Janice Kaffer and Bill Marra: Healthcare CEOs Should Never Lead From Their Office Desk

Episode 46 promo, with Bill Marra and Janice Kaffer (Hotel Dieu Grace Healthcare)

As past and present CEOs, Janice Kaffer and Bill Marra approach the role with different strengths but are united in their belief that CEOs need to be visible and hear directly from frontline staff and from patients and families.

Show Summary

Welcome to Healthcare Change Makers, a podcast produced by HIROC. I’m Ellen Gardner with Michelle Holden and Philip De Souza.

Today’s guests are Janice Kaffer, former President and CEO of Hôtel-Dieu Grace Healthcare in Windsor and Bill Marra, current President and CEO of Hôtel-Dieu Grace Healthcare

Although she formally retired from the CEO position in January, Janice has stayed involved through a project looking at re-establishing the hospital’s role in long term care. She’s also taking an Executive Coaching course at Royal Roads University.

Bill and Janice have a connection based on mutual respect, admiration, and camaraderie, some of it formed through working closely during the pandemic and their shared passion for the mission of Hôtel-Dieu Grace Healthcare.

Bill’s association with the hospital goes back to his teen years when he worked in the dietary department. Although his career took him in many diverse directions – including serving six terms as a municipal councillor for the City of Windsor – he never fully stepped away from the hospital. He stayed involved through his work on the foundation and as VP, People, Mission, Communications and Corporate Affairs.

When Janice approached Bill about being part of the CEO succession plan, he was humbled and flattered. The hospital is engaged in many development projects and a key area of focus for him right now is attracting new talent and developing the leadership team. Bill is comforted knowing he’s got Janice on speed dial whenever he needs her.

Mentioned in this Episode


Imagine you could step inside the minds of Canada's healthcare leaders, glimpse their greatest fears, strongest drivers and what makes them tick. Welcome to Healthcare Change Makers, a podcast where we talk to leaders about the joys and challenges of driving change and working with partners, to create the safest healthcare system.

Ellen Gardner: Welcome to Healthcare Change Makers, a podcast produced by HIROC. I'm Ellen Gardner, with Michelle Holden and Philip De Souza. Today's guests are Janice Kaffer, former President and CEO of Hôtel-Dieu Grace Healthcare in Windsor and Bill Marra, current President and CEO of Hôtel-Dieu Grace Healthcare. Although she formally retired from the CEO position in January, Janice has stayed involved through a project looking at re-establishing the hospital's role in long-term care. She's also taking an executive coaching course at Royal Roads University.

Bill and Janice have a connection based on mutual respect, admiration and camaraderie, some of it formed through working closely during the pandemic and their shared passion for the mission of Hôtel-Dieu Grace Healthcare. Bill's association with the hospital goes back to his teen years when he worked in the dietary department. Although his career took him in many diverse directions, including serving six terms as a municipal councillor for the city of Windsor, he never fully stepped away from the hospital.

He stayed involved through his work on the foundation and as VP of people, mission communications and corporate affairs. When Janice approached Bill about being part of the CEO succession plan, he was humbled and flattered. The hospital is engaged in many development projects and a key area of focus for him right now, is attracting new talent and developing the leadership team. Bill is comforted knowing he's got Janice on speed dial whenever he needs her.

Ellen Gardner: Well, welcome Janice and Bill. It's great to have you both on Healthcare Change Makers. Janice, it's been a few months since we talked. And at that time, a few months ago, you were just stepping into what you were calling semi-retirement. It was a time of big change and transition in your life. So bring us up to date. How's it going?

Janice Kaffer: It's always interesting how the things you imagine are going to happen actually don't happen at all. So I had this vision in my head about what my post full-time work life would be like. And it was a vision of relaxation and picking up the odd project and taking time for myself. And all those things that the books tell you that you're supposed to do, gardening and reading and picking up a new hobby and all that kind of stuff. And actually, that isn't what happens at all. The last six months have been filled with an incredible amount of change in my life. And some of that, I have started reading for pleasure again, which is such a treat in so many ways, but my family dynamics have changed. I've had some family move into the home.

