BY: BRIAN YANOFCHICK, M.A., M.B.A.
Mr. Yanofchick is senior director, mission and leadership development, Catholic Health Association, St. Louis.
Each year the Catholic Health Association sponsors a program in Italy, conducted at the Vatican and other Catholic sites, for system leaders of Catholic health care. The most important "take away" from this program, which we call the Ecclesiology and Spiritual Renewal Program, is the realization by participants that their ministry is very much connected to the larger community of the Catholic Church. This awareness develops through such experiences as attendance at a general papal audience in St. Peter's Square, where thousands of people from around the world gather weekly to hear a brief presentation by Pope Benedict XVI and celebrate their communion with the rest of the international church. It comes, too, by way of the experience of visiting Assisi and drawing closer to the spirituality that guided St. Francis of Assisi and St. Clare in their work. Their spirituality is among guiding lights of important health care ministries in the United States. Finally, the connections between church and Catholic health care are communicated through interaction with leaders of Vatican departments, or "dicasteries," with an interest in the health care ministry.
At the end of the 2009 program, one participant, a CHW board member, offered a simple but powerful insight. He said the experience had shown him that the ministry of Catholic health care is a delicate dance between the demands of business and the demands of mission, and that in the dance, mission should always take the lead.
This metaphor speaks powerfully to the challenges faced by leaders of Catholic health care in this struggling economy. The cost of charity care is at budget-busting levels for many hospitals as more unemployed, and therefore uninsured, people access care. These challenges parallel those faced by other industries. A worldwide survey of 500 human resource and business leaders by Personnel Decisions International revealed that cost-cutting pressures were reported by 83 percent of respondents as the most difficult challenge they have faced in 2009.
In response to these mounting pressures, many health care systems have enlisted the help of firms to find ways to trim costs and increase efficiency. The result, often, has been wrenching decisions to reduce staffing levels and services. And inevitably, the pressures have led to difficult discussions regarding the capacity to serve non-paying patients. Decisions and discussions such as these provide tricky music for the dance of mission and business.
This dance does not take place in private, but in the very public setting of our communities where our stated values are well known and our "steps" are watched very carefully. It brings to mind the television show "Dancing with the Stars," in which celebrity figures pair up with professional dancers to compete against one another. Just as those celebrities put their pride on the line to attempt complicated dance movements in front of millions of television viewers, the steps taken by Catholic health care in tough economic times are closely scrutinized for alignment with our stated values.
Unlike the television show, where the performance of this or that celebrity quickly becomes lost in collective memory, the actions we in Catholic health care take — rooted as they are in public promises linked to our faith tradition — create lasting memories for patients, families, co-workers and communities. Understanding the crucial nature of our steps, we do well to ponder the question: What does the dance look like when mission takes the lead?
First, we would acknowledge that all health care providers in the United States are dancing in the same arena; that is, in the environment of our current health care system. This is true for faith-based and secular institutions alike. However, Catholic health care claims to dance to a different tune: to respond differently to the challenges that the difficult economic environment presents.
For instance, when mission takes the lead, Catholic health care moves beyond the usual, though obviously important, concerns about finances. Our steps take us into the public realm, where we join with others in a bigger dance: one focused on universal health care coverage as a contribution to the common good, and to the need in health care for such holistic elements as palliative and spiritual care. When mission takes the lead, our presence demonstrates our respect for life from conception to natural death and gives a richer texture to policy discussions because of our focus on the full human impact of reform.
Meanwhile, closer to home, our ministries deal with the current realities of rising costs, a rising number of self-pay patients, constricted capital budgets and other challenges. What does it look like when mission takes the lead in this part of the dance?
In a challenging environment, success comes only when the right people are placed in the right jobs with the right level of support. And so recruitment and selection are essential starting points. Mission takes the lead when a recruitment and selection process takes into account not only the specific skill set required of a particular job, but also the values and ethic that guide an individual's approach. The screening process probes for and confirms evidence beyond the right words that a candidate does indeed put into practice a leadership style that aligns with the vision of Catholic health care.
The dance of mission and business requires a special kind of coordination and preparation. The time for mission and business to find the right steps is not in crisis moments. Like a complicated stage dance performance, there should be preparation, practice and an agreement about who moves where and when long before the public spotlight is shining on us.
One important way this is accomplished is through effective leadership formation. The word formation here is important because it implies a skill set beyond the mechanics of a particular job. It implies an alignment of the personal vision and values of an individual decision maker with those of a larger community. Mission takes the lead in our organizations when key leaders are offered the opportunity to reflect on their work in light of core values, such as the common good, the preferential option for the poor and a just workplace. Each of these has implications for common business practice that could lead to far more creative outcomes than those driven only by the bottom line.
Recently, in a very rich discussion with some leaders of a Catholic health system about the financial challenges of caring for a rising number of uninsured patients, a chief executive officer expressed his expectation that leaders analyze their local communities in a holistic way, taking the initiative to reach out to other community leaders, to address root causes and to serve people in need. This is an example of a leader who is giving mission the lead in the dance with business.
This kind of insight may come naturally to some. For others, it is possible to learn. But this learning is a process, not an event. Mission takes the lead when organizations make leadership formation as much a part of the fabric of their business model as other more familiar aspects of day-to-day work. This formation prepares leaders for those moments when it is very hard to determine what the right steps should be. We should not wait until the curtain goes up to begin learning the right moves.
Copyright © 2009 by the Catholic Health Association of the United States
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