CommonSpirit institute focuses on putting human kindness into practice
gains new momentum
By JULIE MINDA
A group of organizations that created the Age-Friendly Health Systems movement and has seen the practices put in place across the nation is working to spread the initiative to additional U.S. sites.
The partnering organizations, which include CHA and some of its members, want to ensure that the nation’s aging population has access to high-quality health care that addresses elders’ oftencomplicated needs in a comprehensive way. The organizations are doing this through the Age-Friendly Health Systems movement founded by The John A. Hartford Foundation. Built up by the foundation’s longtime partner, the Institute for Healthcare Improvement, and supported by dozens of health systems and thousands of facilities, the initiative seeks to equip increasing numbers of health care providers to better understand and meet older patients’ wants and needs.
Their focus is on the “4Ms”: what matters, medication, mobility and mentation.
“The collaborative approach we’re taking helps patients feel the health system knows them and aligns with their needs,” says Kimberly Kindred, CommonSpirit Health system vice president of patient experience in the care continuum.
IHI Senior Director KellyAnne Johnson says, “At the end of the day, it’s about older adults. They deserve care that is predicated upon what matters, and we as a health
By LISA EISENHAUER
The mission of the Lloyd H. Dean Institute for Humankindness & Health Justice is to bring to life a tenet of CommonSpirit Health —“Health justice starts with human kindness,” says the institute’s president.
Dr. Alisahah Jackson has been at the helm of the institute since it was founded two years ago to honor CommonSpirit’s then-CEO as he neared retirement. She was formerly CommonSpirit’s vice president for population health innovation and policy.
Lloyd H. Dean was one of two inaugural leaders when CommonSpirit was created in 2019 by the merger of Dignity Health, where
CHRISTMAS BLESSING
Archbishop Gustavo García-Siller blesses Christmas trees during a lighting ceremony Dec. 3 at CHRISTUS Children’s in San Antonio. Each department at CHRISTUS Children’s adds an ornament representing their respective areas to the hospital’s main tree. Each department also decorates a tree of its own. The hospital will donate the departments’ trees to Catholic Charities Archdiocese of San Antonio. The charity then gives the trees to families in need.
HOLIDAY CREATIONS • CommonSpirit hospital staffers in Nebraska give donated canned goods a festive spin. Story on Page 12.
Medical respite facility supported by Sisters of Charity prepares for aging population
By NANCY FOWLER
Across the country, unhoused patients struggle to heal after being discharged by hospitals to shelters and the streets. They have no help with managing medications, locating dialysis and other equipment and keeping follow-up appointments. While their conditions range from diabetes to amputations to cancer, they all share a strong likelihood of ending up back in the hospital — again and again.
In Cleveland, there’s another option:
he had been CEO, and Catholic Health Initiatives. The merger formed the nation’s largest Catholic health care system.
Dean stayed in CommonSpirit’s top post alone when his co-CEO, Kevin E. Lofton, who had led CHI, retired in mid-2020.
“When Lloyd Dean retired or made the announcement that he was retiring in 2022, there was a lot of conversation around what could we do to honor the amazing work and legacy that Lloyd has contributed over the span of his career,” Jackson recalls.
Jackson says Dean was a longtime advocate of the healing power of kindness. She remembers hearing him expound on the
‘One voice’ Our Lady of the Lake’s gospel choir creates harmony across disciplines
By VALERIE SCHREMP HAHN
Be careful if you get in the elevator with Cheryl Allen and start to hum.
Allen knows a joyful noise when she hears it. She’s the director of the gospel choir at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, part of the Franciscan Missionaries of Our Lady Health System.
“I’ll take it as a God thing,” she says.
“Right here in the elevator with me, you have a song in your voice?” she might say.
And she might ask: “Do you want to join the gospel choir?”
Allen, a senior generalist in human resources of environmental services, has directed the gospel choir, a volunteer
The Lloyd H. Dean Institute for Humankindness & Health Justice uses posts on social media to promote its work centered on the healing power of kindness.
Visiting Nurse Paula Freeman-Vida checks the blood pressure of a resident at Joseph’s Home, a medical respite facility in Cleveland that serves men who are experiencing homelessness.
Kindred Johnson
KEEPING UP
PRESIDENTS/CEOS
Organizations within CommonSpirit Health have made these changes:
Michael S. Lawson to CommonSpirit Health Houston market president, effective Dec. 30. Lawson previously was president of OhioHealth’s Grant Medical Center. He succeeds Matt Brown, CommonSpirit senior vice president, operations/transformation, who was interim Houston market president. That market includes eight hospitals in Greater Houston.