We contemplated selling our house and then we've changed our mind and we're not selling our house. And so, we've had all these big life change discussions happening, my husband and I, and I've been involved in an educational program at Royal Roads University executive coaching program, which has been taking up a ton of my time. But what I would say is overall, it's been an amazing six months. I am well, I am healthy. A friend of mine told me I look younger, which is always a great thing to hear. And overall, I will say that the six months, if this is how retirement is going to be by and large, it's a good thing.

Ellen Gardner: When we talked in January, Janice, you were going to be working on a special project with Hôtel-Dieu Grace. And can you give us some details now about where you're at with that?

Janice Kaffer: I think I can. Bill can I?

Bill Marra: Of course.

Janice Kaffer: Okay. Just checking with the new CEO to make sure we're all good. One of the strategies that our organization had when Bill and I were working together still on the executive team at the hospital, was to really take a look at expanding our footprint in the community. And one of those areas of expansion that has had a lot of coverage, is getting into housing, social housing, and really taking a look at some of the vulnerable populations that Hôtel-Dieu Grace Healthcare is uniquely concerned about in the Windsor Essex community.

And one of the other initiatives that the board had approved was for the organization to look at re-establishing our role in long-term care. Hôtel-Dieu had a long-term care facility in our portfolio many years ago, and that had closed.

The board had approved us to work on achieving a long-term care license and building a long-term care facility within the umbrella of Hôtel-Dieu Grace Healthcare in order to do two things. One is to provide an opportunity for seniors who have complex issues and healthcare needs, and those who have mental health issues to have an opportunity to be able to be accepted in long-term care. 

In our community, there is a deficit for certain populations in long-term care. And Hôtel-Dieu Grace Healthcare has a number of individuals living in the hospital, or at that time living in the hospital that could move to a long-term care facility, if the facility had the specific footprint to be able to care for them. So that was the project we were working on and submitted the application and now, Bill and his team are navigating the processes of working with the government to get that approved.

Ellen Gardner: Are you going to stay involved with it, Janice because it doesn't sound like it's completed by any sense?

Janice Kaffer: If the current senior team is in agreement, I would love to sit on an advisory board for when it gets started or something like that. I'm here, I live in Windsor Essex. Bill knows where to find me and we talk regularly. So, I haven't actually taken on a lot of volunteer work yet. I'm allowing myself some time to figure out what all the different things are that's going to happen in my life and where I need to be and how I can add value. But Hôtel-Dieu Grace is always going to be a priority for me and anything that the hospital and Bill needs, I will always be there.

Ellen Gardner: Bill, I'd like to pull you into the conversation. You've had a very different career path. You were a city councillor for the city of Windsor for 24 years, and that made you the longest serving member of council. So, congratulations on that. You had some very significant accomplishments during that time. Things like advocating for a better border route through tunnelling and expanding public transit. I know that being a councillor requires having tenacity and not being afraid of confrontation, taking an opposing stance in order to make a difference. Did you find that to be the case and how has that experience been useful to you in your role at Hôtel-Dieu Grace?

Bill Marra: It was a fascinating experience and the growth that I was able to enjoy both personally and professionally has served me really well in my career. While I was a member of council for the six terms, I was also juggling a full-time career. I was Executive Director of a children and youth agency as it was a transfer payment agency for the province of Ontario.

I really expanded beyond the typical requirements of a member of council. I chaired a number of standing committees, I really immersed myself in the work. When I think of the accomplishments in my political career and there were some big projects. You identified one, for example, the border crossing that was complicated, complex, and at times incredibly challenging. But I'm more proud of the libraries that we built and the park enhancements that we created in our communities.

Bill Marra: I had a huge social housing complex in my ward at the time. And I focused on it tremendously for about 10 years around investments in that area. Because for me, it was really fundamental around the role that I played around quality of life, balance for individuals, serving those individuals that I represented that perhaps were disadvantaged or challenged or less privileged. And I wanted to ensure that every moment of every day that I served in that capacity, I was creating impact. And it has really translated nicely into the leadership roles that I've had. Whether it was the executive director role that I had at an agency called New Beginnings, or when I joined the hospital 11 years ago, I've been able to rely very heavily and quite successfully in my political career on my network of contacts, I left on a very positive note, so it's really helpful.

