Leadership Academy_C5 RES V_JAN 23-24, 2024_Participant Guide

Leadership Academy Participant Guide

COMMUNITY 5 | RESIDENTIAL V January 23 - 24, 2024

ASCENSION LEADERSHIP ACADEMY Participant Guide Community 5 | Residential V January 23 - 24, 2024

The following guide represents a summary of key ideas. Additional concepts may be presented. Presentations may be made available after the program via download as they become available.

Please send requests and inquiries to: AscensionLeadershipAcademy@ascension.org.

Ascension Leadership Academy Community 5 Residential, Session V Participant Guide ©2024 Ascension Leadership Academy.

All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems.

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CONTENTS DAY ONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Sacred Space

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Opening Remarks and Dialogue

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Project Recommendation Presentation Leading a Culture of Innovation

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The Virtues of Justice and Prudence

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Ecclesial Relations

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Reflective Close

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DAY TWO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Sacred Space

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Wicked Problems and Regaining the Strategic High Ground in Healthcare

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Ascensions’s Balance Sheet Strength and Key Financial Metrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Resilience: How Values Safeguard Resilience and Compassion with Healthy Boundaries . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Virtues in Action Leadership Reflection Process Sponsorship Check-In

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

Academy Journey: Demonstrating Impact Reflective Close

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. . . . . . . . . . . . . . . . . . . . . . . . . . . 125

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Introduction to the materials PARTICIPANT GUIDE This guide contains core content for the session, distilled from the presentations you will see throughout the program. You can use the exercises and notes logged within for reference as you progress through the program.

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DAY ONE

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SACRED SPACE Jason Alexander and Rachel Raymond

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OPENING REMARKS AND DIALOGUE Joe Impicciche

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PROJECT RECOMMENDATION PRESENTATIONS Soren Kaplan

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Objectives • Share recommendations from projects • Define next steps for implementation

Outcomes • Final project recommendations with input and actions for moving forward

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Consumer-Centric Solutions Framework

Recommendations Presentations

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Presentations (30 minutes) 1

Recommendations (20 min) 1. Medication Assistance 2. Ascension Market Bulletin 3. RASS 4. Bringing Care to the Community

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Builds and Actions (10 min)

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LEADING A CULTURE OF INNOVATION Soren Kaplan and Aaron Ferber

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Objectives • Gain insight into the role and importance of innovation culture • Define actions for instilling innovation across Ascension’s culture

Outcomes • Understanding of innovation culture with actions for leadership

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Innovation Culture Organizational Culture:

norms and values that guide behavior

Innovation Culture:

an environment that promotes freethinking, an entrepreneurial spirit, and sustainable value creation across all levels and functions of an organization

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3 Levels of Innovation

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Design Thinking Process (Behaviors)

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Team Working Sessions • Find a partner and discuss the following: a. What type of innovation is most relevant to your own role as a leader? b. Considering your Hogan Assessment insights, what is at least one action you can take to help foster innovation in your team, department, or market - that taps into your strengths?

• Return in 20 minutes ready to provide a verbal summary of your conclusions.

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NOTES

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VIRTUES OF JUSTICE AND PRUDENCE Sarah Reddin

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Objectives • Facilitate individual and communal growth in virtue rooted in Ascension’s Values and Identity as a Catholic Ministry • Integrate senior executive competencies and capabilities into experiential and reflective learning activities that are aligned with Ascension’s strategic plan and the ABIDE framework • Engage opportunities to innovate and develop the skills required to deliver an unparalleled consumer, patient and associate experience

Outcomes • Demonstrate a growth mindset through ongoing reflection on their practice of virtuous servant leadership • Promote a culture of inclusion that enables compassionate, personalized care for all, especially those most in need • Articulate the union of Ascension’s Mission and Strategic Plan as the foundation of and reason for all that we do

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Our Community

Enneagram: Communication Styles Type

Speaking Style

Body Language

1: The Reformer

Precise, direct, detailed; “should, ought, right”

