As director of mission integration at California Hospital Medical Center, Samuel Scriven — also a trained chaplain — is like a physical conscience at the tables where decisions are made.
"[A mission integration leader is] simply a professional who is able to influence the organization to ensure that the mission and values are woven into the fabric of the ministry or into the hospital or healthcare system," Mr. Scriven told Becker's in a recent interview. "We do that in a number of different ways, from the one-off conversations we have with people in the hallway, or one-on-ones with our executive team, or in strategic planning meetings about financial burdens and stressors."
At California Hospital Medical Center in Los Angeles — a Catholic facility under the umbrella of Chicago-based CommonSpirit Health — Mr. Scriven's role is far-reaching. He participates in meetings from the organ donation and "humankindness" committees, to the ethics team, to the C-suite. Wherever he goes, he helps guide conversations through a mission-oriented lens, which tends to reprioritize the patients CommonSpirit serves. It is rare that this sparks a debate; the groundwork is laid "really well," especially in the executive suite, Mr. Scriven said.
"I spend a lot of time developing a lot of relationships with those executive leaders, where we're having conversations on the side. So when I'm in the room, in that larger senior leadership team meeting, I don't have to say very much. We've had a lot of conversations, and my job is to help set the tone for the conversation when we're together," Mr. Scriven said. "There's a piece of the job that is being patient with how to use your moments of influence, allowing the decision process to work organically and recognizing when we're moving down the wrong path."
But even the most ethically grounded hospitals are facing headwinds when it comes to identity, Mr. Scriven said. As big-name corporations such as Amazon and Walmart crack healthcare and mergers create sprawling systems, sticking to one's roots becomes more challenging.
"The hard question for every hospital right now is, 'How do we keep what is central to us so we don't have to compromise who we are by becoming someone else — while not closing the doors?'" Mr. Scriven said. "I've got our CFO's financial plan for the 2024 fiscal year taped on my wall in front of me because even in a big system, at a community hospital, we also have our financial stressors. And when you're a standalone, you could potentially be even more stuck.
"Thankfully, every hospital I've ever engaged in — for profit, nonprofit, big systems, little systems, religious, non-religious — they're made up of people who care deeply about an intersecting mission between all of us, which is to see people who are vulnerable feel safe and well. There is someone or many someones at every hospital who care deeply about that central mission of caring for the sick. So my hope would be that at any hospital, there's someone there who allows space to pause and to ask them the central questions along the way."
At CommonSpirit, that discerning question is, "Who are we meant to be?" It sets the foundation when searching for new partners and donors and knowing when it is time to sunset an initiative, he said.
Numbers and metrics will always play a role in the decision-making process; there's an "endless supply of dashboards," Mr. Scriven said, chuckling. But figures are not everything. Asking some combination of "where, what, how" questions — "Who do we want to be known as? What are our intentions? How do we want to be perceived?" — can help ground hospitals. Maintaining that identity becomes increasingly important as more competitors enter the arena and more stakeholders fill the bleachers.
California Hospital Medical Center was founded by a physician 140 years ago. Now, as part of one of the nation's largest nonprofit health systems, which operates more than 140 hospitals, CHMC partners with Catholic-based and community-centered organizations to stay true to its roots.
"[CommonSpirit] tries to retain the culture and history of each individual place without creating a franchise health system," Mr. Scriven said. "It's a lot easier to create a predictable system where everything's the same. But we don't need another McDonald's. We need a unique healthcare system in our neighborhood that meets the needs of our community."