Making APAC a process – System-led leadership and learning to work more smartly

29 Oct 2015

Paul Ingle talks with Geraint Martin CEO Counties Manukau DHB

PI: I have heard it said that APAC itself is the child of Ko Awatea and Counties Manukau, so with 1,400 people here you must be feeling like a proud parent?

GM: A little bit like that, I think. We have been doing this now for a number of years and the idea of APAC started off with the ‘How do you create a community in our part of the world’? Where you get like minded people who really are passionate about health and passionate about how we improve it, and ‘How do you spread the skills and the knowledge and the networking that go into support and under pin that’?

I think it’s really important to have a conference like APAC that brings all of those people together. The kind of networks, the friendships, the collaboration that it exposes are really quite awesome and it has really begun to build a community of interest, a community of leaders really focused on improving healthcare. Really the hope around APAC was to stimulate that kind of community.

PI: And at 4 years, has it met or exceeded expectations?

GM: Oh look, it has really exceeded my expectations. I think it has exceeded everyone’s expectations. We started off with a few hundred people four years ago, and here we are now with one and a half thousand. Bigger than we were last year when we were in Melbourne, and hopefully when we go to Sydney next year, it will be bigger still.

Which shows, not that we’re clever, but that what we are doing I think, is that we have met a hunger, a need in the system like this and people have come along to it.

So, it is now one of the biggest healthcare improvement conferences in the world. That is a remarkable thing to have seen in four years, but again that is about a hunger for this, this is the real underlying issue of why this has happened.

PI: At the Thought Leaders dinner, a couple of evenings ago, you and members of your team, were all really encouraging people to think about how APAC could improve and how that will look in 2016 in Sydney.

You, yourself, you must have a view of how it could look further out from that in 5 years time, in 10 years time. What does that look like to you?

GM: I think it is all about momentum and, yes, we got to a great start but I want to move away from the idea that you have a conference once a year and everyone meets and they feel good for a couple of days and then they go back to the ranch and they are suddenly alone again.

What I want to turn APAC into over the next few years is something that is not an event, but a process. It is a staging place in a process that is continual.

So yes we have a conference, and yes we meet. There are lots of things going on, networks going on, lots of work together that we are doing across the Tasman, we have feedback at the next conference and it becomes a process, not just a sort of jamboree once a year.

PI: And have you seen that (APAC become a process rather than an annual event) start to happen already?

GM: It has started to happen already. I have been spending most of my time at this conference meeting with organisations and literally planning all of that out because I think everybody understands it is important to keep this ongoing.

The incredible thing is, all of the answers to the problems that we are facing are all here. It’s just we don’t know where they are. Ok, there are some things we sort of came to, but I am pretty certain that out there, somewhere at this conference, there are people who have sorted out solutions to problems that I am finding. I want to find what those answers are, I want to be able to build up solutions we can share, so we can actually spread, right across the patch, and find the improvements in healthcare we are looking for. I don’t want to just invent it in my own patch, I want to be inventing it collectively.

PI: I was interested in Minister Coleman’s comments around the need, certainly in the New Zealand context, to develop a sense of Team Health New Zealand and I had not heard that term before. And what does that look like from your perspective?

GM: I think it is the collaborative again, the working together for a single purpose. I think, as I mentioned when I was speaking earlier, If you look at those teams with the greatest competitive edge, those who are achieving the most, they are the ones with the fantastic collaborative teams.. I mentioned the All Blacks. They have such a strong team ethos, a strong team collaboration I believe it is collaboration that leads to competitive edge, not the tooth and claw competition but how we work together to be the best we can. It is critical. It’s the same thinking around Team Health New Zealand.

PI: Going with that theme of collaboration, I think some of the other commentary we hear coming through is also the need for health to integrate horizontally so holding hands with education, with welfare. More broadly than just in health. Is that a possible evolution of APAC?

GM: Very much so. I think the ability to work multi-sectorally to leverage people’s life chances, to be able to sort out people’s healthcare by sorting out their wellness.

Learning to work more smartly is very much a priority. This is where a lot of our agendas will be going in the future.

The thing is, we can only become so technically efficient. What we are talking about with multi-sectorial work is really transformational change. Which will keep people well, home, in a way that we have not seen before. And that again, will keep people away from hospitals. This is the absolute critical revolution we have got to go through.

Really, if we want to be leading edge, and I believe we need to be leading edge if we are to be successful, then APAC will be working more and more on focusing on these areas.

PI: That approach of thinking and acting in a more cross-sectoral way is going to take a different type of leadership in a way.

GM: I think we are moving more towards, what I call, system led leadership. The leaders of the future won’t just work in their patch and become really proficient. We will also need leaders who are able to bring people together, able to tie together coalitions, coalitions of interest that will make a difference through multi-sectoral work, move away from silos.

Getting people who can bring those people together, not through any sense of hierarchy, not through any sense of being the boss but being the advocate that can sway, the person who creates the space so that action can take place.

PI: I guess the other thing coming through, we heard it last night, and today again, is that people find APAC a source of inspiration. Beyond APAC, you in your leadership role, what do you focus on, where do you look for inspiration, is it in health, or beyond health or both?

GM: I think my biggest inspiration came from when I made the decision to come into healthcare in the first place. My first stop was history and I was actually doing a PhD and decided I did not want to do that any more and I actually sat down and asked, ‘What do I want to get out of a career?’ and it was two things: It was a sense of public service and it was a sense of doing something that was incredibly complex and so that is how I ended up in healthcare. And those two things have inspired me ever since. I grew up in a challenged part of the world and in a challenged community and it was the teachers and the doctors, who supported me and allowed me to have the kind of life chances I have had and the careers I have had. I can’t do more than thank them, but perhaps I can make it happen for some other people as well. That inspires me.

The other thing that inspires me is the people that I work with – the dedication, the professionalism – all the types of people in healthcare makes for a very special space. So what inspires me? I think leaving the world in a better place than what I found it really.

PI: In terms of Counties, I am aware that next year, you will have been at Counties for ten years and you will have seen a lot of change over that period of time. What are some of the things that stand out for you? The moments, I guess, that you are most proud of?

GM: I think, the first big moment would be, the changes that we did early on in ED. We’ve got the biggest ED in Australasia. We had the kind of issues that people will be familiar with. But, we worked together as an organisation, as a team, everyone together. We designed how we wanted to work, first of all in the hospitals and now across the whole system.

What we’ve done since 2009 is 95% of our patients go through within six hours. Nobody gets treated in the corridor despite being the biggest ED in Australasia. You go in there and it is silent.

I think the biggest improvements that we made in the patients that we treat is phenomenal, but I think the confidence and the can-do-ness that that gave us, to go further, bolder and harder, and knowing how we can do that, that first comfort. That would certainly be one highlight.

There are actually too many highlights to talk about.

I am incredibly proud of the team that I serve. I could go on about the things we have achieved. But, if I can just mention one more.

We’ve got a program called ‘Grow Your Own’ where what we do is work with local schools to get young kids to be interested in the hard sciences and therefore be available to us in terms of the kind of careers that we have. You know – doctors, nurses, therapists. But, the crucial thing is getting them continually engaged in education. Just to see how they as kids, and you have something like 200 go through that now, and many, many more physiotherapists, doctors, have come out of that pipeline.

To see what’s happening to those kids and what has happened to those kids families as a result of that program has been really, really exciting and incredible. Very satisfying. So if that’s another highlight.

PI: Very inspirational stuff. Thank you for your time.

GM: Thank you.