And Jan and I have worked very closely together, obviously. It's been really helpful over the years to be able to pick up the phone and directly call other community leaders, whether it be elected officials or senior bureaucrats throughout the region, knowing how to navigate bureaucracy, knowing how to navigate political dynamics and really parlay into positive results for Hôtel-Dieu Grace Healthcare.

Ellen Gardner: It's interesting Bill that you were a councillor and you had, I think you continued to have a role at Hôtel-Dieu Grace, and you had another responsibility outside of those rules. How did you juggle all those things? It sounds like they were very different and probably equally demanding positions.

Bill Marra: They were quite diverse. You're correct. And then that was one of the benefits of it. The focus of the work that I did in any of those roles had very common denominators: they were community-based, people-based, it was around improving quality of life, regardless of the role. It did come to a point a number of years ago, where I had a very frank conversation with Janice, in fact, and I made a commitment to her that around 2017, that it was time for me to leave politics and really clear the deck, so that I can immerse myself in a different way with healthcare.

So, I voluntarily left politics four years ago now, because it did get to a point where there were some conflicts around time commitments and what was required of the role that I had embraced. At the time, Janice had also offered me the opportunity to be part of the succession plan for the organization. So, I took that quite seriously.

I still pinch myself every once in a while, to be honest with you, it's a very humbling experience, to be asked to lead an organization of this nature. And you have to appreciate even my own personal background. I'm a first-generation Italian, grew up in a very humble environment. My father was a factory worker. My mother raised four kids. We had very little growing up, but what we had meant everything to us, and we knew nothing better. And to come from little Italy and work at a hospital as a teenager, and then lead that same hospital later on in my fifties, it's humbling. And I serve with humility and take this responsibility very seriously. So, a few years ago when the opportunity presented itself, I cleared the deck and immersed myself fully and I find myself in the role that I am today as a result of those good decisions.

Ellen Gardner: Jan has told us, you owe a lot to the upbringing you had and the role that your parents played in making you interested and invested in your community. And so, it does sound like something you share in common that you both have strong ties to where you come from. And that really impacted the way you've lived your life and run your career.

Bill Marra: It certainly has. And further to that, Janice has been one of those influences on me as well, especially the manner in which I've embraced this role. Obviously, I've known Hôtel-Dieu Hospital, Hôtel-Dieu Grace Hospital and Hôtel-Dieu Healthcare, the different variations of it, my whole life. I worked at Hôtel-Dieu Hospital as a teenager in the dietary department. I served on the board 20 years ago, but what was not ingrained in me from those experiences, was something that I learned from Janice. And it's embracing the mission and the faith-based focus of this organization, it's really become a part of my fabric.

I really began to understand it more when Janice was here and we were close colleagues, and it seemed like every time she came back from some key meetings with partners, whether it be at the national level or even through our international partners, it was the mission of the organization that continued to be an important part of the messaging that Janice conveyed to us and servant leadership was an incredibly important aspect of that. So I credit Janice just as much as my upbringing and the many other people that have influenced me. I've had three wonderful mentors in my life, three strong women that I met through professional relationships and Janice certainly is one of them and continues to be one of them.

Janice Kaffer: Bill has been very kind to me, in saying something like that in the past. And I very much appreciate it, but I think the message for leaders who are listening to us, is that you really never know who's watching you and what they're taking away from you.

I had a wonderful conversation last week with a young man who just graduated from the Odette School here in Windsor. And he reached out to me through his professor to talk about how to build a career and what are some of the things that are important and how to kind of figure out where you're going to go, where to from here kind of thing, once you graduate and had a wonderful conversation.

