AccountabilityManagement
November 29, 2012

Back from the brink: Refocusing Ornge

Even before controversy shook the organization to its foundation, Ornge was always an anomaly in the Ontario world of ABCs (agencies, boards and commissions).  

Ontario’s air ambulance company was created in 2005 in an effort to bring a fragmented provincial system under the stewardship of a single not-for-profit organization. The reality, in fact, was much different. By late 2011, the organization had morphed into an unusual private-public, for profit/not-for-profit hybrid – one with 19 separate entities and more than 30 bank accounts – that would soon be laid bare on the front pages of Ontario’s major newspapers.
 
The focus of the organization had strayed from its core mission of providing air ambulance and related services to the people of Ontario, toward a fixation on generating business outside of the province. A series of media stories in late 2011 revealed a host of problems: a lack of transparency and accountability, taxpayer-funded executive salaries growing unchecked without being subjected to public scrutiny, as well as a variety of patient safety and operational issues.  

When an organization such as Ornge begins to fall apart, it doesn’t happen in a systematic, predictable way. After Deb Matthews, Ontario’s Minister of Health and Long-Term Care, installed new leadership in January 2012, new revelations about the extent of the damage appeared almost daily.

How could this have happened? That question has been at the core of a number of audits, investigations and committees, but ultimately it comes down to two missing pieces. An organization like Ornge requires a board of directors who can think for themselves, and have their noses in the business to keep management in check. In addition, it’s essential to have a firm foundational document that provides focus and gives enough operating freedom, but is strong enough to impose penalties if the organization fails to deliver. Those two items were both absent at Ornge.

To correct this, a new, independent, top tier board of directors was appointed, made up of seven volunteers from across Ontario with considerable experience in health care, government, industry and aviation. A committee structure was created to address specific areas of concern, including governance, human resources and compensation, finance and audit, quality care and operations.  

Next, the Performance Agreement with the Ministry of Health and Long-Term Care was renegotiated and signed. Among the many transparency and value-for-money enhancements, Ornge’s funding is now tied to key performance indicators; executive expenses are reported publicly; and the government has control over changes to Ornge’s corporate structure. The amended agreement also improved patient care through the appointment of a Patient Advocate and the creation of a Quality Improvement Plan.  

There was also a significant crisis in leadership as frontline staff had lost confidence in senior executives. Within months, the former CEO and all his direct reports were replaced by a transition team comprised of senior members of the Ontario public service on secondment to Ornge, along with experts in paramedicine and aviation. The transition team was tasked with ensuring the core business – transporting patients safely to the care they need – remained functional as the organization underwent audits and reviews by as many as nine separate third-party organizations, while at the same time making necessary personnel and operational changes. Not to mention motivating a workforce exhausted from months of daily media stories.

During the initial crisis phase, communication was especially important. Townhall staff meetings were held twice monthly at the beginning and now once a month. Rather than relying on briefings from outgoing executives, management turned to the people on the frontlines for information. The organization also reached out to stakeholders such as patients, Emergency Medical Services agencies and hospitals, who had been largely neglected or ignored under previous leadership. Many were forthcoming, and their advice helped shape policy.

The delivery of air ambulance service involves two of the most heavily regulated industries in Canada:  aviation and health care. Under these circumstances, change can be exceptionally time-consuming.  While there is still much work to be done, the organization has moved on from the initial crisis into a phase of reputation recovery. While the task of bringing Ornge back from the brink is both challenging, as well as a little messy, the 19,000 patients transported  each year makes this a worthy pursuit.

Ron McKerlie is interim president and CEO of Ornge. Prior to his appointment, he was deputy minister for Government Services and Secretary of Management Board of Cabinet. 

About this author

0 comments

There are no comments for this post yet.

Be the first to comment. Click here.

Accountability
 
We live in the age of paradox.  Never before in human...
 
Despite a rapid expansion in digital democracy initiatives around the globe,...
 
On October 22, 2018, elections were held in Ontario’s 400+ municipalities....
 
What are the key initiatives to support government innovation and change?...
 
Buying Social. Responsible sourcing. Ethical procurement. Sustainable procurement. Whatever name you...
 
