STARS Air Ambulance has been saving and changing many lives. Not only by way of responding to medical emergencies but also through Philanthropy, inspiring others to help as well. The CEO behind this great organization, Andrea Robertson, is here in this episode to talk with Douglas Nelson about the origin story of STARS and how it maintains its enviable model and loyalty from corporate partners within the sector. She takes us across the art of fundraising, working with the board, and staying within your niche. What is more, Andrea then reveals some of the secret sauce that put their organization up with success.
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STARS Air Ambulance With Andrea Robertson
Our guest on the show is Andrea Robertson. She’s the CEO of STARS since 2011. We’re pleased to have her on the show. Welcome, Andrea.
Thank you. I am pleased to be here.
Tell us a little bit about that organization, then I’m going to ask you how you got there in the first place.
It’s an interesting story that is worth telling. A long time ago during the Vietnam conflict, our founder was a young medical student and found himself in Vietnam. He saw and witnessed what MASH units were able to accomplish. He went home and a few decades later, he finds himself as the professor of medicine and the leader of the emergency department in the Foothills Medical Center in Calgary. He, with a colleague named Rob Abernathy, who was the medical director of the emergency department of the old Calgary General Hospital. They were seeing patients coming in that were dying. They felt if they’d reached definitive care within a shorter period, they would indeed have survived. There’s a famous index case that we often refer to as a mom who had delivered a baby and had some postpartum complications and died. She would have been saved if she had reached the City of Calgary faster.
STARS was born by those two physicians coming together and unbeknownst to their spouses, signed away their homes and rented a helicopter. They asked a bunch of people to volunteer places in rural Alberta at that time, they think they needed our help. That’s how STARS was born in 1985. We’ve been in service for many years. In 2011, I came on and expanded into Saskatchewan and Manitoba. I have been in the business for that period and have cared for more than 42,000 people. We know that we saved many lives along the way and certainly changed many lives for certain. It’s a wonderful story to build a business like this. I don’t think you would do it. The business model is a bit crazy. One of the reasons we continued to succeed is because we are a niche market. We provide a small, narrow, piece of the healthcare system that we have to be good at. The mode of transport that we use is that I am very clear that this business is about critical care medicine. The fact that we use a helicopter to get there is another piece of our business.
When I described the STARS, it has primarily three major pillars. The first is being a critical care medicine. It’s important to get across what sets us apart from other air medical programs in the world that our care is completely provided oversight by critical care physicians. We have 100 physicians that work for STARS and their background is all emergency medicine, critical care medicine or anesthesia. They do this because they love it and they provide oversight to all of our crew and when required are on the aircraft as well. It does set us apart. The second line is business aviation and it’s a complicated one. When I came into this, I didn’t appreciate how complicated aviation businesses. It’s over 56% of our annual spending goes to aviation. It’s a crazy expensive part of the business. The business of revenue generation at STARS is a combination of three things. It is government funding, which is different in every province in which we work. Philanthropy, we are a bit of a machine in that regard. We raise a great deal of money every year and we do revenue generation out of our call center where we do some remote monitoring and we get paid to do that. It’s a simple business when it gets down to what we do. How we get there is a little more complex than I think meets the eye.
You mentioned philanthropy and that you do raise a significant amount of money. I’m sure you’re aware that STARS is viewed as the gold standard for corporate partnerships in fundraising, not just in Western Canada but across the country. The model and the loyalty that your organization has from corporate partners is the envy of the sector.
It is the nature of what we do. The industries that we have partnered with for a long time have their employees or their companies are working in rural and remote parts of Canada. We’re part of their safety budget line. It’s not always direct philanthropy from our corporate donors. Sometimes it is about their safety spent because we are either getting paid by them to do monitoring of their people that are working remotely or monitoring one of their remote work sites or highways or byways or whatever their industry is. In addition to that, they have an invested reason to support us to ensure that we’re there if something that does happen to one of their employees or one of their employees’ families.
I would imagine having that relationship, whether it’s part of the safety spender philanthropy or both takes a lot of trust that’s built over time. As CEO, how have you approached building those relationships and fostering those relationships?
I’d love to say I had a grand plan.
In hindsight, everyone has a grand plan.
When I came on, Dr. Powell, our founder, the intent was that I would take over as CEO and he would teach me the business of philanthropy over time. Through an unfortunate series of events, I ended up taking over as CEO faster and he, fortunately, is still around. He had some health issues in the early days. The transition happened quickly. I learned the art of fundraising by trial and by fire and with some unbelievably talented fundraisers on our team. I am fortunate to be surrounded by great people, but the focus of my early days was all about operations because we were expanding. We had the fortune of having great people in the other provinces to help us get our fundraising efforts started. We had great early success in Saskatchewan and with corporations, not in small part because we had great government support there. We call them our grandfathers STARS and Saskatchewan fellow named Rod Gantefoer, who was the finance minister in the Brad Wall government. It opened a whole bunch of doors for us.