When I left that conversation, I was energized and feeling really good. And I realized that one of the things that I really enjoy very much and that I think shows up in what Bill just said, is that notion that when you have a moment to just slow down and stop and talk about what are some of the things that you've learned in your life and what are some of the things that inspire you and how have you lived your values through your career and how do you make decisions based on those values? And those are some of the questions this young man asked me.

Janice Kaffer: That kind of a conversation doesn't happen enough, I don't think, in healthcare from the people that are in the decision-making seats to the people that want to be in the decision-making seats. And so, I know that Bill takes the time, because I've seen him do that when he was still in the VP role when I was working with him. But I think that's one of the really important leadership pieces, is to always remember that mentorship piece – always to remember that notion that, there are people that are watching you, and there are people that are learning from you. We have an obligation to make sure that what they're taking away from us is positive and reinforcing and inspiring, if we can be inspiring in what we're doing and how we're doing it.

Ellen Gardner: You both worked together for a time in the lead up to Bill taking over the CEO role. It does sound like your style's meshed very well. I want to ask both of you, what you really learned from each other when it comes to leadership philosophies and working style?

Janice Kaffer: I am not an extroverted kind of social being. I am a person who prefers to be at the back of the room. When we had a social thing going on at Hôtel-Dieu Grace, my preference was always to be in the chairs and Bill taking on the role at the front of the room, the spokesperson, the host, the MC, all that kind of stuff, because I think one of the things that Bill and I did very well together, is complimented each other's strengths. That is not my strength. My strength is not the front of the room. My strength is really back of the room watching the body language of the individuals, making sure that our message was getting across and that kind of stuff.

And frankly, any kind of full-scale public speaking (we used to do town halls at the hospital) I would have to be on stage, on message for a whole day. I would be exhausted for days after that because that is not something that I enjoy doing. I have to really work hard to build the energy for that.

That's something that comes very naturally to Bill. And so that kind of synergy between Bill and I, frankly, I hadn't ever really experienced it the same way to the extent that Bill and I had that kind of almost non-verbal connection that I didn't really have to explain, because Bill's leadership style was very much complimentary to mine and different than mine. And so, we made a really good team.

Bill Marra: One of the qualities that I admire the most was her authenticity with people, particularly our people, our staff. Her authentic effort to get to know, to understand and respect the people around her. To the point Janice was making earlier, you are watched and frankly quite scrutinized when you're in a senior leadership role and every time you walk into room or on a unit, people do listen and watch and carefully discern what you're saying. 
Janice's authenticity and her genuineness was always one of the most obvious and prevailing characteristics that resonated with people. It was effortless, it seemed like on her part. I understood that in a very different way after a long career. I've been working for over three decades and this brought a new dimension to how I approach my work and my relationship with people as well.

Ellen Gardner: Janice, when we talked to you had talked about how part of the mission was to move beyond Hôtel-Dieu Grace Healthcare being just a service provider and really taking an important role in the community. That was a learning for you, and you also moved the organization along in terms of playing that role. I wonder if that's something that you communicated with Bill about and where you're at on that Bill, because you would've certainly had connection to the community through being a city councillor.

Janice Kaffer: Yeah. So I'll answer first. And so yes, Bill and I worked on that together through most of the time that I was CEO. And in particular over the last, I would say probably three to four years. Bill knows everybody in Windsor Essex. Everywhere we went, Bill introduced me to people. So I retired from Hôtel-Dieu Grace Healthcare knowing maybe, I don't know, a hundred people, I imagine a hundred people, Bill knows a hundred thousand people. And I'm kind of exaggerating, but not really. And so, when you think about being connected to the community, the two of us made a formidable team and people saw us together as a team that was quite committed to the work of building community.

And so some of the ideas we had would not have made it beyond idea without Bill's input, without Bill's connections, without Bill's talent and ability to be able to conceptualize it within a political and a planning framework and some of the kind of skills and backgrounds that he brought to the table.

So, for me, you can have a great idea. Any CEO, any senior leader can have a great idea, but executing on an idea takes more than one person with a vision. It takes a team with a commitment to that vision and the ability, the talent, and the ongoing energy to kind of pass over all the hurdles and barriers to get to the end result.