In this episode, Lori Turnbull discusses the positive side of disruption,...
 
The Annual Financial Report of the Government of Canada Fiscal Year...
 
According to a 2018 study led by Dr. Michael McGuire, Senior...
 
Imagine your favorite world class service provider replacing the Board of...
 
When Mark Zuckerberg checked out of Harvard for California’s Silicon Valley,...
 
In his article, Gaming the System, How the misuse of data impedes...
 
My observation is people often take the view, “no one else...
 
The recent 2018 Senate Report examining the Government of Canada’s Phoenix...
 
Human services agencies play a vital role in society, providing a...
 
Tornado warnings broadcast a few weeks ago in Eastern Ontario and...
 
Canada’s international reputation for welcoming and integrating newcomers is unparalleled. At...
 
A few years back, consultants with ghSMART told us the biggest...
 
On today’s show, J. Richard Jones sits down for a chat...
 
Procurement modernization has been a Government of Canada (GC) policy priority...
 
It takes a lifetime to build a reputation and just moments...
 
Over the past two decades, codes of ethical conduct have become...
 
Earlier this year the Canadian government took a crucial step by...
 
On the global scene, technology has revolutionized and automated the work...
 
Over the past decade, major Canadian procurement projects have encountered increasing...
 
Prime Minister Justin Trudeau has, on many occasions, expressed his commitment...
 
In this episode, CGE radio show host J. Richard Jones speaks...
 
There is growing pressure on governments around the world to be...
 
Public servants are responsible for providing advice and support to the...
 
Today, the challenges facing governments are increasingly shifting away from traditional,...
 
Management in the Government of Canada is continuously searching for new...
 
Rankings of public sector entities has been big trend for quite...
 
Canadian Government Executive media through its upcoming TechGov event is providing the...
 
Ships docked in a harbour may not be going anywhere; however,...
 
The International Monetary Fund (IMF) in issuing its annual review of...
 
There’s no shortage of organizations claiming to have a digital transformation...
 
Cybersecurity professionals have sounded the alarm for years, and they are...
 
Cost estimation is becoming an extremely important skill within government due...
 
In this special episode of CGE Radio, your host John Jones...
 
Security professionals have an obligation to communicate risks and recommendations to...
 
Risk is always present in any undertaking, no matter the size...
 
Cost overruns have become institutionalized in the federal government, according to...
 
Last year, procurement Minister Jody Foote was prompted by the swirling...
 
Professionals, managers, and executives in the cost estimation industry can gain...
 
In this episode, hear from Carl Hammersburg, Manager, Government and Healthcare...
 
A new study from the Conference Board of Canada gives our...
 
In the world that we are living in today, free and...
 
The delivery method developed by Sir Michael Barber, chief adviser to...
 
Rules and accountability are helpful in developing and standardizing processes but...
 
Canadian doctors were told that climate change impacts human health and...
 
Even as talks between the government and federal workers affected problems...
 
The largest effort in 20 years to seek public input on...
 
Ottawa has overhauled the process by which justices are picked for...
 
July 27 was pay day some federal public workers that finally...
 
The Senate committee looking into Canada’s Syrian refugee program wants the...
 
In this episode, editor-in-chief, Patrice Dutil talks about the need for...
 
Yes, according to the former head of the Canadian Security Intelligence...
 
As much a 20 per cent of grade seven students in...
 
A Quebec superior court judge facing allegations that he helped commit...
 
In a move meant to the strengthen liability and compensation regime...
 
We often read news articles about rampant drug addiction and suicide...
 
Upon receiving numerous complaints regarding add-on fees that turn making economy...
 
Are you absolutely clear what the government wants to achieve? Are...
 
Veterans Affairs Canada is not adequately managing the drug component of...
 
Whether responding to emergencies back home or assisting regular troops abroad,...
 
Some public servants will have to request their departments for emergency...
 
A landmark Supreme Court ruling has paved the way for some...
 
The Canadian Radio-television and Telecommunication Commission (CRTC) yesterday heard from several...
 
At least one prime minister has resigned, another in under fire,...
 
It appears it was not just the Mounties that were affected...
 
