Wednesday, February 27, 2008

My Goals for Fiscal Year 2008

Because I believe strongly in total transparency, and since I have already shared CHRISTUS’ overall goals, I thought it would be appropriate to share my goals for the current fiscal year.

In September or October, when our Board of Directors completes my evaluation, I will share my self-evaluation, and measure how I believe I’ve met my goals for this fiscal year.

My goals for this year are:

1. To achieve and sustain improvement in the Business Literacy Metrics
a. Reach or exceed the budgeted operating income of $50 million.
b. Achieve and maintain days-in-cash of 190.
c. Sustain present bond rating of both Standard & Poor’s and Moody’s.

2. To achieve and sustain improvement in the Service Delivery Metrics
a. Patient Satisfaction:
i. Inpatient – 90 percent
ii. Emergency Department – 70 percent
iii. Outpatient – 70 percent
iv. Ambulatory Surgery – 75 percent
b. Associate satisfaction – 80 percent
c. Associate engagement – 80 percent
d. Physician satisfaction – 60 percent

3. To continue to develop and fully implement a program to increase cultural competency throughout CHRISTUS, including the continuing support and participation in the CHRISTUS leadership academy, our Center for Management Excellence and our coaching and mentoring programs.
a. Continue the Mentorship program with 50 percent of mentees being ethnically
b. Continue the CHRISTUS Academy, maintaining current diversity at 46 percent, or an increased percentage.
c. Continue to provide career advancement opportunities for CHRISTUS Academy graduates.
d. Continue to increase the number of diverse candidates—ethnic, gender, age and capabilities—on the regional leadership teams, both in the U.S. and on the Senior Leadership Team, as openings occur.

4. Acquire and integrate McKenna into the San Antonio region and create a new region by partnering with St. Vincent Health System in New Mexico.

a. Definitive agreements will be signed.
b. Leadership teams reporting to the Senior Operational Officer will be in place and functioning.

5. Recruit and fully integrate a new Senior Vice President for Mission, Ethics and Spiritual Care into the Senior Team and CHRISTUS Health
a. Oversee search process that must formally commence by September 2007.
b. Final candidate must be identified by February 2008, with a start date of April 2008.
c. Oversee two-month orientation and transition with Sister Theresa McGrath, who currently holds the position.

6. Commence and be a full participant in the Futures Task Force II
a. Read all pre-session material.
b. Attend all sessions.
c. Participate n Learning Journeys as deemed appropriate.

Wednesday, February 20, 2008

My Expectations as we Travel to our 2009 Summit

As we review our past nine years, it is clear that we will need to raise our expectations in order to accelerate our Journey to close the gaps between our present levels of success and those “stretch” goals I identified in my last post.

This will include the following 10 focuses on our behaviors. I expect these from our CHRISTUS family as we travel to our June 09 summit:
1. A greater sense of urgency;
2. Less patience;
3. More focus on the need for results;
4. More sharing of best practices;
5. More persistent and positive in the face of setbacks;
6. Consistently producing positive and measurable outcomes in our Four Directions to Excellence, Advocacy and Philanthropy;
7. More rapidly enhance quality and service outcomes;
8. More rapidly using patient, Associate and physician feedback to identify and act on opportunities for improvement;
9. More quickly develop and embrace efficient and effective models to care for the uninsured and
10. Sustain our number 1 position in community value as we continue to live our Mission.

We can no longer benchmark ourselves against our historical progress or our peers. Instead, we must know our new competitors, which now include retail pharmacies like CVS, technology vendors and the retail world at large. We must become increasingly skilled at predicting the “toxic side effects” of change, and more comfortable with the controversy change can cause. We must continue to innovate and change ahead of the curve if we are to provide high quality, excellent health care to our communities and continue on our path to becoming a national influencer.

In order to ensure this timely transformation, we must:
• Increase CHRISTUS Health’s capacity for early change by more deliberately fostering continuous renewal as part of every day operations.
• Generate confidence in early change by sharpening CHRISTUS Health’s business acuity through comprehensive market sensing and responding capacities.
• Change from “being in the health care business serving people” to “being in the people business doing sacred work by delivering excellent health and wellness care.”
• Accelerate the behavioral changes needed to start and sustain transformation by using leading-edge tools and techniques for sensing and responding to organizational change barriers and opportunities.

Our greatest challenge as CHRISTUS Leaders is that we must find a way to get 28,000 full-time and part-time Associates and 9,000 physicians, in multiple countries from multiple cultures, to think in similar terms about the purpose of our ministry and what they individually must do to accomplish that purpose and be aligned. We must all share the same mindsets, and we must believe that nothing is impossible.

Wednesday, February 13, 2008

CHRISTUS Health’s Journey to our 2009 Summit

My discussions of the various aspects of CHRISTUS’ Journey to Excellence in previous posts should make clear CHRISTUS’ belief that if health systems are to reach excellence, they must have clearly defined goals accompanied by metrics which incrementally increase over reasonable time periods based on the previous improvement.

This is critical, because most changes in health care do not occur in a straight line or linear fashion, but rather have very slow improvement in their initial phases, then hit a tip-point and have more rapid improvement over the following several years. This clearly has been our experience in measuring our improvement in our four Directions to Excellence as part of CHRISTUS Health’s Journey to Excellence over the last 9 years. This can be easily seen in the map of our Journey below:

However, a Journey to Excellence often requires a leadership team to deal with present operational issues which are more often dealt with in a “crisis mode” of intervention. In order help us sustain our vision of the potential and rapid changes that can occur post-tip-point, we believe it is important to set clearly-defined stretch goals with metrics to be reached every three years. In CHRISTUS, we call these our “summits” on our Journey to Excellence, and these parallel governance conferences where we bring in our key board representatives from both the U.S. and Mexico, along with the regional and business unit CEOs to not only review our successes, but to lay the expectations for the next summit.

