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SARAH REDDIN, D.HCML
Vice President, Ministry Formation–Mission Integration, Ascension

Health care's internal pressures and external headwinds are numerous and complex. Certainly, patient care remains at the core, but in various roles leaders and team members must consider factors as broad as employee engagement and retention, health equity, pandemic trauma and fatigue, and much more.

In addition, Catholic health care specifically is experiencing affronts to identity, the very core of our ministry. Where will our ministries find the resources necessary to carry out a preferential option for those experiencing poverty? How do we reconcile the disconnect that some employees feel between their sense of purpose and the challenges we face to live the ministry's mission, vision and values? What legislation can we rely on to navigate governmental reimbursement models, and what supports can we turn to in order to resist systemic pressures on Catholic health care's principles and commitments? How do we live our Catholic identity amidst today's changing needs? And, even more, what does it mean to be Catholic health care?

Our mission-inspired communities of health care professionals can find answers through communal reflection on the links among personal, professional and organizational identities, and the ways they intersect and support each other. This is the essence of ministry formation. Through the discipline of formation, health ministries can ensure human flourishing and the integrity of ministry identity in consistent and inclusive ways.

UNDERSTANDING OF SELF AND MINISTRY'S IDENTITY
In many Catholic health systems, the work of ministry formation is most clearly identified through its leadership programs. At Ascension, these include the ministry-wide 18-month Executive Ministry Leadership and 12-month Foundations of Ministry Leadership programs, undertakings that have been going strong since 2004 and 2009. At Bon Secours Mercy Health, leaders are provided ministry formation through its Stories of Grace program. And Intermountain Healthcare provides Living Our Values Everyday for managers and direct caregivers.

While these are just some examples of formation programs, there are also innovations occurring in CHRISTUS Health's Core Focus program and Ascension's newest cohort-based Roots of Ministry Leadership program. Introduced in 2021, Roots — as it is informally known across the system — provides a series of six local retreats that teach and explore the principles of Catholic ministry identity in a case study format via hybrid delivery, alternating in-person and live virtual retreats. The retreats provide supervisors, managers and directors the opportunity to develop distinctive ministry competencies in an applied setting.

Formation experiences are provided in other ways, including organizational spirituality initiatives (for example, prayer and reflection practices, employee spiritual well-being resources, annual feast day celebrations and resources for organizational milestones and transitions), team-based sessions on various themes (for example, theological virtues and writings from the foundresses) and small-group departmental integrations that bring formation into teams' daily operations. This combination of programs provides the organization with multiple pathways to advance human flourishing and sustain the ministry's identity with integrity.

To embody Catholic health care in our work requires a strong understanding of self, the ministry and the organization. This awareness is nurtured by tradition, faith, sacramentality and a sense of community; it also means responding to evolving needs. Catholic health care's self-identity is curated by exploring — through methods that source shared values, beliefs and connections — Jesus' healing ministry, the stories of the religious founders and coworkers' present-day narratives. Through the practice of self-understanding and the rigorous cultivation of our strengths, wisdom and innovation facilitated by ministry formation, Catholic health care can find the answers needed to address today's challenges.

THE IMPACT OF FORMATION
Why is formation essential to Catholic health care? What is the organizational impact? Recent results from Ascension's formation programs highlight some of the reasons:

• Formation is a retention strategy. Research on Ascension's Foundations of Ministry Leadership program reveals that participants are 10.5 times more likely to stay with the organization for at least two years than those who did not participate.
• Formation is a well-being strategy. Participants in the Cultivating Reverence for Living program, provided virtually through sequential modules, reported a 15% reduction in perceived stress over the six-week engagement.
• Formation is an employee engagement strategy. Employees describe formation's small-group model as a way to find meaning in their work. One participant described it as fulfilling "my need to be grounded back into why I chose this [work] … an amazing refresher, inspirational and rewarding. "

Without formation, the nurturing of connection to one's purpose and community is left unattended. Thus, the real "why " of formation can be best understood as a demonstration of the Catholic health ministry's anthropological and theological foundation, rooted in the image of God, or the imago Dei. It is from this belief that a deep reverence for all human persons to be seen in the fullness of who they are — deserving of respect, dignity, justice and belonging — flows. Thus, formation's core outcome is articulated: Who one is shows up in what they do, and what they do influences who they are. With the same holding true for teams, groups and ministries as a whole, the distinctive contributions of formation toward growing a culture of ministry are revealed.

