BY: DIANE IRVIN and BLAIR GAWTHROP
Ms. Irvin is vice president and Ms. Gawthrop is manager, corporate communications,
Strategic Programs, a Denver research and consulting firm.
A recent study shows that leaders in Catholic health care are strongly committed
to the mission, vision, and values of the ministry. They are smart, know their
business, and demonstrate their commitment daily in workplace behavior. They
are good, professional role models and are typically polite, self-controlled,
and willing to lead by example.
The study was conducted by Strategic Programs, a national research and consulting
firm based in Denver. We have assisted numerous Catholic health care systems
in the design and implementation of "360-degree" assessment programs
for leadership development. Indeed, having conducted more than 2,500 assessments
of leaders in the health ministry, our firm possesses a significant database
of leadership behaviors demonstrated by executives and other managers in Catholic
health care. The study described here, conducted for CHA, analyzed data from
more than 1,000 assessments in order to establish a benchmark behavioral profile
for the 21st century leader in Catholic health care.
The aggregated results — involving managers, senior managers, and executives
in 10 Catholic health care systems in 44 states — provides a clear picture
of the qualities embodied in today's Catholic health care leader. The results
present normative data that can serve as a comparison for individual leadership
styles, competencies, and subcultures in the Catholic health care community.
Defining "360-Degree" Assessment
A "360-degree" assessment provides a leader or manager (the subject)
with job-specific performance feedback from people in his or her circle of impact
(the respondents). This feedback comes from superiors, peers, direct
reports, customers, board members, and others related to the subject, as well
as from the subject himself or herself. The use of multiple respondents in performance
feedback increases the reliability of the results.1
When the 360-degree process is customized to the culture of an organization,
the resulting reports provide individuals with information regarding others'
perceptions of their workplace behavior, thereby revealing both areas of strength
and areas for development. We at Strategic Programs work with client organizations
to customize 360-degree assessment programs so as to incorporate subjects'
input in developing job-specific questions, reflect performance expectations
aligned with the organization's mission and values, form respondent groups
sizable enough to ensure respondents' anonymity, and provide easily interpreted
reports that include recommendations for development planning.
The Catholic health care systems that are our clients consistently use 360-degree
assessment for professional development planning. (A few are moving conservatively
toward other applications, such as performance review and succession planning.)
Data collected in 360-degree assessments can also provide useful information
for the selection of new hires for specific positions and to establish benchmarks
In this project, our team was assisted by researchers from the Industrial and
Organizational Psychology Masters Program at the University of Colorado at Denver
and the Social Science Department at Regis University, which is also in Denver.
After mapping the more than 2,000 behavioral questions in the customized assessment
questionnaires used by our Catholic health care clients, we standardized the
questions to reflect 108 core behaviors. (CHA's Ministry Leadership Development
Committee reviewed the mapping.) There was sufficient data to report on 103
of these behaviors; this data was included in the study.
These behaviors were then linked to 10 competencies, eight of which are included
in CHA's Mission-Centered Leadership Competency Model: Spiritual Grounding,
Integrity, Integration of Ministry Values, Care for Poor and Vulnerable Persons,
Performance Excellence, Information Seeking, Change Leadership, and Shaping
the Organization. Two other competencies, People Development and
Personal Characteristics, were added to house the remaining behaviors.
Following the mapping of behaviors, all scores in the database were converted
to a five-point scale; and respondent groups were mapped into five core relationships
(self, supervisor, peer, direct report, and other). Various leadership
levels in the database were identified as executive, senior manager, or
manager. The executives were CEOs, chief operating officers, chief
financial officers, and others with "chief" in their titles. Senior
vice presidents also were included if they were responsible for setting their
organization's direction and strategy. Senior managers report to
executives and are responsible for key departments or functions. Managers
report to senior managers and supervise supervisors. Although we have, for Catholic
health care clients, developed assessment tools for all three leadership levels,
the majority of assessments in this study concerned the executive level.