He was leaving the government and moving into the next phase of his life and we hired him. He helped us secure unbelievable partnerships with companies like Mosaic and Nitrium and others that made it possible for us to get started there. We enjoy great support in Saskatchewan because of some of those early decisions. Calgary, Alberta is far more about what happened evolutionarily over time. Oil and gas, we early supporters of ours for what I stated, all those early reasons where they were looking for additional safety support, we were looking for partnership. STARS honestly grew by one patient at a time. People were exposed by the fact that we were able to save a farmer or someone in the industry and support group. The support through agriculture has grown almost case by case. We’re getting better at the bigger global aspect. I would be completely remiss if I didn’t say our board was everything. From the early days to the present day, we have an incredible board of directors. They open doors. This is a governing board.
It’s not a fundraising board. I know one of your questions is going to be about the capital campaign because we’re in the middle of a big one. That is a separate structure to our board entirely. Our board of directors has been we have the usual corporate structure of skills matrix and because of the geography we serve, we think it’s important that we have regional representation. As a consequence of what we need in terms of skills and regional representation, we have a large board. We’ve got some transitions. We’ve got anywhere between 18 and 20-member board. I need to say that I don’t go through any time where I’m not reaching out to one or more of them for one need or another. They’re unbelievable. I don’t know if you’ve peaked to see who’s on our board, but it’s an impressive group of people.
What percentage of your time would you say is dedicated to directly working with the board?
We only meet quarterly and then have all the usual committees. The ramp-up to the board is quite time-consuming and board is time-consuming. I talk to my board chair no less than a couple of weeks, 0.5 hours of catch up. It always seems to be something going on here. The ramp-up to the board is probably 20 to 40 hours.
It’s one of the interesting things that we see when we’re working with boards. When we ask the CEO, “What percentage?” you artfully avoided giving a percentage.
Our board, they make us better. I never leave a board meeting without some learning or some way to improve this organization. I’m fortunate, but I don’t run this board. The board runs the board. They’ve got good governance practices. They choose who’s going to be on the board. We’ve got good time limits or term limits. We use the skills on the board very intentionally. When we are going into this capital campaign, two of the board members, well-known CEOs in oil and gas, assisted me by pulling a group of on the guest CEOs together for a conversation. Did they do fundraising? Did they ask us first? Not in any way, shape or form. We’ve got a major medical issue. We’ve got two highly trained physicians on our board, not with our level or type of expertise, but separate and distinct. We’ve got aviation lawyers on the board. We’ve got purchasing aircraft trying to decide how to do that, current CEOs, past CEOs, people who sat in my seat, I cannot say enough about them. They’ve been amazing.These days, it's easy to get outside of your swim lane and get distracted by something that is not your core business. Click To Tweet
One of the magic phrases that every board should want their CEO to say is, “Our board makes us better.” You gave a couple of good examples of how the board does that. Is that something that’s evolved over time or has that been baked into the organization since its founding?
It evolved over time, but by nature which has been on this board, they simply have taken the reins and made us better. I can go back many years. Hugh Bolton was a well-known director. He was one of the directors who hired me. There are a million examples of people like Hugh that had been on our board. I can speak to the board members who I’ve worked with within the last years. They are phenomenal and they continue to amaze me. I think it’s the nature that the board runs the board and makes the board better, for me, is the key ingredient. You’ve got to have an amazing board chair and your committee chairs, audit and finance for us is everything because it’s a complex, expensive business. Conversion fleet for us is hugely risky and what we do is risky. Our safety and risk community, those would probably be the two high state committees we’ve got. We’ve got amazing chairs in those communities. Those things do make a difference. Those chairs are choosing what directors are going to be on those committees to help them. Their table stakes, but I think that often we think of social enterprise as less stringent around governance rules. I would put our governance practices up against any public company.
How have your conversations with the board changed since you’ve been in the CEO role? Are you more comfortable letting the board run with decisions or are you more active in helping them make those decisions?
