The Strategic Plan

Building Capacity & Strategic Repositioning

Establish within the IDEAA Office a cadre of internal consultants with knowledge and skills in:

• Quantitative and qualitative data analysis.
• Accessibility guidance and expertise.
• Organizational analysis.
• Change management and organizational development.
• IDEAA change – Knowledge of and skills in discerning and dismantling systemic discrimination and the several forms of oppression i.e., ableism, racism, anti-Black racism, anti-Indigenous racism, homophobia, sexism, and Whiteness.
• Talent management systems.
• Human rights.
• Accountability.
• Professional development and education.
• Advancing health equity for all ESGs in Ontario.

The IDEAA Office

• Reposition the IDEAA office to the Office of the Chief Executive to demonstrate UHN’s unwavering commitment to IDEAA change. This strategic repositioning confers on IDEAA and its implementation the authority of the Chief Executive, counters marginalization and ensures the integration of IDEAA into all of the employer’s systems, policies, and programs. 
• State that the Office is accountable for the integrity of IDEAA and its implementation and integration within UHN. The Office is accountable for embedding IDEAA into UHN’s policies, programs and  operations 
• Ensure that IDEAA at UHN is centralized, adequately funded and resourced and that the program’s leadership staff, and individuals tasked with the role of IDEAA Lead in the many UHN departments acquire the required levels of skills and knowledge to achieve their job demands.  The Office is accountable for the integrity of IDEAA and will be consulted on the appointments of all IDEAA Leads.  
• Require that all roles across the UHN that have responsibility for IDEAA within their departments have a dotted line reporting relationship to the IDEAA Office.  This ensures quality control and consistency and eliminates any pockets of siloed counterproductive IDEAA work. 
• Appoint the IDEAA Office to lead and manage the biennial Pulse employee engagement survey that will serve as an IDEAA audit.  

• • The IDEAA Office shall analyse the results of the engagement survey, identify performance gaps, ensure performance gaps become performance objectives for the accountable executive, develop a corporate action plan and lead the discussion at the Council. 

• The IDEAA Office will take direct responsibility for the analysis of the IDEAA Workforce Diversity Scorecards submitted to the Leadership Council. The Office shall consult with P&C (People & Culture at UHN) and Division Executives and report to the Council.  
• The IDEAA Office will review and consult UHN’s Division Heads to enable them to achieve quantitative and qualitative goals and IDEAA outcomes.  

Governance

The CEO shall establish the IDEAA governance infrastructure. The governance structure is essential for ongoing success. The structure that we propose, positions IDEAA strategically as a corporate priority, by integrating it into UHN’s overall corporate strategy. This will consist of the IDEAA Leadership Council,  the Employee Advisory Group, the Anti-Racism Leadership Council, the Education Advisory Group and the Accessibility Advisory Group. UHN’s Chief Executive will chair the IDEAA Leadership Council. Having the CEO at the helm sends a clear message to the entire hospital network and to external stakeholders that IDEAA is mission-critical and is fundamental to the healthcare and business goals of UHN. The CEO shall hold senior executives accountable and use the biennial Pulse employee engagement survey as an IDEAA audit and ensure that performance gaps identified in the survey will become performance goals for the accountable managers.  Change Management. The CEO will adopt a change management model that recognizes that IDEAA change is an evolutionary organizational development process inspired by the leadership vision and implemented by skilled resources.  They will align strategies and goals to the organization’s readiness and culture, prepare the organization for change, and prioritize communication, education, feedback, and information sharing as critical success factors. The CEO will strengthen UHN’s change management capability and make it a core competency for all leaders.  Essential Elements for Ongoing Success. These are clear accountability, ownership, consultation, marketing, metrics, performance management, monitoring, re-alignment and the collection of employee and patient self-identification data and the maintenance and ongoing analysis of the employee and patient self-identification databases. 

The IDEAA Leadership Council  

The IDEAA Leadership Council will provide a focused, structured and intentional approach to designing and monitoring the implementation of IDEAA at UHN. In the first instance, it shall meet quarterly. If there are concerns or challenges not being addressed, the Council will meet more frequently. All meetings of the IDEAA Leadership Council will be open and virtually accessible for all UHN employees. The Council may choose to hold certain meetings on camera.  

Membership 

The IDEAA Leadership Council will consist of a cross-section of executive leaders. The VP Health Disciplines & Chief Nursing Executive shall be the Council’s co-chair. Lived experience, cultural awareness and dedication to EGAP and OCAP principles will be considerations for membership and selection.  

