Focusing efforts toward the poor. A system raises its consciousness

In 1987 the Holy Cross Health System (HCHS), South Bend, IN, appointed a Task Force on the Care of the Poor to determine whether the system was fulfilling its ministry to the poor during these times of scarce resources. Specific charges were to assess the system's qualitative and quantitative responses to the issue of caring for the poor; review the recommendations in No Room in the Marketplace: The Health Care of the Poor and assess their applicability to HCHS; and recommend management and system governance strategies that creatively address the care of the poor. After months of meetings, research, and difficult questions, the task force completed a report that is tied to The System Strategic Plan. Using strategic plan objectives in six key areas, the task force developed measurable criteria, which each system facility is expected to meet annually. The report demands a focused effort toward care of the poor and requires that the annual performance evaluations of senior managers throughout the system include an assessment of the organization's efforts to provide healthcare services to the poor. This is intended to make each senior manager consciously reflect on the implications for the poor in all actions that he or she takes.