I wish it had been anyway, shape or form status quo going on. It feels like we’ve gone from crisis to crisis. I would confess that our strict strategic plan has been more of an operating plan than a strategic plan. I think that we even have evolved to asking the board and relying on the board to help us with strategy. We’re going to go into a five-year plan and how we’re going to address it. Board and management will be different than we have in years past. I’m hoping the young result comes out as it is a nice five-year strategic plan and not another their operating plan. It’s easy for us to fall into what’s immediately before us. The markets are crazy. We’ve got blockades and we’ve got ag problems and we’ve got virus problems and a lot is facing us. It’s hard to keep your head up and above all of those things. It’s one thing that the board can help you with.
How much would you attribute that engagement to you? What did you describe as a board that is aligned around the purpose of the organization? You described STARS as being fairly niche, and it’s bundled with the healthcare system, but complex as a business. Does that narrow niche help keep everyone focused on what needs to get done?
We often talk about staying in your swim lane. There’s a desire, particularly when you’re in this crazy economy to look at all different ways you can to create more revenue or take a different approach in. I think it’s easy to get outside of your swim lane and get distracted by something that is not your core business. We’ve stayed focused in and it’s probably one of the reasons that we remain successful.
Something that helps the board stay focused on what it’s doing. One of the things we see a lot with organizations that has a broad mandate, they’ve interpreted their mandate as being broad. Is it hard to keep everyone focused on what we’re trying to accomplish, not over the next five years, but what we’re trying to accomplish in the next quarter, the next month or the next week? In your niche, you’re able to keep them focused on those things.
I think so. The committee structure and the structure of the board is working well. I’ve never seen an issue with a lack of focus by the board.
That is a powerful statement. I think a lot of your colleagues are probably quite envious of you being able to say that or wish that they could say it as well. You mentioned the economy and philanthropy play a very significant role. Let’s turn to that capital campaign. You are in the midst of a $138 million campaign to replace and renew the fleet of helicopters. You’re well past halfway in that campaign. Given where the economy is at, how are the conversations with prospective donors different than they were maybe at the beginning of the campaign?
We’ve not been in the campaign all that long. We were fortunate to receive a significant amount of money from both the federal government and provincial governments. I need to say that we have raised a little under $12 million in a short time. I would say that the most important message for me is STARS is always in a capital campaign. What we raise in a year is a typical campaign size. We raise anywhere from $40 million to $50 million every single year to operate. That’s a year in, year out. Our biggest concern is a capital campaign eroding our base operating. That’s probably the biggest concern and that’s when we talk to donors. That’s what we talk about is, “If you’re interested in supporting, do you support us in addition to what you’re normally doing?” At the end of the day, we need fuel for the helicopters and to be able to pay the employees. It comes down to that. We’ve taken maybe an atypical approach also with this campaign because of the size of it. We are going after large gifts. Thousand-dollar gifts we’re trying to get, we’re trying to learn large gifts. So far so good. Rightfully pointed out, it’s going to get tough because we’ve got about a quarter to go. It is a tough slugging.
That’s typical with most capital campaigns. How is that discussion of asking people to make a special gift or to make a gift in addition to their regular support? What have you learned from your donors in those conversations?
They totally get it. It’s either a yes or a no. Our campaign cabinet has been effective. We’re gigantically fortunate. I don’t know if everybody would know the name Brad Wall. He was the Prime Minister of Saskatchewan. Since it has moved into private life, he has agreed to be our volunteer campaign cabinet chair for the whole organization. We have Brad and then we have campaign leaders in every jurisdiction. Alberta’s got more than the others because of the size of the province. They all volunteer and I meet a lot of that conversation that has occurred without STARS staff. The initial conversations have been those volunteers opening the doors and then we go back or the gift is secure with our volunteer cabinet members. So far, when we’ve gotten into the conversations about capital and operating, if it is a known entity, people that have supported us in the past, they’re accustomed to that with us. That’s not an abnormal ask. For new people, they seem to understand when we explain our financial model.
Keeping that many volunteers all saying the same thing is no small challenge on its own.
Some of them are past board members.
That would help.
Two of them are in Alberta. One is Dave Mowat who used to be the CEO of ATB. He was board chair and my boss for six years when I first started and is one of our volunteers. He knows us with an image of our lives. Those things are super helpful. He can go into any room and speak for us with not only clarity but with complete accuracy. These are people that are calling their friends. Many of the conversations are informal to begin with, but so far it’s been successful.
I wish you all the best of luck in the last quarter of the campaign. I am interested because this comes up working with a lot of clients. The relationship between the volunteer campaign cabinet and the board. What we see typically well-meaning, well-intentioned individuals wanting to contribute. Sometimes the cabinet wants to stray into the governance lane and sometimes the governing board wants to stray into the fundraising lane. How does your cabinet in your board interact?