Simon Ratliff to president and CEO of Bakersfield’s Mercy Hospitals of Bakersfield, California. Ratliff succeeds BJ Predum, who has been named president of Dignity Health California region’s Central Valley market. Ratliff most recently was CEO and president of Wilkes-Barre General Hospital in Northeastern Pennsylvania.
Dr. Douglas Ross to president of Dignity Health St. Joseph’s Hospital and Medical Center in Phoenix. He was chief medical officer for CHI St. Vincent System in Arkansas and president of St. Vincent Hot Springs Hospital.
Donald J. Wiley is retiring as president and CEO of Dignity Health San Joaquin market area, which includes St. Joseph’s Medical Center of Stockton, California. He has worked at St. Joseph’s for 34 years.
Scott McConnaha is stepping down as president and CEO of the Manitowoc, Wisconsin-based Franciscan Sisters of Christian Charity Sponsored Ministries effective Dec. 19. Tim Loch, CFO and vice president of finance, will be interim CEO until the organization identifies a permanent replacement.
Shane Smith to president of SSM Health’s Fond du Lac, Wisconsin, market, which includes St. Agnes Hospital in Fond du Lac. Smith was vice president of medical group operations for the Fond du Lac Regional Clinic.
Winfield Brown to president of St. Mary’s Health System in Lewiston, Maine, and senior vice president of Covenant Health of Andover, Massachusetts. He was interim CEO of Mt. Ascutney Hospital & Health Center, part of Dartmouth Health. In his St. Mary’s role, Brown replaces Cindy Segar-Miller who was interim president of St. Mary’s. She is transitioning into a new role with the hospital’s parent company, Covenant Health. In her new position, she will help guide the strategic direction of the health system and will have oversight of its hospitals.
Harrison Kiser to president of Ascension Saint Thomas Hospital West in Nashville, Tennessee. He will retain his role as chief operating officer. The change is effective Dec. 8. Gordon B. Ferguson plans to retire in late June 2025 as president and CEO of Ascension Saint Thomas Rutherford in Murfreesboro, Tennessee. He has worked at the facility for 26 years. Both hospitals are part of Ascension Saint Thomas.
Brian Pierson to Mount Carmel Grove City president and chief operating officer. He was interim president and chief operating officer. The facility in the Columbus, Ohio, area is part of Trinity Health’s Mount Carmel Health System.
Serving migrants
The president and CEO says Catholic Charities of San Antonio is doing "God's work" in serving those coming across the nation's southern border.
Glucose monitor
Missouri-based Mercy implants the world's first 365-day continuous glucose monitor. The Eversense 365 monitor is designed to manage Types 1 and 2 diabetes in adults.
Reproductive care
An obstetrician-gynecologist at Saint Peter's Healthcare’s Gianna Center addresses infertility issues while helping women improve their overall health.
Embracing the spirit of Christmas by serving the vulnerable
By JOSEPH IMPICCICHE 2024-2025 Chairperson CHA Board of Trustees CEO, Ascension
As Christians around the world unite to celebrate Advent, we are called to reflect on the miraculous gift of Jesus’ birth. Born in the humblest of circumstances, Jesus reminds us to open our hearts, care for those around us, and remain attentive to the needs of our communities.
The Gospel of Luke recounts Mary and Joseph’s journey to Bethlehem, culminating in the birth of our Savior. In Luke 2:7, we read: “And she brought forth her firstborn son, and wrapped him in swaddling clothes, and laid him in a manger; because there was no room for them in the inn.”
This vivid scene — a child born into fragile circumstances, swaddled and laid
in a manger, because no proper shelter was available — resonates deeply. It reflects both the vulnerability of our Savior and the profound need to ensure that no one is turned away in their time of need.
This story holds a powerful parallel to our mission as Catholic health care providers. Just as Mary and Joseph faced barriers, countless individuals today encounter obstacles in accessing health care — barriers that leave them feeling unseen, marginalized, and without support. Our calling is to break down those barriers, creating places of care where everyone is welcomed with dignity and compassion.
For generations, Catholic health care has been a beacon of hope, answering the call to serve those in need with hospitality and unwavering love. Today, our ministry continues that legacy, meeting the challenges of housing instability, financial hardship, and limited access to essential services. In every act of care, we strive to recognize the image of God in each person we serve, as if caring for Christ Himself.