The data analyzed included average scores for base questions, regardless of
how the questions were expressed. For example, "committed to professional
development" might be expressed as "fosters professional development"
for one organization and as "supports professional development" in
another. In short, the intent or spirit of the question, rather than its precise
wording, was the determinant for how questions were mapped.
We created a profile of the participating Catholic health care leaders based
on composite scores by competency (see Table). The
profile shows an overall score of 4.19 on a 1-to-5 (low-to-high) scale. The
study results suggest that no single competency stands out as either an overwhelming
strength or an area for serious improvement.
As noted earlier, a consistently strong characteristic of Catholic health care
leaders is "commitment to the mission, vision, and values of Catholic health
care." These leaders are smart, know their business, and demonstrate their
commitment daily through workplace behavior. They are good professional role
models and are typically polite, self-controlled, and willing to lead by example.
Not surprisingly, they score highly in the competencies Integration of Ministry
Values, Performance Excellence, and Personal Characteristics.
On the other hand, health ministry leaders have development opportunities in
the behaviors of "holding people accountable" and "being more
aware of the impact of their power on people in order to lead more effectively."
The competencies with the lowest average scores are People Development,
Change Leadership, and Integrity. Readers alarmed to find that the Integrity
competency is not a salient strength among Catholic health care should note
that, in the mapping, Integrity included 10 different behaviors, with
the lowest scoring behavior being "holds people accountable." In some
industry sectors, only one behavior would be assessed for Integrity.
Clearly, Catholic health ministry organizations hold this characteristic in
such high regard that they measure it more rigorously than other organizations
David Black, vice president, leadership development, Catholic Health Initiatives,
Denver, observed, "All of us as employees desire an opportunity to excel,
to learn and grow, and to be recognized for having made a difference. We all
desire open, direct feedback; in fact, we crave it. However, our cultural patterns
are such that we are overly cognizant of people's feelings. We refer to
this as being ‘Catholic nice.' As a consequence, we may not be inspiring
employees to greater levels of contribution." Keeping Black's words
in mind, it is easy to understand how Catholic health care leaders might be
perceived as not "consistently holding others accountable to high standards."
The study showed that senior managers and managers of Catholic organizations
received higher scores in this behavior than executives did.
The competency People Development is currently an area of relative weakness
in ministry leaders at all levels, the study showed. Although leaders at all
levels experience similar challenges, expectations concerning performance rise
with a person's responsibilities and position in the organizational hierarchy.
People will rate a certain level of performance lower for an executive than
for a manager simply because they expect more of the executive.
In examining the behavioral profiles of executives, we find their lowest scores
in four behaviors: "champions the ideas of others," "holds direct
reports accountable," "provides useful coaching and counseling,"
and "reinforces people for successful performance."
On the other hand, the competency of Performance Excellence is an overall
strength of these leaders, and there is not much differentiation between levels
of leadership with regard to this competency. However, executives are seen as
being weaker in "establishing priorities," which could actually be
a weakness in communicating priorities to those they lead.
Care for Poor and Vulnerable Persons is a competency of seven behaviors
that reveals an apparent contradiction in perceptions. Executives score high
in "conducting assessments identifying opportunities to provide services,"
yet they score low in "analyzing needs." This may suggest that they
are seen by respondents as more competent in gathering the necessary data than
in acting on it. This competency often received the lowest self score,
indicating that the subjects themselves feel that they are not doing enough
and recognize that more action is needed.
Change Leadership includes 13 behaviors. A striking dissonance exists
between executives and leaders at other levels in a single behavior, being "adaptable."
Executives scored significantly lower than managers, which could reflect the
perception that executives "stay the course" once they have made a
decision. It is also true that organizations that change direction drastically
often get new leadership. Conversely, new leadership may also be the catalyst
for a change in direction.
