Dear Colleagues,

As you know, Dr. Catherine Zahn will be leaving UHN in November and will assume the role of CEO at the Centre for Addiction & Mental Health on December 1. Catherine is literally irreplaceable- so we will not try to find someone who can replace her. Instead we will realign UHN management structures in a way that will prepare us for the fiscal challenges we will be facing in the next few years as well as the opportunities that always present during a time of system stress.

In realigning our management, the most important issue for me is to strengthen integration across our three hospitals. This focus is best represented by the tag line "Three Hospitals- One Team". The future of Canadian hospitals is integration of multiple sites under one management structure. This enables efficiencies that allow us to focus dollars on our patients' care. The downside of multi-site models is that healthcare staff  tend to identify with hospitals- not corporate structures. The history of UHN is to develop best practices in the management and engagement of staff in multi-site hospitals. In this next phase of UHN's evolution we will emphasize the special identities and roles evident in our three hospitals while also emphasizing the common vision and purpose that unite us into "Three Hospitals- One Team".

The second theme that needs re-emphasis is our Programmatic organizational structure. As we develop "Three Hospitals- One Team" we will ensure that our programmatic services are strengthened and that our "care silos" are de-emphasized. The enhancement of programmatic organization and care will also be emphasized by our current strategic planning process which is largely based on the plans of our nine multidisciplinary programs.

Finally we need to strengthen the role of our Program Medical Directors (PMD's). The unique UHN matrix emphasizes the importance of our clinical staff by providing PMD's with tremendous influence over our UHN strategic directions. At the same time, we expect our PMD's to be international leaders and their scholarly pursuits often make it difficult to fit their influence into their schedules. We need to work on this element in our "Three Hospitals- One Team" plan- more to follow on this.

In starting the organizational change I will make several straightforward alterations to our responsibilities which will be effective immediately:

Dr. Charlie Chan will take on several new responsibilities as Vice-President Medical Affairs and Quality. Charlie will assume executive leadership of the Quality Committee of the Board and take on executive responsibility for Infection Prevention and Control and share executive leadership for Pharmacy with Emily Musing. Charlie will also work with me in ensuring that the Program Medical Director role will be more influential in strategic decision making at UHN.

Senior Vice-President Emma Pavlov will assume executive responsibility for our Medical Laboratories Program.

Vice President Finance Justine Jackson will take on executive responsibility for the Medical Imaging Program as well as UHN Infrastructure. Justine will also strengthen her leadership of our supply chain management processes and relationships with Plexxus.

Our five Clinical Vice-Presidents (Sarah Downey, Marnie Escaf, Jeanne Jabanoski, Scott McIntaggart and Kathy Sabo) will report directly to me as I take on the direct executive responsibility for our integrated clinical programs.


All of the other Vice-Presidents who currently report to me on our organizational chart will continue in the current reporting relationship.

In developing this "Three Hospitals-One Team" theme we will review our management structures to enhance inclusiveness, effective decision making and reduce time spent on meetings. We will carefully review the purpose of every UHN committee and emphasize the "decision rights" of all leaders in the organization.

In starting this re-design process, I have asked the five Clinical Vice-Presidents to join the UHN Executive (current members Bell, Chan, Pavlov and Jackson) to form a time-limited Transition Council which will have responsibility for advising me on structures that will support "Three Hospitals- One Team". We will meet weekly for the next couple of months and reports from our work will be forthcoming in Straight Talks.

Finally it is important to recognize institutional wisdom. I have asked Drs. Mary Ferguson-Pare, Michael Baker and Bryce Taylor to serve as "Ministers Without Portfolio" (in addition to their usual responsibilities) during this transition process to advise me directly based on their years of developing and understanding of what makes UHN special.

Catherine Zahn's departure offers us a unique opportunity to strengthen the way that we pursue our Vision and Purpose working together as three hospitals and one team. Please send me any thoughts that you have regarding this next phase of UHN's evolution as a leader in Canadian healthcare.


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