Nimira Dhalwani: Staying Connected to What’s Happening on the Ground

Cover art for episode 61 of Healthcare Change Makers

(Access show transcript) As Chief Technology Officer for The Hospital for Sick Children, Nimira Dhalwani does not lose sight of what she and her team are trying to achieve. They stay true to their guiding principles when adopting new technologies and place a focus on understanding the needs of patients, families, and staff.

Show Summary

Stress and burnout within IT have been on the rise, which is why it’s transformative to create a sense of work life balance which leaders can help implement. Nimira believes that it’s important to check in with her team’s wellbeing and be there for each other outside of work to establish solidarity and balance. 

“You take care of yourself first, then you take care of others,” says Nimira when explaining the importance of prioritizing one’s health and leading by example for her team. 

In this episode, Nimira offers her wisdom on preventing burnout, embracing technological change within IT, the importance of sharing learnings, and staying connected with patients and their families.

Mentioned in this Episode

Transcript 

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 Changemakers, 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.

Philip: Hey, listeners, it's Philip here from HIROC, and I'm also here with Abi. Hey, Abi.

Abi: Hi, Philip. I'm looking forward to hosting Nimira today. As the CTO of The Hospital for Sick Children, Nimira has so many important insights on providing connected care for clinicians and patients.

Philip: Exactly. Nimira shared so much that Abi and I took turns asking questions to Nimira, and we learned so much about her approach to digital integration, how she stays connected to the needs of patients and their families, preventing burnout and so many more topics.

Abi: This is an exciting episode for sure, so let's get to it. Everyone, meet Nimira.

Philip: Welcome, listeners. We're so delighted to have Nimira with us today. Welcome, Nimira.

Nimira: Thank you, Philip. I'm very excited to be here with you.

Philip: Excellent. Nimira, you've been at SickKids now for over seven years in various infrastructure and tech roles. What is it about the organization that drew you in and has kept you so engaged?

Nimira: Thanks, Philip. Every time you hear the word SickKids, there's a feeling that is evoked, and I think that has kept me here. In fact, I think that's what drew me here. I always felt that the vision and the mission for SickKids was so powerful. It's simple and yet it says the whole story, healthier children and a better world. It really speaks to our culture at the hospital where everything that we do is focused on patients and their families and how we make sure that what we do at the end of the day supports them. So when you talk about IT infrastructure, sometimes we get lost in the infrastructure side and IT stuff.

When you step back and think about why are we doing all this work, it's so easy for us to connect that to our patients and families. So feeling that I'm making a difference in the lives of patients and families is something that's drawn me and it's kept me here. The other thing I think I would also say is the people and the culture. It really doesn't matter where you are in the hospital and what teams you're interacting with, you feel it with everyone to say, "We take care of our patients and families and we take care of each other." That culture is worth everything that we have at the hospital.

Philip: Absolutely. Speaking of the connectedness you have to the healthcare system, you also sit on the Regent Park Community Health Centre Board. So why is it important for you to give back in this way as well?

Nimira: Yes, this is one of my volunteer opportunities. One of my core personal values is giving back. I'm a member of the Ismaili Muslim community, and one of our founding principles is to give back to the communities, the community at large, to improve the world and make it a better place for everybody. So Regent Park Health Centre really drew me in because their model of taking care of patients and families is very unique. They look at the holistic approach, and it's not just healthcare. That's so important to think about when you think about an individual, to say sometimes their health is impacted by their surroundings and their social economic status and what's happening to them. So I really wanted to be able to serve in that area, to understand and to give back to more of a community approach and really juxtapose to where I am in the acute care hospital and seeing what works in both ends of the spectrum and how does the healthcare system function at large to support the families?

Philip: That's fantastic. Speaking about the culture from SickKids, and even just I can tell from your own personal values and the culture collaboration and giving back seems at the center of that. I can actually feel that in all the folks that we've interviewed SickKids from Dr. Cone. We interviewed him on this podcast, and check that episode out.

Nimira: Thank you.

