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By KATHLEEN NELSON

"If anyone wishes to be first, he shall be the last of all and the servant of all."

— Mark 9:35

Mercy Health System of Southeastern Pennsylvania has gone old school in training its leadership for the future. It has created a program for managers based on the concept of servant leadership that has surprised its creators in its level of acceptance.

This spring, 415 staff members at the supervisor, manager, director or executive level were invited to participate in the voluntary training program. Through September, 93 percent had attended at least part of the program and 152 had earned servant leadership certification.

"I am overjoyed," said Susan Croushore, president and chief executive of the system based in Conshohocken, Penn., in suburban Philadelphia. "In my mind, I thought maybe 10 to 20 percent would sign on to this, that it might take a few years for leadership and culture change. I really didn't expect this."

Though references to leaders as servants go back to the Bible, the concept as applied to business leadership crystalized in the writings of Robert Greenleaf, who published his essay "The Servant Leader" in 1970. Central to Greenleaf's message in the essay is the leader's effect on those he or she leads: "The best test, and difficult to administer, is: Do those served grow as persons? Do they, while being served, become healthier, wiser, freer, more autonomous, more likely themselves to become servants?"

He also founded The Greenleaf Center, which offers training through online programs, speeches, conferences, consultations and seminars and has published dozens of books and study guides. Jeff Miller, a faculty member at Greenleaf, said servant leadership is particularly well-suited for health care.

"Servant in no way means subservient, but it appeals to people who have a heart for service and a head for results," Miller said. "I think that's what you're after in a health care setting."

Shifting gears
Croushore became familiar with Greenleaf's theories in the 1980s, when the essay "enlightened me to a whole new level of leadership. Before, my experience was rooted in paternalistic, top-down decision making, and I was somewhat uncomfortable with that. This spoke to my values, and I tried to use the principles in the positions that I've had."

Croushore took over as chief executive of Mercy in October 2013. Mercy Health System is a part of Trinity Health and includes four acute care hospitals, a home health care organization and a Program of All-inclusive Care for the Elderly. It co-owns a managed care plan.

"Servant leadership is an old topic, but when I came to Mercy, I was struck by our commitment to mission, and that's really what servant leadership is all about," she said.

The topic also came up in the interview process for Janel Field, who was hired as Mercy's performance management consultant in November 2014. Like Croushore, Field had completed servant leadership training before joining Mercy, and she developed a program tailored to Mercy shortly after being hired. Central to Mercy's customized program is Seven Pillars of Servant Leadership by James W. Sipe and Don M. Frick, Greenleaf's biographer. According to the authors, a servant leader is a person of character, who puts people first; and a skilled communicator, who is a compassionate collaborator. The servant leader has foresight, leads with moral authority and is a systems thinker who is comfortable with complexity.

Mission alignment
Servant leadership training at Mercy consists of a two-hour introductory class, eight hours of online course work and about 15 hours of exercises, some of which is from Seven Pillars, which participants can do on their own or in groups. Mercy allows the participants to complete all the training as part of their regularly-scheduled work day.

Field said she isn't surprised managers have embraced the program so enthusiastically.

At a summer ceremony at Mercy Fitzgerald Hospital in Darby, Pa., Susan Croushore, president and chief executive of Mercy Health System of Southeastern Pennsylvania, presents the servant leadership certificate to Kathy Conallen, right, chief executive of Mercy’s acute care operations.

"The philosophy of servant leadership is very well-aligned at Mercy and at Trinity Health," Field said. "So I don't want to say it was an easy sell or a no-brainer, but it fit in so well to our mission, vision and values."

Perhaps most important, graduates apply the concepts in their daily lives.

"I think that some of the principles — being a person of character, doing what you say you'll do, being honest, following up — are things I try to do every day," Field said.

In the cards
Dr. Theodore Katz, medical director of the central appeals unit for support services at Mercy Health System, relies daily on a deck of cards he received in training. Each card has a characteristic of a servant leader on one side and the actions one can take to demonstrate the characteristic on the other side.

"I keep them on my desk to remind myself from time to time what I want to focus on," he said. "Surgeons in general tend to be egotistical, but I know I don't know it all."

Katz spent 10 years as a trauma surgeon in the army and commanded a combat support hospital as a member of the Army National Guard.

"Without really calling it servant leadership, the military is a form of it," he said. "The thing I got out of the pillars was condensing it and putting it all together. Each step of my career has built up my character and leadership. At Mercy, it's all coming together."

Trickle down benefits
Tahara Johnson, health information management supervisor for Mercy Philadelphia, recently joined the ranks of supervisors and jumped at the chance for the training, not realizing how soon she'd apply the principles. Shortly after earning certification, a member of her five-person staff didn't make it to work on a weekend, which Johnson didn't discover until Monday.

"So my Monday person was totally swamped," she said. "I could tell she was unsure what to do. So I put my bags down and jumped right in to show her the teamwork aspect that I'd been trying to teach them, to become the compassionate collaborator, to take some of that work off her plate."

The rest of the staff followed Johnson's lead, so the next day, Johnson brought in doughnuts to show her appreciation. A member of her team approached her later, she said, "to say thank you because they were not used to that kind of leadership.

"The attitude of the servant reflects the leadership here. I believe this program is really going to have a great effect on the health system. As our leaders become more compassionate and people of character, the goals that we're reaching for will trickle down to all the employees as well and make us better for it."