Leading one healthcare philanthropic organization would be a tough calling for most mortals, so why not run two? It seemed like the enormous task of leading the Royal Alexandra Hospital Foundation is not enough to satiate the drive and passion of such a leader as Sharlene Rutherford, who went on to lead the creation of a second nonprofit, the Pan Alberta Women’s Health Foundation. In this episode, she walks us through the challenges of running both organizations, including engaging donors and boards to buy into their initiatives, leading a committed team to excellence, and doing advocacy work for better healthcare provision. Join in for an exciting conversation!
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Royal Alexandra Hospital Foundation With Sharlene Rutherford, President & CEO
In this episode, we have Sharlene Rutherford. Sharlene is the President and CEO of the Royal Alexandra Hospital Foundation in Edmonton. In that role, she also leads the Alberta Women’s Health Foundation. Sharlene goes deep into the conversation about the importance of advocacy and balancing that with fundraising messages in the hospital, building relationships with the government, and expanding the work of the Lois Hole Hospital for Women across Alberta. Throughout the conversation, she gives great examples and thoughtful questions that you might want to ask yourselves in your own organization as you’re building collaborations and partnerships yourselves. This is a great conversation. Please enjoy Sharlene Rutherford.
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Welcome, Sharlene.
Thank you so much for having me on. This is great.
Sharlene, I am so excited about the conversation we are about to have. It is rare to have someone who is leading two organizations at the same time. One movement-based organization is the Alberta Women’s Health Foundation and one institutional-based organization is the Royal Alex Hospital Foundation. How do you balance it all? Tell me about those two organizations and how you balance being CEO of both at the same time.
It all starts with having great people working in the organization and being passionate about the causes. I would start with the Royal Alexandra Hospital Foundation because leading this organization has been such a great privilege and an honor. I had the great fortune of learning from someone who led this organization for many years and that was my predecessor, Andrew Otway. I learned a lot working for Andrew.
I got to see how the foundation made such an incredible difference across the Royal Alex Hospital campus and across areas like the CK Huey Heart Center, the Orthopedic Surgery Center, the Eye Institute of Alberta, and the Lois Hole Hospital for Women. It goes without saying this is a very large and very busy campus with a lot of medical centers of excellence.
It was through our work with the Lois Hole Hospital for Women specifically that led to the natural progression of starting the Alberta Women’s Health Foundation. This pan-provincial fundraising brand works to elevate women’s health and women’s health research. I would add to that because I would also say that not only have we launched the Alberta Women’s Health Foundation. We are a third founding member of something national and that is Women’s Health Collective Canada through the Women’s Health Brands that we’ve connected with our sister foundations, BC Women’s Health Foundation and Women’s College Hospital Foundation.
The three of us started Women’s Health Collective Canada, and that exists in the space. That same space, the Children’s Miracle Network exists in when it comes to fundraising for children’s health and children’s health research. That’s been in existence for many 40 years and they’ve been so tremendously successful raising billions of dollars but there was nothing that existed in the women’s health space. We launched this national brand to be able to work with corporate Canada in that way. It is a nice extension working as lead for the Royal Alex Hospital Foundation and how that dovetails so nicely into part of our campus on women’s health across those two other fundraising brands.
When you get to work first thing on Monday morning, is it color-coded which organization or which meeting you’re going to be in from Monday to Friday?
I laugh because do you know what I do? I have color coding in all of my appointments. CK Huey Heart Center is red. The Orthopedic Surgery Center is green. The work with boards is blue and Lois Hole Hospital for Women and any of the women’s health file meetings are all coded as purple. You’re right, that is. That’s part of the way of keeping it straight, for sure.
Who am I in this meeting?
I know but it’s great.
Engaging Stakeholders
We described the breadth of the work that happens at the Alex and Adult acute care Basis. It is, if anyone’s been on the campus, you feel like you’re in quite an industrial complex of healthcare. It is quite a place. That’s enough to keep any one person or any one foundation focused and you mentioned those centers of excellence. Working with your board and your team, how do you decide where to focus your efforts as a foundation in terms of engaging donors and raising money for the particular areas of such a broad organization?