Philip: We've also interviewed some folks like Dr. Daniel Rosenfield and Greg Kennedy who talked about virtual care. It's definitely something that permeates throughout your organization, absolutely. So what's one piece of advice you'd give to other healthcare leaders? As we head rapidly down this road of digital integration, artificial intelligence and everything that comes with it?

Nimira: The adoption of technology is going to be coming in, so we cannot resist change. We cannot resist the new technologies coming in to help and support us in the direction we are moving in. But while we're trying to adopt these new technologies, we shouldn't lose sight of what it is that we're trying to achieve. We know patients are coming into the hospital because they want treatment, they want to make sure that they go home and they're well and they're healthy. So let's think about how do we use these technologies efficiently? How do we develop guiding principles around the ethical use of these technologies, and how do we also make sure that we think about some of our inclusion principles? Technology certainly is there to support us, and AI is going to be there to transform the way we deliver healthcare to support our patients and families.

But are we inadvertently not allowing some of the patients to take benefit from these technologies just because of some of the challenges that come along with it, like biases that come into through AI or who has access to particular technologies as well? So it is a holistic approach. It's not just IT working in isolation and developing these new technologies, but really, all of us need to come together, all aspects. We need the clinicians at the table. We need the data scientists at the table. We need the technology gurus, we need the bioethicists at the table to really come together and formulate our strategic direction and how we optimize the use of all these new technologies coming in.

Philip: Oh, I'm so happy you said that, Nimira. You provided that grounding of the objective, what are we trying to achieve to support safe care for our patients and their families and of course, our staff as well? One thing I got also, collaboration. I love it how you mentioned that it's not just a IT team goes and builds something and pushes it out [inaudible 00:07:06] it's about getting the different voices at the table. So I'll throw an extra question here. What have you learned through the process of ensuring other voices come to the table? Is there a piece of advice you'd give to, for example, other CTOs and other leaders out there in healthcare who want to ensure that they bring a variety of voices to the table?

Nimira: It's important, one of the lessons we've learned is that sometimes we go to the traditional groups that we are comfortable with, and we go to them because we get decisions faster. They understand what we're talking about, and we need to make decisions very quickly. But sometimes we actually do need to step back and say, "Who haven't we heard from?" The other thing is to be able to think about educating people. Some people may not have a voice because they don't understand what it is that we're talking about. So some of the things about AI and generative AI or some of the concepts coming through are quite new.

It's only after you understand the concepts that you're able to have an opinion and you can share that. So what I would recommend and urge everyone to do is to think about A, how do we educate people and then try and bring in those people that we normally don't bring to the table and just to hear their voices. Sometimes they may even bring in something we would've never thought about, so I hope we adhere to that and also some people just take that away and have this principle of inclusion.

Philip: Oh, I love that, education and new voices at the table. That's fantastic. So I'm going to shift gears a bit. We know that, like I mentioned, how we came to meet you that in the past few months you've been focused heavily on the cyber attack that hit SickKids in late December of 2022. So you've been very open in sharing some of the learnings, which we at HIROC, and I know all our subscribers value. So with cybersecurity in general, when we tend to keep things close to our chest and maybe not share every detail for a variety of reasons, but why is it important for you to speak openly and, of course, teach others like your peers in the sector about the learnings across the country?

Nimira: Thank you. We at the hospital are very fortunate to have our CEO, Ronnie. He's really shown us to say, "We need to collaborate and we need to come together and work together, especially when it's in the time of difficulty and time of need." So we did go through a cyber incident, and it was challenging for us. There were some things that we were prepared for and we were able to drive forward. Some things that I had personally taken away from other individuals and organizations that had shared their lessons learned, and what I felt at that point in time is to say, "I'm so glad I had that information because it's helped us move slightly faster in making sure that we minimize the impact to our patients and we're able to get to continuing to provide care for our patients." In the pediatric world, we sometimes have to think to say, when I use the word patients, these could be tiny little patients under the age of two or maybe age of three or babies that are there.