While every ministry across our Catho-
Foundations of Catholic Health Care Leadership
JANUARY 30 — MARCH 20, 2025
Foundations Live is an interactive eight-week engaging virtual program with sessions each Thursday from 1–3:30 p.m. ET.
lic Health Association is unique, we are united by our shared calling and rooted in a tradition of radically inclusive love. Across our organizations, caregivers work tirelessly to support patients facing immense challenges. As we celebrate this season and look to the new year, I encourage each of us to consider how we can make room for those in need — by tending to their needs, listening with empathy, and extending the compassion they deserve.
May we see our work not as an obligation but as an opportunity to serve as instruments of God’s love, ensuring our doors are always open and our care always available to those seeking hope and healing.
I pray you and your loved ones find peace, joy, and a renewed sense of purpose. May we carry forward the light of Christ, making room for all who seek care and extending His love to those who need it most.
With deepest gratitude and blessings, Joseph Impicciche
Catholic Health World (ISSN 87564068) is published monthly and copyrighted © by the Catholic Health Association of the United States. POSTMASTER: Address all subscription orders, inquiries, address changes, etc., to CHA Service Center, 4455 Woodson Road, St. Louis, MO 63134-3797; phone: 800-230-7823; email: servicecenter@ chausa.org. Periodicals postage rate is paid at St. Louis and additional mailing offices. Annual subscription rates: CHA members free, others $29 and foreign $29.
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Lawson Wiley Ross Pierson Ratliff Smith
“Joy
adapts and changes, but it always endures, even as a flicker of light born of our personal certainty that, when everything is said and done, we are infinitely loved.”
— POPE FRANCIS, EVANGELII GAUDIUM #6
Wishing peace and joy for all people!
Merry Christmas and Happy New Year
The Catholic Health Association of the United States
Ann Alvers Liwäy Arceo Lori Ashmore-Ruppel Amy Ballance Kyle Belobrajdic Keon Blackledge
Trevor Bodewitz Paula Bommarito Cara Brouder Leslie Brown Tom Bushlack Sandy Buttery
Tony Cable Loren Chandler Bruce Compton Season Cooley Kimberly Crossman Kathy Curran
Dan Daly Lisa Eisenhauer Chris Fields Jill Fisk Vicki Gant Dennis Gonzales Sr. Mary Haddad
Valerie Schremp Hahn Madeline Hantak Tracie Heck Rebecca Heermann David Hein
Angie Henderson Emily Henke Darren Henson Valerie Herron Nate Hibner Brenda Hudson
Katie Hurley Brian Kane Charlotte Kelley Karla Keppel Norma Klingsick Margaret Kriso Joe Lepore
Nancy Lim Jenn Lyke Cheryl Mance Dottie Martin Josh Matejka Sr. Teresa Maya Andre Mayne
Ken Mayo Crystal Mendez Julie Minda Kim Montesa Cherie Moran Clay O’Dell Michele Oranski
Nick Osterholt Paulo Pontemayor Kevin Prior Brian Reardon Katrina Reid Diarmuid Rooney
Ken Schanuel Amanda Schreier Lisa Smith Indu Spugnardi Yvonne Stroder Lucas Swanepoel
Betsy Taylor Sheryl Ullrich Dee Walsh Dyana White
We Will Empower Bold Change to Elevate Human Flourishing.SM
Wishing you and your loved ones great joy this Christmas and holiday season, and throughout the coming year.
When they [the wise men] saw the star, they rejoiced exceedingly with great joy.
And going into the house, they saw the Child with Mary His mother, and they fell down and worshiped Him.
Then, opening their treasures, they offered Him gifts, gold and frankincense and myrrh.
Matthew 2:10-12
Prayers for peace and joy to you from Ascension Our caregivers, support teams and subsidiaries are grateful to be part of a vibrant Catholic healthcare community, dedicated to spreading peace, love and joy to all people, all year round.
And the angel said to her in reply,
The
SpiritHoly
Therefore the child to be born will be called holy, the will come upon you, and the power of the Most High will overshadow you.
of
SonGod.
1:35
May God bless you and yours with good cheer through the holidays and good health through the new year.
Psalm 86:9 and the goodness of God fill your spirit this holy season. wonder of Christmas May the
All the nations you have made shall come to bow before you, Lord, and give honor to your name.
Let
St.
Trinity
Trinity
As we prepare to celebrate the birth of Jesus, we give thanks for God’s greatest gift to us. May we be expressions of God’s healing love during these weeks of Advent, and always remain steadfast in serving those who are poor and vulnerable. www.providence.org
“So now faith, hope, and love abide, these three; but the greatest of these is love.” – I Corinthians 13:13
Caring for our communities in Minnesota, North Dakota & Wisconsin
May the love that brings healing and peace to the world be born in each of us this Christmas season.