With so many centers of excellence across the campus, you could think of them all as hospitals within the larger health complex. There are competing interests across the board when it comes to growing excellence in patient care. There’s no question. For our team, we’ve grown significantly in the past few years and I’m happy to talk more about that. Even so, we are still one foundation with finite resources and finite energy and the board of directors that holds us all accountable.
Those conversations we have about where we expend our efforts are based on the areas that input patient care in the biggest ways. We take a look at the projects that the Orthopedic Surgery Center has before them. We take a look at Lois Hole Hospital for Women. We try and evaluate what are the best cases to take out to donors.
We try to ensure that we have the right people assigned to those cases to take them out and have the capacity to expand the focus. That’s such an important word for me, focus because as you can imagine on a campus like the Royal Alex, it’s quite easy to lose your focus with so many things happening. If you overlay or on top of that, the work that’s happening at the Royal Alex when it comes to our inner city population and the crisis that’s happening in opioid use, overdoses, mental health addictions, and homelessness.
This is an area of care that the Royal Alex is very good at handling. The Royal Alex is very good at handling the toughest cases and tough medicine. Our foundation has had to apply some consistent focus and energy in there as well. That’s not always the easiest case to take out to a donor. It’s so very important. There was an article in the Globe and Mail. I’m sure you saw it about the housing remedies that are being called for across Canada.
What’s happening is the issue of growing homelessness across our country is impacting the ERs in hospitals across our country, because inevitably, if you are homeless, you will end up in an emergency department at some point. What they call the frequent flyers into the emergency department. There are a lot of impacts on the healthcare system. We’re asked to help alleviate that and take care of those things.
Your foundation has been one of the leaders in my experience and in my travels hearing about the work the Royal Alex Foundation has been up to over the last number of years. Extending the work of the foundation and the funding of the foundation beyond the four walls of the hospital and funding into the community. You mentioned that can sometimes be a tough case to take to donors, but how do you approach that? How do you work with your board and with your donors to ensure that those vital dollars are available for those services?
That’s a good point. One of the things we always want to try and do is when we’re considering a case that takes our fundraising, our fund development teams outside the walls of the hospital is what is the clear line of sight back into the hospital. There has to be a clear line of sight there. I’ve got a couple of examples to share with you.
We were very successful in our work fundraising. It is something called Pregnancy Pathways, which was an effort to help find stable homes for women who are homeless and pregnant. I can’t imagine being homeless. It’s much less homeless for two. We were able to develop a quite sophisticated case around this. We created videos and a case document. We even developed a logo for the initiative, which continues to be used in our work years ago.
The clear line of sight though for us was our obstetrics and gynecology team came to us and said, “These women are patients at our hospital. These are our patients. When they present, when they’re in labor, if they have not had good obstetrical care and leading up to delivery. There are big challenges. Can you help us by securing housing again?” Which means wrap-around support services for these women. That’s why we got involved and it’s like everything we do get involved. There is a clear line of sight to an area of care or a program here at the Royal Alex that benefits from the support as well.
I’m curious in a situation like that when you’re taking a step outside of the four walls and with good cause with a clear connection back and the medical leaders are asking you to get involved in this. Who says yes? Is this a conversation you have with your leadership team or with the hospital? How does your board get involved in the approval of taking on a project like that?
The first line of looking at this comes with the leadership of the foundation and what we know our capacity is. There is certainly a clear line of sight as we have conversations with the site leaders at the Royal Alex. Ultimately, that case is taken to the board of directors and we make a presentation to the board. You need to have board buy-in for a couple of reasons.
In terms of the board that provides fiduciary oversight and good governance, that’s important that they have a good understanding of a fulsome understanding of what we’re working on and how they can help support it. Also, the litmus test of how does this still fit with the strategy plan of the organization, which the board endorses which I’m measured against in my role as a CEO as I’m evaluated. It’s a two-parter senior leadership of the organization that assesses this and makes a recommendation. It comes to the board for their approval and endorsement as well.
I imagine the case of pathways for pregnancy was a pretty open-and-shut case for the approval of something like that.
