Beyond the Walls: Moving to Population Health

September-October 2015


Art Valero

Catholic and other-than Catholic alike, health care systems in the U.S. are engaged in change, and, it almost goes without saying, the challenge of change is not new, nor is the turn to strategic planning to address it. How, then, is the current climate of change different? What does it require of us as we strategize for an uncertain future in Catholic health care?

For decades, we have had an eye on our mission and a defined marketplace, and we have served those in need of healing with compassion and commitment. We have extended hospital services through clinics and carefully chosen outreach, according to our plan. We merged, purchased, partnered, created systems and networks of services, but did all this within our own framework.

The difference, it seems, in today's reality is that we are being called to change our paradigm and extend the mission beyond our own entities, reaching out into communities to partner, merge, acquire or develop relationships in ways and with whom we may not have engaged previously.

We are immersed in the chaos and creativity of being Catholic health care in this changing, exciting and challenging environment. Early in his pontificate, Pope Francis compared the church to a field hospital during a battle to heal and bring wholeness; to bring the good news of the Gospel to those in need; and to bring hope to people where they are and in ways that they need. While the pope's analogy and invitation is addressed to the church, I believe it applies similarly to Catholic health care. Who better to extend hope, healing, compassion and care — the healing mission of Jesus Christ — within and creatively beyond the walls of our institutions into communities, among the people where they live, in the conditions of their everyday realities?

As we reflect on and plan for our commitments to population (community) health, we will be creative, courageous, collaborative and compelling as we have always been. Solidly informed, reflectively undertaken ethical discernment will continue to be central as we address the "who, what, where and how" of merging, partnering, reshaping and moving into new relationships in our continued commitment to why we do what we do.

The discernment process gives focus and attention to these all-important questions. With mission as compass and our values as guiding principles, we will reflect, probe, discuss and address the many and sometimes complicated ethical perspectives and issues that arise. We will reach out with intention to organizations, institutions, groups and individuals that are public, private, for-profit, faith-based or not, even those previously viewed as competitors, in forging new relationships, developing partnerships, undertaking mergers or acquisitions. The issues are myriad, the concerns rarely black-and-white and the devil is in the details.

So it has been, and so it will continue to be. The "why" remains unwavering, and the "how" takes its direction from the Gospel message of love. We can authentically and with integrity be the face of grace — a meaningful, compassionate presence of Jesus the healer — through the hands and hearts of those among and with whom we minister.

All of this requires vigilance, for the way will not always be clear or easy. Just as Pope Francis calls the church to go beyond its walls to become a field hospital of hope, so, too, must the church's ministry of healing reach beyond its walls, trusting in God's spirit of wisdom and compassion. We can and will work with the right people to do the right things for the right reasons in ways that extend hope to all God's people.

Vigilance means keeping a constant watch over the "who, what, where and how" of the ministry as it takes different shape, partners with different collaborators and carries out its mission through different configurations. The touchstone for authenticating our continued change is the foundation of our heritage. It is not the heritage of any one religious congregation, but, rather the heritage of the rich tradition of healing and hope found in the Gospel and expressed in the catholic (universal) tradition that grounds us all.

Here is what is at the heart of who we say we are as Catholic health care: respect for the essential dignity of each human life; reverence for our earth; commitment to justice in the biblical understanding of right relationship; stewardship of human and all other resources entrusted to us for the common good of the communities we serve. These also are the touchstones against which we regularly, vigilantly and consistently strike the different relationships engaged in the various ways of delivering care and building pathways to happier, healthier, more whole communities wherever we serve.

Just as ethical discernment is essential in authenticating, developing and implementing the "who, what, where and how" of the ministries we undertake, so, too, must those entrusted with sponsorship of this changing ministry within the church keep vigil. The "why" and the "how" of what we do are constants, and they require our commitment to assure that these are not watered down in our efforts to do things differently and not compromised in new relationships, collaborative efforts and designs for delivery of care.

Will we need to find different ways of doing some of the traditional things we do? Spiritual care, for example, will be necessary, but expressed and provided differently. No doubt we will struggle with the details, but the ministry will be present. Safe, quality, compassionate care remains essential, not to be compromised or watered down in our "reaching beyond the walls."

Those who sponsor the ministries will need to ask hard questions and remain watchful. This will require a constant commitment to be the voice, eyes and ears for mission and uncompromised values. Just as we need formation and ongoing education for those whose heads, hands and hearts carry out the day-to-day ministries of healing, so, too, new ways of doing ministry will require ongoing formation and education of those who are entrusted with the ministry of sponsorship.

We are charting new courses through turbulent waters; we are feeling our way darkly into an uncertain future. This is not different from what has happened in the past: Were not most Catholic health ministries born and developed, planned and implemented in similar environments? Different, less multifaceted perhaps, but similar in that the need was there, change was required, adaptation was the order of the day. And it happened!

Are we any less capable, less resolved to meet the needs of God's people now? I don't think so. Anything worth doing is worth doing well; anything worth doing well will not be easy; anything that is not easy is better done together. Some of the specifics may be unclear and the pathways rocky. Mistakes may accompany the best of efforts, but together, with faith, trust and a willingness for the undertaking, Catholic health care will be a viable and essential part of the church Pope Francis is calling for. It will be a field hospital for the health, healing and wholeness of our little parts of God's wounded but wonderful world.

SR. KATHLEEN PRUITT, CSJP, is a member of the PeaceHealth System board of directors, which is responsible for sponsorship and governance. She also serves on the PeaceHealth Peace Island Medical Center community board. PeaceHealth is based in Vancouver, Washington.

Beyond the Walls- Moving to Population Health

Copyright © 2015 by the Catholic Health Association of the United States

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