MEASURING SUCCESS
Methods for assessing formation's impact are an essential component to ensure a thorough portfolio of resources for all health care professionals and partners. To determine formation's personal impact on participants, the use of a net promoter score survey question — commonly used throughout health care and other settings to determine customer satisfaction and loyalty — offers a valid and defined method. For example, when applied to a formation program, feedback on the survey question "How likely are you to recommend this offering to a colleague? " provides insight into the offering's facilitation, content and overall participant experience.

Recently, Ascension's formation team pushed deeper to measure the effectiveness of its efforts and developed a set of personal impact survey questions. Participants respond to a set of 12 statements and prompts, such as "Because of this formation experience, I have a better understanding of Ascension as a ministry. " The use of a common participant survey across a variety of programs, modules, materials and experiences provides a consistent data set essential to report the formation offering's ongoing impact, its planning and its collaborative design.

EXPANDING FORMATION'S REACH
The ministry's commitment to human dignity and maintaining the integrity of its identity brings to light the questions of where, how, by and for whom should formation be provided. Increasingly, Ascension's formation programs have opened new pathways to integrate this discipline.

As one example, as a component of Ascension's well-being strategies for nurses, formation modules and materials help to nourish spirituality and belonging and move participants beyond resilience to flourishing. Other departments and teams across Ascension engage in annual formation as part of their learning plans through offerings themed around vocation, community and ministry. Additionally, our boards, executive teams and sponsors are active participants in quarterly formation sessions centered on our values, theological virtues and principles of Catholic social teaching. Diversity and inclusion are an important part of this work. Ascension's mission and ministry councils provide annual celebrations and rituals, cultural events, volunteer opportunities and well-being sessions for employees in our hospital, clinical and administrative sites. Weekly prayer and meditation groups meet in-person and online to explore faith and spirituality in communal settings. Furthermore, spiritual direction sessions are offered for free to any Ascension employee as part of the ministry's support for their holistic health.

These integrations can serve as a leading approach for mission integration to pave new trajectories for formation curricula, resources and services to be experienced in more equitable ways than ever before, resulting in expanded access for associates.

Formation is a core obligation to our sponsors as an essential, ongoing mechanism for nurturing and growing the integrity of ministry identity. Human beings are constantly in the process of being formed. Through engagement with the Divine, our personal sense of self and our experiences — including those we encounter at an individual, organizational and ministerial level — shape who we are becoming. Specifically in health systems with staff from increasingly diverse backgrounds, formation is critical to shaping the health ministry's self-understanding. By meeting participants where they are on their continuous path of formation, leaders and facilitators can — if for a few minutes, months or years — create opportunities for reflection on identity in community over time that strengthen the ministry itself.

CONCLUSION
Everyone in Catholic health care can play a part in formation. Leaders of formation programs can advance the conversation by participating in CHA's virtual gatherings to learn, build community and share best practices. Mission integration leaders with some or no formal formation responsibilities can commit to bringing reflection on identity into collaborations with colleagues across the ministry. Clinical, operational or administrative leaders can understand formation's significant contributions to employee engagement, well-being and retention and partner with mission integration colleagues to open avenues to formation opportunities.

Through formation, individuals, teams and communities encounter their own and others' humanity shaped and held by the ministry's Catholic identity. These encounters nourish the seeds of identity that can provide solutions to the challenges Catholic health care faces today and tomorrow. Investing in ministry formation is living our Catholic identity. The ministry's future depends on it.

SARAH REDDIN serves as vice president of ministry formation–mission integration at Ascension. Reddin and her team are committed to delivering increasingly equitable access to formation programs, resources and services for the health system's associates and affiliated partners. She also is a member of CHA's 2022 class of Tomorrow's Leaders.

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