Eyes focused, good posture, coordinated clothes

2: The Helper

Ask questions, focus on other person

Smile, relaxed posture, open body movements

3: The Achiever

Clear, efficient, logical; avoid negative topics

Confident, “put together,” acts to generate effect

4: The Individualist

Expressive, personal, creative

Intense, focused, calm

5: The Investigator

Selective work choice; focus on facts

Contained, few gestures, self-controlled

6: The Loyalist

Analytical, cautious; “what-ifs”

Concern, empathetic, reacts quickly to danger

7: The Enthusiast

Quick, spontaneous, upbeat; reframes

Smiling, bright-eyed, highly animated

8: The Challenger

Bold, authoritative, big picture

Strong presence, modulates tone for impact

9: The Peacemaker

Detail oriented, looks for both/and, agrees

Easy-going, relaxed, animated expressions

What is the motivation underneath your speaking style and body language?

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Justice: Principles of Human Dignity and the Common Good Human Dignity • Inherent, inalienable worth and value • Not contingent upon race, gender, socio-economic status, autonomy, etc.

• Made in “image and likeness” of God: the imago Dei

Common Good • The sum of social conditions and basic goods necessary for flourishing • Respect for persons, social welfare, peace and security • Includes the right to: life, food, clothing, shelter, medical care, rest and “necessary social services”

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What are the Implications of Justice?

Solidarity • Commitment to the good of all and of each individual • See the “other” as our neighbor • Offers the possibility of participating in the common good

Subsidiarity • Persons are always capable of giving something to others • Freedom to develop capabilities already present at every level of society (organization) • Locating the solution at the level most appropriate to the problem

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Theology of Prudence Practical wisdom is the combination of moral will and moral skill.

- Aristotle, 384-322 BC Prudence is right reason with respect to action.

- Saint Thomas Aquinas, 1225-1274 AD

Eight Integral Components of Prudence Aquinas

Memory Understanding Docility Shrewdness Reasoning Foresight Circumspection Caution

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Acting with Prudence

Remembering Presence Foreseeing

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Virtue of Prudence Effective Means

Ineffective Means (Incompetence)

Good Means

Bad Means

Good Ends

Practical Wisdom (Prudence)

Goal Fixation (Teleopathy)

Well intentioned

Bad Ends

Cunning

Evil

Ill - willed

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NOTES

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ECCLESIAL RELATIONS: KEY INSIGHTS FOR EXECUTIVE MINISTRY LEADERS Thomas VanOsdol and Sarah Reddin

NOTES

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Objectives • To understand the role of the Sponsor and Bishop as key elements of Ascension’s identify as a ministry of the Catholic Church • To engage in dialogue regarding the ecclesial relationships between bishops and the health ministry

Outcomes • Understand the role of Sponsor and Bishop • Understand and commit to the essential responsibilities of executives in the ecclesial relations strategy

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The Gospel Context of Health Care To understand the significant role of the Catholic Church in health care throughout the centuries, one needs to look at the faith of those who have attempted to imitate the love, compassion, and healing of Jesus.

The work of healing and the acts of compassion that envelop it are seen as a continuation of Christ’s mission that is enabled by his life-giving grace.

It is out of this context of faith, hope, and love that the Catholic health care ministry came into existence.

United States Conference of Catholic Bishops Ethical and Religious Directives for Catholic Health Services No. 3

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Role of the Sponsor The Sponsor ensures that all the activities of the ministry operate in conformity with its Mission, Vision and Values, consistent with the teachings and laws of the Catholic Church appropriate to the provision of health care.