It checked all the right boxes in terms of a good fundraising case for us with a great outcome. That’s the same as the ARCH program. The addiction recovery and community health program that we were an early supporter and adopter of and became an early fundraiser on this and created a program probably a dozen years ago that remains something that defines the Royal Alex.
Royal Alexandra Hospital Foundation: Addiction recovery and community health is a golden thread of care that it runs through all of the areas of excellence.
Addiction, recovery, and community health is a program that is a golden thread of care that runs through all of the areas of excellence here at the hospital. That was a program that our foundation went to St. Mike’s in Toronto to take a listen to what they were doing there. Something very similar that we could then bring to our hospital, which geographically, is situated in the heart of Edmonton, so in the core of the inner city.
You mentioned the role of the board in approving these projects and finding a way to say yes. One of the offhanded comments that a lot of people make when they start strategic planning or even annual planning is, that we need to figure out what we’re going to say no to. There’s some healthy discussion that can come from that, but in our sector, organizations struggle more frequently with how to say yes to things. What are those things going to be most important? What are the things that are going to animate our strategy, our work, and our conversations with donors? How do you work with your team first, your senior leadership team first to find those things that you’re going to say yes to?
It’s coming together with the senior leaders to evaluate a case. In that respect, it’s working with the hospital leadership to see how a case animates them and their response to the case and their buy-in. You get a clear line of sight to what the finish line will look like when you’re talking to the leadership of your hospital. Often, our decision on whether or not to go forward with a case out into the community is dependent on how it’s positioned to us and how we know our physician leadership and the administrative leadership of the hospital are behind it or not.
That’s a big tell for us because we want to be successful. We don’t want to take on anything that could be potentially successful. We want to take things that we know we’re going to be successful in. That’s important to the board. Part of it is the trust that the board has in the leadership and in particular in the CEO. It goes back also to my relationship with my board and the questions that they are able to ask me, both during the meetings and in-camera sessions with them. There’s a trust there and they know me very well. I’m fortunate to have a board that’s very engaged and wants to be partners in our success while also understanding the role of governance versus operations.
We don't want to take on anything that could be potentially successful. We want to take things on that we know we're going to be successful in. Click To TweetCreating The Pan Alberta Women’s Health Foundation
They get so excited by these great ideas they want to push the buttons and pull the levers and then be involved in operations. It can be a challenge to keep them away from the control panel. How do you manage that as CEO?
I haven’t had too many issues there at all. They want to help. People want to help. They’re on the board of a health charity for a reason. They’re interested in health care. Maybe they’ve had an experience in health care or they’re impressed with the work that the hospital does. They understand the importance of the work of the hospital and they want to be part of that. They want to have something to weigh in on and to comment on. That’s very important.
We want to make sure that those big discussions happen on our board. In fact, we’ve restructured even the agenda of our board meetings to allow for that opportunity for good conversation where they can talk about something we may or may not do and weigh in on it in a more fulsome way. That’s important and I rely on that guidance very much.
Talking about restructuring board meetings could get me into a super nerdy side pool here. I want to come back to something that may be more interesting for our readers. Not just for my own interest. We talked a little bit about expanding the role of the foundation beyond the four walls and supporting community-delivered services for those patients or those individuals who are going to be in the hospital. You’ve taken that a couple of steps further in two instances. I want to talk about the lead-up to the decision to create a pan-Alberta Women’s Health Foundation and to animate that conversation across the province. How did you come to that decision? Let’s start there. How did that come to be?
It came to be from, first of all, our work with Women’s Health Collective Canada. It was working at that national level first, which is when you think about it, it’s a little bit backward. We were working at that level first and seeing what our peers at BC Women’s Health Foundation were able to do under the banner of this brand.
We looked at that and we thought, “We support women’s health. We support a women’s health research Institute,” which we do to a large degree. We’re responsible for supporting all the women’s health research that happens in our province through that Institute. It made such good sense to establish something that gave it a name. We were already doing the work.
Royal Alexandra Hospital Foundation: We’re responsible for supporting all the women’s health research that happens in our province through that institute. So, it made such good sense to establish something that just gave it a name.