So we need to make sure the hospital is functioning and we are able to take care of them. So if you think about the other hospitals, the same principles apply. So we actually took a family-first approach to say what we understand what we are going through at the hospital, we'll share what we can within our organization, help our teams and our staff understand what the issue is and how can we all come together to drive things forward? Then we collaborated with our partners within the healthcare system where possible and shared what we could. We certainly had to work with the appropriate individuals to be able to get the right support to drive the resolution of the issue. But what we could share, we were trying to share. My goal at the end of the day is if a hospital or a healthcare organization is able to take away one or two steps where they can be better prepared and they are better supported, I think we've done a good job.

Philip: Oh, absolutely. Absolutely. The sessions that I've been where you or your colleagues have been speaking about the learnings, everyone has left that session by saying, "Wow, I didn't know that," or, "You know what? I need to get back to my organization, and bring the key learning points you brought up, I need to bring those points up at their boardroom tables and their variety of meetings and forums at their organization." So I can see right off the bat how you have started conversations about... all positive, how you started conversations. So keeping that in mind, how has your personal leadership style changed or has it at all since the attack?

Nimira: That's a great question, and I'm trying to think about what is my leadership style. I have to say, I don't think I have one leadership style. Earlier on in my career, I was introduced to a course, and it was called situational leadership. It really allowed me to think about who you are in a particular situation. So there are times when everything is good, the teams are driving and they know exactly where we're headed. So you're stepping back and you're just there as a coach and you're trying to just move things along and thinking strategically and longer term to say, "How do we get the teams moving in that direction?" But there were incidents like the cyber incident where you need to be directive.

So at that point in time, I had to really step up, make some decisions, drive some of the decisions forward, and bring in the right people, that I needed to collaborate with the right people and really ask for help when needed. So keeping that in mind, I think there was a good test of how you do need to have the flexibility to adapt to the various situations. There are some situations that are more challenging. I think they test your abilities to pivot and adapt, but certainly, I think it's reinforced the fact that the situational leadership philosophy is one that works for me.

Philip: Now I'm going to pass it over to Abi. Abi has a few questions for you as well.

Abi: Hi, Nimira. It's been amazing listening in so far in hearing your points on your leadership style collaboration, all of that. Being a fellow McMaster alum too, it's great to have you on and learn more about you, so welcome.

Nimira: Thank you.

Abi: So we're a bit biased as communicators, but can you speak to how integrated the communications and IT teams are at SickKids and how they can better support each other in their work?

Nimira: Thank you, Abi. The foundation of being able to support each other is grounded in the ability to understand each other, and our communication teams is there to support us in that function. Sometimes us as IT teams, we love acronyms and we are very technical focused and our language is not in the right way that makes people understand the impact of what is it that we're doing. So we work very closely with our communications teams for internal communications and external to be able to say, "What is the work that's happening on the technical front? What is the impact to our clinicians? What is the impact to our patients and why is it important for us to know? That in itself, I think that relationship has done two things.

It's enabled our communications team to understand IT better and it's enabled the IT teams to help articulate some of our work in a manner that is more understandable to the end users or our clients. So I strongly believe this partnership and communication between IT and communications teams or public affairs teams is foundational. You sometimes find when we go up to understand the funding opportunities or technical opportunities, if we're not able to articulate the impact, the risk, it's very difficult for business leaders to say, "Then why should I be able to fund this particular opportunity?" So this partnership has been beneficial for both groups. So this I thought was a fantastic question, Abi.

Abi: Thank you, Nimira. I loved your points about impact and beyond just explaining what is happening, explaining the why, the how, to make sure that everyone fully understands what's going on.

Nimira: That's right.

Abi: On that note, how do you and your team stay connected with the needs of patients and families? Because as we know, SickKids is, of course, patient centered and patient focused.