The Church

Participating Entities Congregation of St. Joseph

APPOINT

Ascension Sponsor

Daughters of Charity Province of St. Louise

Sisters of St. Joseph of Carondelet

Participating Entities

Alexian Brothers

Sisters of the Sorrowful Mother

Potential new participating entity

APPOINTS

Ascension Board

Ascension Sponsor Ministerial Public Juridic Person comprised of 5-12 appointees

APPOINTS

Chief Executive Officer

Ascension Board

Ascension Subsidiaries

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Responsibility of the Diocesan Bishop As principal teacher, the bishop invites openness and receptivity to the splendor of truth by proclaiming the Church’s teaching and safeguarding the moral and doctrinal integrity of Catholic health care.

As sanctifier, the bishop exercises his ministry by ensuring the celebration of the sacraments and by providing for the overall pastoral care for the sick, their families, and the medical professionals in health care settings throughout the diocese…

The bishop, as pastor, governs the particular church in ways that seek appropriately to coordinate the healing ministries in the interest of the common good.

United States Conference of Catholic Bishops Ethical and Religious Directives for Catholic Health Services No. 9

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Our Practical, Proactive Ecclesial Engagement Model • Know your bishop • Never let your bishop be surprised • One bishop does not speak for all bishops • Know how and to what extent your bishop wants engagement and communication • Appreciate the difference between the bishops authoritative role and consultative role • Appreciate that Church teaching often requires interpretation and application to particular circumstances

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NOTES

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ECCLESIAL RELATIONS: THE PASTORAL ROLE OF THE DIOCESAN BISHOP IN CATHOLIC HEALTH CARE MINISTRY Bishop William Wack

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REFLECTIVE CLOSE Audra Pratt

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Reflection and Conversation What are you taking forward from today’s learning experience?

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DAY TWO

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SACRED SPACE Mo Chadwick and Gagan Singh

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WICKED PROBLEMS AND REGAINING THE STRATEGIC HIGH GROUND IN HEALTHCARE Kenneth Kaufman

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Objectives • Comprehend the concept of “wicked problems” and analyze the current challenges within healthcare • Gain insight into the three critical existential questions for health system organizations • Explore the tactics for reclaiming the strategic high ground, including organizational listening and learning and essential strategic thinking

Outcomes • Identify “wicked problems” in the context of healthcare • Articulate the three critical existential questions relevant to health system organizations • Demonstrate tactics required to reclaim the strategic high ground in healthcare organizations and effectively engage in organizational listening and learning, allowing them to gather valuable insights and data

CONFIDENTIAL ©2023 Kaufman, Hall & Associates, LLC. All rights reserved.

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Wicked Problems • The concept of wicked problems was developed in 1973 by social scientists Horst Rittel and Melvin Webber • Unlike math problems, wicked problems have no single, correct solution.

• A solution that improves one aspect of a wicked problem usually makes another aspect of the problem worse.

• Poverty is a common example of a wicked problem.

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Wicked Problems Have Five Characteristics 1. They are hard to define.

2. It’s hard to know when they are solved.

3. Potential solutions are not right or wrong, only better or worse.

4. There is no end to the number of solutions or approaches to a wicked problem.

5. There is no way to test the solution to a wicked problem—once implemented, solutions are not easily reversible, and those solutions affect many people in profound ways.

CONFIDENTIAL ©2023 Kaufman, Hall & Associates, LLC. All rights reserved.

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The Wicked Problem of Healthcare • Healthcare has long been one of our nation’s critical wicked problems.

• The broad and persistent effects of COVID have made those problems more numerous, more complex, and more pressing.

• Like all wicked problems, the wicked problems of healthcare can be defined in many different ways and from many different perspectives.

• Let’s look at a few of the more consequential wicked problems currently confronting America’s healthcare systems.

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The Catalogue of Problems Drive Three Critical Existential Questions • Is the Hospital of the Past the Hospital of the Future?

• If it isn’t, then what does the Hospital of the Future look like?

• How would one go about creating the Hospital of the Future?

CONFIDENTIAL ©2023 Kaufman, Hall & Associates, LLC. All rights reserved.