By doing this, we recognize what changes might be needed in the organization to successfully complete the next leg of our Journey. During the conference, we can then present workshops filled with the right learning experiences and new tools to aid leadership to reach these higher expectations.

For June of 2009, our next summit, we have outlined specific goals which we have been talking about for the last three years in particular, and several of them have been our focus for the last 9 years. Two have to do with our metrics for our four Directions to Excellence, advocacy and philanthropy; three are related to our internal and external audiences and three are related to recognitions we hope to achieve.

The first category, those related to our four directions, include reaching all of our Journey to Excellence goals in each direction. Our performance on these metrics must be at or better than the 90th percentile of similar-sized organizations, both in the U.S. and Mexico. For philanthropy, our goal is to achieve fundraising which will be equal to 1.5 to 2 percent of our net revenue. Regarding advocacy, we will continue to measure the number of issues we have brought to the attention of our local, state and national governments, and how much money we have saved in the form of reimbursement in regard to the specific issues we have advocated for.

In addition, we recognize that not only reaching these metrics is critical, but sustaining the gain over long periods of time is really the ultimate goal. Therefore, sustaining excellence is a second goal for our 2009 summit. We discussed previously that there were two periods in CHRISTUS’ history where we did not make the planned progress in all of our directions to the degree that we had hoped. Those periods were our Fiscal Years 2002 and 2007. Although we had good reasons and explanations for this lack of progress, an excellent organization will hardwire their processes in place to mitigate these periods of stabilization or even decline in improvements.

Hence, sustaining excellence and learning the best practices to make this happen, which is evident in many of our facilities at present, is a must for our entire organization by June 2009.

The three goals we have for both our internal and external audiences include educating all of our Associates, physicians, patients, residents and their families so they might understand the best ways to deliver excellent health care and the best ways of incorporating excellent health into their practices of daily living. We also wish to influence both our internal and external audiences to make sure that when they ask themselves, “Where is excellent health care delivered?” they immediately think of CHRISTUS facilities, programs and clinics. A specific example would be embedded in our hopes that we would be invited to the discussion that the new president of the U.S. will have on determining the best ways to redesign U.S. health care. Our third goal under this category is to provide appropriate rewards to both our internal and external constituencies so as to appropriately stimulate a culture of excellence and innovative thinking.

With regard to the award category, we are hoping by 2009 to enhance the locations where we are considered to be the employer of choice, because we know that if our Associates (employees) and physicians are happy and choose to work with us, they will most likely provide outstanding service to everyone who enters our doors. This will, of course, help us attain our metrics in our service quality direction. And because we have done a comparison of our Journey to Excellence goals, the Joint Commission goals, Magnet status and the Baldrige award, and found their goals and requirements to be almost identical, we are hoping to expand the Magnet nursing status to a majority of our acute, inpatient sites and at least apply for the Baldrige award for our entire system on or shortly after we reach the June 2009 summit.

Wednesday, February 6, 2008

CHRISTUS Health: Nine Years of Change, Nine Years of Progress

On Friday, Feb. 1, CHRISTUS Associates, physicians and volunteers around our system celebrated the ninth anniversary of the formation of CHRISTUS Health on what we call CHRISTUS Day.

As we, the CHRISTUS family, embarked upon our ninth year since the formation of CHRISTUS in 1999, we paused to reflect on the awesome role and responsibility that each of us share as health care Associates and physicians. Accepting and striving each day to fulfill our mission – to extend the healing ministry of Jesus Christ – means that each of us is on an extraordinary journey.

Our Journey to Excellence, which began in 1999, is a profound, awesome journey on sacred ground. On the occasion of our ninth anniversary, it is my prayer that each of us was energized and would recommit ourselves to be an excellent CHRISTUS healer. We must use this coming year to accelerate our Journey to Excellence as we travel to our 2009 summit.

I asked the leaders in CHRISTUS to start deciding what they are going to do differently to make that happen. I think we share the same commitment to excellence, the impatience in not reaching or sustaining some of our metrics and the desire to accelerate our Journey. Our patients and residents and their families are depending on us to make this sacred CHRISTUS Ministry excellent in all of its aspects. The celebrations of our ninth birthday are the time to reignite our passion and refuel our accelerated action plans!!!

CHRISTUS Health is a large family, and size itself can at times be a barrier to creating excellent, consistent and predictable behaviors, as well as practices and processes which reflect the CHRISTUS Health promise. However, the true advantage of our large family is the wealth of knowledge, experience, kindness and compassion that our Associates, physicians and volunteers bring to our patients and residents each day. Because we know excellence can only be delivered by excellent Associates and physicians, we have consistently committed much time and money to educational and enrichment programs for our CHRISTUS family. The birthday celebrations that were held throughout our system are part of that educational and spiritual enhancement process.

In addition, we have a myriad of educational opportunities available for all, including:
• GED programs
• Tutoring
• Tuition reimbursement
• Center for Management Excellence
• Touchstone best practice program
• Councils for shared learning among affinity groups
• Senior Leadership Academies
• Leadership enrichment training
• Ethics Institute
• Leadership retreats
• Governance conferences

Each one of us, in some way, is a formal or informal leader. By our daily actions we are role models for those we serve as well as those with whom we work. Committing to life-long learning and excellence in all we do is essential for creating the passion required to extend the healing ministry to all we touch each day.

Yes, the complexities of health care will always create new challenges for us as we continue our Journey to Excellence. But we must never forget that our dreams will come true if we live each day truly believing that nothing is beyond our reach if we reach out together. Para nosotros. . .nada es imposible!