I recently spent a day in Hamilton with VON staff.  Seeing what staff and volunteers do on a daily basis is a unique privilege.  I am a strong believer there is an enormous value to see and be part of the work that an organization does.  Whether it is the CEO or those who are more removed from the front line, we all need to make time to experience first hand the work our organization delivers.  The benefits are many; the opportunity to connect with staff and volunteers demonstrates that the leadership of the organization cares and values their work. At the same time, it provides the CEO and senior leadership with the opportunity to see first hand how some of the policies, programs and initiatives are being implemented.  For me, I also find that these opportunities give me the opportunity to think about the roles we play and how we might improve our organization.  While boardroom discussions and high-level meetings are important, what happens in the field is my testing ground.

So during my visit to Hamilton, I went out with two volunteers to deliver Meals on Wheels, made a home visit with an RN, visited the adult day program (which also has an overnight respite), and spent time with staff and management.  The lessons I learned, the ideas I heard, and the excitement generated through seeing this amazing work are just a few of the benefits.  Take a “simple” program like Meals on Wheels, which relies heavily on volunteers who usually change every day of the week.  You really see how it takes a village to look after those who need our support.  One of the volunteers I went with to deliver meals has been volunteering for 27 years, longer than most people stay in any paid job.  She is probably in her early eighties but looks and acts like she is in her late sixties (volunteering is good for the body, soul and mind).  Her reflections and thoughts were clearly about the clients whom she knows so well.  In one of the homes, a PSW was helping with bathing and other home-making activities.  My thoughts immediately went to the system fragmentation and the multiple agencies that people have to deal with.  VON brings the meals, another organization provides the PSW; it can’t be easy for a 90+ year old who lives alone to manage.

I noticed another issue of fragmentation when I went into a client’s home with the RN.  The client’s needs (really the patient) were very complex and the RN goes to the home at least twice a day, each day. The client needed some medication management but when the spouse tried to contact the physician (at 2 pm), there was no reply. Wouldn’t it have been easier if we had Nurse Practitioners who could go into the homes at the request of the RN or LPN and help with medication management and other clinical issues? Wouldn’t it be better if we had one integrated electronic health record that all practitioners could access and communicate to one another to help make clinical decisions that benefit the patient and family?

So, the things you see, hear and observe when you are in the field are essential to providing the right leadership and policy talk at both the board table and with political circles.

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