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ASCENSION’S BALANCE SHEET STRENGTH AND KEY FINANCIAL METRICS Liz Foshage

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Objectives • Enhance comprehension of Ascension’s key performance indicators • Attain insight into Ascension’s Investor Relations • Acquire an understanding of the significance of credit ratings

Outcomes • Articulate and understand key financial measures of Ascension’s financial strength • Effectively present the financial performance in the most favorable manner for external stakeholders • Demonstrate enhanced stewardship of the System/Markets’ resources and assets

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Credit Ratings and Outlook • Rating – A measurement for investors that represents an indication of the ability of an organization to repay its debt • Outlook – Indicates a rating may be raised in the near future (if positive) or lowered (if negative); outlooks are generally, positive, stable or negative • Since Ascension has issued Publicly Traded Bonds (~$6.6B outstanding), we are rated at least annually by the rating agencies: – Separate annual presentations to all three rating agencies (late August 2023) – 2023 Ascension participants - Joe Impicciche, Eduardo Conrado, Sally Deitch, Liz Foshage and Chris McCoy • Implications of Ascension’s favorable credit rating – Supports Ascension’s credibility with investors – Lower cost of capital for future debt borrowings with minimal impact on current portfolio – Greater access to financial products that provide flexibility (line of credit, other debt instruments) – Less restrictive financial covenants for future borrowings

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2023 Ascension Credit Ratings and Outlook Update Rating Agency

Current Rating and Outlook

Prior Rating and Outlook

Moody’s

Aa2; Stable outlook

Aa2; Stable outlook

Fitch

AA+; Negative outlook

AA+; Stable outlook

S&P

AA+; Negative outlook

AA+; Negative outlook

• 2023 Credit Rating Review Results – Annual review resulted in very successful outcomes for Ascension – Credit ratings affirmed by all three agencies – Only change was outlook update to negative from Fitch

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2023 Credit Review Insights • Ascension Credit Strengths – Significant size and scale with revenue diversification across geographies – Centralized operating model with recent management realignment to improve capabilities with a focus on data analytics to support operations – Demonstrated ability to execute upon strategies and also achieve economic improvement plans – Detailed roadmap to improve operational performance in FY24 and beyond through volume growth, rate and pricing and cost levers – Progress towards portfolio reconfiguration strategies to drive growth and realign underperforming Markets – Strong liquidity position and moderate leverage profile provide flexibility • Ascension Credit Challenges – Weak operating performance and operating cash flow generation - Ascension must drive a significant and sustained improvement in operating performance for FY24 and beyond – Liquidity - recent operating performance has added stress, contributing to a decline in days cash on hand. Ascension’s balance sheet can not continue to support another year at the same rating without operating cash flow generation

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RESILIENCE: HOW VALUES SAFEGUARD RESILIENCE Krista Gregory

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Objectives • Explore the relationship between our day-to-day experiences as leaders and our personal and professional values • Recognize how difficult emotions and burnout arise when we are not living in alignment with our values • Practice tools for understanding and affirming our values

Outcomes • Interpret our good days and bad days as related to values, not necessarily burnout • Utilize a daily, simple resiliency tool to keep personal and professional values aligned with self • Explore how the behavior of the persons we lead may be reflective of a misalignment with their personal and/or professional values

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Checking In From the Last Residential 4 Brief review of what we learned: – Know Your Plimsoll Line, Plimsoll Line Check-In and Zone of Resilience – Finding Your Anchor, Name it to Tame it/Feel it to Heal it, STOP – Deep, abdominal breathing, The Golden Rule Remix, Supportive Gestures 4 Since the last residential, in what circumstances have you used some of the awareness tools like STOP, Finding Your Anchor and Name it to Tame it/Feel it to Heal it?

4 How has having an increased awareness of your inner critic and its potential effects on your leadership language changed since the last residential?

4 Have you discovered your go-to Supportive Gesture that we learned at the last residential or one that you were using before and now can use intentionally to regulate your nervous system?

