We all know as health care leaders, providers, Associates and administrators that the challenges in health care have gotten increasingly complex and will seemingly only increase in their magnitude and complexity for the foreseeable future.
This reality demands that we as health care leaders must be constantly developing new methods for addressing these challenges and hopefully transitioning into innovative delivery models with little disruption and seamless flows for the people in our organizations.
Because of the magnitude of these challenges and the constant feeling that the issues must be addressed totally and immediately, we often let ourselves believe that rapid change is possible and that the “miracle cure” or the alternate answer will become visible to us in a short period of time.
However, looking over my experience in making health care changes in the last 40 years, I constantly must remind myself that health care change is never linear, meaning that we don’t go from A to B at a constant pace. Rather, what we see is that health care change is extremely slow, as we are trying to develop input from the multiple constituencies both at the bedside and in administration to determine not only what they believe are the best answers, but also to develop ownership of the solutions.
This plays out as many steps of progress which are slow and arduous, and encompasses weeks or months--and in some cases, even years. The health care environment is a big ship, which is on most days slow to turn in a new direction. However, with continuing focus and attention to goals--such as those defined in our Journey to Excellence--it has been my experience that we will reach a tip point where the changes, although they are not necessarily as rapid as one would like, do reach an acceleration point which then speeds up the further changes which lie ahead.
My experience was recently reconfirmed in a presentation given by several members of the 6th class of our Senior Leadership Academy participants in their latest session this month. During this session, their required book review was Good to Great by Jim Collins. In it, he speaks of the flywheel concept, which in reality is the concept supporting my observation for health care change over these four decades.
It reminds us that initial change is slow, but with constancy of leadership and clarity of an organization’s mission, vision and values, change can be accelerated. Health care change is no accident—and although the flywheel process is the only process that will work at the end of the day--it is possible to achieve the metrics embedded in our Journey to Excellence. In fact, this has been already been demonstrated by several of our regions and business units.
In hopes that you will be as committed to this learning and energized by hearing Jim Collins’ description from his book, you can click here.
Wednesday, March 19, 2008
Wednesday, March 12, 2008
Our International Strategy and the Opening of a new Hospital in Mexico
We have previously discussed the strategic drivers for our CHRISTUS Health umbrella strategy, which is causing us to evolve our portfolio in the next several years to approach the one-third acute care, one-third non-acute care, one-third international services goal.
The last one-third, our international strategy, has been recently expanded with the opening of the new CHRISTUS Muguerza Reynosa Hospital in Reynosa, Mexico, which is directly across the border from McAllen, Texas. Before we discuss the specifics of this new campus, let us connect the dots to the specific drivers of our international strategy.
In 2000, we were called to explore the possibility of entering a partnership with the family who established the Muguerza hospital in Monterrey in the 1950s. We implemented a partnership in 2001, fulfilling our international strategy in Mexico. Based on our brand recognition and our high quality of care and driven by our Journey to Excellence, we were invited to expand into other hospitals in Monterrey and then into hospitals in other states in Mexico.
Along with this expansion, we developed an adjacency strategy, which includes our convenient clinics and our ambulance services and also developed a separate corporation to care for the poor in each community into which we expand. This corporation, known as Adaleida Lafón, now consists of six clinics and short-stay hospitals with the plan to open in three additional locations in 2008. In addition, the adjacency strategy will encompass the development of a senior campus program which will hopefully be implemented in 2009.
So where does Reynosa fit into these strategies? An additional direction to our international strategy, which was developed in 2006, was to look into building new hospitals and clinics in communities directly across the U.S. border in Mexico where there are 400,000 people or more who do not have reasonable access to high-quality health care presently. Nearly 40 communities fit this description, and Reynosa is the first one where we have fully implemented a strategy in response to the great need identified.
At present, we are identifying the next two sites for similar campuses and will use the learnings from a thorough debriefing on the Reynosa experience to make sure these future projects are done even more efficiently and effectively. The reason these are being identified as cross-border strategies for CHRISTUS Health is that people in the proximal U.S. communities have the ability both to walk and drive across the border to seek health care in the state-of-the-art clinical campuses. Thereby we are meeting the needs of both U.S. and Mexican citizens while at the same time enhancing our cultural competency in delivering health care to the growing Hispanic communities in the United States.
