REVIEWED BY MATTHEW THIBEAU
John R. Griffith and Kenneth R. White, with Patricia A. Cahill
Health Administration Press, Chicago, 2003, 266 pp., $56.70 (paperback)
Although Thinking Forward: Six Strategies for Highly Successful Organizations
is the story of one Catholic health care system, the lessons to be learned from
it are transferable beyond health care management. The authors, John R. Griffith
and Kenneth R. White, PhD, have, in selecting Catholic Health Initiatives (CHI),
Denver, as their subject, chosen an award-winning system with an impressive
record of success. "Thinking forward" is the phrase that Patricia
Cahill, CHI's former president and CEO, used to describe how the CHI associates
approach their work. It is a process that constantly seeks to improve professional
services delivered and personal growth.
Griffith and White choose an engaging format for presenting their findings.
It is a combination of background information, data, and interviews with CHI
associates, who bring the healing ministry of Jesus to those they serve. This
ministry business model identifies CHI's role as advancing the mission,
vision, and values of CHI as a national Catholic health ministry.
In their analysis of CHI's processes, the authors have focused on six
critical areas of operations:
- Governance
- Service lines
- Complex case management
- Prevention
- Support services
- Service excellence
It is interesting to note that many of those areas also have been the focus
of CHA's Envisioning a Future Health Care Delivery System task force.
CHI was formed in 1996 by 10 Catholic congregations of women religious, through
the merging of three existing health care systems. Expanding in 1997, CHI now
operates in 64 communities in 19 states, with 66,000 associates. The 64 communities
are organized into 47 "market-based organizations" (MBOs). The national
organization relates directly to the MBOs. CHI's operating model involves
five elements: commitment, accountability, support, stewardship, and value (p.
5). The CHI model is an empowerment model and a learning model. Its culture
is maintained by five foundational elements:
- Commitment to core values
- Measurement and goal setting
- Strategic and financial planning activities
- Centralized services and resources
- Rewards management
The consistent application of these elements encourages managers and associates
to strive for continuous improvement.
The authors go to great lengths to detail how CHI has embedded within the system
effective use of what the system calls a "balanced scorecard." The
balanced scorecard is a conceptual framework for translating an organization's
vision into a set of performance indicators, which are distributed among four
perspectives: financial, customer, internal business processes, and learning
and growth. Some indicators are maintained to measure an organization's
progress toward achieving its vision; other indicators are maintained to measure
the long-term drivers of success. Through the balanced scorecard, an organization
monitors its current performance (finances, customer satisfaction, and business
process results) and its efforts to improve processes, motivate and educate
employees, and enhance information systems — its ability to learn and improve.
"We believe CHI has built a model that has the power to transform 21st-century
healthcare and promote healthy communities," the authors write. "CHI's
model is not unique, but we believe it is effective. The strength of the model
is its ability to identify and build an environment that is attractive to both
customers and provider stakeholders. Communities that adopt the model will find
they have a vehicle to find solutions to the problems of healthcare that other
approaches cannot" (p. 237).
CHI was founded "to nurture the healing ministry of the Church by bringing
it new life, energy, and vitality in the twenty-first century . . . by transforming
traditional health care delivery and creating new ministries that promote healthy
communities" (p. 3). In highlighting CHI in this book, Griffith and White
have given health care in general and Catholic health care in particular a road
map for excellence.
Matthew Thibeau
Senior Vice President
Strategy and Organizational Effectiveness
Catholic Health Association
St. Louis