BY: DONNA MEYER, PhD, and RAYMOND WEI
Dr. Meyer is system director, community health services, CHRISTUS Health,
Irving, TX; and Mr. Wei is manager, strategic planning/community benefits, CHRISTUS
Santa Rosa Health Care, San Antonio.
A CHRISTUS Health Study Emphasizes the Importance of Telling Our Stories
to the Public
SUMMARY
In a time of public scrutiny, it is paramount that Catholic health care organizations
examine their commitments to their communities and effectively communicate community
benefit activities to stakeholders—employees, physicians, patients, and
the public.
CHRISTUS Academy, a leadership development program at CHRISTUS Health, Irving,
TX, conducted two studies regarding community benefit. The first researched
community benefit practices at more than 20 highly respected, tax-exempt CHA-
and VHA-member organizations, comparing them with the practices of about 40
publicly traded, for-profit organizations. The primary conclusion was that community
benefit is not just about measuring the numbers—it is also about "telling
the story." Unlike the for-profit organizations, tax-exempt health care
organizations tend to struggle with adequately measuring and reporting their
community contributions.
In a second study, the academy surveyed CHRISTUS Health's employees and
physicians regarding their knowledge of the system's commitment vis-à-vis
identifying and meeting community needs. The vast majority said the system is
important to the community and is actively involved in understanding and meeting
the needs of the community. However, they also ranked the system lower in terms
of working with other community organizations, being a leader in community health,
and being known for sponsoring volunteer activities. These lower rankings indicate
that the community benefit activities are not well publicized or known within
the organization.
Catholic health organizations must take an active approach in communicating
their work to the public, the media, and each other. In doing so, they fulfill
an integral part their mission.
Safe, affordable, and accessible health care for all—especially for those
who are poor or vulnerable—is the hallmark of the Catholic health ministry.
For more than 275 years, the ministry's service, commitment, and motives
were plain for all to see. A Catholic facility not only served the community
but also often stood as a symbol of the community. (Remember when photos of
Catholic hospitals graced the covers of phone books?) However, the health care
environment has changed, becoming increasingly complex and difficult for the
public to understand. Much scrutiny has been placed on the billing and collection
practices, margins, executive compensation, and tax-exempt status of not-for-profit
health care organizations.
Communicate, Communicate, Communicate
In this time of close scrutiny it is paramount that the Catholic health
ministry examine its commitments to its communities and effectively communicate
community benefit activities to stakeholders and to those they serve—employees,
physicians, patients, and the public.
For the Catholic health ministry to thrive in the 21st century, the dictum
of "Do good and maintain a low profile" must evolve to "Do good
and talk about it." Today the public is more informed about its health
and researches its health care options. In most cases, an organization's
website and printed literature do not sufficiently emphasize, or even mention,
what the organization contributes to the community. Health care organizations
today need to present a compelling message about their mission and contributions
to society.
A team sponsored by CHRISTUS Academy, a leadership development program at CHRISTUS
Health, Irving, TX, was asked to evaluate the way the system measures community
benefit activity and recommend changes as needed (see Box).
The team researched community benefit practices at more than 20 highly respected,
tax-exempt CHA and VHA, Inc., facilities and compared them with the practices
of about 40 publicly traded, for-profit organizations. Some of the for-profit
organizations were involved in health care; others were not.
The study was completed this May. One of its primary conclusions is that community
benefit is not just about measuring the numbers—it is also about "telling
the story." Tax-exempt health care organizations tend to struggle with
adequately measuring and reporting their community contributions. In contrast,
most of the 40 for-profit companies surveyed have adopted the concept of "social
accountability." These corporations, through multiple forms of media, make
themselves visible in the community and tell an excellent story about their
community service. They also partner with other organizations to fund community
programs; and they cite, as their contributions, large dollar amounts rather
than a percentage of net revenues. For example, if a billion-dollar company
were to contribute $100,000 to a children's home, that would be significant
for the home and sound wonderful to its community—even though the $100,000
was but a miniscule percentage of the firm's total revenue.
