CIM Client Showcase

A Chat with Daniel Dwyer, senior vice president of mission integration, Trinity Health

What are some of the most profound implications of health care reform for Catholic healthcare institutions?

Well, first the good news, and there is a lot to be positive about. A number of people who have not been covered and did not have the best form of access to care will have it and have better care than in the past. We always took care of them, but they would show up in the ER with congestive heart failure or another chronic illness that should have been treated much earlier. Now, a good 20 million people will have access to primary healthcare. Women will have opportunities to avail themselves to more prenatal care and other preventive measures that have been sorely lacking. 

There are going to be some real challenges in handling the demand, though, because there is such a shortage of primary care providers in many communities. As an industry, we’re just not prepared to do preventive care. We’re really good at acute care. Now, we need to better grab hold of how to keep them well instead of just caring from them when they are sick. In many ways, this gets to the root, the notion, of holistic care. Trinity has been working on this for a number of years. 

In fact, a stimulus for engaging in the relationship with the Veritas Institute evolved from  a thoughtful assessment of the implications of health care reform for Catholic health. Before the law passed, we had six work groups that were analyzing and anticipating the implications of the law. One of those work groups was the Catholic Identity workgroup – we looked at the legislation and wanted to expand what we meant by the principles of Catholic health care, and determine how to maturely work and communicate with our bishops. We also took a look at financial implications and clinically integrated systems as a whole - all of the nuts and bolts issues that would become a reality. We identified what those implications were, and we adjusted our strategic plan for the organization with new priorities, with an eye toward how to go deeper into the world with non-Catholic providers and partners. We asked ourselves:  how do you engage and truly make an impact?

How has Trinity Health committed itself to the integration of mission in all its activities, decisions and strategies?

We are conscious about doing mission discernments about all significant decisions  and changes in strategic direction, on a local level and across the system. Through mission discernments and ethics due diligence, we are constantly asking what are the implications to our identity as a Catholic ministry, and how are those implications impacting our key stakeholders? We use the mission statement as the ground from which 25 or so questions are asked about the different components of the matter at hand and how it reflects our mission. That process has been in place for a great while. All mission leaders are part of a senior leadership team, and at the point where decisions are considered, we have a seat at the table and are part of the discussion. Do we need to do a discernment? I would say that is a part of the fabric – really the gold thread - of the Trinity culture.

How does the Catholic Identity Matrix (CIM) play into this integration?

What we’ve learned from our first five engagements is that there are numerous opportunities to broaden and deepen our identity as Catholics. In each assessment at every ministry location, we can see opportunities for improvement (OFIs). We have established follow-up activities that are substantive initiatives – that will have a material impact and truly change how we see ourselves. It’s been very enlightening. The different ministries are getting to pick up on some patterns across the ministries. For instance, our metrics are very weak in many of the key elements, so there is a general sense of needing to determine how we can measure across the ministries. While we have a lot of qualitative impressions about impact, we see that we need a much greater impact in a quantitative way as we go forward in the process. 

How have the CIM assessments served as a conversation starter with the bishops?

The bishops that are in the places where we have done this are delighted that we are doing these types of assessments and having these conversations. When we were talking with the Davenport bishop (our first engagement was in Clinton, IA), the editor of the Diocesan newspaper came in to learn more about the CIM and our process in the ministries. Likewise, the bishop in Columbus, OH, was pleased on a number of different levels – from his confidence about an organization that he is very impressed with [University of St. Thomas] and has experience with [as he served as a rector at UST]. Across the board - Boise, Idaho and eastern Oregon - they are all very happy to hear about an effort that we are really serious about: being Catholic and living out what that means. What will be interesting is this year we will be working hard to distinguish metrics for "act in communication with the church," and I’m looking forward to sharing with the bishops and seeing what they think about our effort.

There is a unique relationship between the areas of corporate ethics and Catholic identity.  What is your distinctive take on corporate responsibility within a corporation such as Trinity Health?

We put the sign on the wall, the ‘shingle out’ so to speak, and we say that we are serving together in the spirit of the Gospel. When you say we are the healing ministry of Jesus you have declared that you must attain that aspiration to the extent that you are serving all people. Pretty high standard. So Catholic social thought is really taking the Gospels and operationalizing them. The principle of “participatory workplace” – you can draw a direct line to the Sermon on the Mount, Beatitudes, and what that means about being a leader, manifestable teachers. How do you justify yourself? How do you provide evidence that shows you are living your mission? When you are depending completely on external funding and that funding source declines, you have to deal with expenses in a new way. People’s jobs have to be eliminated and decisions are made with a different lens, all of which can look like we are just a business making money. So that principle of stewardship becomes paramount. How do we balance stewardship issues with a perception that we aren’t ever going to lose our Catholic identity? 

Business vs. mission – I don’t think there is an equation per se. Our business practices have to reflect the mission and when they don’t, people have a right to ask what is going on. As a $9 B business, you can’t sustain without pretty solid business principles, so how do you conduct business in a spiritually grounded way? The CIM is a wonderful way to give experience and grounding, practically eliminating the dichotomy between mission and business. Sr. Mary Roch Rocklage (former CEO Of Sisters of Mercy) used to say if Catherine McCauley of the Sisters of Mercy had a nickel, she’d rub the buffalo off of it. Some of the most hard-nosed business people I have met have been the Sisters. Before Medicare and Medicaid, the Sisters would say they did whatever needed to be done. They didn’t walk away from obstacles. It was a manifestation of their call, their vocation. They would close hospitals if needed and start them in places where they were needed. 

How does an organization truly breathe life into its guiding principles?  How does assessment play a role in this process?

We need to do formation. We need to have our leaders participate in formation that is deep and extensive enough to understand what it means to be a leader of a Catholic ministry and a non-profit health care organization. Leaders need to be invited to explore their own spirituality and harness the core source of purpose and meaning that is within all of us. The CIM gives us a way to evaluate our formation program. How good is it? We can use the CIM to serve as a baseline assessment of early formation. In many of our institutions, only a very few have had formation.  Years from now, if a CIM is done and it shows significant opportunities for improvement, then you may have identified a flaw in the formation program. This type of formation evaluation is pivotal. All organizations have an identity - whether it’s Catholic or not. We will see whether formation makes a difference. Enron had an identity. What the CIM does is to put a mirror in front of us and see who we are and where we need to grow.