On Nov. 19, St. Michael’s Hospital announced the departure of President and Chief Executive Officer Jeff Lozon effective June 1, 2009. Luckily, we had the opportunity to speak with Mr. Lozon before he assumes his new role as president and CEO of Revera, a large North American provider of seniors’ accommodations and services. Lozon, not surprisingly, has been applauded for his tremendous work with St. Michael’s during the last 17 years — the transition of the hospital into a world-leading teaching hospital has been no small feat. Bill Downe, chair of St. Michael’s Hospital Board of Directors and president and CEO of BMO Financial Group, has credited Lozon with “building a values-based academic health sciences centre, grounded in compassion and a commitment to innovation and recognized as a beacon of good management.”

Like an experienced leader often does, however, Lozon credits the St. Michael’s team with the accomplishments it’s made. “The progress our hospital has made could not have happened without such a wonderful team of people,” he remarks. Indeed, 17 years is a long history for one person, and Lozon was kind enough to share how an entrepreneurial spirit and commitment to a wonderful cause helped the hospital grow into the kind of healthcare center that, he says, is going to be difficult to leave.

St. Michael’s is a Catholic hospital located in the heart of Toronto’s downtown. The hospital was founded in 1892 by the Sisters of St. Joseph to care for the sick and the poor of Toronto’s inner city. Since 1892, the team at St. Michael’s has preserved a commitment to compassion and excellence as the hospital has evolved into a leading centre for innovation in patient care, teaching, and research.

St. Michael’s Hospital is fully affiliated with the University of Toronto, and it leads the way in clinical care, education, and research in heart disease, trauma and critical care, neurosurgery, arthritis and osteoporosis, keyhole surgery, diabetes, and cancer care. The hospital is also one of the primary facilities for care of the homeless and vulnerable populations in Toronto — a population often overlooked. As the designated adult trauma centre for downtown Toronto and a major referral centre for the province, the hospital treats some of the most critically ill and complex patients in Ontario.

Lozon joined St. Michael’s Hospital in 1991 as chief operating officer. In the same year he was appointed president and CEO.

SK: How did you choose St. Michael’s? When you came to the hospital it was in a serious debt situation, and things were a bit of a mess.
JL: I took a Masters in Health Administration at the University of Alberta, and after having spent a year working at a teaching hospital I had set a personal goal to be the president of a big teaching hospital by the time I was 40. I was lucky enough to achieve that, but it wasn’t just that I wanted to be president, I wanted to be a part of something bigger.

SK: You became president and immediately had to turn things around, or the hospital would have faced a disaster situation.
JL: It was pretty dicey. However, the biggest problem was that people didn’t understand that we had so much debt in the first place. We understood that there was a problem, but didn’t understand how big the problem was. Shortly after I joined, the government released an investigative report stating that we were $63 million in debt. Considering that the operating revenue of the hospital at the time was $170 million, we were in debt one-third of our revenue — not an easy place to be in. What happened then was that we signed a framework agreement that essentially allowed us to pay back the debt in six years. But we had to be extremely disciplined. In retrospect, it was difficult but also a great opportunity for the hospital.

SK: So after all your hard work, is it that magnitude of a challenge that you’re after when you move to your new role at Revera? It will be a completely different healthcare environment.
JL: Leadership life is about new challenges. Revera represents a different field of work, a different type of environment, and a different challenge — one that I’m ready for.

SK: Why not move to another teaching hospital?
JL:This is the best teaching hospital in the country, in my eyes. I wouldn’t want to go to another one, in the same role. It’s a simple as that. Going somewhere different was attractive to me, but I could never equal the experience I’ve had here, at a leading teaching hospital.

SK: What are some of the most important milestones you’ve been a part of at St. Michael’s? Perhaps some of the key shifts you’ve seen in your 17 years with the organization.
JL: The first key milestone was definitely the financial turnaround in the ’90s. It was the most dramatic turnaround I’ve been a part of. A second pivotal change for us would have to be our merger with the Wellesley Central Hospital. It happened at a time when the health service restructuring commission directed us to merge with Wellesley, which at the time was about 80 per cent as big as we were. That merger was proven to be one of the most successful hospital mergers of the restructuring period. We essentially doubled in size and gained an important critical mass. Some hospital mergers take years and end up breaking apart. But our merger was successful and a huge milestone for us. The third achievement that I think deserves highlighting is our overall transformation. We’ve transformed from a hospital focused only on its local area and jurisdiction into one that plays an integral role in healthcare on a provincial, national, and international stage with research and education programs that continue to flourish. We’ve really taken our responsibilities as a partner with the University of Toronto and other academic institutions seriously.

Under Lozon’s leadership, the hospital has grown in leaps and bounds. Not only did St. Michael’sundergo the most dramatic financial turnaround in Canadian history, it also saw the creation of the 17-storey Cardinal Carter wing; established world-renowned clinical and research programs; and is currently building the Li Ka Shing Knowledge Institute, which is scheduled to open in 2010. The institute is comprised of the Keenan Research Centre and the Li Ka Shing International Centre in Health Care Education.