Perception Is Reality
In general, for-profits realize the importance of (and profitability in)
being responsible, corporate citizens. While negative publicity regarding social
responsibility has recently affected public perception of both for-profits and
not-for-profits, most for-profit companies still manage to tell their story
in a positive light. How is this possible? These corporations produce large-scale
campaigns involving television and newspaper ads, billboards, brochures, and
other media to convey tightly focused messages to the public. In doing so, such
companies strengthen the public's perception that they are socially conscious
organizations.
Imagine for a moment that an organization makes a significant contribution
to the community it serves. This organization's work is based on values,
service, and sincere commitment to improving the health and well-being of those
it serves. This organization's "story" features life, death,
hope, healing, and even—and if you look closely enough—some near-miracles.
This is not "perception." It is the truth about one organization's
impact. Collectively, it is the story of Catholic health care and of the communities
served by the ministry. We who are involved in Catholic health care need to
tell such stories about our contributions to building community, addressing
community challenges, and encouraging health and well-being. And we need to
highlight the daily, heroic efforts of our employees.
Where Do We Begin?
Once upon a time, we could let our good deeds speak for themselves. Today,
we must take a proactive approach in communicating our work to the public, the
media, and each other. Our communication vehicles do not need to be glossy or
costly, but they do need to be memorable and consistent in message and method.
We must be master communicators and listeners, engaging in honest, open, ongoing
dialogues that address the topics of quality, customer service, compassion,
mission, and vision. In addition, as a ministry, we must continue to take a
systematic approach in planning, monitoring, reporting, and evaluating the community
benefit activities and services we provide to our communities. Implementing
these steps is not just about generating "good public relations."
It is about fulfilling our mission and communicating honestly, openly, and frequently
with those whom we serve.
Communication Starts at Home
The CHRISTUS Academy team also surveyed CHRISTUS Health's employees
and physicians regarding their knowledge of the system's commitment to
identifying and meeting community needs. Of the 2,719 responses received (a
12 percent response rate), the vast majority said the system is important to
the community and is actively involved in understanding and meeting the needs
of the community. However, those same individuals ranked the system lower in
terms of working with other community organizations, being a leader in community
health, and being known for sponsoring volunteer activities. These lower rankings
indicate that the community benefit activities are not well publicized or known
within the organization.
When the responses were further broken down according to job category, they
revealed an interesting but logical disparity—that senior managers were
the best-informed of survey participants, followed by managers, and then staff
members and physicians. One staff member commented that "very little information
about community programs is consistently shared."
The study's key lesson was that everyone in our organizations needs to
know and be able to tell our stories. Physicians and staff are the best ambassadors
of our message, given their frequent contact with the public. But they cannot
be good ambassadors unless they are aware of all the positive work being done
by the ministry.
And Continues Outside the Walls
"Advancing the State of the Art in Community Benefit" (ASACB)
is a project sponsored by the Public Health Institute, an Oakland, CA-based,
not-for-profit public health organization and six health care providers in four
Western states. The project is intended to develop and implement a national
model for community benefit programming. With this model, the project's
sponsors hope to increase effectiveness and sustainability, ensure access for
diverse communities, facilitate institution-wide alignment and accountability,
and deepen hospital engagement in local communities.
The ASACB project recommends that institutional policy measures be put in place
to transform community benefit into a core function of the organization. Two
of ASACB's institutional policy measures are meant to ensure that the community
benefits message gets out:
- Developing formal mechanisms to inform and encourage involvement of key
leaders and employees
- Soliciting input from and disseminating community benefit information to
diverse community stakeholders
Sr. Carol Keehan, DC, chairperson of CHA's Board of Trustees, recently urged
the Catholic health ministry to "lift up your voice."1
By doing so, we establish credibility; deliver fairly on our commitment to communicate
with those whom we serve; and, most importantly, become role models for truth
telling. Today it is not enough to simply sing our own song as a solo—what
we need now is an entire chorus singing our stories in harmony.
NOTE
- Jeff Tieman, "Sister
Carol Urges Ministry to 'Lift Up Your Voice,'" Catholic
Health World, March 1, 2005, pp. 1, 6.
