Organizational Redesign

As we discussed previously, for reasons that we believe are quite sound, we are transforming the CHRISTUS Health portfolio to one-third acute care, one-third non-acute care and one-third international. In order to accomplish such, it is necessary for our senior leadership team to review the leadership capabilities not only within our own team, but also within the leadership teams of the 11 regions that presently comprise our health system.

As the team reviews these capabilities, it may be necessary to look at both the organizational and governance structure of the system to make sure that our peoples’ capabilities are appropriately aligned. Although I will not discuss specific organizational changes that might evolve over the next several months or year on my blog, I think it would be appropriate for us to converse about several principles which might guide this process.

First and foremost, this transformation will require a clear understanding of not only what is included under the umbrella of non-acute care, but also a clear understanding of the rapidity of the growth in non-acute care as the factors driving it seem to be accelerating its growth at an unprecedented rate. Presently, we are defining non-acute care as “care which does not require a traditional inpatient bed in an acute setting.” However, this definition does include care that requires beds in non-acute settings, such as rehabilitation medicine, and our nine hospitals providing long-term acute care. Of course, all outpatient services would be included in this category, and this division will also include new ambulatory care programs which will evolve due to the technology advancements we discussed in detail in past posts.

At the present time, we are categorizing our non-acute care in four categories:
1. Outpatient care, facility dependent;
2. Outpatient care, non-facility dependent (visiting home nurses, etc.);
3. Inpatient care requiring non-acute beds (rehab) and
4. Housing, including both senior campuses and housing for the underserved.

In addition, our senior care is broken down into independent living, assisted living and nursing home, including memory units. It is clear by reviewing this list that both present and future leaders will need to possess new capabilities and leadership skills if we are to add needed competencies into our leadership portfolio, which has been developed mainly through educational courses and experiences which have been garnered predominately in acute hospital settings.

Then how will we gain this knowledge? Since many of our bachelor’s and master’s health care programs in the country have historically been driven by hospital knowledge, we believe this non-acute care training must occur predominately through our own capabilities. To do this, we have strengthened our organizational development department and are now offering formal courses and experiences in the following four areas:
1. Coaching and mentoring - We are identifying those people who we believe have strong capabilities to be future leaders, but perhaps do not recognize such or feel confident enough to apply for the 3 levels of training outlined below. Consequently, we are assigning each of these people to a coach from our senior teams for a one-year period. Formal training in coaching and mentoring has been provided for the over 60 people who are now serving as coaches, and a formal evaluation by the mentee is done at the conclusion of the year-long program. Now in its fifth year, we have proven that based on this coaching and mentoring—which is usually done by a mentor and a diverse mentee—that these people have gained the confidence and knowledge to apply for and be selected for our more advanced leadership programs.
2. Center for Management Excellence – This four-day workshop has been designed through a Senior Leadership Academy project (see below) to train all managers in a very focused way in the basic skills that they need to manage both the acute and non-acute areas of operations. All present CHRISTUS managers have gone through this course and all new managers go through the course in the quarter they were hired, since it is now repeated every three months during the calendar year.
3. Senior Leadership Academy – Now in its sixth year, a multidisciplinary committee selects 30 candidates from an applicant pool of strong directors and managers in CHRISTUS Health who have demonstrated the skills and motivation to take on additional leadership responsibilities. Through five three-day sessions, and by working on one of four assigned projects, which when completed should help CHRISTUS advance on its Journey to Excellence, these academy members gain a broad exposure to both operational and strategic issues including detailed business literacy and an enhanced focus on governance, which is rarely experienced at this stage in one’s leadership pathway. It is important to note that these graduates are given the first opportunity to apply for leadership openings throughout the organization, and over 30 percent of academy graduates have been promoted.
4. Talent management and succession planning – In order to make sure that there is always a potential internal leadership pool from which to fill the top senior leader and regional leadership team spots, the first class of 16 outstanding leaders have been organized to participate in succession planning and talent management. These participants, who are identified by having outstanding performance in the prior three years as well as outstanding potential based on statistically significant testing, are assigned external coaches for 1 year. During this year, intense developmental plans are implemented to address necessary growth opportunities so that at the end of the year, these 16 people should have the full array of skills necessary to be the transformational leaders of CHRISTUS Health tomorrow.

Yes, at the end of the day, transformational leadership and organizational structural changes must be made to move an organization such as CHRISTUS Health from its traditional hospital inpatient focus to an exciting to one-third acute care, one-third non-acute care and one-third international portfolio. At present, this transformational knowledge must be gained internally, providing future leaders with the knowledge and experience required to be successful.