Now, let’s look at the Reynosa project more specifically:
On March 3, CHRISTUS Muguerza Reynosa hospital held a grand opening and blessing ceremony. Reynosa is located in the Mexican state of Tamaulipas.
This hospital required an investment of $19 million U.S. Dollars, and is a 25-bed facility designed to provide primarily outpatient services. Its operating room capacity, imaging capability and patient flow design is a new concept in Mexico.
Reynosa’s ER is the largest emergency room in a private hospital in the entire state of Tamaulipas. The technology in place is of the highest caliber, and the physicians selected to serve on the hospital medical staff have been hand-picked for their excellence in medical care and interest in innovative service delivery.
The innovative ideas in this new model, including facility design, patient flow and through-put processes, medical staff standards and increasing community access to service will be carefully monitored and tested over the next year.
The last one-third, our international strategy, has been recently expanded with the opening of the new CHRISTUS Muguerza Reynosa Hospital in Reynosa, Mexico, which is directly across the border from McAllen, Texas. Before we discuss the specifics of this new campus, let us connect the dots to the specific drivers of our international strategy.
In 2000, we were called to explore the possibility of entering a partnership with the family who established the Muguerza hospital in Monterrey in the 1950s. We implemented a partnership in 2001, fulfilling our international strategy in Mexico. Based on our brand recognition and our high quality of care and driven by our Journey to Excellence, we were invited to expand into other hospitals in Monterrey and then into hospitals in other states in Mexico.
Along with this expansion, we developed an adjacency strategy, which includes our convenient clinics and our ambulance services and also developed a separate corporation to care for the poor in each community into which we expand. This corporation, known as Adaleida Lafón, now consists of six clinics and short-stay hospitals with the plan to open in three additional locations in 2008. In addition, the adjacency strategy will encompass the development of a senior campus program which will hopefully be implemented in 2009.
So where does Reynosa fit into these strategies? An additional direction to our international strategy, which was developed in 2006, was to look into building new hospitals and clinics in communities directly across the U.S. border in Mexico where there are 400,000 people or more who do not have reasonable access to high-quality health care presently. Nearly 40 communities fit this description, and Reynosa is the first one where we have fully implemented a strategy in response to the great need identified.
At present, we are identifying the next two sites for similar campuses and will use the learnings from a thorough debriefing on the Reynosa experience to make sure these future projects are done even more efficiently and effectively. The reason these are being identified as cross-border strategies for CHRISTUS Health is that people in the proximal U.S. communities have the ability both to walk and drive across the border to seek health care in the state-of-the-art clinical campuses. Thereby we are meeting the needs of both U.S. and Mexican citizens while at the same time enhancing our cultural competency in delivering health care to the growing Hispanic communities in the United States.
Now, let’s look at the Reynosa project more specifically:
On March 3, CHRISTUS Muguerza Reynosa hospital held a grand opening and blessing ceremony. Reynosa is located in the Mexican state of Tamaulipas.
This hospital required an investment of $19 million U.S. Dollars, and is a 25-bed facility designed to provide primarily outpatient services. Its operating room capacity, imaging capability and patient flow design is a new concept in Mexico.
Reynosa’s ER is the largest emergency room in a private hospital in the entire state of Tamaulipas. The technology in place is of the highest caliber, and the physicians selected to serve on the hospital medical staff have been hand-picked for their excellence in medical care and interest in innovative service delivery.
The innovative ideas in this new model, including facility design, patient flow and through-put processes, medical staff standards and increasing community access to service will be carefully monitored and tested over the next year.
Wednesday, March 5, 2008
The CHRISTUS Talent Management Program
On Feb. 7, we recognized the completion of our first Executive Development program (which we originally called the “Talent Management” program) with the graduation of 16 CHRISTUS executives who spent the last year on a learning journey. Participants in the year-long program were each assigned an executive coach to work with throughout the year. They worked with their coaches to create a formal development plan and attended three learning sessions. These sessions focused on negotiations, cross-cultural competency and Catholic theology and identity, highlighting our community in ministry.
As I have said here before, leadership development is critical for CHRISTUS in order to guarantee that we are “growing future” leaders who can ensure that our ministry is successful into the future. I want to congratulate these leaders and acknowledge them for contribution hard work this past year.
