Forming Leaders in the Business of Health Care

March-April 2008


Ms. Canales is executive vice president, organization and talent effectiveness, Trinity Health, Novi, Mich.

To thrive in effectiveness is to be centered in wholeness. In treating our patients in Catholic health care, we strive to heal body, mind and spirit —— the "wholeness" of a person. Our mission at Trinity Health is: "We serve together … in the spirit of the Gospel, to heal body, mind and spirit to improve the health of our communities…." We intentionally and deliberately integrate leadership practices that incorporate mission into current and future business processes. Human beings — with their minds, bodies and spirits — are at the core of our leadership development. Our vision is to be the most trusted health partner for life, and create and sustain a healthy, high-performing organization that nurtures the spirit and supports our associates along a journey of being living models of our mission and values.

Generations of Leadership
Since the 1700s, U.S. Catholic health care was led by religious sisters and brothers, who founded and operated Catholic hospitals. They created a culture of service and ministry. Their formation was as assumed as a college education is for leaders today, and conducting health care as a ministry came naturally to them.

Much of the second generation of leadership — especially in the areas of mission, ethics, spiritual care, community benefit ministry and organizational development — came from people who entered Catholic health care in a lateral move from some other ministry. These leaders were often trained for other ministries (campus ministry, parishes, Catholic schools, etc.) and learned health care on the job. Now, the leaders carrying this faith-based ministry rarely come from a ministerial background. They are mostly lay people with skills and competencies developed outside of the Catholic ministry. In fact, some of these employees came from industries outside of health care (e.g. information technology, finance, automotive, etc.).

Although many new leaders moving into Catholic health care may be aware their organization is faith-based, they may not see themselves — nor their work — as part of the ministry of the church. The founding congregations, however, entrusted to us a ministry that drives the decisions of the business and enables us to act as a social service. Today, health care organizations must intentionally focus resources that ensure current and upcoming leaders get the opportunities to embrace the ministry at the crux of their personal and professional development. Without this intentional focus, organizations cannot fulfill their mission.

Trinity Health Journey
Trinity Health has a rich Catholic heritage. In 2000, Mercy Health Services (Sisters of Mercy of the Americas) in Farmington Hills, Mich., and Holy Cross Health System (Congregation of the Sisters of the Holy Cross) in South Bend, Ind., consolidated and formed Trinity Health. These congregations entrusted their health care ministries to a new sponsor, Catholic Health Ministries. The members of this new sponsor are vowed religious and lay persons. The sponsor and Trinity Health recognize that lay persons are increasingly responsible for guiding this ministry into the future.

Since its genesis, Trinity Health has made certain the Catholic heritage has been integrated into its core business and human resource processes, specifically in the areas of succession planning/talent management, associate and leadership development, and cultural transformation.

Leadership Formation
Several Catholic health care organizations have centered on the advancement of leadership formation for the past few years and have made some impressive advancements for the betterment of the Catholic health care industry. At Trinity Health, we define leadership formation as a disciplined process rooted in Christian spirituality and theology that:

  1. helps individuals own and articulate their call to ministry, their role in the ministry of the church, and the integration of their spiritual journey with their daily work.
  2. ensures the healing ministry of Christ is made manifest in the infrastructure and balanced measures of organizational effectiveness.

From Trinity Health's perspective, outcomes of successful leadership formation include the ability to articulate a theological understanding of mission in Trinity Health and apply Catholic teaching — including the church's social teachings — to organizational and business practices. Formal commitment to advance core values, cultural attributes and mission standards of Trinity Health exists (leadership development, holistic care, spiritual care, workplace spirituality, etc.). Leaders facilitate prayer and theological reflection as well as facilitate dialogue and appreciative listening for groups.

In collaboration with the Vocare program of the Aquinas Institute in St. Louis, Trinity Health is piloting an 18-month formation program called the Advanced Leadership Program — Mission and Ministry. This program focuses on the following:

  • interactive e-learning modules
  • an intensive on-site session for each module
  • individual mentoring/personal formation
  • retreats
  • applied learning
  • experience/project in local ministry

Learning modules include:

  • foundational theology
  • the person and mission of Jesus
  • the church and its mission/history
  • heritage of Trinity Health
  • Catholic social teaching, ethics — personal and organizational
  • ethical and religious directives/mission discernment/values-based, decision-making processes
  • body, mind, spirit care/spirituality in the workplace

Trinity Health is currently placing a leadership formation leader into the mission integration function to guarantee the ministry focus continues to be embedded into business and human resource processes throughout the organization. This person is responsible for leading the formation process and partnering with associate and leadership development, talent management and other areas within the organization to continue advancing our ministry.