The role of leader in Catholic health care requires proficiency in many competencies,
including Spiritual Grounding (labeled Spiritual Guidance in some
systems' competency models). Leaders are expected to demonstrate their
personal spirituality to all groups with whom they interface. In our study,
leaders saw themselves as others saw them in such behaviors as "consistently
exhibits caring and respectful behavior," "demonstrates self-awareness,"
"finds personal meaning in work," and "fosters a culture of spirituality."
This congruence is additional evidence that these leaders do, in fact, lead
Of the 103 behaviors examined in the study, "leads by example" was
rated eighth highest and had the highest agreement overall among respondent
groups. Therefore, we can say that this behavior is the most salient strength
exhibited by leaders of Catholic health care.
Differences in Levels of Responsibility
The research also explored differences at specific behavioral levels and between
levels of leadership and relationship to respondents.2 We can therefore make
a comparison of three different levels of leadership: executive, senior manager,
Overall, significant differences exist among the study's subjects, based
on different levels of responsibility. These differences are partly due to behavioral
expectations at each level: the higher the level, the higher the expectations.
We also should note that the customizing of 360-degree assessments to different
leadership levels produced different expressions of core questions. For example,
"visionary" might be described at the executive level as "seeing
the future of the organization as it will be impacted by trends in health care
and the economy five years out." But senior managers might describe "visionary"
as "meeting quarterly goals and fiscal year objectives." And managers
might describe it as "addresses priorities for this week and next month."
In general, peers tend to hold each other to higher standards, whereas direct
reports tend to give their superiors higher scores. This suggests a competitive
culture among peers and a motivational style of leadership among supervisors.
Culturally, Catholic health care is, in general, a gentler, kinder, more polite
workplace environment than other industry sectors, and, in such an environment,
rating bias may influence the scores. As we noted, our study yielded an overall
score of 4.19 out of 5. Based on our firm's research across all industries
since 1988, this rating is a bit inflated. In implementing a 360-degree program
for a client, Strategic Programs attempts to reduce rater bias by offering training
for respondents. And in constructing the assessment questionnaires, we use descriptors
such as "competent" or "meets expectations" for the midpoint
in a rating scale, rather than the term "average." We do this because
we have learned that respondents tend to interpret "average" as sub-par
Moving respondents from being "Catholic nice" to being realistically
candid, even in the anonymous feedback of 360-degree assessment, will take time.
It is likely that a follow-up to this research, repeated in the next few years,
will show respondents with a greater emphasis on candor, as a result of learned
trust through successful 360-degree experiences.
"Often, 360 is not implemented well," said Rimas Yurkus, Strategic
Programs' president. "Implemented ineffectively and with no follow-up,
it is of little or no value. Done poorly, it can do more harm than good; done
well, it is a truly powerful experience that can move an individual and an organization
to the next level." The vital part of the successful 360-degree process
is education. Over time, participants begin to trust the process and, as a result,
are empowered by their ability to contribute candid feedback. A 360-degree subject
is given a tool and a means of profiling his or her performance and charting
a course for development, as well as a benchmark for measuring his or her growth.
This study of ministry leaders is a starting point from which to build. With
additional demographic information, a more detailed profile of the leader in
Catholic health care can be developed. In future research, assessments from
individual facilities could be compared to the overall profile to uncover unique
contributions and deficits. The profile of the leader can be monitored over
time to identify growth and new challenges. There are many opportunities for
greater understanding of leadership in Catholic health care and for growth and
development of leaders. Meanwhile, these scores by core behaviors provide the
first benchmark of Catholic health care leadership in the 21st century.
For more information, contact
Strategic Programs at 800-800-5476.
- J. M. Conway and A. I. Huffcutt, "Psychometric Properties of Multisource
Performance Ratings: A Meta-Analysis of Subordinate, Supervisor, Peer, and
Self Ratings," Human Performance, vol. 10, no. 4, 1997, pp. 331-360.
- Statistical research conducted by Richard C. Williams, School of Professional
Studies, Social Science Department, Regis University, Denver.
Copyright © 2004 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.