Bill Marra: I've continued the legacy of that work that Janice had established for us. The challenge that I've been facing recently, and it's a challenge that I'm working through and we're going to get there. We've had a significant turnover in leadership at this organization since last June. In fact, it was a year ago this month and the month of June that retirements began to happen. And some of them Janice will recall were retirements that were postponed, because of the pandemic. Some of them perhaps were accelerated, because of the pandemic. But when I looked at the number of directors and members of the executive leadership team, if you include Janice, eight individuals have left in a year.

And so, the challenge that I'm referring to is really getting the mindset of the reconfigured senior management team if you will, getting the mindset shifted to where we were as a team coming into the pandemic. And part of the challenge has also been shifting the mindset from pandemic to going forward. We have a window over the next couple of years to trigger some key decisions that are consistent with the direction that Janice had established. We are working on a housing initiative through our business trust in partnership. There's a couple of partnerships that are available to us.

Bill Marra: We are growing the organization, but not for the sake of growing it, not because we're empire building. To the point that I was making earlier, we're aligning what we do so well with community needs. So the long-term care, we're really good at that. We have outstanding leaders and frontline staff that do work with our geriatric assessment program, our geriatric mental health programs. We're really good at mental health. We're really good at working with the aging population. So, our long-term care facility is going to be very unique and special and have some anomaly programs and services that you won't see anywhere else. But it won't be just about Hôtel-Dieu Grace Healthcare, it will be, how do we support other long-term care partners in this region.

Ellen Gardner: Janice, you must watch all these things unfolding with great interest. I know you're still involved, but I want to ask you if you have any advice for Bill, as the hospital tackles some of these big challenges and implements a lot of these ambitious plans?

Janice Kaffer: Yes, I guess I'll always have advice. Back in the day, years and years and years ago, we talked a lot about magnet hospitals, and we talked about all the different strategies that different organizations in the US and Canada were putting in place to be a preferred employer. And we see all these awards, the best employer, top employer and all these different things. But when you really boil all of those things down, work has to be fulfilling. So the only advice I would ever give any leader, including Bill is to always remember that piece of it, which is that you can have all the strategies on paper, they can look effective, they can be effective.

You can have great KPIs in terms of turnover and absences, but if your people aren't happy and if they aren't having fun at work, there's always going to be that missing element to it. So for me, that's always been a part of it. And that's why I spent a lot of time going out on the units talking to them, is to always hear that from them. Are they happy? Do they feel connected to the mission of the organization? Do they understand what we're about? Do they have things that they want the CEO to hear about so that they're feeling like they're connected to the top decision-maker. That's really the only advice I'd give any senior leader.

Ellen Gardner: It sounds like you both truly believe in the importance of culture and communication. Bill, do you see that as being even more important now for leaders to be good communicators?

Bill Marra: I find that at times individuals will decide on their own, who they think should hear something or be updated on something, or who should be part of the information that's being shared. And there's a real easy approach to this, unless you're dealing with some obviously sensitive and very confidential information – share, be transparent, share it all, share the challenging information, share the good news, be vulnerable in how you share your information as well. It's okay to talk about what makes you tick and what worries you. It may not always be great news, but the respect and admiration you'll have from those that you support or those that you lead, because you're communicating with them, you're keeping them engaged. They're to feel part of the organization. They're going to feel the buy-in.

Janice Kaffer: And one thing I'd add to that, Ellen, is that being a good communicator is also about actively listening to the organization and people in the organization. And I've said this in a different podcast I was interviewed in and it is something that I believe very strongly, is that CEOs can very quickly, if they allow themselves, they can very quickly be in a bubble of misinformation, because organizations are hierarchical, there's a certain number of people that report directly to the CEO, a certain number of people that report to those people and downward into the organization. So, for a CEO to get information, it often has to go through a number of filters before it hits a CEO's desk.

