BY: PETER J. GIAMMALVO, PhD, and GEORGE F. LONGSHORE
Peter J. Giammalvo, PhD, is director, leadership
formation, and George F. Longshore is vice president, human
resources, Catholic Health East, Newtown Square, PA.
"Efficiency," "effectiveness," "market position" — these
have for years been the lingua franca of health care. For-profit
institutions add "return on investment" to the lexicon. When
most health care organizations attempt "leadership development,"
they generally bring all these factors to their assessment of
possible future leaders. They identify a small number of stellar
performers (in terms of efficiency, effectiveness, etc.) and
cultivate them for potential leadership roles.
In Catholic health care, however, technical administrative
skills are only part of the leadership preparation picture.
The unique mission of a Catholic health care institution — its
ministry and fidelity to the spirit of its sponsors — requires
more of future leaders.
At Catholic Health East (CHE), we have taken a different approach.
CHE is a Newtown Square, PA-based system comprising 19 decentralized
organizations, which we call "regional health corporations"
(RHCs). Seeking a leadership development program that blends
mission and business imperatives, we created CHE's "Leadership
Formation Initiative" (LFI). The LFI will, first, foster a large
pool of potential leaders within the organization, and, second,
draw from this pool the leaders who will guide CHE far into
A Different Kind of Initiative
Many organizations have tried to institute consistently successful
leadership development and succession planning. Most simply
identify and develop a few "high potential" individuals, but
such "stars" may leave the organization. Shifts in management
can cause an organization to scramble, losing sight of its leadership
objectives. Mergers and acquisitions can disperse the small
number of people chosen for development; so can conflict about
who is or is not is a "star." Finally, failure can result if
the organization does not codify and synchronize its leadership
development model with its mission, vision, and strategic plan.
CHE created the LFI to avoid such problems.
The LFI was put together by the system's Leadership Development
Advisory Group (LDAG), consisting of the system CEO and several
CEOs, executive vice presidents, and mission and human resources
personnel from the RHCs. The LDAG was assisted in this work
by the system's Sponsors' Council, composed of representatives
of the sponsoring congregations.
One way the LFI differs from other leadership development
plans is by greatly enlarging the pool of people "grown" from
within the organization. CHE currently has nearly 200 executives,
most at the vice presidential level in the system's various
organizations, who are considered potential leaders.
This strategy reflects the overall inclusiveness of CHE's
culture. We believe that everyone has the potential for development.
It is not our style to select only a few individuals for that
opportunity, thereby perhaps blocking the progress of a quiet
"champion." CHE's sponsors, board, and senior management team
have all contributed to the creation of the LFI and are totally
committed to it. CHE's strategic plan details that commitment
by articulating the "measures of success" used in "cultivating
excellence in leadership."
Foundation of the LFI
Leadership formation is especially important in today's Catholic
health systems, including CHE. These often venerable institutions
were shepherded for many years by their founders, congregations
of religious women whose numbers are now dwindling. CHE is sponsored
by 13 congregations of religious women and a public juridic
person. To perpetuate and strengthen their mission, the congregations
involved are transitioning their leadership functions over to
Leadership Formation Systemwide
The system's Corporate Leadership Development Committee (CLDC)
oversees the LFI's implementation. Through 2001 the system moved
judiciously to acclimate its decentralized corporate culture
to the idea of leadership development. The committee wanted
to confront any obstacles that might arise before instituting
the initiative on a systemwide basis. By the end of 2001, most
of CHE's vice presidents had been through the first cycle.
Each of the RHCs (including nursing homes, hospitals, and
multifunction organizations incorporating both acute and long-term
care) has a CEO who is an employee of the system. Although CEOs
have broad autonomy in leading their organizations, they collaborate
closely with CHE in regard to mission, ethics, strategy, capital
allocation, and some areas of operations. "Selling" the LFI
to these CEOs was not difficult because they all clearly saw
the value of ensuring the future of the ministry by systematically
developing prospective leaders. Some RHC CEOs have even proceeded
to establish local programs modeled on the CHE effort.