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Tool: Embodied Boundaries

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“

Relevant Quotes:

“ Saying ‘no’ is also saying yes to something else. Even though setting boundaries can be uncomfortable and disrupt the status quo, eventually it feels good because we are saying yes to our values, to our integrity, and to our wellbeing.”

– Dr. Marissa Knox

“ A ‘no’ uttered from deepest conviction is better and greater than a ‘yes’ merely uttered to please, or what is worse to avoid trouble.”

– Mahatma Gandhi

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What Does A Good Day Look Like?

• What happened on your last good day?

• What emotion(s) did you have?

• What does that experience show about what’s important to you?

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…and the Bad Days?

• What happened on your last bad day?

• What emotion(s) did you have?

• What does that experience show about what’s important to you?

• What action can you take to align yourself more closely with your values?

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Relevant Quotes:

“ We don’t feel strong emotions about things we don’t care about.”

– Dr. Susan David

“ The things you are passionate about are not random; they are your calling.”

– Fabienne Fredrickson

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Tool: Small, Daily Gifts • Consider a value with which you’d like to be more aligned and write it below.

• What is a small, daily gift you could give to yourself that relates to this value?

• Now write down this small, daily gift as a statement to yourself about how you will connect with what matters to you each day. (keep it simple)

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Examples of Small, Daily Gifts

Offering ourselves small, daily gifts helps us routinely access what matters to us.

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NOTES

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RESILIENCE: COMPASSION WITH HEALTHY BOUNDARIES Krista Gregory

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Objectives • Explain the difference between empathy and compassion • Explore how empathetic resonance is related to burnout • Practice a tool to create emotional boundaries between ourselves and those experiencing pain

Outcomes • Recognize the difference between empathetic resonance and healthy compassion • Understand how disentangling from another’s emotions, distress and/or pain allows for more sustainable, compassionate care • Contextualize the resiliency tool in a variety of healthcare leadership settings to create healthy boundaries for ourselves and the people we serve

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Compassion vs. Empathy Empathy refers to feeling the feelings of other people as though they were our own.

When we are compassionate, we maintain a distinction between ourselves and the others who are suffering.

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Compassion with Healthy Boundaries “Everyone is on their own life journey.

I’m not the cause of this person’s suffering, Nor is it entirely within my power to make it go away, Even if I wish I could.

Moments like this are difficult to bear, Yet I may still try to help if I can.”

– Dr. Kristin Neff

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Relevant Quotes:

“ You cannot keep giving to others if you do not give to yourself, first. It is like pouring water from a vessel: you cannot pour and pour without ever refilling it—eventually it will run dry.”

– Leslie K. Lobell

“ A world without empathy is a world where we are dead to each other. But also, in a world where we are always vicariously suffering, it can be overwhelming. We need to maintain our capacity to be in resonance with other people, but also to see clearly–I am not that person.”

– Roshni Joan Halifax

“ You are not required to set yourself on fire to keep others warm.”

– Joan Crawford

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Tools You Learned So Far… 1. Know Your Plimsoll Line 2. Plimsoll Line Checklist 3. Zone of Resilience 4. Finding Your Anchor 5. S.T.O.P. 6. Name it to Tame it. Feel it to Heal it.

7. Deep, Abdominal Breathing 8. Golden Rule Remix 9. Supportive Gestures 10. Embodied Boundaries 11. Signposts for our Values 12. Small, Daily Gifts 13. Reliving Compassion 14. Compassion with Healthy Boundaries

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Action Items between RES V and RES VI • Notice small and large tasks to which you might say, “no.” If it doesn’t seem reasonable to say “no” when you want to, consider other options like delegating or negotiating.

• When you notice a strong emotion (anger, frustration, joy, excitement), consider what value it is showing you. If you are out of alignment with the value, what action could you take? Or, how might you adjust your perspective?

• Everyday find a small way to connect with what you really care about in your life. This action can take 5 minutes or less.