Let’s give it a name, brand it, and push it out even further and connect it to the national link, and have something that’s truly successful. That gave us the opportunity to operate in more of an advocacy role for women’s health as well. It wasn’t a big stretch for us. The reason is because of all the work we were doing to support the advancement of women’s health in a hospital as well as the health research that’s happening in women’s health and to grow that, too.
It’s not like we created this brand and then started doing the work to legitimize it with the case at all. That work was happening for well over a decade, close to 16 to 18 years. It was an opportunity and a time that had come. It’s from working with others in the social profit sector that led us to the conclusion that this is where we needed to be.
It’s relabeling the container rather than building the container from scratch. I’m sure I’m not the first person to point this out to you and you know it in your day-to-day work at the Royal Alex Foundation. A lot of healthcare philanthropy is very local. You stretch and start telling a pan-Alberta story. How was that received by other hospital foundations as they learned of or had the opportunity to work with the Alberta Women’s Health Foundation?
I had conversations with others in the sector first to say, “This is the route we’re taking.” I had a good conversation with my peer at the Calgary Health Foundation and that one was an important one to have because of the nature of our work as a pan-Alberta fundraising organization for women. I always kept the door open and continue to keep the door open for partnerships in women’s health that are priorities across our province.
It was a conversation that I needed to have and to say, “This is the route we’re going.” Again, it wasn’t any different work than we had already been doing. We were already working in Calgary. We were already working in Southern Alberta and Northern Alberta through our work with the Women and Children’s Health Research Institute. That’s the research institute’s support. Certainly, from Central and Northern Alberta, all the fundraising we had been doing for the lowest whole hospital for women. We were already very active in these areas and beyond. The work itself wasn’t new. What was new was the fact, as I said, that we were branding it now. That we were calling it something.
Interesting thing to someone who has had the chance to speak to a lot of leaders in the sector to work here at the Discovery Group and through this show, that balancing movement philanthropy which Alberta Women’s Health Foundation does represents that push that includes advocacy for equitable treatment of women’s health in the health system and in the research enterprise. Not just in Alberta, but across Canada and around the world.
How do you balance that concept of movement philanthropy, which is we need to put money behind the ideas, the work, and the advocacy to change the story for women’s health and the work of raising money for capital improvements at the Royal Alex itself? There are such different conversations with donors. I’m curious how you balance that. Not just with color coding, but with your planning and integrating it all into a cohesive whole.
This is where the growth of the team has been so important. I would say years ago, this would have been a much more difficult path for us to follow. Particularly in the advocacy work that we are doing in women’s health. We’ve created a couple of very important thought leadership papers. The second one called Surveying the Silence, which highlighted the taboos on women’s health and the impacts of those on women’s lives professionally, personally, and economically.
That has been received as quite an important piece of work and beyond a thought leadership paper and is considered a reference guide. I’ve heard that not from someone in Alberta. I heard that from someone in Quebec who has the paper and is circulating it there as well. That’s important work for us to be doing. You’re quite right, without a larger team in place where we can still have people focused on the CK Huey Heart Center, the Orthopedic Jury Center, and those priorities that are there. We couldn’t be doing this work in women’s health as well.
I just simply wouldn’t be able to justify it but it has gone hand in hand with our work on the Alberta Women’s Health Foundation side. That was one of the reasons for starting the brand. It’s because we truly elevate women’s health across our province this way and we saw it. It didn’t exist here. We saw the gap like we saw the gap nationally and created Women’s Health Collective Canada. We saw the gap in our own province too and saw an opportunity to fill it. They happened one after the other but it comes down to people. Having enough people where you can also have focus because the Royal Alex is more than women’s health. Certainly, far more authentic women’s health.
The Royal Alexandra is more than just women's health. Click To TweetOne of the unique challenges in adult acute care is the close working relationship with the health system which in those health systems all across Canada are connected to politicians that fund them and advocacy can be problematic or it can be challenging. There are examples of it working well and examples of it not working very well all across the country. How do you find that balance between that close working relationship you have with the health system itself and advocating for change of that system through the work of the Alberta Women’s Health Foundation?