SK: Why is a knowledge institute so fundamental for a healthcare centre like St. Michael’s?
JL: A very successful knowledge institute has a whole lot of positive spin-offs to the patient-care side of the hospital. If we maximize the benefit of the knowledge institute we’ll get better care for our patients, and we’ll also be able to attract the highest-quality leaders in the medical field.

It’s all about the people — we realized that when we identified the need for the Li Ka Shing Knowledge Institute. Knowledge translation is fundamental for the future of the hospital — bringing what we know into care for our patients. That made the most sense to us — doing something that could have direct impact on our patients.

The fundraising campaign’s target for the Knowledge Institute was originally $77 million. Lozon says that the hospital’s foundation has raised in excess of $75 million to date and are well on-target to open in 2010.

SK: How difficult/easy has it been to secure government support for your programs?
JL:Both the federal and provincial governments have provided financial contributions to our campaign for the Knowledge Institute, and we’re very grateful for their support.

SK: When you grew the critical mass of the hospital and started doing things like mergers, opening new educational and research centres, how did that affect your culture within the hospital? The history of St. Michael’s is extensive. You must experience cultural shifts.
JL:One of the things I’m most proud of is that the mission and the values of this hospital have been strengthened throughout our history, and our culture of caring has not changed. We’ve maintained a high-touch presence through financial hardships and growth. What we’ve been able to do is add to our culture. Now we have a culture of caring, but also a culture of discovery. It doesn’t just complement our culture, but adds to it, and I’m very proud of that. Some leaders take the view that if you do one thing you can’t do the other, but I’ve always been a big believer of the tyranny of the either/or. I think in our business you really have to believe in what you do. You have to believe that what the hospital does is the right thing, and you can always do more. I’m motivated every day by what everyone inside the hospital does — we save lives that couldn’t be saved before. We care for people that others would prefer not to care for.

SK: How do larger healthcare centres deal with the doctor shortages in Canada? So many Canadians don’t have access to family doctors or healthcare of any kind.
JL:The obvious answer is of course: we need more doctors. But we also need to begin to ask Canadians to look at alternative caregivers, who can be very good at medical practices that normally would be taken care of by a family doctor. This would reduce the burden on our emergency healthcare system. Those are the types of things we need to do to help the system work. We need to unleash the potential of alternative healthcare practitioners. We have the largest family practice unit in Toronto, and those practitioners have a particular calling for the inner city residents. We support a movement to have more accessible healthcare.

SK: How do you strategize for the shaky financial times ahead of us?
JL:The financial picture for hospitals for next year is uncertain. However, we already know there’s a squeeze coming. But we haven’t changed the strategy; we just have to keep focused on our finances. Our fundamental strategies will not change. They may be delayed a little bit, but we’ll keep plugging away. You just have to slow down and remember to think long term.

SK: What partnerships will you look into that will forge full speed ahead, despite the economic decline?
JL:I can tell you, we’ve developed some wonderful partnerships over our history, and we will continue to leverage those, and build and create new ones, in the future — no matter what financial hardships we face.

SK: What kind of legacy are you leaving behind?
JL:I’ve never intended to leave a legacy. But I’m glad to be leaving an organization that is open to change and willing to change. And I’d like to think that that’s something I’ve brought — adaptability. We’re able to meet challenges face on, and I’m so proud of that.

Lozon served as Deputy Minister of Health and Long-Term Care for the Province of Ontario (1999-2000). In 2006, he was also chosen by Prime Minister Stephen Harper to chair the Canadian Partnership against Cancer.

Vision of the Li Ka Shing Knowledge Institute

“To be a world leader in the ethical generation and use of knowledge, to benefit the patients and surrounding community of St. Michael’s Hospital and people throughout the world”

Mission: The Li Ka Shing Knowledge Institute is committed to generating knowledge about:

• The biological mechanisms underlying health and disease.
• The application of fundamental research to improve the understanding and treatment of human disease.
• The best methods of preventing disease and providing health care.
• The social, economic and policy determinants of health.
• The best methods of partnering with our community to generate policy relevant research and ensuring greater health equity.
• The best methods of educating fundamental researchers, health professionals and managers.

The Li Ka Shing Knowledge Institute will provide an environment where researchers, educators, health professionals, students, patients, communities, and the general public work together to provide the best possible preventive and health care. We will engage and partner with communities and individuals so that they can make informed decisions about all issues that affect their health.

Values: As part of St. Michael’s Hospital, the values of the Li Ka Shing Knowledge Institute are: human dignity, excellence, compassion, social responsibility, community of service and pride of achievement. The Knowledge Institute strives to always be innovative, and commits to complete and unbiased reporting of all research results.

The ethical generation and use of knowledge is a commitment to complete reporting of information, including the benefits, harms and societal implications of strategies to improve health.

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