Roles 

The  IDEAA  Leadership Council shall establish corporate IDEAA outcomes and a system of accountability reporting on the UHN’s IDEAA performance areas – research, care, education, employment and the leadership pledge commitments. It shall establish an Employee Advisory Council, an Anti-Racism Advisory Council, an Education Advisory Group and an Accessibility and Accommodation Committee.  

The Employee Advisory Council shall consist of the leadership of UHN’s Employee Resource Groups and bargaining agents. The IDEAA  Leadership Council shall instruct the IDEAA Office to strengthen the existing system of Employee Resource Groups and shall task People, Culture and Community to develop additional employee engagement strategies to give voice to the opinions and experiences of UHN employees of all identities. The IDEAA Leadership Council acknowledges that employee engagement is integral to building trust and ensuring that UHN has an understanding of the differential impact of employment policies and practices on all UHN employees. Employee engagement strengthens the degree to which employees are invested in both their everyday work and the success of the hospital. 

The ERGs will help to drive the workforce diversity agenda and resolve exclusion, under-representation and disengagement faced by each marginalized group – Indigenous people, racialized persons, 2SLGBTQIA+  persons with disabilities and women. The executive sponsor assigned to each ERG will be held accountable for achieving the IDEAA outcomes for the marginalized group. The ERGs will empower and give agency to its membership who currently feel alienated and excluded. 

Anti-Racism Leadership Council. The IDEAA Leadership Council shall establish and Anti-Racism Leadership Council to oversee the anti-oppression and anti-racism work that is recommended in the employment and care environments at UHN. 

The Education Advisory Group. A holistic Education and Training strategy that targets all occupational groups is essential to achieving change at UHN.  The creation of the Education Advisory Group acknowledges this. The Group will guide, monitor and evaluate the impact of the education and training strategies at UHN. 

Accessibility Advisory Committee (AAC). The role of this Committee is to advise the Leadership Council on issues of accessibility and employment accommodation. The Committee shall ensure UHN’s compliance with its legal obligations under the AODA. We recommend that UHN establish an Accessibility and Accommodation Fund that the Committee will administer in partnership the IDEAA Office. 

The IDEAA Leadership Council shall ensure a robust ongoing communication and employee engagement strategy to keep employees informed about the measures the UHN has undertaken or is planning to undertake to implement IDEAA and the Pledge Commitments. The Council is aware of the challenge that UHN’s communication is not valued by many employees as open and honest. This a finding of the qualitative analysis of the IDEAA survey findings. 

Collection and Maintenance of Workforce and Patient Self-Identification Data

IDEAA is data-driven and results must be measurable. This is consistent with the adage, that ‘if you cannot measure it, you cannot manage it!’. Establishing and maintaining a reliable self-identification employee database and a self-identification patient database are foundational. The IDEAA office will lead this system of data collection.  The standard is to, at minimum, achieve and maintain a 60 percent response rate. 

Role of the Data Custodian. We recommend that UHN appoint a Data Custodian who will be accountable for the ongoing collection of employee self-identification data and the maintenance of the employee database. Maintenance of the database requires UHN to follow up with non-respondents to the 2022 IDEAA survey and to ensure that the database includes new data from new hires, promotions, and terminations. An up-to-date and reliable database will allow UHN to establish measures of progress and track organizational and individual performance and establish accountability and metrics. Importantly, the workforce data will also enable monitoring of numerical goal setting and goal attainment for the hiring and promotion of ESG’s  in the UHN workforce. These numerical measures will be included in the IDEAA Workforce Diversity Scorecard.  

The Data Custodian will collect and maintain a patient self-identification database. The ongoing analysis of patient self-identification data and clinical data will strengthen UHN’s research and care capability. Research and care are indivisible. 

IDEAA Scorecard | Metrics | Goal Setting

Accountability, metrics, clear corporate standards, performance expectations, and consequences for non-performance are fundamental. The IDEAA Leadership Council will establish  IDEAA Scorecards as a system of accountability reporting.   

The IDEAA Workforce Diversity Scorecard will track and measure progress.  The IDEAA office will take direct responsibility for the analysis of the Scorecard, developing an action plan and reporting to the Leadership Council. Here are illustrations of the workforce diversity measures that UHN can consider and expand.  

Representation| Shares of Hires. This is a measure of the diversity of UHN’s workforce: the effectiveness of UHN’s talent acquisition practices and the achievement of its quantitative goals. 

Shares of Promotions. This is a measure of the ESGs equitable access to professional development and developmental opportunities, career advancement and upward mobility.  

Movement into Management. This is a measure of access to leadership roles and the diversity of UHN’s leadership pipeline.  

