Several months ago, a special joint meeting of the Mission and Ethics and Human Resource committees of CHRISTUS Health was held regarding the approach to labor unions in our ministries. A representative from Catholic Healthcare Partners presented their journey over several years, as well as a detailed summary of a more collaborative approach they have agreed to in recent months.
While the two committees continue to reflect on these discussions and articulate the best “next steps,” it is important that the board and the Members become more familiar with this issue which most likely will increase in health care in the future.
On Feb. 19, Sister Carol Keehan, the CEO of the Catholic Health Association (CHA) made a presentation to a group of COOs from large Catholic health systems. This presentation regarding a significant labor dialogue which is now in progress, and includes the formation of a task force whose goal is to create a document, that is now in draft, that contains the principles that express Catholic social teaching about labor in a manner consistent with church teaching but not manipulated against unions or management and that would invite reflection and discussion. We see it as the “rules of engagement” when and if labor and management come together. In addition to Sister Carol, this task force’s members include a cardinal, two bishops and four high-level labor organization representatives.
We are hopeful that this document will serve as an important tool to guide future behaviors and discussions regarding this important issue, particularly as it relates to Catholic health care and Catholic social teachings.
Following on the heels of the presentation detailed above, an editorial was published in the New York Times on Sunday, Feb. 20, entitled, “Does America Still Need Labor Unions?” Stimulated by the possibility of the Obama-backed Employee Free Choice Act or “Card Check” being considered by Congress this year, the editors include both voices of support and opposition. The text of this short, but informative editorial is presented for you as follows:
Does America Still Need Labor Unions?
The Employee Free Choice Act, or “Card Check” for short, is one of the most controversial measures Congress faces this year. The bill – first introduced in the Senate in 2007 by Ted Kennedy and co-sponsored by then-Senators Barack Obama and Joe Biden – would make it easier for workers to join unions and would tighten penalties for employers who try to stop them. Supporters such as Human Rights Watch and the NAACP say the bill provides important protections for the middle class. Opponents like the U.S. Chamber of Commerce and the National Restaurant Association say it increases labor costs and hurts the bottom line. Both sides have spent millions on lobbyists and advertising to make their case.
With only 12 percent of American workers in unions, why should the rest of us care? Professor Clete Daniel, a labor expert at Cornell University, says a revived labor movement could benefit workers both in and out of unions. “There is definitely a need for forces that promote a fairer sharing of wealth,” he says, noting that the gap between America’s rich and poor is the largest it’s been since 1928. Over the last 75 years, unions helped secure benefits like unemployment insurance, social Security and the 40-hour workweek.
Others contend that unions have outlived their usefulness. “The workplace is much better today,” says Michael Eastman of the U.S. Chamber of Commerce. “Employers know they need to offer certain benefits and good wages to keep good workers.”
Professor Daniel says Card Check likely would not increase union membership until the economy improves, since workers are currently more concerned about job security than wages and benefits. “Today, most workers are too fearful to take a risk for unions,” he adds.
Wednesday, March 25, 2009
Tuesday, March 17, 2009
Strengthening an Already Great Team
During challenging times, another opportunity that presents itself is the chance to enhance the strength of the leadership teams in a health care organization. Some people naively believe that teaming is easy and is a natural tendency of health care leaders. However, it has been my experience that perhaps the direct opposite is true. Why?
In order for people to accept the responsibility and accountability associated with leadership in health care, which is extremely complex, each individual must be tremendously strong-willed and have very high levels of self-esteem and leadership egotism. It is these very essential traits which guarantee individual success that often provide significant barriers to guaranteeing success in a team that is required to function in a coordinated fashion to reach consensus in both operational tactics and strategic directions.
In addition, these conflicting characteristics are often accentuated in challenging times like this economic crisis, and therefore require the team to pause and determine the most important characteristics of successful teaming and how can they be enhanced.
With this knowledge, I am taking the opportunity to have two workshops with my senior team, one in March and one in July to do the following: 1) articulate my 10 characteristics of strong and successful teams; 2) determine if their characteristics for successful teaming are congruent with mine, or if additional ones should be added; 3) evaluate which of the characteristics we have done exceedingly well over the last 2 years; 4) also determine those which are still presenting challenges for successful implementation and 5) develop action plans to correct the latter and improve them so that ultimately our already excellent team will be as perfect as possible.
I have focused on 10 characteristics of teaming, which I attempted to develop in the teams I have worked with and have had the privilege to lead over the last 40 years. They include the following:
1. Freedom. Team members must feel empowered to try new approaches to their work.
2. Trust and openness. Team members must always feel comfortable sharing ideas with one another.
3. Idea time. Team members must have time to think about and develop new ideas that can be shared with each other on an individual basis as well as in group meetings for further exploration and dialogue.
