BY: ED GIGANTI
Mr. Giganti is senior director, ministry leadership development, Catholic
Health Association, St. Louis.
In discussions about the leadership needs for Catholic health care in the future,
more and more often sponsors and other leaders call for leadership "formation."
Appropriating the word that in earlier decades described the journey young women
and men made in religious life, reorienting their lifestyles for ministry, many
sponsors, in particular, are quick to make clear that formation for busy health
care leaders must and will be a very different process than that experienced
by young sisters and brothers. However, recognizing that the effective leaders
of ministry organizations must know and enact the transforming, healing mission
of Jesus that animates the church's health ministry, many sponsors and
health care systems are redefining formation and developing contemporary processes
for it. (Recently, the members of CHA's Ministry Leadership Development
Committee collaborated on a descriptive articulation of leadership formation
for ministry. I will report on their work in a special section focusing on leadership
formation in the September-October 2004 issue of Health Progress.)
In the past decade, many organizations have invested significantly in leadership
development programs that included competency identification, assessment, mentoring,
and more. They have partnered with leading organizational development firms,
customized proven programs, and created programs from the ground up. As systems
now create and begin to implement formation programs, the question arises
how these activities differ from and complement the leadership development processes
that have been under way for years.
At Sisters of Mercy Health System, St. Louis, attention to leadership formation
permeates all programs and processes of leadership development offered to the
system's executives and managers, a comprehensive palette of developmental
offerings branded as Mercy Leadership Pathways. While some systems are offering
leaders' retreats for spiritual enrichment and opportunities for learning
about Catholic identity, social justice, and more, a team from Mercy's
Mission and Ethics and Human Resources (HR) departments is ensuring that attention
to personal spirituality, mission, and Mercy heritage and culture are seamlessly
integrated into all Pathways programs for leaders, from senior executives to
frontline supervisors. I recently spent an afternoon with this team to learn
more about its approach. I spoke with Brian O'Toole, PhD, vice president;
Lynette Ballard, director of mission training and development; and Steve Isenhower,
vice president, and Kelly Pingleton, director of leader effectiveness, both
from the system's HR department.
New Leader Orientation
There are three large pieces to Mercy Leadership Pathways: New Leader Orientation,
the Pathways Curriculum, and Mercy Leadership Institutes. New Leader Orientation
takes place quarterly at Mercy Center, a retreat facility on the grounds of
the motherhouse of the system's sponsoring congregation. The program is intended
for anyone new in a leadership role in one of Mercy's regional organizations,
which are called "strategic service units" (SSUs). Participants are chosen to
attend by the leaders of their SSUs. The SSU pays travel expenses to the program
in St. Louis, and the system office pays the cost of lodging and meals.
"This program gives new leaders an opportunity for a retreat, time to
slow down, to reflect, and share with one another about how they are called
to their leadership roles," Pingleton told me. During the orientation,
participants have a chance to meet the system's leaders, including President/CEO
Ron Ashworth, and learn about the heritage of the Sisters of Mercy. They also
learn about Catholic identity and the church's justice teaching and how
these apply to health care and to work life. O'Toole teaches sessions on
the Ethical and Religious Directives for Catholic Health Care Services
and the system's ethical decision-making process. Sr. Mary Roch Rocklage,
RSM, chair of the system's board, explains what it means to be sponsored
by the Sisters of Mercy, including what the sponsoring congregation expects
of leaders and managers.
"Right from the start, the atmosphere is very important," Ballard
said. "They arrive at noon, have lunch together, slow down a bit, and then
come together for prayer. When they meet with Ron [Ashworth], it's an opportunity
for them to tell him what they bring to the system. His message to them is that
'We're interested in you, in who you are.'"
Pingleton said that participants come to the program having read some advance
materials: selections from the constitution of the Sisters of Mercy, a short
biography of Mercy foundress Catherine McAuley, an article on the system's
strategic initiatives, and similar items. During the orientation, system vice
presidents who "champion" these strategic initiatives meet with the
group and brief them.
Ballard said that throughout the orientation, the theme of "call"
is threaded through prayers, reflections, and discussions. "After the meeting
with Ron, we begin the conversation about call with a story from Scripture,
the story of the call of Samuel. The participants resonate with the notion of
call, both what calls you here and what keeps you here. This reflection allows
them to articulate what they may have felt intuitively." Some participants,
she added, take this opportunity to talk about what led them into health care,
what it means to be of service to others who are in need, and to contrast their
experience with the for-profit motive that is dominant in society. "They
sometimes say, 'Something beyond my choice brought me here.'"
New Leader Orientation also includes a daylong introduction to Mercy's
12 leadership competencies. This, too, is an opportunity for mission education.
"Brian has done an outstanding job of articulating how each competency
is grounded in the ministry of Jesus and Catherine McAuley," Pingleton
said. She gave an example of how the competencies are taught. "One of our
leadership competencies is 'Models compassion for others.' We created
what we call the 'gown exercise' to teach about this competency. Participants
get into small groups, and one person puts on a hospital gown and plays the
patient, another plays a family member, another plays the professional caregiver,
and they role play. Then we talk about what compassion looks like, feels like.