Talent Management
We advance our ministry through a formal talent management process for the top leaders. At Trinity Health, we renamed our human resources function "Organization and Talent Effectiveness" (OTE). Effectiveness is part of the name for a reason. OTE is about results, people, and sustainable and healthy growth. OTEs aim is to be the foundation for human development so the organization can move towards leadership greatness, have sound human resources practices to support the enterprise, and own the capacity to be trusted advisors to the organization.

Talent management at Trinity Health is an integrated strategic business process designed to ensure the continued growth of talented leaders, coupled with sound succession planning efforts. The leaders selected for their roles demonstrate an ability to provide vision, compassion, leadership, and technical skills necessary to support Trinity Health's mission and vision of becoming the most trusted health partner for life and are committed to advancing the health care ministry. A primary goal for launching this process was to better evaluate the leadership talent — who they are, what their strengths and areas of improvement are, and what their career paths are within the organization.

Trinity Health is committed to developing talent and advancing leaders within the organization. The components of Trinity Health's talent management include competency and performance assessment, talent review, development planning, and succession planning. Through our annual talent review process, individuals are identified for potential advancement. Talent management and leadership development collaborate to design specific career paths and development opportunities to ensure these individuals have the necessary skills and attributes required to be a leader within Trinity Health.

Trinity Health does qualitative, 360-degree competency assessments that include feedback on their performance against leadership competencies. One of the competencies is being mission-centered. Characteristics of this competency include:

  • setting high personal standards, demonstrates unwavering commitment to integrity, and behaves in ways that reflect Trinity Health's mission and values.
  • expressing compassion for others and respects all people.
  • valuing diversity.
  • understanding and articulating our heritage, mission and values and uses them to inspire others.
  • continuously working to align processes, behaviors and policies and reconcile any inconsistency between words and actions.

Following the assessment, a learning/development plan is created and development opportunities for that leader are identified. Historically, feedback and data collected through our 360-degree process has shown mission-centeredness to be a strong competency for our senior leaders. Those leaders that have identified mission-centered as an area of opportunity works with leadership development to identify specific development opportunities to enhance their competency, skill and knowledge in this area.

Executive Coaching

Each leader is expected to have a learning/development plan created, which addresses any developmental gaps or needs as well as building on strengths and talents. The plans encompass many different venues for development including on-the-job assignments, participation in community or non-profit boards, coaching/mentoring or enrollment in the leadership development series described below. Whether the development plan is intended to stretch the leaders skills related to innovation and growth, creating a learning culture, open communication, or other competencies, they are laid upon the foundation of our mission, using our Catholic heritage as the framework of how we conduct ourselves and our business.

Leadership Development
In collaboration with our talent management and succession planning efforts, Trinity Health's learning and development activities also reinforce our mission and ministry. These programs are designed to create an environment where leaders have a voice within their organization — with their boss, their peers and in working with their teams. We strive to create an open culture where leaders can do meaningful work and attract people who value our mission and our service to others.

We encourage all leaders to go through a developmental process to obtain a "driver's license for development" before leading others. The series (depicted below) provides a clear, well-defined career progression for leaders in our organization.

The series includes modules for each level of leader within the organization, from new supervisors to vice presidents with high potential. All participants in the programs have an internal or external coach, complete action-learning projects that are carefully selected to align with organizational strategy, and participate in 10 to 15 days of classroom-based experiences.

As we identify leaders with high potential, we review opportunities to enhance their skill and knowledge sets. For example, each year, we identify leaders who are lacking a foundation in Catholic heritage and social teaching and require their attendance at the Catholic Health Association's Foundations of Catholic Health Care Leadership.

We believe leadership development is a strategic investment in the human capital within our organization and is essential for the achievement of our mission and strategic priorities.