4. Agenda planning. Team members are always encouraged to help formulate meeting agendas to add critical topics on the spur-of-the-moment and to participate in rolling agenda planning as far in the future as they can see.
5. Conflict. If team members are participating in robust and meaningful discussions, they will occasionally experience personal tension and conflict. It is imperative that each individual team member and the group at large learn how to deal openly and honestly with these tensions, causing them to be as healthy as possible rather than disruptive.
6. Debate. As indicated above, robust discussions must be a hallmark of every team meeting, and therefore team members must have the ability to constructively discuss and challenge one another’s ideas and approaches while being open to listening to others intently as their positions are being expressed. A great philosopher once said that is why we have two ears and only one mouth.
7. Idea support. Team members must encourage one another’s ideas and participate in healthy discussions with appropriate professional pushback to bring the right ideas to a level of understanding so that they might be implemented into future planning.
8. Risk taking. Team members must be comfortable in making decisions and taking actions when the team leader is not present. They must feel comfortable that Monday morning quarterbacking is not an operational strategy of the team leader. Instead, debriefing to learn is undertaken to review decisions made as individuals which impact the whole organization and reflect on the team’s accountability and responsibility.
9. Challenge and involvement. Team members must always feel connected to the team and therefore the organization, but simultaneously always stretched by their work and take pride in it. However, this stretching must not be in excess; the team members must feel that they have the ability to balance their personal and professional lives.
10. Playfulness and humor. Team members, if they are to be successful, must see their workplace and their team meetings as times and places that can be at least partly relaxed and filled with fun. I have utilized humor over my years in health care as a way to create an atmosphere in which team characteristics can be openly and honestly expressed. Likewise, with humor, I have been able to communicate some of my toughest and sternest messages.
In a future blog post, I will share with you any additional characteristics our team has added and describe the action plans we agree upon in the July workshop to improve those characteristics so we are not only better qualified to navigate through this perfect storm, but any future storms which undoubtedly will become a part of our second decade as we travel to 2019.
In order for people to accept the responsibility and accountability associated with leadership in health care, which is extremely complex, each individual must be tremendously strong-willed and have very high levels of self-esteem and leadership egotism. It is these very essential traits which guarantee individual success that often provide significant barriers to guaranteeing success in a team that is required to function in a coordinated fashion to reach consensus in both operational tactics and strategic directions.
In addition, these conflicting characteristics are often accentuated in challenging times like this economic crisis, and therefore require the team to pause and determine the most important characteristics of successful teaming and how can they be enhanced.
With this knowledge, I am taking the opportunity to have two workshops with my senior team, one in March and one in July to do the following: 1) articulate my 10 characteristics of strong and successful teams; 2) determine if their characteristics for successful teaming are congruent with mine, or if additional ones should be added; 3) evaluate which of the characteristics we have done exceedingly well over the last 2 years; 4) also determine those which are still presenting challenges for successful implementation and 5) develop action plans to correct the latter and improve them so that ultimately our already excellent team will be as perfect as possible.
I have focused on 10 characteristics of teaming, which I attempted to develop in the teams I have worked with and have had the privilege to lead over the last 40 years. They include the following:
1. Freedom. Team members must feel empowered to try new approaches to their work.
2. Trust and openness. Team members must always feel comfortable sharing ideas with one another.
3. Idea time. Team members must have time to think about and develop new ideas that can be shared with each other on an individual basis as well as in group meetings for further exploration and dialogue.
4. Agenda planning. Team members are always encouraged to help formulate meeting agendas to add critical topics on the spur-of-the-moment and to participate in rolling agenda planning as far in the future as they can see.
5. Conflict. If team members are participating in robust and meaningful discussions, they will occasionally experience personal tension and conflict. It is imperative that each individual team member and the group at large learn how to deal openly and honestly with these tensions, causing them to be as healthy as possible rather than disruptive.
6. Debate. As indicated above, robust discussions must be a hallmark of every team meeting, and therefore team members must have the ability to constructively discuss and challenge one another’s ideas and approaches while being open to listening to others intently as their positions are being expressed. A great philosopher once said that is why we have two ears and only one mouth.
7. Idea support. Team members must encourage one another’s ideas and participate in healthy discussions with appropriate professional pushback to bring the right ideas to a level of understanding so that they might be implemented into future planning.