There's always a mix of humor and very rich personal discussion,"
Supporting the development of the Mercy competencies is a plan for an entire
curriculum of courses, most of them four-hour modules that will be delivered
at the SSU level. "If Pathways is going to be our platform for leadership development,"
Isenhower said, "we have to have a full catalog." Since kicking off the Pathways
program two years ago, 12 courses have been developed and rolled out to the
facilities. Also, an extensive network of Mercy faculty has been mobilized for
the delivery of this curriculum.
Senior leaders at Mercy are required to participate in at least two days of
"key" Pathways curriculum training, Ballard said. This key training,
addressing critical themes such as "leading change" and "service
leadership," is developed first for the system's annual senior leader
events, held each fall for SSU CEOs and vice presidents and system executive
leaders. Following these events, the key training is deployed throughout the
system for leaders at other levels.
These key training events offer an opportunity for spiritual growth, introspection,
and prayer. But sometimes, O'Toole said, it is not easy to move senior
leaders to reflection. "One of the greatest challenges is that people are
busy and active. It's not that they don't want to be introspective
and reflective; we just have to find different methodologies that match their
pace and their own spiritualities."
At a recent training session, O'Toole involved the leaders present in
what he calls "the Barcalounger experience." After gathering the group
in a room furnished with comfortable recliner chairs arranged in a circle, O'Toole
asked them to read and comment on a case study about a hospital CEO inundated
with pressures involving financial performance, physician relations, and sponsor
expectations, among others. O'Toole opened the dialogue by asking participants
what the CEO in the case should do.
At first they started talking about the case, problem solving for this fictional
CEO [O'Toole said]. But quickly they moved to talking about their own
experiences. As soon as one or two began to reflect personally, then the whole
group moved in that direction. We were able to push the dialogue with questions
like, What makes it difficult to delegate? What is hard about working as a
team? What got you into this work? What is frustrating you now? Through the
case study, they had a work-related way of reflecting on their own personal
experience. The key was having something work-related.
All Pathways courses have been and will continue to be developed internally
by system staff in Mission and Human Resources. Pingleton and Ballard share
responsibility for the curriculum development. Pingleton has a staff that includes
a full-time instructional designer and two HR coordinators who handle production
and distribution of course materials. Development and piloting of each course
takes five or more months. Courseware typically includes participant and facilitator
guides, PowerPoint presentations with scripts, and, in some cases, books and
videos, some of which have been produced by Mercy. These toolkits are provided
at no additional cost to the SSUs, so, Isenhower said, "there is an incentive
to use them."
"The skill part of what we are teaching is probably the same as for any health
care organization," Isenhower said. "The Mercy piece is not what we do
but how we do it, how we do performance management or confrontation about
O'Toole said, "I use the metaphor that we put on our 'Mercy
glasses.' We ask: What does conflict management look like through the Mercy
lens? We learn from highly regarded long-term Mercy co-workers, and we get input
from the mission leaders, the local educators, and the sisters as we shape the
content." Ballard gave as an example of the system's course on worker
satisfaction. "Of course we teach that in a workplace where people are
engaged, there will be fewer injuries and absences and lower turnover. But we
define the just workplace as one in which people are in 'right relationships'
with one another. Our leaders come to understand that workplace justice goes
beyond satisfaction metrics. It's who we are together as a community."
Another course addresses how to "hire for fit" with the Mercy culture.
"It took over a year to do research, interviewing the sisters and using
other resources, to customize standard behavioral event interviewing questions
and develop screens to evaluate candidate responses for Mercy fit," O'Toole
The third major part of the Pathways program is the quarterly Mercy Leadership
Institutes, which are planned and conducted at facilities for local leadership.
While serving strategic goals, these institutes also examine the Mercy heritage
and tradition, and such dimensions of ministry leadership as relationship building
and workplace justice.
Not an Easy Task
The challenge in integrating these mission messages into the courses, O'Toole
said, is "how you weave it in without diluting the importance of the skills
we are training for. We don't want to soft-pedal the mission message, but we
also don't want to overdo it."
"Brian has been particularly emphatic about dispelling the notion that
being in ministry doesn't mean not being accountable, that you can't
apply the 'hard skills' in a faith-based ministry because it would
not be compassionate," Isenhower said. "They might seem to be mutually
exclusive, but we try to put them together in what one of our sisters calls
'compassionate assertiveness.' The hard skills are important, but
practiced with respect for the individual and the other dimensions of our Mercy
In the past, Mercy conducted leadership for ministry programs that were parallel
to but separate from leadership development programming. "The challenge
for leaders was to bridge these two programs," O'Toole said. Isenhower
said that the roll-out of a systemwide "Mercy Service" initiative
in 2001 allowed the system to integrate these two approaches.
"The hard part is that we are creating everything for leadership development,"
O'Toole said. "It takes a lot of time and effort, really trying to
figure out how to blend these two pieces together. It's a collaborative,
interactive process that involves not only our two departments, but even Ron
Ashworth." Pingleton noted that Ashworth has devoted countless hours to
reviewing courseware and brainstorming with staff about future courses. "We
try hard to be clear and faithful to the mission in a way that is meaningful
to our leaders," O'Toole added.
Isenhower said the Pathways program is "wildly successful" and that
the system receives many requests from SSUs for course kits, training, and consulting.
Total audience for the Pathways program is 1,900 leaders throughout Mercy. The
system plans to spend $3.5 million over five years to support Pathways, a figure
that does not include the cost of staff time for development or participation.
For more information on Pathways, contact Kelly
Copyright © 2004 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.