Easing tension

Rev. Audrey Whitney chats with Stephanie MacLaren, interim executive director of Hospice Prince Edward at a community at St. Andrews church in Picton last Wednesday.

Interim hospice head departs after smoothing things out

When Hospice Prince Edward (HPE) held its community meeting last Wednesday, it looked like smooth sailing for the organization.

Good news, because when Stephanie MacLaren, executive director of the Prince Edward Family Health Team, stepped up as interim director HPE five months ago, the organization was navigating some very choppy waters.

A cut in service, a combative relationship with the regional Community Care Access Centre (CCAC) and overwhelming pressure from a poorly thought out change in governance had pushed former executive director Nancy Parks to resign.

In her wake, fear and hostility from members, users, volunteers and the public about the direction of HPE led to most of the board resigning. It signalled a sinking ship. Only board chair Birgit Langwisch and treasurer Mary Camp remained in what could no longer be called a legally constituted board. There just weren’t enough people.

But the Family Health Team, who had seen many clients receive excellent end of life care at the hospice, would have none of it.

“Hearing through the grapevine that board members were steadily resigning put a bit of panic in our hearts,” says MacLaren. “Suddenly, you have this organization with no executive director and no board. It’s really going to threaten the service, perhaps disrupt the service. Often in healthcare, once that disruption happens it can be really hard to get things back on track in a good way.”

With the support of the team, MacLaren took on a dual role, working with Camp and Langwisch to rebuild. MacLaren says the move makes sense, because primary care providers like the family health team, are often left out of the decision-making process when it comes to palliative care, and her participation was a bridge between two services that should be connected.

“I would say that there’ve been a lot of communication tensions between CCAC, primary care, Hospice Prince Edward that are endemic to our healthcare system. They get exposed little more in such a small organization, but communication with healthcare provider partners is always an ongoing issue. So we’ve put in place a more collaborative process,” says MacLaren. “I think we’ve put in place the steps to get it there. I think that now we’ve got to walk our talk and make it so, but I think we’ve got the pieces in place to make it so.”

The first step was to cast the net, bringing in a new board. Once that was complete, they began to tackle some of the issues that had brought HPE to its knees in the first place.

With the help of retired municipal County clerk Victoria Leskie; the board is revisiting its problematic bylaws and governance rules and is rewriting a document that has led to strife amongst the board and hospice members.

They have also ensured professional service is available to clients of the hospice, 24 hours per day. The loss of this service was one of the sticking points that motivated Parks’ exit from HPE.

“I am reassured to know that 24 hour care has been been reinstated in the residential hospice,” Parks said in a statement.

It’s just a small part of the work the board has done to get back on course.

“It’s perhaps been a little bit slow, but we’ve been working pretty hard to make it happen,” says MacLaren. “[The board has] been able to now start to address some of the governance issues, which they couldn’t do without having that legally constituted corporation. They needed to do that piece first and then move to the next stage, reviewing the bylaws, exploring the membership issues—what’s going to best serve this community in terms of accountability, transparency and engagement.”

Now, with things on their way back to normal, MacLaren is moving on. A job offer near Haliburton and her family means both the Family Health Team and Hospice PE will be seeking new executive directors. This time, two separate people will hold the position, but MacLaren is certain the relationship that has been forged between the two organizations will continue.

“The only things that I’ve heard—and this is healthcare gossip—is the desire to see those pieces come more closely in line with primary care, which makes much more sense, especially in a community like this. Primary care providers are probably the most knowledgeable in terms of what’s happening with patient care, as are the homecare providers. To have those two entities working together would be smashingly successful.”