Securing God's position in hospital hierarchy Mission: Perceiving health care as a ministry, chief mission officers perform a variety of important tasks at Catholic hospitals.

March 27, 1997|By M. William Salganik | M. William Salganik,SUN STAFF

Hospitals have chief executive officers and chief financial officers. Some have chief operating officers and chief information officers.

Roman Catholic hospitals also have chief mission officers.

"We all have different titles, but we have similar roles in all the Catholic hospitals in Maryland," said Sister Patricia Smith, R.S.M., assistant to the president for theology, mission and ethics at Mercy Medical Center in downtown Baltimore.

"The role really evolved as the number of sisters who were staffing and managing health care diminished. Someone needed to be in charge of keeping an eye on the mission of the order."

The growth of hospital mission directors "does coincide with the decrease of religious women, but also with the increase of health care as a business," she said.

"We want to be sure to call up the primary reason for being in this work," said Dr. Ann Neale, senior associate in the mission services department of the Catholic Health Association, a national organization based in St. Louis. She said virtually all of the 600 Catholic hospitals in the country have someone in charge of mission.

They run programs for the poor. They consult on medical ethics, in some cases even doing "ethics rounds," like medical rounds, to see that all patients have been considered. But their work extends to participating as a member of senior management in all decisions: opening or closing a medical program, hiring a top administrator, launching a joint venture.

"God is present not just in the holy stuff, but in the board room," Smith said.

"We see health care as a ministry, not as a business or an industry," said Sister Ellen Eisenberger, D.C., vice president for mission services at St. Agnes Hospital in Southwest Baltimore.

"Our health services are framed by our mission, and our mission is framed by the Gospel."

Which isn't to say the mission directors can ignore business reality; they say they realize that their institutions have to remain solvent.

"The CFO and I wouldn't disagree about the need to reduce personnel costs," said Brother Arthur R. Caliman, C.F.X., vice president, mission and foundation at Bon Secours Hospital. But the mission director would try to make sure downsizing is done in a way that's fair to employees -- even if the layoff had to be slightly larger to make sure savings targets are met while workers received adequate severance and out-placement help.

"The results may be the same, but the process is different," said Sister Rose McCully, C.S.C., vice president of mission services at Holy Cross Hospital in Silver Spring.

"We have a lot of pressures today, and a lot of decisions that have huge business implications. There's a continuum from surviving to thriving," Smith said. "Our role is to keep asking: 'Are these business decisions best in terms of our mission?' "

For example, Caliman said, when the hospital is hiring a top administrator, "My slant on an interview is slightly different; it's motivational and value-driven. I ask questions like, 'Are you comfortable leading a public prayer?' The point of the question is: Are they a religiously motivated person?"

"In its most limited sense, it can be seen as policing -- the person at the table who sticks their hand in the air and says, 'Is this fair?' " said Jane Durney Crowley, CEO of Bon Secours Baltimore Health Corporation.

But in "mature" organizations, she said, the relationship is not adversarial. "When the finance guy asks the mission questions, and the mission guy asks the finance questions, that's when you know you've gotten there," Crowley said.

"That's not to say debates haven't occurred within our organization, but they tend not to be polarized."

Maryland mission directors said they had been trained and had worked in philosophy, theology and education, but not health. The Catholic Health Association offers some training, conferences and guidebooks. Many of the hospitals are part of larger networks, which themselves have mission directors to work with those at each hospital.

"Our corporation does mission evaluation," McCully said. "We get an outside visit from the corporate office to see what is to celebrate and ways to live the mission more fully."

Locally, the mission directors also depend on each other for help, getting together once every few months and phoning each other in between.

The agenda for their most meeting last week, at the Center for Health Enhancement of St. Joseph Medical Center -- a holistic health facility started under the leadership of Sister Anne Patrice Hefner, O.S.F., vice president for mission and ministry at St. Joseph -- shows the type of problems that concern them.

Eisenberger, who is just starting a "parish nurse" program at St. Agnes, wanted to know how the other hospitals organized their programs. Was there a full-time coordinator? Were the nurses paid or volunteers? She jotted down the phone numbers of coordinators from the other hospitals.

Caliman wanted to know how his colleagues tracked how many orders not to resuscitate dying patients had been written, and whether the number was appropriate. He showed a graph tracking trends at Bon Secours. McCully told him of a pilot study done in the Holy Cross intensive care unit.

Hefner said she had formed a committee to track state legislation, and wanted to know whether other hospitals testified on legislation with implications for health and ethics.

Smith reported on a mission statement and code of ethics she had been working on.

The mission directors said they had never come across anyone with a similar job at other Maryland hospitals. "But we need to be very modest and not pretend we have a corner on the market of good health care or compassion," Smith said. "What we have is a clear platform to speak our values out loud."

Pub Date: 3/27/97

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