Interviewing and Selection
The LFI actually comes into play even before a candidate for an executive position
is interviewed. For each available position, the hiring executive develops a
preferred-candidate profile that includes the 15 core competencies in the Leadership
Profile, as well as other specific position requirements. He or she will have
previously agreed with colleagues on the competencies most critical for the
position and discussed the extent to which the ideal candidate should possess
Depending on the position, interviewing may involve people
other than the hiring executive. If so, the interview team must
decide beforehand whether the sessions are to be conducted by
a single interviewer, a pair of them, or the whole group. If
interviewing is done sequentially, each interviewer should emphasize
one or two competencies. To help them observe the relevant ethical
and legal parameters, interviewers will have copies of the Guide
to Interviewing and Selection, a CHE brochure based on the
principles of behavioral-event interviewing.
Before the candidate arrives, the interviewers review and
consider closely each of the competencies, along with specific
position requirements. The Guide clearly enunciates indicators
that point to an individual's ability to demonstrate the competencies.
These include, for example:
- Embracing Ambiguity indicators that show whether
the candidate can cope effectively with change, make decisions,
and act on them without having the total picture, as well
as communicate organizational change as an opportunity rather
than a threat.
- Business Acumen indicators that show whether the
candidate possesses knowledge about current and possible future
trends affecting the organization; knowledge of competing
organizations; awareness of the way strategies and tactics
work in the marketplace; and understanding of the operational,
financial, and regulatory dynamics of U.S. health care.
Interviews probe a candidate's ability to meet all of the competencies
and the mission and performance criteria in the Leadership Profile.
Catholicism is not a prerequisite for a position at CHE, which
employs people of all religious and ethnic backgrounds and gives
them equal opportunities to become system leaders.
Interviewers begin by explaining that the process is based
on the Leadership Profile, which candidates are given at the
interview, along with answers to any questions they may have
about it. As the interview progresses, those conducting it take
notes in a prescribed fashion, thereby making it easy to compare
accounts later. In addition, each interviewer ranks the candidate
(on a three-point scale) according to his or her apparent ability
to fulfill each competency, giving evidence to support the ranking.
The Guide is perhaps especially useful in offering,
first, sample questions interviewers can ask to evoke replies
related to the pivotal competencies, and second, descriptions
of some verbal and behavioral responses they can expect to such
questions. Take "Justice," for example. At CHE, this means:
"We act as advocates for a society in which all can realize
their full potential and achieve the common good." The candidate
being interviewed might reply that a truly fair health care
- Treat employees justly and respectfully
- Deal fairly with everyone and refuse to play favorites
- Act to ensure that diversity is encouraged at all levels
- Encourage providers, insurers, and policy makers to secure
the human right to health care, especially for the poor and
- Actively seek to form partnerships that promote health
in the community
To probe a candidate's sense of justice, the Guide
suggests that interviewers ask a candidate to describe "a situation
in your job in which the 'right thing to do' was not obvious
and you had to struggle with the alternatives." Interviewers
might also ask candidates to describe, for example:
- The advantages and disadvantages they have noted concerning
diversity in the workplace
- Situations in which they have attempted to work in partnership
with another organization in the community
While asking such questions, interviewers will observe in
the candidate such traits as:
- Self-awareness (the candidate seems to recognize how his
or her own feelings might affect decisions)
- Candor (the candidate is capable of straight talk)
- Integrity (the candidate refuses to try to please everyone)
Each of the Leadership Profile's seven "Core Value" and eight
"Leadership" competencies is similarly parsed in the Guide.
The interviewers try to estimate, from a candidate's verbal
and behavioral responses, how effectively he or she might accomplish
the four "Mission and Performance" outcomes as well. And, of
course, interviewers are free to ask other questions to elicit
knowledge, skills, experience, and abilities critical to a particular
After a session is completed, all the interviewers get together
(in a teleconference, if necessary) to discuss it. CHE believes
that group discussion is a key element in achieving a shared
view of the position and the candidates for it. Interviewers
who meet as a group can, while comparing their assessments and
explaining their rationales, articulate the areas in which they
agree and those in which they disagree. The interviewers write
down both agreements and disagreements, as well as other issues
they may want to consider later.
In some cases, the interviewers can reach a final decision
during the postinterview meeting. If not, the information brought
together there will be reviewed by those who have hiring authority.
CHE's orientation program is an integral part of the LFI. Orientation
is designed to be not just new executives' introduction to the
system but also a strategic link between their recruitment and
selection, on one hand, and their assimilation into their new
roles, on the other.
The system offers orientation at the corporate level and,
for new RHC executives, at the level of the local institution.