• When you are distressed by the pain of those around you, consider where you are on the Empathy v. Compassion drawing and who are the people standing behind you.

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VIRTUES IN ACTION LEADERSHIP REFLECTION PROCESS Michelle Kohler, Sarah Reddin, Katie Thenhaus, and Tom VanOsdol

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Objectives • To develop the practices and competencies for awareness of self and others to shape the action-reflection process in and through leadership, integrating the Virtue of Prudence

Outcomes • Explore key moments of experience as doorways to the deeper story of who you are as a leader • Inquire to reveal layers of meaning, motivation, gifts and blind spots to leadership • Recognize patterns that enable and hinder leadership • Discover Virtues that are active or needed

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Virtues: A Summary

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VIA Experience • Reflection • Share Key Leadership Moments • Select Member’s Moment for Reflective Sharing • Reading #2 • Clarifying Questions - integrating the Virtue of Faith • Exploratory Questions - integrating the Virtue of Faith • Heart of the Matter - integrating the Virtue of Hope • Member Insights - integrating the Virtue of Love • Gratitude, Prayer, and Return Instructions - integrating the Virtue of Prudence

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Ground Rules • Engage with the Value of Reverence: respect for the dignity and diversity of life • These are sacred stories of human beings not problems to be solved • Double confidentiality - stories are not shared outside of VIA, or invited to be discussed more outside of VIA • Silence and space are good - not to be feared • Suspend judgment • Practice self-reflection by drawing on what is going on inside you and developing self-awareness • Group makes space for equal participation by all • Trust the group and the process

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Pre-Work for Residential VI - VIA Reflection Our theme for Residential VI is the Virtues of Faith, Hope, and Love.

Virtue of Faith: “Rooted in transcendent mystery” Virtue of Hope: “Seeing the “real” and resolutely responding with what is good” Virtue of Love: “Embodying God’s own compassion”

Write about a key leadership moment using one of these prompts: Faith: “A moment where I experienced the presence of God in a leadership encounter…”

Hope: “A moment where my view was clouded, preventing me from seeing “the real” and responding with “the good.”

Love: “A moment where I saw God’s own compassion in our ministry…”

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SPONSORSHIP CHECK-IN Katie Thenhaus

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Sponsorship Covered in October • Sponsorship Overview • Career Action Planning • Effective Engagement

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Career Action Plan Recommended Roadmap

Check-In • How have you set up your engagement with your sponsee?

Meeting cadence?

• How are you using the career planning tool?

• What is your sponsee looking for from Sponsorship?

How can the other Members assist?

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ACADEMY JOURNEY: DEMONSTRATING IMPACT Katie Thenhaus

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Objectives • Identify and articulate specific instances of collaboration, connection, efficiency, or strategic initiatives that have positively impacted Ascension’s operations • Gain input to prepare and share a brief presentation in April’s residential on the demonstrated impact of learnings

Outcomes • Demonstrate the practical application of leadership skills gained during the Leadership Academy and its positive impact on Ascension’s mission and strategy

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REFLECTIVE CLOSE Ryan Schuler

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Justice and Prudence What have you learned about yourself as a leader this week?

• Through our reflection on, experiences of, and learning about Justice and Prudence?

• Through our shared learning about: – Leading a Culture of Innovation – Understanding the Pastoral Role of the Diocesan Bishop in Catholic Health Care Ministry – Uncovering Wicked Problems and Regaining the Strategic High Ground in Healthcare – Identifying and Recognizing How Values Safeguard Resilience – Contextualizing Resiliency Tools to Create Healthy Boundaries – Practicing the Virtues In Action process

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Academy Blessing As one community, Let us gather ourselves, Body, Mind, Heart and Soul, In the presence of God’s Spirit, Who dwells in and among us all.

We offer the work, joy, Refreshment and learning of this day For the sake of those who are served By the good being done through us.

4600 Edmundson Road St. Louis, Missouri 63134 314.733.8000