Put on then, as God’s chosen ones, holy and beloved, heartfelt compassion, kindness, humility, gentleness, and patience.
Colossians 3:12
The wonders of His love
Let us all rejoice in hope, pray for peace, and love one another.
May your season be touched with the amazing grace of Christ’s love.
May your season be touched with the amazing grace of Christ’s love.
May your season be touched with the amazing grace of Christ’s love.
Merry Christmas
Merry Christmas
Damond W. Boatwright
Merry Christmas
President & CEO
Damond W. Boatwright
Hospital Sisters Health System
President & CEO
Hospital Sisters Health System
Damond W. Boatwright
President & CEO
Hospital Sisters Health System
CommonSpirit hospital turns donated groceries into building blocks for festive displays
By VALERIE SCHREMP HAHN
It’s common for a hospital to host a canned food drive around the holidays. It might not be so common to build an elaborate display out of the donated goods for everyone to enjoy.
For the past several years at CHI Health Creighton University Medical CenterBergan Mercy in Omaha, Nebraska, goods collected in an employee drive have been turned into festive creations: a steam train, a fireplace mantel flanked with Christmas trees, a moving truck, a giant snowflake, even a boxing ring with hospital administrator photos superimposed over cutouts of boxers and referees.
The elaborate displays, in the hallway of the hospital pavilion, are created to engage employees and highlight the annual Feed the Need effort. The food drive benefits Siena Francis House, a shelter and service agency for people without homes in Omaha.
During a ceremony hosted in front of the display a few days before Christmas, the hospital presents the food and a check to Siena Francis House. Last year, the hospital presented food and other goods worth
$36,000 and a check for $25,000.
This is the 21st year for the drive, a tradition the hospital inherited from the old Creighton University Medical Center, which in 2017 merged with CHI Health Bergan Mercy Medical Center to create the current hospital. The hospital is part of CommonSpirit Health.
Erin Santiago, the director of pharmacy for CHI Health, oversees the effort and says she often doesn’t know until the last minute what the display will look like.
“Honestly, I’m kind of a last-minute person,” she says. “It’s nice to see what food rolls in. And then you get ideas based on the shape of the food.”
If the display builders get several giant cans of green beans, for example, they can build a tree out of them. They’ve stacked and lined up boxes of paper goods and wrapped them in white tablecloths, which they did one year to create the giant snowflake. Last year’s “All Are Welcome” theme included a long table that represented holiday traditions across diverse cultures.
“That reflected on CommonSpirit’s values of inclusion and diversity and taking care of all of our patients,” says Santiago.
>> Read more about the creative initiative and see more photos
chausa.org/chw
Michaela Kanoski, director of volunteer and guest services for CHI Health Creighton University Medical Center-Bergan Mercy, adds flourishes to a display arranged into a holiday living room scene. “It’s really one of the biggest drives each year, and we definitely count on them to be able to support (us) in that way, because we can plan,” says Silvia Rodriguez of Siena Francis House, which receives the donations.
of the displays.
May the light that surrounds us this Christmas fill your heart with joy.
Wishing you and yours good health in the year ahead.
“We also en ust y to her special pa age and we beg the Divine Infant never to f sake y . We pray that, acc panying y always and everywhere, He will supp t, enlighten, advise, gladden and ble y with His nipotent li le hand - at every step and in every m ent - in all y r unde akings, di iculties, and su erings.”
- Ble ed Mary Angela Chris as Le er, 1863
A Child is Born, a Savior
Isaiah 9:6
As we celebrate the Christmas season, we reflect on the spirit of hope, compassion and service that defines our Mission in health care.
Thank you for your commitment to improving access to care in our communities.
May this holiday season bring you joy, peace and renewed strength as we look forward to working together to enhance health care access in the new year.
Dean institute
From page 1
topic when he was a featured speaker at a health care conference she attended many years ago.
“Someone posed the question to him, ‘What’s the most innovative thing that you’ve seen in health care?’” she recalls. “And this is what he said: ‘The most innovative thing that I’ve seen in health care yet is a simple and proven idea: that kindness has the power to heal.’”
Kindness trademark
“
There’s decades and decades of science around the importance of kindness, compassion and trust. We at the institute are really wanting to make sure people understand that this is not soft science.”