Nimira: I think there's a physical kind of response and then there is a philosophical response as well. We're now in this hybrid work mode, and a lot of our IT teams are virtual and they work from home. So one of the challenges we have is, how do we stay connected to what's happening on the ground? We certainly are both at the hospital and hybrid, and we really are trying to get the teams to come into the hospital, spend some time with the clinical teams, do some rounding and be proactive in our approach to understanding to say, "What are some of the challenges or even what are some of the things that are working really well at the hospital?" I think those are good reinforcements for our IT teams. So the physical presence within the healthcare environment, I think it is a critical component for us to stay connected to the needs of our patients and families, but also the needs of our clinicians that we're taking care of.

The other thing that I would talk about from a principal perspective is we should be inviting the clinical teams and patients at our tables. If we're thinking of bringing about new technologies as I talked about earlier, it would be really good for us, and we certainly do this on a regular basis, try and run these ideas by our clinicians and our patients and families. We have steering committee meetings that we set up and we make sure that we've got voices from all the clinical areas. Then we've also got patient representatives there too to give us that voice. We're very excited, in the next couple of months, we'll be launching our brand new building that's coming up soon. We've got a significant dedicated team called Project Horizon that's been driving that piece forward. But really, they've been able to bring all the voices to the table, look at patient's perspective, family's perspective, think about the IT perspective, so really staying connected to the hospital and the patients both from a physical perspective but also trying to connect in our communications.

Abi: Wonderful, and that point ties into your point earlier about making sure there's more people at the table, more opinions heard, more perspectives heard, so that's awesome. So as we know, all healthcare jobs are tough, but we're hearing increasingly about the stress and rise in burnout of IT professionals in healthcare. So with this being said, what do you do personally, Nimira, to stay balanced, meaning focused at work and connected to who you are outside of work?

Nimira: I have to say I love my work, and sometimes I do spend a lot of hours, and there is a possibility of burnout. I think I have mechanisms in place that really help me stay focused in life. There are a few things that I gravitate towards. One, I'm very blessed to have my parents and my sister in my life. They keep me grounded. They are there to listen to me. They encourage me, they give me guidance, and I have to say I am who I am because of who they are in my life. They've stepped up with me and stayed with me through the challenging times.

They in fact, with their day-to-day lives and their experiences have shown me what life is about, and so that helps me stay grounded in terms of both my work and that I need to take care of myself outside. So who am I outside? I think I'm the same person, but I enjoy doing a few things. As I mentioned earlier, I do spend a lot of time volunteering and contributing to our community, and we certainly can chat a lot next time about my other community work as well.

Abi: Yes.

Nimira: But I also enjoy taking those short moments, those short moments where I can squeeze in a time for a hike. I love nature. I think it's that time to really rejuvenate, to allow the nature to inspire me and to take that stress away, and that really helps me stay grounded. Then throughout the day, I actually try and make time, short periods of time, but also some dedicated time to practice my faith. I meditate and really, those things help me stay centered. One of the sayings my grandmother used to tell me is that you take care of yourself first and then you take care of others. It may sound selfish, but it is your health and your well-being that is so important that if you are not well today, you can't take care of others. That stays with me every day, and so having that thought in the back of my mind, I try and achieve as much balance between my work and my personal life.

Abi: You brought up so many amazing points, Nimira, when it comes to the importance of having a solid support group that will hear you out and be there for you, and the fact of if your day-to-day is so busy, having those small moments of solitude, whether it be in your case, hiking, practicing your faith and meditating. So that's so important that you brought this up, especially to prevent burnout. With this being said, how does the points that you've mentioned about staying balanced in your personal life trickle down to your team, and how do you make sure that they too are able to find that balance?

Nimira: One of the things that I encourage all of my teams and the time that we spend being there for each other outside of work, it's nice to start off a conversation by asking how they're doing, how is their family and how are their... Some of the things that sometimes families want to share that are really, really good news, and sometimes they'll share with you that things are challenging. I actually would appreciate when my team members share with me some of the challenges that they're going through 'cause that way I can help them. We have all of our team members that can support them. The organization is really supportive of some of the challenges and times that we have. They understand how much work we have as well, and they've provided a lot of supports and services that we have. So getting to know our team members outside of work, I think, is a really strong piece. So we try and do a few fun things whenever we have a little bit of time, but we are trying to make more time to get to know each other.