8. Risk taking. Team members must be comfortable in making decisions and taking actions when the team leader is not present. They must feel comfortable that Monday morning quarterbacking is not an operational strategy of the team leader. Instead, debriefing to learn is undertaken to review decisions made as individuals which impact the whole organization and reflect on the team’s accountability and responsibility.
9. Challenge and involvement. Team members must always feel connected to the team and therefore the organization, but simultaneously always stretched by their work and take pride in it. However, this stretching must not be in excess; the team members must feel that they have the ability to balance their personal and professional lives.
10. Playfulness and humor. Team members, if they are to be successful, must see their workplace and their team meetings as times and places that can be at least partly relaxed and filled with fun. I have utilized humor over my years in health care as a way to create an atmosphere in which team characteristics can be openly and honestly expressed. Likewise, with humor, I have been able to communicate some of my toughest and sternest messages.
In a future blog post, I will share with you any additional characteristics our team has added and describe the action plans we agree upon in the July workshop to improve those characteristics so we are not only better qualified to navigate through this perfect storm, but any future storms which undoubtedly will become a part of our second decade as we travel to 2019.
Wednesday, March 11, 2009
Putting system directions to work in local facilities
Many of us who have the opportunity to work in large systems or organizations know that being part of a sizeable “family” may present obstacles in the adoption of system directions or priorities. One strategy to combat this includes holding people accountable, which we do in CHRISTUS through many avenues, including regular conference calls with local leaders (CAP calls) where we review regional performance. However, many of our facilities and regions have found that taking system directions and personalizing them or “making them their own” can lead to even greater adoption.
Kristin Baird, president of Baird Consulting, Inc., recently held a series of educational Webinars on passionate leadership in health care, and invited me to participate. I met Kris when she was writing her most recent book, Raising the Bar on Service Excellence - the Health Care Leader's Guide to Putting Passion into Practice, because she spent some time interviewing me for one of the chapters.
The Webinar included a discussion on fostering a strong sense of purpose, and we also invited a manager at one of our CHRISTUS facilities to share her experience with putting these strategies into practice at a local level. Kristal Fults, RN, who serves as nurse director of the 33-bed medical telemetry unit at CHRISTUS St. Patrick Hospital in Lake Charles, La., joined us to lend her expertise. You can view our section of slides from the Webinar here.
I shared the history of the CHRISTUS Health brand, including information on the four directions of our Journey to Excellence, as well as our focus on transparency. I also touched on barriers to excellence, leadership keys to success and important habits that leaders should develop.
Kristal then provided specific, practical examples of how she and her staff at CHRISTUS St. Patrick put our Journey to Excellence and its four directions into practice every day. She listed some of what she considers barriers to culture change (denial, blame, rationalization, etc.). She also spoke about some of her keys to success, including rounding on her department. Kristal explained that rounding not only puts her into regular contact with the Associates who report to her, but also allows her to appreciate them and provide them with the tools they need to be successful. Kristal also detailed how her rounds on patients in her department improved patient satisfaction as well as the satisfaction of her Associates. These opportunities give her a chance to be a good example and go above and beyond when necessary; for instance, she may work as a nurse’s assistant for a day if they are short-staffed or someone calls in sick.
CHRISTUS St. Patrick has also instituted some interesting spins on CHRISTUS programs. They utilize our nursing dashboard (similar to our balanced scorecard, which provides a succinct, easy-to-read summary of our progress in measurable outcomes). However, they also drafted their own “standards of behavior” with Associate input that aligns with CHRISTUS’ Core Values but also makes a statement about the issues that are important to local CHRISTUS Healers.
In addition, CHRISTUS St. Patrick holds monthly drawings from a list of all the Associates who have been named or thanked in patient satisfaction surveys. The winners of this drawing are awarded $50 on the spot. They also utilize varied committees, teams and councils as well as CHRISTUS’ recognition tools, which allow Associates to award each other “Spirit Bucks” for a free drink in their cafeteria.
Kristal’s staff also participates in peer interviewing and individualized orientation, which allow frontline staff to participate in the hiring process. These Associates then mentor and coach the new Associates they helped to hire, which creates a mutually beneficial relationship.
They also participate in the community activities, which improves the perception of our brand in the communities we serve, while benefiting the community and our Associates by providing a better place to live.
It is important that while we hold our regions accountable for instituting system programs and creating measurable improvement, we provide them with the encouragement and support to create additional programs that support these directions and further our Journey to Excellence on a daily basis.
Kristin Baird, president of Baird Consulting, Inc., recently held a series of educational Webinars on passionate leadership in health care, and invited me to participate. I met Kris when she was writing her most recent book, Raising the Bar on Service Excellence - the Health Care Leader's Guide to Putting Passion into Practice, because she spent some time interviewing me for one of the chapters.
