Written by Michael Connelly & Michael O'Brien, Ed.D.

Mr. Connelly is president and CEO of Catholic Healthcare Partners, Cincinnati; Dr. O'Brien is CEO of the O'Brien Group, Cincinnati, an international consulting firm that coaches senior-level executives on leading transformational change and increasing organizational performance. He is the author of Profit from Experience: A Guide to Knowing Yourself and Influencing Others, Berkley, 1998.

Like those of other organizations, senior leadership teams in most Catholic health care institutions operate according to a strict, hierarchical decision making model. The organization's structure largely dictates how strategy is formulated, how decisions are made, and how problems are solved. The chain of command is the rule of the day. Decisions float from the top down, without a great deal of input from those below the uppermost layer of management.

But this may need to change. Catholic health care organizations are experiencing a host of new pressures, including changes in strategies, structures, regulations, work processes, and employment policies. In addition, they are facing unprecedented marketplace competition. Whenever there is a challenge of this magnitude, strong leadership is especially needed. Unfortunately, however, it is also at such times that leadership is difficult to provide. To keep up with the pace and scope of these challenges, it is imperative that organizations utilize the intelligence of their entire leadership to make change happen better and faster. Operating within the strict confines of the organizational hierarchy can oftentimes slow the implementation of critical and necessary change initiatives and stifle good ideas that might bring about new, creative strategies to manage change and "grow" the organization.

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