How to Communicate Effectively with Our Publics
In 2003, a work group convened by CHA and involving many different systems
and people developed Telling Our Story: A Communications Plan for Community
Benefit Reporting. The following are recommendations to organizations seeking
to improve their communication with the public.
- Utilize established CHA/VHA, Inc., community benefit guidelines when determining
community benefit contributions and report actual costs of services provided.
A copy of the guidelines, Community Benefit Reporting: Guidelines and Standard
Definitions for the Community Benefit Inventory for Social Accountability,
can be accessed at www.chausa.org/sab/commbenguidelines.pdf.
- Remember that the reporting process should not be considered an end in and
of itself. It should be used as a continuous improvement tool (as a self-evaluation
tool) to drive performance and track data as well as give the public a picture
of your commitment.
- Ensure that reports have as much intellectual rigor as possible. When quantitative
data can be applied, talk about outcomes measures. However, realize that quantitative
data is not always applicable to social services. A case study or brief description
of an activity, accompanied by pictures of smiling people, is valid and useful
as an illustration. But, without analysis, reliable conclusions cannot be
drawn. This does not mean reports need to be overly academic, but they should
have a professional approach.
- Provide concrete data about dollars contributed, the number of individuals
helped, and outcomes achieved. Ensure that programs are focused on the health
priorities of the community.
- Share your "best practices" with other community organizations.
- Put a human face on your communications—incorporate the stories of
individuals who were helped through one or more of your programs.
- Be sincere and consistent. This is not advertising. Our facilities should
not support worthwhile causes solely for promotional reasons. Activities should
be related to or congruent with our core health care ministry.
- Explain the breadth of community benefits provided by your facility or system.
Mention charity care, educational programs, and clinical and community services.
Include unreimbursed costs and remember that, even if in cases where there
are no unreimbursed costs, some services—simply because they exist—serve
as a benefit to the community.
- Recognize your community partners. Collaboration helps ensure effective
use of limited resources. Recognizing partners reinforces the perception that
the hospital is an integral part of the community.
- Develop a plan that outlines tactics for ongoing communications with your
employees and the public about community benefit activities. Identify the
communication vehicles available for reaching these groups (newsletters, staff
and community meetings, the Internet, your own intranet, health programs and
events, and others).
A variety of tools are available to help you in your communications efforts.
These include:
- A CHA Community Benefit website, which can be found at www.chausa.org/sab/sab.asp.
Available to all who want to share resources and ideas, the site includes
a communications toolkit containing the Communications Plan for Community
Benefit Reporting, the VHA Guide for Communicating Value, and examples
of reports from several Catholic systems.
- Public Perception Project materials, which can be found at 63.151.17.224/CHA_FTS/psi.
- The ASACB's own guide, Advancing the State of the Art in Community
Benefit: A User's Guide to Excellence and Accountability (Public
Health Institute, Oakland, CA, November 2004), which can be accessed at www.phi.org/pdf-library/ASACB.pdf.
The CHRISTUS Academy
CHRISTUS Academy is a yearlong leadership development program sponsored by
CHRISTUS Health. The academy's objectives are to:
- Reflect on and discuss the future of Catholic health care and the role of
spirituality in the delivery of services
- Complete a leadership curriculum that includes courses on finance, governance,
strategic planning and business practices, decision making, organizational
relationships, and future trends and issues in health care
- Work in small teams to address systemwide challenges that fall outside team
members' own work experiences and responsibilities
One of the four projects assigned to the 2004-2005 class was titled "Establishing
System Indicators and Appropriate Levels for Community Benefit." The team
was asked to evaluate the effectiveness of the current system indicator for
measuring the benefit that CHRISTUS Health provides to its communities, as well
as the amount of benefit provided, and to recommend new levels and indicators
that may be more appropriate and provide a better measure of the value of CHRISTUS
Health's contribution to "improving the health of local and global
communities." The team members are Novella Medlock, Sr. Rosanne Popp, CCVI,
Rebecca Simon, Louise Thornell, Raymond Wei, and Melissa Williams.