In both instances, the program is intended to further familiarize
new executives with the mission, core values, vision, and strategic
plan of CHE and its RHCs and to inaugurate their exposure to
the organizational culture. Having first heard about these things
during the recruitment process, new executives will have a consistent
message reinforced in the orientation program. The same message
will be repeated throughout the leadership development process.
Of course, one should not underestimate the value of the traditional
"meet-and-greet" aspects of orientation. What better way to
get to know a culture? New executives will also have an opportunity
to meet people with whom they will be interacting in other system
locations. Executive orientation is offered at CHE's corporate
offices at least twice a year. Specially focused orientations
are also held as needed for new CEOs.
Assessment and Performance Management
The Leadership Profile's Core Value and Leadership competencies
are the basis of leadership assessment at CHE. Overarching them
is an executive's ability to achieve the Mission and Performance
outcomes. Clearly, future leaders will be those who are consistently
able to meet these criteria.
However, CHE keeps leadership assessment and development largely
separate from performance appraisal because the system is looking
for different things from each process. Executives gain compensation
increases and bonuses by achieving system performance measures,
which include mission fulfillment goals, operational/financial
goals, and human resources goals. These measures, combined with
individual performance objectives, comprise CHE's regular performance
management system for executives.
Since Core Value competencies are a vital part of executive
leadership, the ways in which CHE executives demonstrate these
competencies are a part of their assessment and development
as leaders, along with their regular performance appraisal.
If an executive were to perform outstandingly in meeting a financial
goal but fail to demonstrate a core value — such as integrity — in
meeting that goal, he or she would demonstrate a serious gap
that supervisors would need to address. Core Value competencies — who
you are — are thus assessed twice, in both the performance appraisal
context and the leadership assessment and development context.
In the Leadership formation arena, an executive's supervisors
review his or her competencies with an eye toward closing gaps
that may exist between weaker skill ratings and highly important
competencies. An executive who demonstrates proficiency in the
Leadership competencies is likely to do well on the performance
outcomes, of course. But CHE shies from too close a connection
between these two aspects at this stage. Instead, we aim for
a 360-degree assessment of each executive's leadership competencies,
primarily for the purpose of development. This includes requiring
executives to complete self-assessments and soliciting feedback
from their peers, supervisors, and the people who report directly
to them. We believe that this method encourages a level of communication
and substantial interaction between executives and those who
evaluate them, allowing supervising executives to provide support
to each person in developing all the Core Value and Leadership
Leadership Formation and Succession Planning
CHE's CLDC oversees the work of assessment, development, and
succession planning for executives reporting to senior management.
The senior executive positions are, in turn, reviewed by a CHE
board committee. Both committees are charged with ensuring that
CHE maintains a strong "bench" of executives for future Catholic
health care leadership.
Leadership assessments result in confidential reports that
are released to the concerned individual alone. However, because
these assessments are the basis of CHE's leadership development,
the system is building a highly restricted database to contain
information about its nearly 200 executive leaders. Each file
includes a basic biography of the person, along with his or
her assessment findings, a development plan, and notes concerning
the interest he or she has expressed in possible future leadership
With this database, CHE intends to shape its succession plan.
In contrast to other organizations' programs, the LFI provides
a substantial pool of candidates for future leadership, rather
than concentrating on grooming just a few "select" individuals.
This plan allows for ongoing appraisal of the system's "bench
strength." Moreover, those being assessed are fully aware of
the process and what it might mean to their futures. They know
that the system makes personal and family circumstances a part
of succession planning and that it has absolutely no bias against
those who choose not to move or transfer, for instance.
Indeed, CHE sees its LFI as a way of developing leaders for
Catholic health care in general, not just for CHE. We realize
that we have a responsibility to others in Catholic health care,
and we freely acknowledge that some of our potential leaders
will inevitably decide to work elsewhere in the ministry. If
other organizations seek their talents, they will find that
our leadership development concepts and plans are transportable.
Anyone who has participated in our LFI will be well prepared
to serve as a leader in other areas of the ministry.
Any sensible organization needs to develop leaders for the
future. Doing so is especially important for a Catholic health
care organization, in which the values of a healing ministry
must be coupled with business and market success.
CHE's LFI continues. We want to be able to demonstrate to
leaders at all levels exactly how they can move vertically or
laterally through their hospitals, long-term care facilities,
and other organizations and within the system itself. CHE's
sponsors challenge us to adopt the program systemwide, not just
because it contributes to achieving our mission as a Catholic
health organization, but also because it builds leadership that
Copyright © 2002 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.