Abi: Absolutely. Building that connection outside of work is so important and helps build that community inside of work.

Philip: I'll ask you, are you watching any, oddball question, do you have any guilty pleasures binging a TV show on any streaming service? Do you ever do that?

Nimira: This is a fun question. I will watch any hospital TV show you can find. So in my university days, I used to watch ER, and during COVID, I really watched every single episode of Grey's Anatomy.

Philip: Okay.

Nimira: Mind you, I was closely scrutinizing their technology and the use and some of the risks that they were taking, but certainly, somehow I enjoy watching hospital TV shows.
Philip: You know what? I could to a certain degree, but there was a show called New Amsterdam. Did you ever watch that one?

Nimira: Yes.

Philip: For some reason, I gravitated towards New Amsterdam, obviously, maybe because it was in New York City, but I loved the, I forget his name now, the chief doctor, he always had a saying like, "How can I help? We talked about how we felt, that expression, that saying he would say, "How can I help?" We felt that the reason why we connected with him so much is because people like you and Dr. Cone and all the other people who've been on this podcast and we've connected with, we just felt that this is something you all do every day. "How can I help?"

Nimira: That's exactly it. You're absolutely correct. In fact, you know what? I think we use that term all the time, and I think that if you look at that TV show that question, it's a really interesting one because sometimes, sometimes that question got him into trouble, right?

Philip: That's right.

Nimira: Say, "How can I help?" Then you got to work within boundaries.

Philip: Yes.

Nimira: If you're not within those boundaries, it can be challenging. So it's great. I love that TV show, and it really has some entertainment value, but also some educational components.
Philip: We also teased ourselves about the show to see what things were accurate in healthcare and what things were not so accurate.

Nimira: Oh, yes.

Abi: That's actually a perfect transition to our lightning round. So our lightning round is a few quick and short questions. Nimira, you can just say the first thing that comes into your mind.

Philip: So Nimira, what was your first job ever?

Nimira: I was a takeout cashier at Swiss Chalet.

Philip: The next question is, I'm probably wearing a bit off script, but one is the first part of the question is, do you have or are you a mentor to somebody?

Nimira: Yes, I am.

Philip: Okay, good. The second question, the backup question is, what's a piece of advice from a mentor that stuck with you and that you live by or that you think about?

Nimira: One of my mentors says, "Strive for excellence."

Philip: Ah, I like that.

Nimira: Sometimes that path is very, very challenging, and it's very easy and nobody will know that you are not striving for excellence. But if you adhere to that principle, you will know what excellence looks like, and you will feel the difference and others will feel that difference.

Abi: Last question is, so living in and around Toronto, what's your favorite thing about the city?

Nimira: I have to say it's the diversity. You get to experience so much in terms of the types of cultures, the spaces, if you think about people, food, languages, and it's a beautiful place to appreciate what this world has to offer to us. So I think there's opportunities for us to explore the diversity. There are also a lot of beautiful spaces that allow us to all come together and engage in dialogue and to understand how do we take advantage of the fact that we have such a fantastic diversity in our community, and how do we make that a strength for us in Toronto? I absolutely love it.

Abi: I love that answer about diversity. Yes, Toronto is the most diverse place. On that note, those are all the questions we have for you today, so thank you so much, Nimira. It was a pleasure getting to know you and picking your brain. You brought up so many fantastic points about collaboration, about hearing different voices and all of that, so thank you so much.

Nimira: You're welcome. Thank you for having me, and it was a pleasure talking with both of you, Abi and Philip. I look forward to staying connected.

Thank you for listening. You can hear more episodes of Healthcare Changemakers on our website, hiroc.com, and on your favorite podcasting apps. If you like what you hear, please rate us or post a review. Healthcare Changemakers is recorded by HIROC's communications and marketing team and produced by Podfly Productions. Follow us on Twitter at @HIROCGROUP or email us at communications@hiroc.com. We'd love to hear from you.