Carol Baumgarten’s office is in a warren of administrative space in Calgary’s Tom Baker Cancer Centre. Here, Baumgarten works as the director of cancer care teams for Alberta Health Services (AHS). On her wall is a small poster that says Keep Calm, We’re the Dream Team.
Keeping calm is essential. For more than five years, Baumgarten has overseen all the ambulatory clinics at the Tom Baker Cancer Centre and the Holy Cross Centre, including the Blood Marrow Transplant Clinic. It’s her job to develop the procedures, policies, processes and educational resources that improve patient care.
Each day, Baumgarten must address a variety of challenges, including those posed by Calgary’s growing and aging population; demand for health services is increasing, and cancer cases among this population are becoming more complex. Baumgarten must also keep up with innovations in oncology and track gradual shifts in the way that patient care is delivered — all while managing her team and nurturing relations with other departments and units. She describes her days as chaotic, but she’s laughing when she says it.
“A typical day is not typical. If you asked anyone in cancer care, that’s what you would find,” she says.
Baumgarten began her health care career more than 30 years ago as a central supply aide. She was following in the footsteps of her mother, a trained midwife and emergency nurse. After becoming a registered nurse, Baumgarten worked in different units in Calgary before taking on the role of gynecological oncology coordinator at the Tom Baker Cancer Centre in 2000. This period of her career, which lasted until 2008, was when Baumgarten began to explore the ideas that have shaped her career ever since.
As gynecological oncology coordinator, Baumgarten was in charge of organizing
everything from surgery times to treatment and palliation — in addition to delivering front-line care. Managing the movement of patients between institutions and clinics so that they could access the care they required was a complex process.
“At that time, I realized that in order to deliver the best care possible, we needed more of a systems approach,” Baumgarten says. She decided to gain a greater understanding of how she and her patients fit into the larger institutional structure.
Baumgarten credits her team at the Tom Baker Cancer Centre for empowering her to explore new ideas. “I don’t know that I’d be the person I am today if I didn’t have the physician group that I worked with,” Baumgarten says with emotion. “I’m a naturally curious person. They challenged me and they pushed me to be open to questioning, and that’s how I grow and how I learn.”
To better understand the organizational and strategic side of health care, Baumgarten enrolled in an MBA program in 2008 through Royal Roads University. On her first day at business school, Baumgarten’s class was asked to do a SWOT analysis (a breakdown of an idea’s Strengths, Weaknesses, Opportunities and Threats). Baumgarten didn’t know how.
“I sat there like, ‘What am I doing here?’” she says. “And then I thought, ‘You know what? I do that every day — just differently. I call it a diagnosis differential, but if you step back it actually looks like this.’”
Baumgarten gained confidence as she realized that her nursing experience actually gave her certain advantages in the world of business. Successful management requires soft skills like empathy, communication and the ability to build consensus — skills nurses hone every day.
“When you’re feeling your most supported, whatever that means to you, that’s when you can develop the most.”
Business school gave Baumgarten a new set of techniques and terms to apply to the challenges she faced daily: negotiation, change management, buy-in. “At the time, it wasn’t language we used in health care,” she says. “But if you want to open a clinic, start a program, or change a structure or policy, you need [business] skills.”
Today, Baumgarten ensures front-line nurses have the opportunity to attend training such as change management and process improvement sessions. She says attendees are usually surprised by how applicable the information is to their roles.
Baumgarten moved into the role of assistant unit manager of ambulatory clinics in 2008. When she noticed clerical staff at different clinical sites (the Tom Baker Cancer Centre and the Holy Cross Centre) were unfamiliar with each other’s roles, she applied her business education to the problem. She developed training opportunities and standardized processes, changes that allowed clerks from different tumour sites to cover for each other. These changes also ensured patients would receive the same quality service.
Now, as director of cancer care teams, Baumgarten uses the strategic mindset she honed as a business student every day. When patient surveys indicated that two components of cancer care needed improvement — Information Education and Coordination & Emotional Support — Baumgarten wanted to find out why. In 2014 and 2015, she conducted a series of qualitative interviews with the Patient and Family Advisory Network, a team of more than 80 volunteer members from across Alberta who provide feedback to AHS.
Baumgarten says she loved the experience of conducting the interviews and gathering information. Through the conversations, ideas took shape, solutions presented themselves and a bigger picture emerged. The process motivated her to look at delivering care in a different way.
“It involves a shift in thinking, from reactive to proactive,” she says.
Baumgarten’s team has changed the way patients check in at outpatient reception, but Baumgarten says there is more work to do. “We’re going to get there — it’s just going to take some time.”
Baumgarten considers all her achievements to be team efforts. To her, building a sense of community, trust and support among colleagues is not just desirable, it’s essential. “You cannot talk about patient experience without staff experience,” Baumgarten says. “When you’re feeling your most supported, whatever that means to you, that’s when you can develop the most.”
Carole Chambers, the provincial director of cancer services, pharmacy, for AHS, is a long-time co-worker and collaborator of Baumgarten’s. She describes Baumgarten as a great listener — someone who is capable of breaking down the silos that tend to separate health care teams. Chambers says she recently found an appreciative note from Baumgarten stuck to her office door.
“It made my day,” Chambers says. “You’re way better situated to find solutions to tough issues if you’re dealing with positive people.”
Chambers and Baumgarten recently worked together on a multidisciplinary pharmacy-oncology initiative. Now, when a patient visits a cancer care clinic for the first time, all medications and substances they’re taking are documented. This improves patient safety by preventing unexpected drug interactions. Chambers says taking a cooperative approach was the most effective way to make this change.
“To have the ability to sit down and speak with mutual respect on tough topics is a rare thing, and that’s why I value it so much,” Chambers says. “I think [Baumgarten] is amazing.”
Baumgarten has long since finished her MBA, but her education has continued. At the end of 2017 she submitted her draft thesis to the University of Liverpool for a Doctorate of Business Administration. She’ll spend 2018 working on edits and doing a verbal thesis defense. If all goes to plan, she’ll graduate this December.
Her studies occupy most of her spare time — that and watching her two sons (aged 13 and 14) play hockey and baseball. When Baumgarten finishes her degree, she jokes that she hopes to actually develop some hobbies of her own. For now, she’s happy to keep pursuing big ideas and solving health-care problems.
“You know sometimes when you just find your place? That’s what this place is,” she says.
Growing a Leader
Carol Baumgarten, who spent 30 years working in health care and oncology before becoming director of cancer care teams, is described by colleagues as a “grown leader” rather than an “inserted leader.” Certain phases of her career have helped her grow, shaping the values and strategies she applies to her current role.
Career phase: Primary Gynecological Oncology Nurse, 2000 – 2008
Value learned: Take care of your team
“That unit was a family. There was an appreciation for each other. They say that trust is the foundation of any team, and when you have that it’s magic.”
Career phase: Assistant Unit Manager Ambulatory Clinics, 2008 – 2011
Value learned: Adopt a systems approach and a strategic mindset
“Any good clinical idea needs good organizational management. It was an empowering shift from ‘I wish’ to ‘I can.’”
Career phase: Operation Support Lead, 2011 – 2012
Value learned: Apply business principles
“I don’t know how much more effective I could have been if I didn’t do some- thing to further my understanding of business processes.”
Career phase: Director, Cancer Care Teams,
2012 – Today
Value learned: Never stop learning
“Oncology has been a fertile ground to learn and grow. This specialty leaves an imprint on those of us who live and breathe it. My curiosity is piqued every day, which is what I love.”