A while back there have been numerous media reports about the...
 
Performance auditing can lead to more efficient, effective, and economical program...
 
Written By Jason McNaught The Public Service Alliance of Canada was...
 
Independence has long been regarded as a cornerstone of the auditing...
 
Canada is a diverse nation, in language, culture, geography, and, ultimately,...
 
Public sector organizations are under increasing pressure to identify all risks...
 
The government of Canada has implemented several measures over the past...
 
Whether at the territorial, provincial or federal government level, internal audit...
 
An organization’s reputation can take years to build but it can...
 
On October 30, Ontario began second reading of the Public Sector...
 
In the well-known children’s story, an Emperor falls victim to the...
 
The Nova Scotia Office of the Ombudsman is a small operation...
 
I think the ombudsman needs to be independent, because without independence...
 
Today’s business environment changes rapidly to adjust to evolving conditions and...
 
The best internal auditors actually are really good managers first. I...
 
The recent controversy about the actions of some staff members in...
 
Most professionals don’t need more than a sentence at a cocktail...
 
Recent research by the Institute of Internal Auditors Canada aims to...
 
When is it that a politician becomes part of the governing...
 
It’s been a busy couple of weeks on the information, privacy...
 
In 1996, a new budget watchdog, the Parliamentary Budget Officer, was...
 
The Ontario government is moving forward with the creation of a...
 
The Office of the Public Sector Integrity Commissioner of Canada (PSIC)...
 
After the Auditor General’s (AG) report was released on April 30,...
 
In the U.K. system, Permanent Secretaries are what we call Deputy...
 
We are living in a period of rapid change and limited...
 
US public sector employees don’t trust their management to do the...
 
The news of Mark Carney’s nomination as the new Governor of...
 
Following Singapore’s independence in 1965, the controversial leadership of Lee Kuan...
 
Over the past few years, the preparation and delivery of the...
 
In healthcare, cost-cutting can result in cutting what is valued most...
 
For over 20 years Colin Bennett has been exploring issues of...
 
Even before controversy shook the organization to its foundation, Ornge was...
 
It will be the largest international multi-sport event ever held on...
 
We’ve all seen the headlines – BC Ferries, Ornge, la Caisse...
 
It can happen, and it’s noteworthy when it does. Government, business...
 
Kevin Page’s mandate as the first Parliamentary Budget Officer comes to...
 
Governments are challenged to meaningfully mitigate the effects of the financial...
 
Canada is facing a huge financial challenge brought on by massive...
 
For the past one hundred years, democratic states have been moving...
 
It’s so much easier and less painful to learn from the...
 
CGE Vol.13 No.7 September 2007 "If the Public Service, as a...
 
When pondering leadership, we immediately think of exercising our influence downward...
 
CGE Vol.13 No.1 January 2007 "How can I be held accountable...
 
CGE Vol.13 No.2 February 2007 Canada’s Performance 2006 is the sixth...
 
CGE Vol.14 No.1 January 2008 The furor over the $300,000 that...
 
CGE Vol.14 No.2 February 2008 Let’s say you’re a senior manager,...
 
CGE Vol.13 No.1 January 2007 Perhaps it’s a legacy of the...
 
The Independent Blue Ribbon Panel on Grants and Contributions called for...
 
Au Canada, le secteur bénévole et à but non lucratif vit...
 
As the global economy struggles to regain some forward momentum, Canadian...
 
This will be a defining budget for Stephen Harper. It will...
 
It is difficult to determine when the debate about the need...
 
For the next few years, the federal government’s overarching agenda will...
 
Much of the current conversation about the federal government’s economic agenda...
 
Bill Greenlaw is the elected president of the Institute for Public...
 
Have you ever asked yourself the question: ‘How would I evaluate...
 
Last fall, Alberta’s Employment and Immigration department posted online the workplace...
 
In 2006 the world was feeling the aftershocks of a number...
 
CGE Vol.13 No.4 April 2007 Robert Parkins, editorial director, met recently...
 
In the past two decades, the nature of the state has...
 
In recent months, the attention of Canadians has been focused on...
We live in the age of paradox.  Never before in human...