Terminations. Terminations are a measure of retention and engagement. This analysis will determine whether ESGs are exiting UHN disproportionately and reveal whether the termination rates of these groups are comparable to the majority. 

Other Measures to be developed by IDEAA Office. The Consultants recommend that the Office develop IDEAA specific measures and measures specific to the Pledge Commitments.  

Health Equity Scorecard.   Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health. UHN has committed to survey implementation and data governance strategy for the Measuring Health Equity Questionnaire (MHEQ) Ontario Health-Toronto Region. The Health Equity focus on the elimination of health disparities in “equity, inclusion, diversity and anti-racism, and to contribute to better outcomes for patients, families and providers within the health system”  Ontario Health’s Equity, Inclusion, Diversity and Anti-Racism Framework.  Progress toward advancing health equity is measured by the reduction of health disparities. We recommend that UHN establish a multidisciplinary, cross-functional taskforce, to plan and operationalize the achievement of these commitments. Importantly, we recommend that UHN appoint a Black Health Lead to co-chair the Taskforce. We propose too, that the mandate of taskforce be based on the SKILL model and informed by the CDC’s CORE Commitments to Equity that we include below. 

The Policy Infrastructure | Cultural Transformation

Policies form behaviour. Policies are a statement of behaviours, mindset and values that an organization seeks to establish and enforce. Cultural transformation requires that the desired behaviours in the desired state be articulated so that individuals know what is expected of them and that individuals are taught the knowledge, skills and behaviours they must possess and demonstrate to meet their job requirements. We believe that the policy infrastructure shall help to achieve this transformation. Our experience is that the inclusion of certain policies announces what is important to the organization, whereas the absence of specific policies communicates the issues to which the organization does not attach importance.

We propose that UHN develop a policy infrastructure that dismantles all forms of oppression at work: creates a just, respectful and inclusive workplace and that provides physical and psychological safety for all employees. UHN’s mandatory core curriculum will teach all employees UHN’s core values and behaviour expectations. All new employees will receive this training at onboarding and have a refresher annually. All managers shall receive core curriculum management training within 3 months of their appointment to a management role and every two years thereafter.

Policy Development. We recommend that UHN explore an approach to policy development and implementation that requires those who develop policy to:

• Determine who owns the policy and who will be accountable for ensuring its effectiveness.
• Consult with managers who shall implement the policy and those whom the policy impacts.
• State the intended outcomes of the policy and how these outcomes will be measured; and how the achievement of the desired outcomes will be monitored.
• Identify the positions/roles that will be held accountable for delivering the policy’s outcomes: specify the skills and knowledge required to implement: make it mandatory that individuals in these roles acquire the requisite knowledge and skills.
• Develop systems to audit, monitor policy implementation and ensure its effectiveness and consistency in its application.
• Develop and provide the tools to support policy implementation.
• Conduct regular evaluations of the effectiveness and impact of the policy.

High-performing organizations require managers to acquire the required competencies before they are allowed to participate in policy implementation, e.g., selection and hiring, performance management and dispute resolution.

Role of People & Culture

For People and Culture, creating and operating effectively in an IDEAA environment will likely require a shift to a transformational mindset, away from a traditional gatekeeper role. P&C consultants will be instrumental in building the UHN corporate culture of accountability, transparency, opportunity and employee empowerment.

People and Culture will work collaboratively with the IDEAA Office to develop corporate strategies to respond to the findings of the qualitative analysis. In partnership with the Office, the P &C Division will:

• Establish
  • IDEAA outcomes, corporate expectations, performance standards and metrics for each employment system- Recruitment. Selection, Hiring| Training and Development| Promotion| Retention and
• Termination | Reasonable Accommodation.
  • IDEAA core competencies in executive, management, and professional, semi-professional and supervisory roles.
  • Performance objectives and metrics, accountability measures and mechanisms for executives and middle managers and supervisory staff.
• Revise and Develop
  • The policy infrastructure as recommended by the Consultants to facilitate IDEAA cultural and behaviour change. Provide the training and the tools to people managers and supervisors.
  • Employee engagement and feedback mechanisms to identify and remove barriers to inclusion faced by diverse employees at UHN.
• Develop
  • An Education and Training strategy to build UHN capacity for change. Provide all employees with the awareness, skills and knowledge appropriate to their roles and needs.
• Redesign
  • And/ or strengthen UHN’s performance management system. Train executives, middle managers and supervisors in the requirements of the performance management system. Monitor its implementation for consistency and fairness.
• Acquire and Demonstrate
  • IDEAA competencies- awareness, skills, knowledge, behaviours- in order to partner effectively with the IDEAA Office. Mentor and guide their UHN client organizations to achieve corporate IDEAA expectations.