The Webinar included a discussion on fostering a strong sense of purpose, and we also invited a manager at one of our CHRISTUS facilities to share her experience with putting these strategies into practice at a local level. Kristal Fults, RN, who serves as nurse director of the 33-bed medical telemetry unit at CHRISTUS St. Patrick Hospital in Lake Charles, La., joined us to lend her expertise. You can view our section of slides from the Webinar here.
I shared the history of the CHRISTUS Health brand, including information on the four directions of our Journey to Excellence, as well as our focus on transparency. I also touched on barriers to excellence, leadership keys to success and important habits that leaders should develop.
Kristal then provided specific, practical examples of how she and her staff at CHRISTUS St. Patrick put our Journey to Excellence and its four directions into practice every day. She listed some of what she considers barriers to culture change (denial, blame, rationalization, etc.). She also spoke about some of her keys to success, including rounding on her department. Kristal explained that rounding not only puts her into regular contact with the Associates who report to her, but also allows her to appreciate them and provide them with the tools they need to be successful. Kristal also detailed how her rounds on patients in her department improved patient satisfaction as well as the satisfaction of her Associates. These opportunities give her a chance to be a good example and go above and beyond when necessary; for instance, she may work as a nurse’s assistant for a day if they are short-staffed or someone calls in sick.
CHRISTUS St. Patrick has also instituted some interesting spins on CHRISTUS programs. They utilize our nursing dashboard (similar to our balanced scorecard, which provides a succinct, easy-to-read summary of our progress in measurable outcomes). However, they also drafted their own “standards of behavior” with Associate input that aligns with CHRISTUS’ Core Values but also makes a statement about the issues that are important to local CHRISTUS Healers.
In addition, CHRISTUS St. Patrick holds monthly drawings from a list of all the Associates who have been named or thanked in patient satisfaction surveys. The winners of this drawing are awarded $50 on the spot. They also utilize varied committees, teams and councils as well as CHRISTUS’ recognition tools, which allow Associates to award each other “Spirit Bucks” for a free drink in their cafeteria.
Kristal’s staff also participates in peer interviewing and individualized orientation, which allow frontline staff to participate in the hiring process. These Associates then mentor and coach the new Associates they helped to hire, which creates a mutually beneficial relationship.
They also participate in the community activities, which improves the perception of our brand in the communities we serve, while benefiting the community and our Associates by providing a better place to live.
It is important that while we hold our regions accountable for instituting system programs and creating measurable improvement, we provide them with the encouragement and support to create additional programs that support these directions and further our Journey to Excellence on a daily basis.
Wednesday, March 4, 2009
CHRISTUS' Continued Focus on Wellness
The findings of Futures Task Force II support CHRISTUS’ focus on the growth of our non-acute and international programs and services, with continued support for acute care. As we consider an era of health care reform and what will be required to adequately care for all Americans, it is clear that a focus on wellness and prevention will be important as well.
To this end, CHRISTUS is continually implementing and/or expanding programs and services that aim to improve the wellness of our Associates, residents, patients and their families.
Today, I am in Beaumont, Texas, attending the opening of the first CHRISTUS Healthy Living™ Spa – Murad Inclusive Health Center®. This spa is located on the campus of CHRISTUS Hospital – St. Elizabeth, and is part of our retail services and wellness initiatives. The spa provides traditional services such as massage, manicures, pedicures, non-invasive face lifts, facials and body waxing as well as other treatments such as laser skin treatments, laser hair removal and ILP skin rejuvenation. The medical spa is overseen by a physician on staff who serves as its medical director, which allows for more complicated cosmetic procedures to be performed safely and effectively.
In addition, at the CHRISTUS system level and in many of our regions, Associates who participate in CHRISTUS’ Healthy Habits program online must earn wellness credits to receive a reduction for their FY 2010 benefits plan year, as well as a cash reward. Associates can earn wellness credits by participating in healthy living programs and challenges together with a wellness assessment that will allow them to identify unhealthy behaviors such as high stress and obesity and to address them with intensive online counseling, coaching and training.
