It’s been the toughest year so far for the aged care sector, but adopting new agile ways of working between the chair and CEO have allowed Mercy Health to manage extreme challenges with 10,000 staff across 50 sites, including 34 aged care facilities, that proved to be insurmountable for other aged care operators. Here’s how they did it.

    One of the most high-risk and confronting decisions taken by the board and CEO of Mercy Health during the COVID-19 crisis this year was to decide whether to shut the doors to family and other visitors to protect their aged care residents.

    Mercy Health Group CEO Stephen Cornelissen FAICD said he had a “robust discussion” when presenting alternatives to the board. “It was a risky decision because it was one that carried a huge risk when you think of what happened in New South Wales with Newmarch House in Sydney. All of that was very raw,” he said at a recent joint AICD/ACSA virtual event: Aged Care Governance – The Chair and CEO Relationship.

    The board agreed unequivocally that they would go down the path of letting visitors into the facilities.

    “In residential aged care, we made a call with the executive that we would not cease visitors, so we wouldn't have to lock visitors out of our aged care facility,” he said.

    While this was a higher-risk approach, which involved adhering to many COVID-19 protocols, it was one that allowed the organisation with its 10,000 staff across hospitals and aged care facilities to stick to its humanitarian mission and religious values.

    “I think it was a tough decision, because it was about whether we are committed to our mission and what we believe is people being relational, and therefore requiring their loved ones as part of their life, or whether we are committed to the best risk management process of eliminating any access points you possibly can.”

    Swift joint action by chair and CEO

    Mercy Health still has COVID-19 positive patients in its hospitals and aged care centres so is still in the critical response phase, particularly in Victoria, Mercy Health chair Virginia Bourke GAICD told the AICD webinar. “This wave of the pandemic is still playing out in our facilities, so in some ways it feels a long way from any kind of recovery.”

    However during the response phase, there were critical actions taken by the chair and CEO working more closely together than usual to enable them to tightly co-manage the crisis on a daily basis.

    The role of the chair and the board became much more operational. “During this time, we have delivered so much more operational material. Virginia knows almost daily the numbers of cases that we're dealing with, how many staff are affected, when they're working, what site they are at. That is a level of detail no chair would normally have, but in this situation I think it's been very helpful,” says Cornelissen.

    Information flow to the board also increased dramatically, said Bourke. “The board is receiving a lot of operational information, but I think that is really vital because the board can see and have confidence in the response of the organisation,” she said. “We see what's happening at each site, with changes in guidelines, and changes in government directives.

    “On a daily basis, we can see what's changing, and what's new, and we know how our residents are and how our patients are. I think that level of information – while it might seem purely operational – has certainly given us confidence.”

    Other steps taken by the board and CEO included:

    1. Setting up an incident command system with a 24/7 roster
    2. Ramping up communications, with daily reports going to the chair
    3. Regular communications to 10,000 staff and direct stakeholders
    4. In aged care homes which have been exposed to COVID-19 cases, daily verbal communications with each resident and their families
    5. More frequent board meetings
    6. Often daily communication between the chair and CEO
    7. New partnerships to cope with the crisis (with St John Ambulance, for example)

    Site meetings are also conducted by the chair and CEO once a year at each of the 50 sites, although this has been limited recently due to COVID-19.

    Bourke believes it is important for leaders to have a presence on sites and to conduct visits. “This gives us an ability to acknowledge our people. And just to walk around and thank people,” she said. A personal thank you goes a long way in a crisis, says Cornelissen. He and the board are ringing 500 staff in September to deliver personal thanks.

    “We've got 500 staff we've identified that have been just going above and beyond what is required over the last four months.”

    The chair/CEO relationship

    Bourke says the working relationship between chair and CEO at Mercy Health has been challenged in recent years by three Royal Commissions, plus this year’s serious health crisis. “I think during this time we have faced a lot of pressure and rather extraordinary circumstances.”

    However, she and Cornelissen had worked well together on the Mercy Health Board and have known each other for a long time.

    “For me, regardless of a crisis or not, the relationship is built on mutual respect. I need to have confidence in the integrity of the other person and I think that's how you build that mutual respect.

    “There also has to be clarity in the roles. I think you really have to understand what is your role in terms of governance, what is your role in terms of management, and you have to be very clear about that and sit down at the start of the working relationship and work these things out.

    “Thirdly, and probably most importantly, you need to have the ability to communicate very candidly and honestly, which is absolutely key. And I think overlaying all of this is a sense of humour.”

    “I'm not saying that it is always easy, but I think each of us respects the role that the other has,” she adds.

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