Mr. Erickson is director, Pastoral Care, St. Mary's Health Center, and Ms. Purcell is an organizational consultant and principal, the Purcell Group,St. Louis. Both are certified Catholic chaplains.
The very foundation of healthcare delivery as we know it is shaky. Amid this turmoil, healthcare providers are being required to reexamine their values and their beliefs about who holds power and what constitutes high-quality care. In addition, they also are being called on to reshape the delivery of care.
To do this, we must view healthcare delivery as a system, not separate, unrelated tasks and forces. The days are waning when the value of specialization outweighs the need to capitalize on every bit of talent available. Organizations that are not actively harnessing all their resources have about as much chance of survival as the proverbial sprinter who specializes in the 95-yard dash.
A Change of Heart
Survival requires more than new processes, alliances, or ways of paying for services. New structures also require a conscious revision in what we believe about healthcare and the way we live out that belief.
Change requires conversion — a change of heart about what gives meaning to our endeavors and the subsequent energy evoked from that kind of commitment. An organization that truly transforms its culture does not conveniently change when external pressures are high, only to return to the old way of thinking when pressures subside. Conversion requires the fuel that powered the founders of many healthcare organizations in this nation, the fuel that keeps physicians and nurses at the bedside far beyond what duty requires. Such a conversion must be a part of any course of change we choose, or we face a fuel shortage that will severely limit our future.
Who among us is knowledgeable about conversion and about this shifting of conscious and unconscious values and notions of power? Who among us has the expertise and experience to help address those areas which will give "soul" to individual and corporate commitments and actions?
Needed: Persons with Soft Skills
Within our healthcare institutions are departments and persons with "soft skills." Employees with such skills are professional change agents who, although overlooked to this point, can assist in the essential and sensitive work of ongoing conversion and the facilitation of meaningful interaction between people.Chaplains, social workers, and counselors are professionally prepared in the business of transformation. They have developed skills to deal with the ambiguity and tension inherent in coping with life events. Working with other care givers, those who have soft skills facilitate healthy resolution of the thorny day-to-day dilemmas that people encounter. Persons with soft skills can also spur growth toward new life in a number of health-related arenas.
Daily, these professionals meet people who face life's challenges — from life-style change to the loss of a loved one to the learning of new life skills. Helping someone in these situations requires far more than an information exchange. Successfully coping with change rests on an intentional and internal refocusing of power and values perceptions. The skills used on the nursing ward or in the counseling room are readily translated into the very commodity often avoided by those trained in schools of medicine or management sciences. That avoided commodity is conversion of heart about the why and the how of our work. That conversion is and will continue to be fuel that powers lasting transformation in individuals and organizations.
Conversion at the Micro and Macro Levels
On a micro level, for example, a nursing vice president might recommend that the head nurse of a volatile unit talk with someone in pastoral care about the poor communication within her unit. This conversation could encompass not only the head nurse's abiding feelings of failure around her inability to communicate with staff and administrators, but also the question of her basic worth as a person. By appreciating each person's experience and by listening, attending, and documenting, a chaplain might be able to draw all parties — administrators, managers, staff, and surgeons — together. Then, with guidance, these persons might be able to acknowledge, as a group, the tense climate of the unit and work together to develop solutions to transform the unit.
When institutional change occurs on a broader scale, such as downsizing or a shift to patient-focused care, institutional conversion is necessary. Care for the human element might be integrated into the stream of complex process revisions by a team of soft-skills specialists, advising and supporting leaders. Energy could be focused on conversion opportunities as change is rolled out. For example, one institution established the Care of People Subcommittee (COPS), which sensitized planning groups to the emotional impact of change strategies. To intentionally focus on the "people" issues, COPS also planned and facilitated portions of meetings at which changes were introduced.
Attending to people's needs is far more humane and effective than any remedial attempts (e.g., increased disciplinary measures) to deal with passive aggression and resistance to change. Organizational changes could also provide a unique opportunity to equip many individuals across disciplinary lines with their own set of soft skills, which will make conversions prompted by future waves of change progressively more profitable.
Much Work to Be Done
Why is it, then, that healthcare organizations (and others) have not realized that a number of persons in their ranks have a significant contribution to make? How have we missed individuals and departments whose participation in these processes could hold one of the keys to re-creation in this crisis rather than mere survival?
The answer is simple: This attitude is no different from any other that shackles us to our past. It's the soft-skills myth that the "touchy-feely" crowd has no place in the tough task of survival in the business world. And many soft-skills folks have not recognized their own value to business.
Administrators, as well as chaplains, social workers, and counselors, have a lot of work to do. They must:
- Demonstrate how soft skills can help heal co-workers and the organization experiencing transformation
- Use segments of organizations in ways heretofore overlooked
- Capitalize on all available resources, regardless of the traditional parameters within which we have always functioned
Who needs conversion? We all do.