And so, in some cases, CEOs get information that is so agenda-driven from the people that are underneath the CEO, that it loses some of its relevance to the frontline. Which is why it is so incredibly important, particularly in healthcare, that CEOs don't lead from their office desk, that they are out and about in the organization talking to people and hearing directly from the frontline staff and from people like patients and families. Because, if you don't hear from the patients and the families and the staff, you can't be 100 per cent sure that the information you're getting from the people that report into you and through them is actually the information you need.

Ellen Gardner: We're just going to close with our usual lightning round. I'm going to ask a few quick questions and really just come in with your first thoughts. So I'd like to hear from both of you. To start, what are you reading now?

Janice Kaffer: I'm reading a couple things. First thing I'm reading, is the Heart of Coaching, which is a book that is part of my program that I'm doing at Royal Roads University. So that's my formal reading. And my informal reading, is I'm diving back into the Lord Of The Rings trilogy. That's something I haven't re-read for a very long time.

Bill Marra: I'm reading a book that was actually gifted to me a while ago. I read it when I first got it, I'm reading again for obvious reasons, it's called Change Is Good, But You Go First. And it's really timely, because in our sector, change is inevitable, change is typically an element that's out of our control, change happened this week. With an election cycle and a new mandate, we can expect something different that comes our way. And the book really focusses around the fact that if you don't have choice around change, you certainly have choice around how you and your team react to it. And it's really timely, because I'm in a new role and because we're facing some significant, in my opinion, some significant opportunities with change. And so, it's really getting the mindset around that.

Ellen Gardner: You're both active on social media. And I really wondered, what's one thing that we can't guess from your LinkedIn or your Twitter profiles

Janice Kaffer: That's a great one. I am an avid June's Journey player.

Bill Marra: I'm a T-shirt and blue jean guy on the weekend. And I love riding my Harley Davidson.

Ellen Gardner: What's one thing that you do outside of work to unwind, and we know Janice, you had discovered Lego when you stepped away from work for a short time. So maybe both of you can tell us, what do you do to unwind?

Bill Marra: I love working outdoors. I grew up in a, like I shared earlier in a first-generation Italian home, and my father had a huge garden in the backyard. We had more garden in the backyard than we had grass. And that really was something that I grew up with. Now, I mean, Janice grew up on a farm, so she would laugh at my garden, because it's a 500 square foot garden, but I love gardening. I love landscaping. I find that very relaxing. And like I said earlier as well, I love going for motorcycle rides. No cell phone, no radio on my bike, no nothing, just turn everything off and it's exhilarating, it's relaxing. So those two fun outside of work activities keep me relaxed. And it puts me at ease. And I think about a lot of other things other than work, when I do those two activities.

Janice Kaffer: For me, unwinding is pretty much my life now as a retired person, but a couple of things that I really very much enjoy, is sitting on my back deck. I live on Lake St. Clair and I have a Lakeside home. So my view is the lake and every day of every season there's something interesting to see out there. Geese, ducks, the day before yesterday we had a white heron that came. So I very much enjoy sitting at the lake. And I like sitting beside the lake on my deck with my second favourite thing, which is a really nice glass of red wine.

Ellen Gardner: Well, you both draw a lot of energy from being outside and wind in your hair and enjoying your surroundings. So I can certainly respect that. I want to thank you both for a great conversation. Just enjoyed it so much and wish you both the best of luck.

Janice Kaffer: Thank you so much for having us on.

Bill Marra: Thank you so very much as well. And I really enjoyed this conversation.

Ellen Gardner: You've just been listening to our interview with Janice Kaffer, former President and CEO of Hôtel-Dieu Grace Healthcare and Bill Marra, current President and CEO of Hôtel-Dieu Grace Healthcare. For more information about HIROC and to listen to past episodes of Healthcare Change Makers, go to our website, hiroc.com. Thank you for listening.

Thank you for listening. You can hear more episodes of Healthcare Change Makers on our website HIROC.com and on your favourite podcasting apps. If you like what you hear, please rate us or post a review. Healthcare Change Makers is recorded by HIROC's Communications and Marketing team and produced by Podfly Productions. Follow us on Twitter at @hirocgroup or email us at [email protected]. We'd love to hear from you.