It illustrates the position that the social profit sector is in or at least an organization like ours are in. Let’s look at it this way, we’re the not-for-profit sector but we fundraise predominantly from folks who are in the for-profit sector. They own businesses, work for companies, and have a certain set of expectations based on their experiences working in the for-profit world, but the funds we dispense at the bigger arena in which we work is the public sector. You have all three.
You think of all three of the concentrant circles overlapping one another. In the middle is the work of our foundation, our response to the needs of the public sector and in this case, healthcare. A board of directors on our side, which as you might expect are, in many cases, very entrepreneurial because they’re corporate leaders themselves. You can see how those three areas have to work very closely together but this is where we also need to manage expectations.
That’s a role that foundations have that may not be talked about very much. When you have a board that says, “Our hospital should be doing this, or we recognize that there’s this busy hospital that needs to have a new patient care tower. We recognize the fact that the Royal Alex has been on the list for redevelopment for many years. Why is this not happening? What can we do to push this forward?”
There’s the enticement to work on the advocacy side and to push forward with the government to make something happen. At the same time, you’re working in a public system where the people who lead the hospital work for the government. You can see where there’s going to be challenges and where there’s going to be tension. As a hospital foundation, in particular, working at a hospital that is ripe for redevelopment and has been for years. It’s well known that here at the Royal Alex, and you probably have heard this, too. We still put 4 and 5 people in a patient care unit sharing a single bathroom. We hear about that all the time.
It’s recognizing what is our role and how far we take this without the support of maybe the health leadership behind us. If we have the support of the health leadership at the hospital and even the levels of Alberta Health Services, it’s far easier to stand up and say, “We’re going to wave this flag. We’re going to jump in front of the parade. We’re going to wave the flag and say, “Change needs to happen because we know we’re going to look behind us and see everyone is marching with us.” You can’t be assured that that’s going to be there. Stepping out into the world of advocacy becomes very difficult.
Advocacy In Healthcare Philanthropy
We can name a couple of examples where foundations jumped out to the front of the parade and ended up being the only float. That has some pretty immediate repercussions for the organization. I appreciate you walking us through that because there is a role for advocacy in healthcare philanthropy to be sure. It is one of the most delicate fragile dances to execute. Your organization, at least from the outside, has done a very good job of that over the last number of years and is a model for others to follow.
Thank you so much. I think we have been, too. We have taken on the role of advocating for our hospital and its needs. We’ve undertaken what I would call most as maybe a softer approach in terms of how we’re reaching out to our MLAs and how we connect perhaps some of the challenges in our hospital to our fundraising causes and how we loop in government to say, “Here’s what we’re doing and here’s why.”
Even going so far as to say our role in inviting ministers to tour the hospital. We’re encouraged to do that and I’m glad we’re encouraged to do that. It’s a great role for us. In some ways, it’s interesting to me that the very people who work in the hospital who work for the government maybe aren’t as free to say, “Here are the challenges that exist and we need to do something about them.”
That’s always been an interesting facet to me because the people who are on the front lines of care and your health managers who are leading care teams are the best suited to share where the challenges are and what could be fixed and where the solutions are. A great example would be Dr. Louis Francescutti, who’s our emergency room physician.
The people who are in the front lines of care are the best suited to share where the challenges are and what could be fixed. Click To TweetI mentioned earlier the story in the Globe and Mail. He’s profiled predominantly in that story, saying, “Here’s the challenge that’s impacting our ER and ERs across the country. Here’s a solution. Here’s what we could be doing differently to alleviate that.” The solutions are right there by the people who are doing the work. It’ll take all sectors working together to listen to them and say, “Let’s put egos aside, and let’s make sure we get this done right.” We have a role to play. in leading that and facilitating that conversation. Also being able to say, “Here’s what we can commit as a case. Here’s what we’ll do to work on this.”
One more question on this advocacy because this is going to be valuable for our readers then we’ll get to our magic where we wrap up the final question but the question on advocacy. When you’re showing that there’s 4 or 5 to a room or 4 or 5 sharing a bathroom and you’re talking about the clear need and the want of the place, the need for redevelopment. When I was working in Edmonton and left the University of Alberta in 2008. It was the exact same issue at the Royal Alex. It’s not a new issue, as you say.
