Beedie and Canadian College of Health Leaders host opioid overdose crisis event

The Beedie School of Business partnered with the Canadian College of Health Leaders to bring together leading experts for a panel discussion on the opioid overdose crisis on February 22, 2017. Moderated by Beedie Adjunct Professor Kate Dilworth, the event – entitled Leadership in the Context of an Adaptive Challenge: The Opioid Overdose Crisis in BC – welcomed leaders with diverse, personal and professional experiences of the challenges faced in tackling the current health crisis.

Before introducing the panel, Dilworth opened the session drawing parallels between the nature of the challenges presented by the crisis – including leadership, risk and operations management, innovation, organisational culture and change management – and the teachings and theories developed by business schools. For Dilworth, there is a valuable place for these skills in addressing this problem and Beedie was a fitting venue for the discussion to take place.

“In healthcare we are very comfortable talking about and often focus on the clinical perspectives of an issue”, says Dilworth. “But the opioid overdose crisis is a very complex challenge and we knew it was important to create the opportunity for leaders to reflect on and share what they are learning about leadership and innovation as they respond in real time to a crisis.” The event also provided the panel with the opportunity to provide ideas as to how other health professionals, and community stakeholders such as universities can add value as we all work towards solutions.

Dr. Christy Sutherland, Addictions expert and Medical Director for PHS Community Services Society, was the first panel member to present, describing the pioneering work that she is leading in Vancouver’s Downtown Eastside. When they began to recognize the scale of the problem, her organization scaled up their provision of Naloxone training for drug users and has now provided over 2,500 Naloxone kits since August 2016.

They then started to set up outdoor clinics in alleyways to provide more accessible treatment to patients, and embedded a clinic in the Downtown Eastside Market. As the crisis worsened, they opened two overdose response rooms, staffed by drug users and medical staff, to provide safe consumption sites – “We were a bit nervous about this, but if you look at the history of supervised consumption worldwide, since it’s been studied, nobody has died,” says Sutherland.

Sutherland’s greatest risk as a leader, however, was to put forward a patient for injectable suboxone therapy – the first time this had been done in Canada. The treatment led to a positive outcome and validated her willingness to seek innovative alternative solutions in the face of an unprecedented health crisis. PHS conducted 1,400 overdose interventions in their hotels during 2016.

The second presenter, Catharine Hume, Co-Executive Director RainCity Housing and Support Society, has faced many of the same challenges as Sutherland. She describes the “bumpy journey” of a leadership role in a housing not-for-profit during this challenging time, “working in a complex, grey area without clarity.”

For Hume, the challenges to addressing the crisis are “discrimination and silence [and] criminalization; people are marginalized.” Within RainCity, they have adapted by increasing staffing at sites impacted by high levels of overdoses, and providing training around Naloxone use and counselling. However, they face the challenge of the organization’s employees keeping up this response over the longer term, and maintaining a sense of optimism in an environment of trauma – while providing care that goes beyond their regular job description. “This is dramatically different work than people signed up for,” says Hume.

Active drug users are the group most severely affected by the crisis, and yet their voices are often lost in the wider debate. Laura Shaver, President, VANDU and President, BC Association of People on Methadone, provided a powerful insight into the lived experience of addiction and the dangers that the community is facing. As well as saving lives in the Downtown Eastside, Shaver is an active advocate for policy change and recently met with Prime Minister Justin Trudeau to share her experiences and ideas for change.

VANDU runs an overdose prevention site, which has served over 1,700 people since December 2016, with no deaths. Shaver highlighted the importance of lived experience in responding to the crisis, summed up as “Nothing about us without us.” Shaver called for action and a multi-faceted approach to the crisis: “One thing is not going to make a difference. It is many things.”

Two leaders from BC Emergency Health Services spoke about the emergency response to the crisis: Dr. William Dick, Vice President, Medical Programs; and Rob Graham, District Manager, Patient Care Delivery, Fraser South. Dick, a Beedie Physician Leadership program alumnus, described the process that led to a mobile medical unit, first used in the 2010 Olympics, being brought into action in the Downtown Eastside, after being in storage for several years, noting that “When a crisis allows barriers to be broken down, good things can happen.”

Graham, a Beedie MBA alumnus, talked about the leadership theory behind the response to a crisis where no one agency has the authority to respond, and collaboration and innovative thinking are required. “The response requires rapid and often uncomfortable decisions,” he says. “The healthcare industry has a very low risk tolerance, but crises like this force you to re-evaluate how you view risk. You have to be comfortable with discomfort.” Ultimately, though, inaction was not an option: “The cost / benefit analysis of not dealing with harm reduction – it’s a no brainer.”

To conclude the event, the panel were asked about what gives them optimism for the future. Graham responded, “This, that’s the simple answer. You have stakeholders from different places, different experiences, coming together to have a conversation about something that is significantly disruptive to society. Having the opportunity to have this conversation is the most optimistic thing and it is really hopeful.”