Hiring for "organizational fit". A St. Louis system has developed tools for assessing candidates' compatibility with the organization

To a great extent, the continued success of Catholic health care organizations is dependent on the selection of co-workers and leaders who are committed to carrying on the organization's mission. The Sisters of Mercy Health System, St. Louis, uses three tools to help leaders be more consistent and objective in assessing employment candidates for organizational fit. The first tool involves behavioral-based interviewing, which looks at a candidate's potential for future behaviors based on his or her past behaviors. The second tool assesses a candidate's values in such a way that accounts for and reduces the interviewer's own subjectivity. And the third tool-values-based interviewing-helps reveal a candidate's natural aptitude for, interest in, and personal agreement with the organization's charism, religious heritage, and values.     

Use and acceptance of the "paper pill". A novel approach to oral contraception.

A randomized, crossover study comparing the acceptance of and attitudes towards two dosage forms of the same oral contraceptive product - a paper presentation and the conventional tablet, was carried out in a network of rural and suburban research centers in the State of Durango, México. The results failed to show any significant advantage (in terms of acceptability or continuation) of the paper formulation. Although two-thirds of the participants indicated a preference for the conventional tablet, there was a high degree of acceptance of the paper formulation among new oral contraceptive acceptors.     

A stochastic model of malaria transition rates from longitudinal data: considering the risk of "lost to follow-up".

A model, using stochastic processes, is developed to estimate some epidemiological parameters of malaria in a homogeneous population from longitudinal data. Assessments of transition probabilities from one state of health to the other are made taking "lost to follow-up" as a competing risk. The model is based on the assumptions that individuals are transferred at constant rate between states, and only one transition is possible between two consecutive surveys. It shows a good fit to the observed data; the model is simple to understand and can easily be used if computer facilities are not available.     

A study of the "crossover population": aged persons entitled to both Medicare and Medicaid.

This study focused on persons 65 years of age and over who were dually entitled to Medicare and Medicaid in 1978. The paper examines their age, sex, and race characteristics, and their Medicare utilization and mortality rates in comparison to persons eligible for Medicare only. The study showed that the group entitled to both Medicare and Medicaid was relatively much older than those with Medicare only, with a mean age of 76.6 years compared to 73.6 years. In the group entitled to both Medicare and Medicaid, the proportion of persons of minority races was four times as great as the proportion in the remaining population. Nevertheless, nearly three out of four persons entitled to both programs were white. In the group with dual eligibility, 71 percent were women, compared to only 59 percent in the Medicare-only population. Thus, the dually covered group may be characterized as being relatively older than other Medicare enrollees, largely composed of white persons and women, and as having a higher proportion of minority persons than the general population. The study showed that a much higher proportion of dually entitled persons were users of the Medicare program than were persons eligible for Medicare only. On a per-enrollee basis, reimbursement was substantially higher for those dually eligible. The study also found differences in the diagnostic conditions of the dually entitled. The data indicate (after being standardized for age) that the death rate was 50 percent higher for the dually entitled. This difference in mortality is partly attributable to the relatively high mortality rates for the medically needy; nonetheless, the mortality rate for the dually entitled who also received cash assistance was 20 percent higher than those for other Medicare enrollees. The excess mortality among this group was notably higher for the age group 65-69, with a 50 percent excess mortality, and for the age group 70-79, the excess mortality was 30 percent. Thus, the dually entitled, in general, experience higher mortality rates than those with Medicare only, and that fact very likely explains to a large extent the higher utilization rates found for the dually entitled in this study. The paper concludes by raising some possible consequences of either Medicare or Medicaid coverage being altered or tightened.     

"Do good and talk about it". A CHRISTUS health study emphasizes the importance of telling our stories to the public

In a time of public scrutiny, it is paramount that Catholic health care organizations examine their commitments to their communities and effectively communicate community benefit activities to stakeholders-employees, physicians, patients, and the public. CHRISTUS Academy, a leadership development program at CHRISTUS Health, Irving, TX, conducted two studies regarding community benefit. The first researched community benefit practices at more than 20 highly respected, tax-exempt CHA- and VHA-member organizations, comparing them with the practices of about 40 publicly traded, for-profit organizations. The primary conclusion was that community benefit is not just about measuring the numbers-it is also about "telling the story." Unlike the for-profit organizations, tax-exempt health care organizations tend to struggle with adequately measuring and reporting their community contributions. In a second study, the academy surveyed CHRISTUS Health's employees and physicians regarding their knowledge of the system's commitment vis-à-vis identifying and meeting community needs. The vast majority said the system is important to the community and is actively involved in understanding and meeting the needs of the community. However, they also ranked the system lower in terms of working with other community organizations, being a leader in community health, and being known for sponsoring volunteer activities. These lower rankings indicate that the community benefit activities are not well publicized or known within the organization. Catholic health organizations must take an active approach in communicating their work to the public, the media, and each other. In doing so, they fulfill an integral part their mission.     

A moral quandary for sponsors. Like the family, and the state, sponsorship is an institution

Nowadays many religious institutes are asking questions about sponsorship. The issue is usually phrased as the sponsoring of institutions. But it might be useful to ask about the institution of sponsorship instead. In The Good Society, Robert Bellah and his associates say that, on one hand, institutions are created by human beings; on the other hand, because we draw our sense of identity from them, institutions create us too. Bellah et al. also say that institutions, being human creations, are susceptible to corruption, especially when great wealth and power are involved. Since hospitals and healthcare systems obviously do involve wealth and power, we sponsors now have many questions, as well as some ambiguity about our sponsorship capability. One might even say that a moral debate is raging in our collective subconscious: Is loss of corporate influence something we would do something about if we could, or have we chosen some other value, such as ministerial diversity, instead? My institute, the Sisters of Mercy, has decided to continue our sponsorship of such organizations. As an institution, sponsorship is an essential bearer of our ideals and meanings. We need this institution to announce, to the world and to ourselves, that whatever power and wealth we possess are committed to mercy and justice.