healthcare system – is a complex role to play. In this episode, Douglas Nelson’s guest is Dr. Jodi Abbott, the President and CEO of the University Hospital Foundation. Dr. Jodi talks about how being in the middle ground can be a flexible advantage. You can move mountains that people in academia or the healthcare system couldn’t.
On that note, technology and the COVID pandemic accelerated change. The crisis pushed everyone to think if there are better ways to do things. Dr. Jodi believes that when you have a crisis, you need to understand and manage it, and also see the benefit that can come from it. Tune in!
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University Hospital Foundation With Dr. Jodi Abbott
Our guest on the show is Dr. Jodi Abbott. She is the President and CEO of the University Hospital Foundation in Edmonton, Alberta. We are thrilled to have her on the show. Welcome.
Doug, it is nice to be here.
I’ve been looking forward to this conversation because as a leader in the social profit sector, you have a unique career path that I hope we can spend a few minutes on before we get into the great work that’s happening at University Hospital Foundation. You started as a President and CEO at the Foundation in January of 2020. All of our readers will know that was two months before everything changed.
Before you were at the Hospital Foundation, you had been the President and CEO of NorQuest College for ten years. It is rare that we see someone deciding, “I don’t want to be president of the college anymore. I’m going to lead this major health foundation.” Tell us a little bit about that journey and what you found once you crossed the street back to healthcare.
It is interesting because I did come from healthcare. I spent the early part of my career in health and the one thing I’ve always loved about it is the complexity of the environment. I ended up moving over to NorQuest College years ago and that was a shift going from healthcare into academia. I remember the, “Who is she coming into the post-secondary world?” During my time there, I had an amazing experience. First of all, we had a very diverse student population. Sixty percent of our students were born outside of Canada, and about close to 40% to 50% of our programming were healthcare-related.
I had an incredible journey at the College and moved from almost tripling the student population from about 6,000 to over 19,000 students. I was able to move something forward in transformation. I was coming to a point that I’m engaged in figure skating as a judge. I always think about elite athletes and knowing when it’s time to go. I always think you can move many things forward. There is a time where you need to look at yourself and say, “What’s the next step?”
Coming back to healthcare, I can’t say I went looking for the foundation role. It was not anywhere I ever thought I would end up. What I find unique about it is being squished in between a large university and an enormous health system. If you want to talk about complexity, it is right there. What I find interesting coming back is that I know academia and healthcare really well. Now I have the opportunity to play as a catalyst between those big entities. There was a tremendous amount of work to do.
Fortunately and unfortunately, from the time I had been away from healthcare and academia, not a lot changed in either of those sectors. Technology has changed and moved mountains so there have been most kinds of changes, but a lot has stayed the same. I like to move mountains and change things. That is why I find myself exactly where I am.
It is such an important organization. You said squished or positioned between the University of Alberta and Alberta Health Services. Being that smaller partner in that triumvirate in many ways offers flexibility and innovation that the two larger behemoth organizations can sometimes struggle with. How have you taken what you learned as a leader in academia and applied that to the innovation that you see happening for the foundation?
A couple of ways. First of all, when you’re the President and CEO in academia, there is a whole academic arm that has a whole lot of leadership impetus. They also have a lot of ability to control because there are strong mechanisms in place. Having learned that in the academic space coming into the foundation space, understanding that both on the academic and health system side is helpful and beneficial.
You are right. We are in the middle of these organizations but it does allow us flexibility. As a catalyst, it allows us to be able to work with both the university site and Alberta Health Services, and to be able to say, “You might not be able to move this but maybe we can.” We can be the person in the middle to move something up the middle and have it flourish where they may not be able to because of their structure, systems, history, etc. It is finding that sweet spot to be able to move big initiatives forward.
The University Hospital Foundation has a great history and reputation for being able to undertake challenges that the university with the health system isn’t ready to take on. You step forward and lead in that, which allows larger institutions to come on board after it is already a reality or success is nearly assured. It is a powerful role for donors to play when they’re supporting a foundation like yours. How have you found the conversations with donors? We have got a pandemic lens on some of those donor conversations you have been having. That desire to innovate and change the state of play, what are you hearing from your donors there in Edmonton?
First of all, in the philanthropic space, sometimes we have our own lens that limits us. We sometimes say, “Donors will think this or say this,” instead of saying, “Why don’t we ask them?” A lot is changing in the philanthropic space as well. We have had many conversations about certain things that we wanted to change and do differently. I can talk about some examples of that.
Oftentimes, what we hear is, “Donors won’t accept that. That is not what we hear from donors,” and then when you ask the question, “Have we actually asked them?” Often the answer is no. I’ve been in the organization for years and I’m still moving in because we have a new strategic plan and we are trying to shift things. As I talk to donors, I think that our space sometimes carries these myths. When you talk to donors, the bottom line is they want to have an impact. They want the organization to move the needle. What we have seen with COVID in healthcare is it allowed us to accelerate things in healthcare that we all thought weren’t possible.