As leaders of the foundation, you’re both pointing to this need. We don’t have the physical plant to provide the care that people deserve, need, or expect. At the same time, you’re raising money for the excellent work that’s happening in the hospital. You’re talking to donors about their investments, making a real and meaningful difference in the lives of patients and the research that’s happening in the place. How do you, as CEO, bridge those two? Those are very different messages about the exact same place.
It can be such a paradox. This is why we’re very careful about how we push out the advocacy messaging and where we take things because, on one hand, you’re talking about the excellence in care that donors are driving and making possible. On the other hand, you’re talking about a lack of patient privacy, dignity, and even safety in your wards because of the crowding in patient care rooms in an old facility that’s aged out and is no longer conducive to providing modern standards of acute care delivery.
How do you balance that messaging? We’re fortunate then in the case that we have medical centers of excellence that we can focus on in ways that do allow us that opportunity to talk about what’s new. The CK Huey Heart Center is in the Robbins Pavilion, which is a fairly new area. The Lois Hole Hospital for Women and even the Institute of Alberta, we talk about things relating to new standards in care.
We talk about the technology and the research chairs. These are all areas in which donors can get excited about supporting healthcare and the advancement of care. In that sense, we’re fortunate, but it is a balancing act. There’s no question it’s a balancing act when we talk about the Royal Alex. It’s such a hard-working hospital. It’s a cherished facility.
I’ve heard one trauma surgeon say in a meeting with me, how loyal and devoted he was to this place and wanting it to succeed because everyone works so hard. He said, “I have an irrational belief in the Royal Alex because it is such a hard-working facility. It gets things done.” In fact, it’s had the workforce of the health system, the workhorse of the province.
When you think about that, what does the workhorse do? I come from a farming background. I’m a Saskatchewan farm kid. Workhorses are never all that pretty and not the fastest, but they carry more than their load always. They’re loyal, steady, dependable, and get the job done. That’s all fantastic to say about our hospital, but is that inspiring to all donors? Not really at the end of the day.
It’s just a fascinating balance, as you say, and one that you and your colleagues have managed to do very well over the last number of years. For our readers who are interested in seeing an organization that has managed to be an advocate and a champion, as well as the cheerleader for the excellence of the hospital, here is a good organization to spend some time looking at.
As we come to the end of our conversation, Sharlene, I want to ask you my favorite question to ask our guests and I’m looking forward to your answer. Our producer, Alex, and I were talking about this before you came on. We have some bets as to how you’re going to answer this. We’ll let you know after we stop the recording of who won the bet. Sharlene, what are you looking forward to?
I’m looking forward to continuing to grow a team. I am. We have such a fantastic staff at the Royal Alex Hospital Foundation. We’ve had significant growth. Years ago, we were barely 22 people and we’re now upwards of 45. That is truly significant but what it does is it shows the belief that the board of directors has in our direction and the success that we’ve been able to demonstrate.
If there is going to be a campaign for the Royal Alex or its emergency department or areas of care here. We need to have great people doing the best work and being in the right roles. That’s what I’m excited about. I’m excited about the team we have and how passionate they are about the hospital and learning about the different areas of care and where we can make a difference.
I’m excited to see what the Royal Alex Hospital will do. I’m hopeful that this government will also see what this Royal Alex Hospital can do and will believe in it and fund what’s needed so that it can be redeveloped into the facility that becomes a hospital of the future because it does so much work the Inner City outwards up through to Northern Alberta, a third of Canada’s landmass, Inner City challenges, and trauma. All of that happens here. That’s what I’m excited about and hopeful for. I don’t know who won the match.
We’ll tell you later, which just means it wasn’t me. Sharlene, I want to thank you for sharing your examples, perspective, and the inspiration that you have been to so many leaders across the country over the last number of years. Thanks for being on the show.
Thank you so much for having me, Doug. It’s been a wonderful conversation. I’m grateful to be on and to be sharing the great work that we’re doing here in Edmonton and beyond.