Fellowship Program: A Focus on Mission
In addition to talent management and development, Trinity Health develops leaders through our fellowship program. Unique to Catholic health care, we provide a development setting where our mission is a dynamic guide for ongoing decision making. As part of the fellowship program, it is designed to attract newly graduated health care administration professionals. Trinity Health offers a mission-focused fellowship to those leaders that have a desire to further their education and learning in the field of mission and ethics. These individuals spend one to two years being mentored by a mission leader from one of our facilities (which we call Ministry Organizations) so they can be placed within Trinity Health at the end of term.

Trinity Health's Strategic Plan: A Focus on Cultural Transformation
Perhaps our most unique program contributing to living our mission is not a program but a journey. In 2005, Trinity Health embarked on a journey of transformational change. Through a strategic planning process, we identified culture — the collective personality of Trinity Health — as an enabling discipline of the successful implementation of our vision of becoming the most trusted health care partner for life. We identified six pillars to form a strategic plan. The Best People/Spiritual Workplace pillar was designed to enhance the culture within the organization. The team leading the pillar consists of respected leaders in mission integration, spiritual care, patient care, human resources, and executive leadership from across the Unified Enterprise Ministry. The team went through a period of discovery to determine key messages about the culture. These messages included:

  • creating a healthier culture with values-based behaviors within our organization.
  • building on our strengths, we must improve our culture in areas of trust, collaboration and the health and well being of our associates.
  • culture dramatically influences the sustainability of our mission in this health care environment, and yet it is comprised of intangible elements of attitudes, beliefs, assumptions, behaviors, and interpersonal relationships.
  • transformational and sustainable change is led by people, through people and in service to people.

Unified Enterprise Ministry

Cultural transformation is a journey that holds the daily intention and disciplined focus on our associates being and becoming living models of our mission and core values. This journey for Trinity Health is the PATH (Passion, Attitude, Truthful and Heart), a transformational journey of change in all of the strategic pillars to bring us to the place of most trusted health partner for life.

Each letter in PATH has two meanings: one reflecting a personal commitment and one a team commitment. Our personal commitment means we must communicate with Passion, holding to a positive Attitude, being Truthful in what we say, and speaking from the Heart. These elements are the basis of a team. If we can fit ourselves to that construct, we can accomplish great things.

The work led us to develop a set of guiding behaviors that one sees, hears, and experiences living within or relating to Trinity Health and its associates. To be successful in sustaining Trinity Health and improving our performance, it will take our collective commitment to change in how we interact with one another, using the guiding behaviors as our compass.

These guiding behaviors are integrated into our human resources/organization and talent effectiveness processes — benefits and pension, development, performance and talent management, etc. — as a way to increase accountability and ensure that we are shifting the culture.

One element of our journey of transformational change is the culture circle, an experience based on our mission, core values, and guiding behaviors. This is an insight-based learning methodology designed to give individuals an opportunity to understand and reflect on their condition thoughts and beliefs that drive their behavior and how these beliefs and behaviors affect the outcomes of the overall organization. Ultimately, the culture circle gives participants personal insight — the first step in shifting individual, team, and organization beliefs and behaviors that positively impact long-term results.

The Path Forward
Formation is inherently an ongoing journey, and it starts with leadership development, succession planning and culture. Each step we take on this journey intentionally directs us to the goal we see on the horizon: fulfilling our mission. Every effort in this process is designed to light the way for our leaders to draw them into the passion and purpose of our work. Our formation efforts start, recognizing that all of our work is relational — with our patients and families, each other, and the communities we serve. We create caring relationships with our associates that drive healing and health. Our business is our ministry; our ministry is our business.

Our goal at Trinity Health is to offer caring and healing relationships that allow people to feel personally connected with our ministry, and enable them to find greater purpose and meaning in their work. When this happens, it is no longer a business or a job, but a calling. Whether our leaders have spent their professional lives within a faith-based setting, or they are joining our organization from other environments, it is imperative all our human capital initiatives point to our mission and are grounded in our heritage of service. Engaged people with common purpose are the key to the success of being the most trusted health partner for life.


Copyright © 2008 by the Catholic Health Association of the United States.
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Forming Leaders in the Business of Health Care

Copyright © 2008 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.