I’m glad you mentioned that. One of the things that I’ve always seen from the University Hospital Foundation is that it plays such a strategic role in accelerating new clinics, ideas and research. Because you can move faster, talk to donors, get funding and get started, you’ve been able to lead the way. I’m curious, coming from academia back to healthcare, what have your conversations with donors been like as you’ve come back into the foundation role?If you're trying to move the needle, you need concentrated effort. Click To Tweet
What has been interesting is early on, you spend time trying to understand the environment, what donors think, how comfortable are they with change, and how comfortable are we with change. What I’ve learned is there is a lot in our industry that sticks and becomes myth-building. What I mean by that is we talk a lot about what the donors want to see and how they want to see their funds being used. Sometimes it makes me scratch my head.
The upside of coming into an organization that is going through a lot of changes is you get to have direct conversations with donors to say, “We are thinking of doing this or that differently. What do you think about this?” What I’ve learned is that the culture in organizations gets pretty set. It becomes, “This is the way we do it here because this is what we believe our donors want,” but sometimes we haven’t asked them.
What I’m seeing as we are moving forward with new ways to raise funds and looking at our world differently is that our donor community and the investors are saying, “That is where we want to go.” It is akin to what we have seen with the COVID pandemic. Prior to COVID, patients, including myself, might have said, “Do I have to drive 30 minutes, try to find a place to park at my physician’s office, wait in the waiting room, or could I just have a telephone call because I have something as simple as renewing a prescription?” as an example.
Our system had felt for many reasons why that couldn’t work. I always believe when you have a crisis, you need to understand and manage it, but you also see the benefit that can come from it. What we have seen is a big transition in digital health. It is something I’m interested in seeing as we move forward with the University Hospital Foundation strategic plan, “How do we transform help?”
I want to come to this strategic plan but before we get there, I want to reflect on what you said as a new leader coming into the organization. You heard that received wisdom of what your donors want to fund and what they’ve funded before. One of the first questions we often ask when we start working with a client, we say, “Our donors only want to fund capital. They only want to fund medical equipment. They don’t want to fund anything else.” What do you ask your donors to support? Often, we find that organizations fall into a habit of only asking for certain kinds of things or levels of gifts, and then mistake that for what their donors want to give but it is how they work.
As a new leader, one of the real opportunities is to pick up the phone, get in front of donors, and have a conversation about what they see as the opportunity to transform healthcare through their philanthropy. As you said, I’m sure many organizations find that their donors want something different. They want something that has more agency in a better deeper partnership with the organizations they support.
It is interesting because then you can have a complex conversation as well and have that conversation with the donor. They are our lifeblood and are absolutely critical to the health system, not just to the foundation. If you look across the Province of Alberta, for example, we have 69 hospital foundations. The revenue that is generated in those organizations helps to move the needle in healthcare.
The challenge that comes is that the donors and our patients know what they want. You then have to figure out how do you create the bridge and the alignment with what the hospital wants and needs, what the university wants and needs. Try to find that bridge that allows for the donors’ needs to be met and to be able to still align and move forward with what the strategy is of the hospital or Alberta health services and the university.
Is there an example that comes to mind when you think about those conversations with donors where your briefing notes said, “This donor only wants to give to X, Y or Z,” and you get into the conversation and hear something quite different?
I’ll talk about it more at a higher system level and two examples rather than a specific donor. One is we have supported an incredible area of Alzheimer’s research. The request came forward from a brilliant physician who is absolutely moving the needle on Alzheimer’s. He came forward to our board as a funding priority. The board saw incredible wisdom in saying, “We are going to raise funds for this piece of research because we believe it is the right thing to do. We think that something can happen.”
When you look at that model of philanthropy, it is a pretty traditional model of philanthropy. If you take it from a different perspective and say, “We believe in this research.” Instead of the donor giving a donation and getting their regular tax receipt, we would say to them, “Still make the donation but we want you to look at this and frame this a little differently as an investment donation. You’re still going to get your charitable receipt because you are making a donation, but we want to be able to treat this somewhat differently. At the end of the day, if there is an opportunity for profit and purpose where we could work directly with the university and the researcher, and this turns into something incredible, then there is a profit that comes back into the foundation. That will allow us to continue with the flywheel so that you continue to have sustainability, and to be able to support incredible clinical care and research.”
There is a set perspective that that’s not what donors want, but when we have had conversations with a few of them, they’re like, “I didn’t think about it that way. Wouldn’t that be amazing because you create a sense of sustainability for excellence in research and clinical care to continue?” That would be one example. The other, and I’m hearing this more as I talk to others across the country, is when we think about philanthropy, we often think it is easier to get a designated donation versus an unrestricted donation that you can use for whatever the highest priority needs are in the organization.