We have two members of our cabinet that are on our board. The cabinet does not interact with the board beyond that. We do regular committee meeting update at the board level. The chair of our foundation committee gets a report at that committee from the campaign cabinet that’s provided by staff and then that gets reported at the board level, so there’s no stray.
The clarity of having that connection between the cabinet and the board in the form of people is considered best practice. When it works, it works well. I want to ask a couple of questions about the organization itself. You described the complexity of it in critical care medicine, aviation and revenue generation. I’m thinking about the revenue generation side of the organization and given the uniqueness of your mission, what makes someone successful? It makes a fundraiser successful at STARS. What do they need to be successful at STARS that they might not need in another type of organization?
We asked some magic sauce here. I’ve run hospitals in my past and worked with the hospital foundations. They’re amazing and do incredible work. The difference is they’re run separately. If I’m running the Foothills Hospital, I’m not also running the foundation. Here, we run everything together. When a foundation person is meeting with a potential donor and the pilot is walking down the hall, there’s this instant synergy. Our people know where their paychecks come from. Whether you’re a nurse, paramedic, physician, pilot, engineer, linky, we call our call center staff, they all know that corporations and individuals are how our bread is buttered. It’s real interaction. If you go to any of our official fundraiser events, we’ll have important patients, previous patients that we phone who speak with, they’re always surrounded by the operational crew. The fundraisers have access to those people. It is not unusual for me to go out to do a big ask that it’s me, a member of the art crew nurse, paramedic pilot, some doctor and fundraising staff.
I’m not sure that kind of collective team is often available to fundraisers. I believe if you talked to them, they would say that that’s something that differentiates us. Then I’d say we are that crazy place that grew over time. If you can name a fundraising activity, we’d probably do it. I think what we’ll need to figure out in our future is what do we do well? I’m shocked that calendars still sell, for example. Every year we talk about it and every year we get told, “No. That’s a long thing you can’t remove.” A fundraiser is an extraordinary place to come and work because if you’re major gifts or just about anything, you can imagine events, you name it, we probably do it. I’m not sure that’s a great long-term strategy, but you could be exposed to about anything here because that’s how we’ve grown over time. The magic sauce is how close we are with operations.
That alignment and that connection to mission make the need for philanthropy or the role of philanthropy clear in the organization.
What I say at every orientation session is, “Who saves lives at STARS?” If not everybody in the room puts up their hands, then we failed. That’s the reason we work here. If you bring in a dollar or you answer the telephone, you’re part of the next patient who gets saved. It’s a direct line of sight to what you’re doing.The magic sauce to an organization’s success is how close it is with operations. Click To Tweet
Andrea, you’ve shared a clear picture of what an aligned and effective organization looks like in the social profit sector. I appreciate how clear you can describe the lines of business. That’s one of the bigger challenges for a lot of organizations, particularly organizations the size of STARS and others to be able to be clear about what you do on a day-to-day basis and why. To have everyone repeat that message back and be on the same page is quite difficult. It sounds like you found that magic sauce at STARS. I appreciate you sharing the story.
Thanks for your time.
About Andrea Robertson
Andrea Robertson believes in a very important motto: the more informed you are, the more you realize how little you know.
She’s had a life-long commitment to learning ever since she was a young nurse, and that drive carried her through many academic achievements, from a Bachelor’s in Nursing, to a Master’s in Health-Care Administration, to an executive fellowship from Wharton University and Ivey School of Business, to an executive leadership program at Harvard.
Her drive is a selfless one. These accolades, as well as her many past leadership roles at Alberta Health Services, Foothills Medical Centre and Alberta Children’s Hospital, were all intended to be in service to her community. For Andrea, there is no greater service than helping someone survive a critical illness or injury. Which is why, as president and CEO of STARS, she is right where she belongs. In this role, she is responsible for the overall direction of our operations and works to build upon our external relationships with donors, governments and key partners. Strengthening these relationships is vital to our ability to provide the best possible service of our communities.
Andrea’s commitment to continuing education and dedication to providing the best care possible has also led her to be an invaluable mentor to many entering the health care field. Formally, she is part of a mentorship program through the University of Calgary. Informally, she works with as many as five young, energetic leaders at any given time. For the students, the reward is Andrea’s wealth of experience and unyielding empathy for others. For Andrea, mentorship is just another opportunity to learn more about the world, through the eyes of her students. It’s through these relationships that Andrea sees education come to life.
Andrea’s leadership and contributions to business and her community have been widely recognized, both as a member of the board of directors of Bow Valley College, Calgary Airport Authority and Canadian Pacific Railway, and as one of WXN’s Top 100 Most Powerful Women in Canada in 2015.