Many Associates also choose to participate in healthy activities taking place outside CHRISTUS facilities that raise awareness about our brand. Associates from CHRISTUS Hospital and CHRISTUS St. Patrick Hospital participated in Start! Heart Walks in their communities, which raise money and awareness for the American Heart Association (AHA) and its research. These Associates raised funds for an important cause while presenting important information about the hospitals’ wellness services. CHRISTUS St. Joseph Villa and CHRISTUS St. Patrick Hospital have also participated in the AHA’s Start! at Work program, an at-work walking program which aims to increase Associates’ fitness levels. CHRISTUS St. Vincent Regional Medical Center will begin this program in March. In fact, the AHA named CHRISTUS St. Patrick Hospital a “Gold Level Fit Friendly Company” in 2008 for their on-site walking route, healthy nutrition choices and online wellness program. Many other CHRISTUS facilities also offer weight management or healthy living programs to their Associates.
Many CHRISTUS regions also sponsor wellness events in their communities that offer free health screenings, seminars and training programs. Some of these events target women’s health specifically; as an example, CHRISTUS St. Patrick Hospital formed a Women’s Health Network in the fall of 2008. CHRISTUS St. Vincent Regional Medical Center allows women who get a mammogram in the first six weeks of the calendar year to purchase a VIP pass to their Day of Beauty event. CHRISTUS Health Southeast Texas will offer its second annual LiveWell Women’s Conference on May 7. This event includes an address by keynote speaker Paula Deen of the Food Network, health screenings and more than 20 workshops covering topics from forgiveness to insomnia.
Many regions are also investing in employer wellness networks with local businesses in their communities. These allow our CHRISTUS entities to bring health information, health fairs, health screenings and educational sessions to other local businesses.
As CHRISTUS moves forward with increasing our focus on wellness, we may institute other changes to our foundational documents which make this concentration abundantly clear to our Associates, communities and everyone we serve.
To this end, CHRISTUS is continually implementing and/or expanding programs and services that aim to improve the wellness of our Associates, residents, patients and their families.
Today, I am in Beaumont, Texas, attending the opening of the first CHRISTUS Healthy Living™ Spa – Murad Inclusive Health Center®. This spa is located on the campus of CHRISTUS Hospital – St. Elizabeth, and is part of our retail services and wellness initiatives. The spa provides traditional services such as massage, manicures, pedicures, non-invasive face lifts, facials and body waxing as well as other treatments such as laser skin treatments, laser hair removal and ILP skin rejuvenation. The medical spa is overseen by a physician on staff who serves as its medical director, which allows for more complicated cosmetic procedures to be performed safely and effectively.
In addition, at the CHRISTUS system level and in many of our regions, Associates who participate in CHRISTUS’ Healthy Habits program online must earn wellness credits to receive a reduction for their FY 2010 benefits plan year, as well as a cash reward. Associates can earn wellness credits by participating in healthy living programs and challenges together with a wellness assessment that will allow them to identify unhealthy behaviors such as high stress and obesity and to address them with intensive online counseling, coaching and training.
Many Associates also choose to participate in healthy activities taking place outside CHRISTUS facilities that raise awareness about our brand. Associates from CHRISTUS Hospital and CHRISTUS St. Patrick Hospital participated in Start! Heart Walks in their communities, which raise money and awareness for the American Heart Association (AHA) and its research. These Associates raised funds for an important cause while presenting important information about the hospitals’ wellness services. CHRISTUS St. Joseph Villa and CHRISTUS St. Patrick Hospital have also participated in the AHA’s Start! at Work program, an at-work walking program which aims to increase Associates’ fitness levels. CHRISTUS St. Vincent Regional Medical Center will begin this program in March. In fact, the AHA named CHRISTUS St. Patrick Hospital a “Gold Level Fit Friendly Company” in 2008 for their on-site walking route, healthy nutrition choices and online wellness program. Many other CHRISTUS facilities also offer weight management or healthy living programs to their Associates.
Many CHRISTUS regions also sponsor wellness events in their communities that offer free health screenings, seminars and training programs. Some of these events target women’s health specifically; as an example, CHRISTUS St. Patrick Hospital formed a Women’s Health Network in the fall of 2008. CHRISTUS St. Vincent Regional Medical Center allows women who get a mammogram in the first six weeks of the calendar year to purchase a VIP pass to their Day of Beauty event. CHRISTUS Health Southeast Texas will offer its second annual LiveWell Women’s Conference on May 7. This event includes an address by keynote speaker Paula Deen of the Food Network, health screenings and more than 20 workshops covering topics from forgiveness to insomnia.
Many regions are also investing in employer wellness networks with local businesses in their communities. These allow our CHRISTUS entities to bring health information, health fairs, health screenings and educational sessions to other local businesses.
As CHRISTUS moves forward with increasing our focus on wellness, we may institute other changes to our foundational documents which make this concentration abundantly clear to our Associates, communities and everyone we serve.
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