Munter: Here’s what CHEO taught me about pediatric health

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One of the very first issues I had to deal with on my first day at CHEO in 2011 was a young child with cancer, hospitalized in our ICU due to a serious hospital-acquired bacterial infection.  

Fortunately, the child pulled through, but it was an immediate and early reminder that, at a place like CHEO, the stakes are high.  

Soon after, CHEO became one of two Canadian hospitals to join the U.S.-based pediatric Solutions for Patient Safety collaborative, committing ourselves to preventing secondary harm such as hospital-borne illnesses among the children, youth and families who rely on us. Today, we have daily safety huddles, rigorous reporting and mandatory safety-habits training as part of our #SafetyFirst approach to care. Making sure we have safe, high-quality, evidence-driven care for kids who are sick is, of course, core to CHEO’s mission.

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Remember though, pediatric care is a little different from much of the care delivered in our broader system. Treatment is often also prevention. Intervening early puts kids on the path to lifelong health and reduces or stops ill health later.  

In other words, making sure kids get diagnosis, assessment and care as quickly as possible will change the future. Not just their own future as measured by their health, growth and development but the future of our whole society. Healthy kids today are happy, productive healthy citizens, parents, taxpayers and innovators tomorrow. 

That’s why such a major focus of recent years has been to right-size the pediatric health-care system to keep up with the growing needs of a growing population of children and youth. Compared to 13 years ago, CHEO now has more beds, clinics, programs, staff and doctors. And so, we need more space. The cranes are up: CHEO has launched the most significant redevelopment ever of our main campus, expanding our footprint and modernizing our existing facilities. CHEO’s operating budget today exceeds $500 million, double what it was 10 years ago. 

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Of course, one of the best things we can do for kids is to make investments and build the systems that prevent them from needing to come to hospital in the first place. That’s true for physical, developmental, behavioural and especially mental health. 

Some of the biggest changes at CHEO in the past decade have come in expanding partnerships to build a more connected system of care for kids. 

Some of that has happened within CHEO — for example, merging our acute care hospital with the outpatient children’s rehabilitation centre; becoming a Canadian digital health leader; or launching first-in-Canada models in eating disorders, newborn screening, concussion treatment and many other areas. 

But most of it has been through partnerships with community agencies, community physicians and other hospitals. 

CHEO is the host organization for the Kids Come First Health Team. The first of its kind in Canada, Kids Come First brings together 70 health agencies and thousands of providers and families to create new services that help make sure more kids get the care they need more quickly. Founded just before COVID, the health team first swung into action to respond to the pandemic.

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It then launched a range of programs like the 1Call1Click.ca mental health service (another Canadian first); a regional pediatric surgical program; urgent care clinics; a vaccination catch-up program; and more. In our region, unlike anywhere else, publicly funded home care for kids is delivered by a pediatric health-care organization. 

We worked with Toronto’s SickKids Hospital to create a shared electronic health record that has already transformed care and research. In the age of AI, it will become a platform for more progress. With McMaster Children’s Hospital in Hamilton and Toronto’s Holland Bloorview Kids Rehabilitation Hospital, we created a new program for kids with developmental disabilities like autism or Fetal Alcohol Spectrum Disorder that’s not based on diagnosis, but rather on need. It’s already resulted in fewer school absences, less family distress and reduced hospital visits.

This is not a victory lap; there is so much more left to do — in fact, in areas such as mental health and child development, increased need for more complex care has outpaced even this considerable expansion of services.  

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Health care has never been sustainable if sustainability means continuing to do the same things in the same way. Governments need to trust people in the field to find new, different and better ways to do things. Out here is where the solutions are.  

More than half a century ago, one of CHEO’s earliest volunteers, Juanita Snelgrove, joined other mothers, grandmothers and pediatricians in refusing to accept the status quo. They made the case for a health-care institution dedicated to the unique needs of kids and families here.  

Snelgrove would drive around Ottawa raising money to help fund the opening of CHEO and then, once the hospital opened, delivering donations such as hats, sweaters and toys to kids. 

Juanita Snelgrove died this summer at age 108. I am glad she was able to join us to help celebrate CHEO’s 50th anniversary just a few weeks before her death. One of the oldest citizens of our community, she knew that taking care of the youngest among us is a moral imperative and the definition of community-building. 

To all my colleagues at CHEO, all the volunteers, donors and supporters, and to all the families who help shape CHEO: thank you for giving me this opportunity to join you in building community. It has changed me as a person and, I promise, I will never be very far away. 

Alex Munter, the longest serving President and CEO of a children’s hospital in Canada, leaves his position at CHEO on Oct. 8. He begins his new job later this fall as the CEO of the Canadian Medical Association (CMA) and the CMA Group of Companies. 

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