I was talking to a President and CEO in the East. His comment, I found interesting. He said, “Sometimes that happens because we think that is what the donor wants and it might be easier for us to sell, but you would be amazed at how many donors will say, ‘You know your business. You know where the highest needs are.’” I might have an affinity to urology, as an example, but I might say, “I want to give you something generally for urology, but it would be better if through the process you decide so that the right things get funded.” That is another mindset change, that it is an industry challenge. It’s not necessarily a difficult conversation with a donor.
In many ways, it is a better conversation with donors because you are showing that flexibility and sustainability in what may happen. Your second example about how we sometimes restrict our own gist is 100% on the mark. It is easier to talk about it and explain where the money goes. A lot of fundraisers express some concern like, “We want to make sure that we can say what we did with the money,” which is a fair thing but restricting the dollars is something separate from being able to report back to the donor, and that you need those systems inside your organization. The idea of telling those big picture stories of what you want to accomplish at the foundation through your support of the brilliant women and men that you are funding is very inspiring.
In my experience, it has always been the case that it works better to lead with priorities about, what is the greatest priority? What holds the highest promise for the work? Start there with the conversation with the donor so they understand how you come up with your priorities, how you work with the smartest kids in the class to determine the best use of the funds in a way that gives them confidence in your process. If you lead with, “I want you to give me $50,000 for this sub-fund in urology,” it may inspire 1 or 2 donors but for the vast majority and particularly significant donors, it is not going to get there.If a vision is uncomfortable, it might be right because the transformation would’ve been done by now if it were comfortable. Click To Tweet
It is very interesting because we are in the midst of a process to say, “What are our three, it is actually going to be four, big priority areas for the University Hospital Foundation?” In the past, what has happened is we have had many priorities come forward. We exist to help to fund things at the Academic Health Center in the university. It is not surprising that people would have a list of things that need to be funded.
There is no doubt and there is never a bad idea because we get incredible proposals coming forward. We have spent about six months talking to about 150 people in the Academic Health Center and beyond because we have gone to the broader AHS and said, “What is the most important for us to focus on? We exist to support you and to make you successful. What should we be focusing on?”
There were two key pieces and I can’t share what those priorities are yet because they haven’t gone through our final internal process. The two things that came out are if you want to show donor impact, you need to focus on some core areas rather than a shotgun. If you’re trying to move the needle on something, you may need concentrated effort there. The second thing as a general piece that came out is we were looking at this in terms of, what is our one-year priority areas? What’s loud and clear from everybody we talked to was, “Why don’t we put three years’ worth of effort into this and see how we can measure the impact?”
We are doing some work on how do you truly measure impact not only through storytelling but also how do you show impact. It is starting to change the conversation in our organization. The Academic Health Center is this incredible culmination of talent from the university, from the AHS, from the site that gets to come together and do brilliant work. If we concentrated our efforts, imagine what would be possible.
Were you surprised by what you heard when you asked that many people what the foundation should be investing in? Were there some messages that came through that you weren’t expecting?
Maybe we could bring it down to three core areas and we have one other bucket. It is only in another bucket because the subcategories under that didn’t theme together well with the other three. There’s not many of them. First of all, when you talk to that many people, there was a consensus that these are the three big things. If we focus on these three big things, we are going to make a difference.
To me, why that was surprising is that over the years, the University Hospital Foundation received funding priorities in many areas. Part of it is we had not sat down and asked. We had not had an organized process that said, “We want to get better than we already are.” If we get better than we already are, that means the Academic Health Center excels and becomes better than they already are.”
What are you anticipating hearing with donors when you go out with those four priorities?
It is interesting because we will hear, first of all, “Okay.” It is partly because of the way we have done things in the past. There will be some real education on why do we pick these areas. That is not a bad thing because we have some incredible gyms in our Academic Health Center that have not been highly profiled and need to be highly profiled. What it will do is it might cause the donor to pause and say, “What about?” It also allows for an incredible opportunity for education.
I believe that with that education, there will be support because part of the underpinnings of the priorities is we have to have the talent in the Academic Health Center to propel anything and everything we do. We’ve got to get the talent to raise the bar. We are pretty darn lucky at the University of Alberta Hospital that we have incredible talent, but talent changes every day. New technologies and skills come out so you can’t sit back and say, “We have got it because we have the Mazankowski Alberta Heart Institute.” It means we have to continue to be the best at the mass.
I look forward to checking in with you in a few months after you’ve had a number of those conversations with donors. There is that education process you mentioned. I think you will hear that the donors are grateful for the clarity.
I think so as well. It will help get everything going together in the same direction and I don’t just mean our foundation hospital and the university. It means the community.
