Jon C. Abeles
Vice President, Operations Excellence
Catholic Health Partners
Cincinnati
[email protected]

Father Kevin O'Rourke's article on institutional Catholic health care summarizes the situational context of our health care ministry today. It also suggests that, despite the ever-changing landscape, Catholic health care should continue as an institutional ministry of the Roman Catholic Church in service to both human flourishing and the common good. I am in full agreement with Father O'Rourke.

Catholic health care, as an institutional ministry, has been exceedingly successful in today's market-driven health care environment as evidenced by its size, geographical presence, market leadership, clinical quality, stewardship of resources, service to the poor and underserved, and advocacy. However, the central challenge confronting Catholic health care in today's secular, pluralistic, competitive and increasingly commercialized world is that of maintaining the integrity of its mission; of continuing to act and develop in ways consistent with the healing ministry of Jesus. This is an ongoing task that requires focused attention, spiritual and moral formation, moral discernment, the creation of supporting structures, evidence-based assessment, and intentional stewardship. Sponsors, board members, and leaders of Catholic health systems must cultivate the conscience of their organizations in ways that renew the commitment of these institutions to the spiritual vision and the moral principles that have nourished and guided them through the years.¹

Although mission, vision and value statements abound throughout Catholic health care, lived experience does not always align with the aspirations espoused. Evidence from many points throughout the ministry suggests there is 'mission drift'. In some settings, essential elements of the tradition have not been maintained, re-woven, or renewed within the operations of Catholic health care organizations. Within the literature and throughout contemporary society, critical voices have questioned whether Catholic health care facilities are truly different from other public or private health care systems.

Today, Catholic health care finds itself at a critical juncture. It is has been thrust into a world of volatility, uncertainty, complexity and ambiguity – and by all accounts, a world that will get even more complicated in the future.² It is a time for leaders to respond with vision, understanding, clarity and agility.³ Without sufficient thought-leadership to inspire both institutional renewal and new conceptual frameworks to enable the healing ministry of Jesus in our time and place, the effectiveness of our ministry may be diminished. With the rapid changes that are transforming health care delivery and technology, the extremely competitive market-based business environment, and recently enacted health care reform legislation, foundational elements of our ministry can be overlooked or marginalized. Some leaders report that there is just not enough time in the day to do everything.

The Catholic Health Association and associated members have worked hard in developing Vision 2020 to outline key enablers to support our moving into the future. But an association can only do so much to precipitate and institutionalize change. Much like the turbulence of the 1980s that brought about significant questions for leadership and sponsors to consider beyond financial viability and operational effectiveness in the rapidly changing environment of their time, a Commission on Catholic Health Care Ministry, like that convened by sponsoring congregations of women and men religious and associated partners in 1987, may be essential to develop a national vision for the future of the Catholic health care ministry and strategies for advancing this vision into the future. A commission of such stature may be a necessary catalyst to create an architecture for the design, development and implementation of a preferred future state that is acknowledged and supported by traditional points of power (bishops, sponsors, boards and executive leaders) throughout our health care ministries. Time is of the essence for Father O'Rourke's vision to be realized as we enter the unfolding future state of health care reform.

As we study our possibilities, there is much to learn from other institutional ministries of the church (such as education) who have perhaps missed their moment in time to proactively design their preferred future state. James Burtchaell in The Dying of the Light, and Melanie Morey and John Piderit, SJ in Catholic Higher Education: A Culture in Crisis provide much to consider as the Catholic health ministry envisions the task at hand.

Until a commission is convened, we can continue to enhance our capabilities and renew our ministry in ways that will enhance our distinctiveness as a Catholic culture in the areas of:

• Recruiting, Selecting and Acculturating Talent

In order to build a strong foundation of sustainable leadership capacity, significant attention must continue to be focused on recruiting, selecting, orienting, mentoring and developing a new generation of formal and informal leaders. The use of behavioral event interviewing to assess business competencies, vocation, values and integrity is a reliable and valid assessment strategy to ensure organizational fit and alignment with mission. One such instrument that has been developed to assist in the new leader selection process is the CHA/Hay Group Mission Based Leadership Behavioral Assessment which is available for CHA member use.

• Explicitly communicating about the theological foundations of Catholic health care, Catholic social teachings and The Ethical and Religious Directives, and
• Accentuating what is currently being done within our organizations in congruence with the healing ministry of Jesus in our time and place.

Although the organization may be congruent with key elements of Catholic social tradition and teachings through enacted practice, those working within the organization may not have full knowledge, awareness, and understanding of what is being done, and how these actions and behaviors relate to the theological core of the organization.

• Formation of the Laity ( Leaders, Associates, Physicians, Boards of Trustees)

In 2010, CHA's Ministry Leadership Development Committee gathered information about leadership formation from health systems throughout the United States. Although this work is not yet complete, several key findings and points of agreement have surfaced in regard to formation, and may provide a blueprint for developing leadership capacity for both today and tomorrow.

• Preparing Ethics and Mission Leaders for the Future

Ethicists and mission leaders are critical to the continuation of the healing ministry of Jesus in Catholic health care settings, through influencing and providing guidance to executive leaders, sponsors, boards of trustees, and associates who touch patients every day. Yet they are scarce, not often accessible in the organizational structure, aging, and due to inadequate organizational succession planning/ replacement planning initiatives, may soon be even less visible. Recommitting to developing leadership capability and organizational capacity in ethics and mission leadership roles has great potential to revitalize the way Catholic health care is delivered in contemporary health care settings.

• Evaluating the Catholic Identity of Catholic Health Care Institutions

The use of an evaluation vehicle by Catholic health systems, such as the Catholic Identity Matrix (CIM) developed by Ascension Health and the University of St. Thomas Veritas Institute, can be an important tool for understanding the congruence of espoused versus enacted elements of Catholic identity.

• Strategically Re-envisioning our Location in an Emerging World of Health Care Reform, and Claiming our Place as Actor, Advocate, and Leaven.

As part of our unique organizational strategic planning processes, a strategic vision can be created in alignment with CHA's Vision 2020 and emerging health care reform legislation to enable key elements a preferred future state.

1. Jon C. Abeles, William Brinkmann, T.Dean Maines, and Michael J. Naughton, The Catholic Identity of Catholic Health Institutions: Challenges and Opportunities in the United States and Germany, (Working Draft, February 2011).
2. Robert Johansen, Leaders Make the Future: Ten New Leadership Skills for an Uncertain World, (San Francisco: Berrett-Koehler, 2009.), 6.
3. Ibid.

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