Fundraising in France on the frontline against Covid-19 #3

4th January by Rodolphe Gouin

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In June last year, we shared two blogs from Rodolphe Gouin, Development and Philanthropy Director of the Greater Paris University Hospitals (AP-HP) and CEO of AP-HP's Foundation on the huge fundraising efforts the Foundation had made to support the hospitals as Covid hit the city. Rodolphe’s final blog summarises a tumultuous 2020, lessons learnt and how that funding has now been spent in the fight against the pandemic.

Eiffel tower

Last June, I shared with you my experience about how the Greater Paris University Hospitals’ Foundation (AP-HP’s Foundation) launched a public appeal to raise money to support healthcare workers and medical research teams at the outbreak of the Pandemic. In my first blog article (dated 9th June), I depicted the way in which French public hospitals slowly but surely came to fundraising. Focusing on AP-HP, which is the largest academic medical centre in Europe, I told the story of its Research Foundation and the context before the Covid crisis hit. In my second article (dated 22nd June), I tried to describe as clearly and openly as possible how we raised 44M€ between March and June 20202 with our 8-strong team, engaging 43,000 donors.

Now, six months later, it is time to round up this blog by providing some insight in to how we’ve used the money since then to make a difference in our community. This is where the fundraiser’s dream can turn into a nightmare and so for this third article, I’d like to highlight the pitfalls and traps we have tried to avoid, some of which are typical in times of crisis but others are connected to our public-private framework. Finally, I’ll conclude with a few of the lessons I’m taking away, personally as CEO, from what has been an astounding year.

Traps, dilemmas and weaknesses

Among all the difficulties one can face in grant-making, some can be beyond your control. I call them traps and all you can do is brace yourself, stay positive and deal with them as they arise.

From the start of the campaign and until now, we’ve had to make sure that the Government or the National Health Insurance would not be funding the needs or projects we were going to support. It was obvious that public authorities would back hospitals at an unprecedented degree. However, what exactly would be done, when and how much would be spent were tricky questions to answer.

For example, we understood early on in March that purchasing ventilators or masks would be irrelevant, given the efforts and strict control set up by the French Government. Significant public funding was also announced for research. However, finding new treatments could not wait for some sort of hypothetical support, therefore, we provided the AP-HP research committee against Covid with specific seed funding, allowing them to get started on the first projects immediately. In the case of national funding programs being successful, monies could be given back and redirected towards other research projects.

Supporting medical research into Covid-19 raised a second difficulty: financing projects that would ultimately be interrupted for medical reasons. For example, we had already given money for an important clinical trial using hydroxychloroquine, when the drug was suddenly banned.

And finally the third risk, which is specific to clinical trials, was to allocate funds to projects that would never be completed due to a lack of patients. As an epidemic recedes, there are fewer and fewer patients to include in trials, thus bringing them to a halt.

The outcome of these situations was by definition unpredictable, but there were other potential pitfalls simply in our dealing with practical dilemmas and, in my experience, these are the toughest. Here are just a handful that we went through. Expedite or cautious: should you save money in case of a second wave in spite of urgent needs, or should you use all of it immediately? Effective or selective: in order to support research properly in critical times, will you ask research teams to write time-consuming application forms and have them reviewed twice, or will you shorten procedures for an immediate impact? Important or compliant: whilst searching for money for a highly promising solution, should you use all donations even those dedicated to incidental issues, or should you scrupulously follow the will of a donor?

The final challenge stems from ordinary organisational weaknesses. When working at the usual pace, forgetting to share information or bypassing decision-making procedures is quite easy to rectify. However, in such a hectic period, when double-checking became a luxury we could hardly afford, any belated correction could become a liability with major potential implications. Therefore, there was no room for error. We struggled to keep that in mind and even then, allocating money to the same project twice is still a mistake that can easily occur.

Results and impact

Fortunately, we noticed most of these issues before it was too late and have successfully spent or assigned 98.5% of the total collected amount. Above all, we can affirm we have had a real impact on our community: we funded 225,000 quality meals over several weeks in April for healthcare workers, as well as PPE for frontline workers and permanent videoconference devices so that patients and families may stay in touch with each other. We supported the research teams to get started on the very first trials for new treatments and to finance both strategic projects to fight the epidemic and non-government funded projects. We equipped a brand new Intensive Care Unit, which was opened in an emergency to face up to the crisis on 9th April 2020, many months ahead of schedule, etc.

What was most challenging for such a small team was to manage the funds and to run this extraordinary campaign at the same time. There is no doubt that we punched above our weight! It is both funny and frightening to think that, just a few weeks before the Pandemic, we were working on an investment plan to acquire our very first IT system… which of course never happened!

A few personal lessons, as CEO                       

Needless to say, such results would never have been possible without an incredible team. I feel enormous gratitude every day for what they’ve accomplished and the two lessons I have learned from this experience as CEO revolve around the intricacies of the job itself.

Firstly, more than ever, I felt that my main responsibility was to manage complexity. Being a CEO is not just addressing many issues at the same time, such as raising and allocating unprecedented amounts of money; the extension of our mission from research to care, hence the necessary adaptation of procedures; and the design of a new strategic plan from June onwards. Embracing all these evolutions and opportunities all together is challenging, of course. But my job was not to think about all of these evolutions and to tackle the problems one by one, but to understand and foresee the multiple impacts on each other, in order to generate a positive general dynamic. Complexity is a matter of feedback. Quite naturally, CEOs are in the best position to cope. In my opinion, this doesn’t convey any more power, but a wider responsibility.

Secondly, I understood that the leadership style which fit me best in this situation was that of captain. I like to play on the field alongside my team, raising funds, designing grants, writing articles, preparing budgets or reorganising the accounting. Over the years, I’d learned to lead more in the way of a conductor, ordering how to play, without actually playing with the other musicians but by giving them instructions. For many reasons, I simply couldn’t take part in the match anymore. I now know that being the captain gives me much more pleasure.

It is common belief that a CEO of a big organisation can simply no longer operate as captain but I think that is a mistake and that it has nothing to do with the size of the team you are leading. Regarding the case at hand, I believe that the worst leadership style would have been be to act solely as commander in chief, playing with maps, dashboards and counsellors, and drawing plans.

What I’ve learned over the past nine months is that these three styles are not fixed positions. They are different manners of dealing with people, projects and problems and that a CEO must choose the style that fits the situation. I could have chosen either with possibly very different results but the fact is that I chose to be captain; a hands-on approach which I have always felt is more adapted to take on the toughest of challenges. In critical situations like the Covid-19 pandemic, it’s the CEO’s personality and capacity to get his hands dirty that brings a team together so they can achieve great things, that counts.