You mentioned it a couple of times, and I would be remiss if we didn’t spend a little bit of time on your strategic plan, Ignite 2030. Maybe you could share with our readers a little bit about the process of how you developed that. I’m very curious to know how you selected 2030 as the goal.
How did we develop it? We had two pieces of work going on in the organization concurrently. I joined the organization in January 2020. I tend to think of a longer-range and bold vision. How do we set something down that makes everyone go, “What are they trying to achieve over there?” We did the work on the strategic plan concurrently with developing a board charter. That was an important marriage between the strategic plan and the board charter because our strategic plan was setting our path on who we wanted to be by 2030.When your community starts to see significant changes, they realize what’s possible and start to gain more confidence. Click To Tweet
The charter boards are incredibly important in what is the governance structure to get there. We did these two pieces of work together. For the strategic plan, we did a lot of environmental scanning and looked at our “close competition,” but we all have the same donors. We looked at our local foundations. We look nationally and internationally. We also look at what is happening in health system transformation, what is new, and where do we want to be.
We went through a series of sessions with our employees and board that included donors. We looked to our health ecosystem, both inside the Academic Health Center and beyond. We talked to a few key donors. That process took almost a year to come to land with Ignite 2030. The reason for the time horizon of ten years is we wanted it to be a bold and courageous plan. Going out to 2030 was about saying, “In ten years, where do we want to be at so that we can look back and notice the shift and the focus that we took?”
I want to compliment you on that. Using the big vision as a way to set direction and that North Star is so important particularly in organizations that are working in complex environments like healthcare for example.
What happens often is in healthcare and post-secondary, we go year-to-year by our budgets. I don’t think we should be driven by budgets. We should be driven by what we are trying to achieve and the budget will follow. Otherwise, we will only think for now and there is always going to be a crisis.
Donors are looking for system change, transformation and impact over time, and those are not measured in simply the dollars you raised in any given fiscal year. It takes longer for those kinds of deep and significant impacts to take effect. We are seeing a lot of organizations that are getting rid of the five-year strategic plan. Some are still doing the three, but we work with a lot of clients that set that ten-year vision.
What are the measurable steps between here and there that you’re going to take in order to make sure you arrive there by whatever the date is that you’ve set? It gets much more dynamic board conversation. It gets more inspiring for donors. It’s clarity to fundraisers and organizations about what you’re trying to accomplish.
As we went through the process, because it is a big vision, it tested some of our previous and sometimes current thinking. It was uncomfortable at times. My view is if it is uncomfortable, it might be right because if you’re talking about transformation if it was comfortable, it would have been done by now. There were uncomfortable times and tensions at that time, and what will help us to achieve this is those tough conversations.
It does take strong leadership to make sure that those conversations are had in such a way that they stick, people feel respected and heard. You’re still able to make the change in the organization that as CEO, you know needs to take place.
The job of a CEO is to be able to bring tough things to the table and grapple with them. Sometimes things will go where you would love them to go. Sometimes, you have to go a little more slowly. One thing that we have learned over 2020 is the importance of language. As a CEO, I am very close to it because I spend time thinking about it, but other people have a fleeting moment on it.
When I use a certain language, I know what it means. I know the intent behind it and the message I’m trying to get across, but I can’t assume that because I’ve said it once, that people understand and feel it like I do. That has been an important learning for our organization. Just because a CEO and the board says it so, it doesn’t mean you all have the same understanding of it.
I’m curious as we come to the end of our conversation. You have done the priority setting process. You are in the final stages of that. You’ve got this terrific strategic plan. You’ve done the governance charter. Having done all of this work on getting the organization ready to perform in a different way, what are you most looking forward to?
We had a meeting with our integration leaders. That includes the director level and the executive level of the organization. Our teams were talking about our core pieces of work that they are working on a three-year implementation plan of Ignite 2030. Three main initiatives were talked about. What was amazing is to see the thought wheels going in the beautiful lines of our team. You can see it all clicking together that, “This is going to build for this, and this is going to build for this.”
What I’m looking forward to in our strategic plan is one, I’m looking forward to the public seeing that we are a different organization than we were. It will come in many ways. When your staff starts to see it, because there is a whole lot of heavy lifting when you go through a significant change like this, they gain more confidence. They know it’s possible.
As a CEO, you don’t see it because you’re in it every day, but when you step back and get comments from your community and teams who are mired in it, that’s what I look forward to, being able to step back and celebrate. That will come through the strategic partnerships that we are growing, the event focus that we are doing differently and growing, the professionalization of the organization, and how our donors are thanked and cared for.
It sounds like you’ve got a tremendous amount of great things going on there. You’ve spent two years working very hard to get to the point of being able to start to use it all again. Thank you so much for being on the show.