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Seventeen health systems across the country — including Bon Secours Mercy Health, CHRISTUS Health, CommonSpirit Health and Providence — signed an "Impact Workforce Commitment" last year to build healthy and equitable local economies through their hiring and workforce development programs and policies.

In November 2013, Pope Francis released the Apostolic Exhortation, Evangelii Gaudium (The Joy of the Gospel). This document outlines Francis' vision of the Church as discussed in the Synod of Bishops in 2012.

In 2021, the Catholic Church began a three-year process called the Synod on Synodality to "provide an opportunity for the entire People of God to discern together how to move forward on the path toward being a more synodal Church in the long-term."

Because those who are vowed religious tend not to adopt a "hey, look at me" attitude toward their accomplishments, it may go largely unnoticed and unremarked upon in contemporary society that U.S. Catholic health care has an extraordinary legacy of leadership.

Let integrity and uprightness preserve me; I wait for you, O Lord. (PSALMS 25:21)

OPENING AWARENESS As we gather, we may find it difficult to find the words that resonate with a meeting agenda, time of year, or the things happening in our neighborhoods or worldwide. We humbly acknowledge the seemingly unending pressures faced by health care leaders today:

When I came to CHA in 2010, one of my first projects was to research the state of in-kind donations — or "medical surplus recovery" — from Catholic health care to organizations in low- and middle-income countries. The resulting research study conducted by Accenture Development Partnerships that year showed that while donations were happening, there was significant room for improvement to ensure our efforts had a positive impact in meeting the needs of people and communities.

In a rapidly evolving health care landscape, almost all health care organizations reported an increased need for regulatory compliance in recent years. To navigate these turbulent waters, a powerful alliance between health care compliance and leadership is not just a choice — it's a necessity.

As Catholic health leaders, we believe in the power of transformation to bring ourselves and our ministries more fully to life. Yet seemingly never-ending and accelerated change wearies us.

Notre Dame Cathedral in Paris readies for its grand reopening on the Feast of the Immaculate Conception in December. Following the devastating fire in 2019 that engulfed its nave, French President Emmanuel Macron pledged to reopen it within a few years. No doubt the ritual will unfold with great fanfare and throngs of believers and onlookers alike.

There is an often-told story about a little boy who wakes up in the middle of the night from flashing lightning and booming thunder, terrified and crying out for his dad. His dad comes in and reassures him, "God is always here to take care of you." Clinging on to his father, the boy blurts out, "But Dad, I need a God with skin on."

Organizational ethics guides institutional decisions to align them with organizational values and is a fundamental component of institutional integrity. Although these principles dovetail closely with those in compliance, legal, human resources and other areas, it is its own distinct area of work. However, since organizational ethics is still an emerging field, it is often unclear what it actually entails, especially in health care.

Physicians are at the core of what it means to be health care — essential leaders of care teams and clinical initiatives who represent the deep purpose of the organization. They are called to heal, and the practice of medicine is the core of their work. Yet, operational leaders often hear physicians say they feel disconnected from much of the organization's decision-making and strategy discussions. For the Catholic health ministry, this gap is worth exploring, especially to sustain our identity, mission and values, as it represents dissonance in a sense of meaning and purpose.

The Catholic sisters who were the primary founders of health care in the United States — for Providence, the Sisters of Providence and the Sisters of St. Joseph of Orange — were courageous, pioneering women. They did not hesitate to brave the unknown to serve those in need and be a source of healing and love in the world. When our founding sisters arrived in the American West, it was still a rugged and harsh frontier. Through discernment and determination, they built hospitals, orphanages and schools.

This past year, CHA introduced a new vision statement: We Will Empower Bold Change to Elevate Human Flourishing. It's an aspirational call to each of us in the Catholic health ministry. With just nine words, CHA's vision statement makes it clear that the health systems of tomorrow must be innovative and courageous, while embracing a mandate to further extend ourselves into all aspects of human flourishing.

As an emergency room physician, Dr. Nicholas Testa saw plenty of pain, suffering and cosmic injustice. "You have moments where you question where is the spirit in this, how is this fair?" he said. But even in the hardest moments, he is apt to think about the many orders of sisters who made grueling treks far from their homes to create hospitals from the ground up. "When I think about what they did with zero money and little support, it reminds me that this hard work is worth it."

In Catholic health care, leadership includes a deep understanding of Catholic identity and a pledge to thoughtfully steward organizations to emulate the healing mission of Jesus.

"Human dignity is the basis of justice, while the recognition of every person's inestimable worth is the force that impels us to work, with enthusiasm and self-sacrifice, to overcome all disparities."

This meditation is inspired by those working to ease the transition of individuals who have recently arrived in this country, usually from places where they are escaping violence, unrest or unjust conditions. The Catholic health care ministry includes community health workers — like those described in this issue's Mission column at Avera Health in Sioux Falls, South Dakota (see pages 61-63) — who are already serving as leaders in their communities. They work tirelessly to draw from their expertise and experiences — some as immigrants and refugees themselves — to build trust between their communities and health care systems. Through the power of their relationships and community building, they help to create an environment where human flourishing is possible.

In 2020, the Catholic health ministry was moved to respond to the deaths of George Floyd, Breonna Taylor and Ahmaud Arbery and the disproportionate impact of COVID-19 on racial and ethnic communities through the renewal of our commitment to equity, justice and the dignity of all persons.