The Associates who participated in the inaugural year-long program recently shared their learnings gained throughout the year and provided valuable feedback to CHRISTUS designed to enhance the program going forward. A dinner to celebrate the accomplishments of the participants was hosted by the CHRISTUS Senior Leadership Team.
The learnings from the first year of the CHRISTUS Executive Development Program will be applied to enhance the program in 2008. CHRISTUS has already seen benefits from the process that will enhance the leadership competencies for the organization.
Consistent with our core value of excellence, we work continually to improve processes and build best practices, and this program is no different. Although the members of the first Executive Development class volunteered to participate, the second year participants were nominated by our regional CEOs and senior leaders. Our Talent Management committee then reviewed the performance and other assessments of each nominee and selected 16 participants for the 2008 program.
The 2008 Executive Development Program began on Feb 12. The class year was launched with a session highlighting the program’s objectives, an explanation of the coaching process and detailed information about what participants can expect. The agenda included exercises and discussions designed to promote participant relationships and heighten self-awareness.
CHRISTUS Health’s expectations with respect to each participant’s obligations were also covered. The coaches for the program have taken the time to learn about the ministry and the foundational documents that distinguish CHRISTUS as a Catholic health care system. They also have learned of the CHRISTUS Journey to Excellence, as well as the unique operational challenges faced by CHRISTUS executives as leaders serving in a non-profit, Catholic, faith-based organization.
The program coaches have also learned about the initiatives taken to position CHRISTUS positively in the marketplace and the efforts being made to establish CHRISTUS as an “employer of choice.” All of the coaches are former executives or business owners who have had practical “profit and loss” experience. They also have extensive, first-hand experience in working with all aspects of development including the emotional, psychological, physiological and spiritual dimensions of human behavior.
This is the newest program added to the CHRISTUS Associate development portfolio and complements the wide variety of programs already available. Other key programs include:
• CHRISTUS Academy
• CHRISTUS Mentorship Program
• CHRISTUS Center for Management Excellence (CCME)
• Leadership Enrichment
• Online Learning
• Workforce Development
As I have said here before, leadership development is critical for CHRISTUS in order to guarantee that we are “growing future” leaders who can ensure that our ministry is successful into the future. I want to congratulate these leaders and acknowledge them for contribution hard work this past year.
The Associates who participated in the inaugural year-long program recently shared their learnings gained throughout the year and provided valuable feedback to CHRISTUS designed to enhance the program going forward. A dinner to celebrate the accomplishments of the participants was hosted by the CHRISTUS Senior Leadership Team.
The learnings from the first year of the CHRISTUS Executive Development Program will be applied to enhance the program in 2008. CHRISTUS has already seen benefits from the process that will enhance the leadership competencies for the organization.
Consistent with our core value of excellence, we work continually to improve processes and build best practices, and this program is no different. Although the members of the first Executive Development class volunteered to participate, the second year participants were nominated by our regional CEOs and senior leaders. Our Talent Management committee then reviewed the performance and other assessments of each nominee and selected 16 participants for the 2008 program.
The 2008 Executive Development Program began on Feb 12. The class year was launched with a session highlighting the program’s objectives, an explanation of the coaching process and detailed information about what participants can expect. The agenda included exercises and discussions designed to promote participant relationships and heighten self-awareness.
CHRISTUS Health’s expectations with respect to each participant’s obligations were also covered. The coaches for the program have taken the time to learn about the ministry and the foundational documents that distinguish CHRISTUS as a Catholic health care system. They also have learned of the CHRISTUS Journey to Excellence, as well as the unique operational challenges faced by CHRISTUS executives as leaders serving in a non-profit, Catholic, faith-based organization.
The program coaches have also learned about the initiatives taken to position CHRISTUS positively in the marketplace and the efforts being made to establish CHRISTUS as an “employer of choice.” All of the coaches are former executives or business owners who have had practical “profit and loss” experience. They also have extensive, first-hand experience in working with all aspects of development including the emotional, psychological, physiological and spiritual dimensions of human behavior.
This is the newest program added to the CHRISTUS Associate development portfolio and complements the wide variety of programs already available. Other key programs include:
• CHRISTUS Academy
• CHRISTUS Mentorship Program
• CHRISTUS Center for Management Excellence (CCME)
• Leadership Enrichment
• Online Learning
• Workforce Development
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
diverse.
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.
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
diverse.
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.
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.
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!
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!
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