— Dr. Alisahah Jackson
Under Dean’s leadership, “Hello humankindness” became part of the Dignity Health brand. The system in 2013 launched a campaign around the catchphrase. The campaign’s goal was “to bring humanity and human connection back into health care.”
“Hello humankindess” and the related campaign is now part of the CommonSpirit brand.
Jackson says the institute is evidence based in its work to show how kindness is linked to better health.
“There’s decades and decades of science around the importance of kindness, compassion and trust,” she says. “We at the institute are really wanting to make sure people understand that this is not soft science. These are things that have actually been shown and proven over and over again to drive outcomes, improve patient outcomes, improve patient experience.”
Jackson and her staff can point to a multitude of research linking kindness to better health. For example, researchers at The Ohio State University published a study last year that found doing good deeds for others can ease symptoms of depression and anxiety.
However, there is also a bounty of evidence showing that the ties between Americans are fraying. This includes studies the U.S. surgeon general pointed to last year in an advisory that called loneliness and isolation a national epidemic.
“We’re in this time where I think it’s important that we reconnect back to our shared humanity,” Jackson says. “We really feel at CommonSpirit that one of the ways to do that is to teach people how to exhibit human kindness and to really support a culture of human kindness, not only in our facilities, but also out in every community that we serve.”
Strategic priorities
As the institute’s president, Jackson says she is focused on bringing awareness to its work, on seeing that the body of knowledge around the connection between kindness and health continues to grow, and on finding ways to use that knowledge to support frontline care providers.
The institute’s work follows four strategic priorities: education, training, research and evaluation. Specific projects the institute has supported include research or studies to:
Understand barriers to peripheral arterial disease screening with a focus on equity gaps in Sacramento, California
Use digital patient navigation to address COVID vaccine hesitancy in vulnerable populations in California and Arkansas
Integrate legal support in primary care to address complex social needs to improve health and reduce health care costs in Port Orchard, Washington
Brisa Urquieta de Hernandez is system director of operations on the institute’s five-person staff. Hernandez has a doctorate in geography and urban regional analysis. Her role at the institute is to develop
partnerships and strategies and oversee pilot projects of innovative care models, all with a focus on advancing health equity and improving health outcomes.
She says she brings a social science perspective to the institute’s work. “When you’re thinking about leveraging the science of kindness, compassion, empathy and trust, what does that mean?” she says, explaining the questions she poses. “What’s that nuance in the interactions between our patients and our providers, our care team, the broader staff, the system, etcetera?”
Hernandez notes that because CommonSpirit has care sites in 24 states, the system can look at its impact on health across diverse geographic locations and demographics. She says that provides an opportunity to take the pulse of the country and pursue the best opportunities to address disparities and promote health justice.
In October, Hernandez oversaw the launch of the institute’s webinar series. The monthly hourlong discussions spotlight different aspects of building a health care culture that integrates the intersection of human kindness and health justice. The goal is to support patients and providers and that advances the best outcomes.
Promoting reconnection
Jackson says the institute is considered a department of CommonSpirit. It works closely with diverse stakeholders across the system, including clinical leaders, philanthropy staff and the communications/ marketing team for support and expertise, she notes.
Dean himself is lending more than his name to the institute. He is an adviser and he helps drum up financial support. In September, the institute had its first Humankindness & Health Justice Summit, a halfday virtual event billed as “the first ever convening of national thought leaders to share insights and best practices and more about how the science of kindness, compassion, empathy and trust can accelerate health justice.”
Dean sat in for a chat at the summit alongside current CommonSpirit CEO Wright Lassiter III. Jackson says the chat was “on the importance of this work and making sure that there is an abundance mindset when it comes to thinking about human kindness and how we actually deliver human kindness at every touchpoint.”
In January, the institute plans to launch The Common Good Academy, which will offer training to clinical providers across CommonSpirit who have responsibilities related to the system’s health equity goals. Jackson identifies goals for the institute that are practical, such as finding ways to ease the strains on clinicians, and lofty, such as driving a global conversation on the importance and value of taking care of each other.
“That’s my aspiration, that we become kind of this global think tank, if you will, on how to reconnect people back to our shared humanity and really drive improvements in health justice with the foundation of human kindness,” she says.
leisenhauer@chausa.org
Dean
Jackson
Hernandez
Gospel choir
From page 1
position, since 2015. The choir started in 2014. It performs about 10 times a year in short concerts or at Mass in the hospital’s chapel or the lobby, where the hospital added a baby grand piano last year.
The choir’s big performances are a living nativity and a Christmas concert in December. The choir, which has been as small as 12 singers or as large as 35, draws from departments throughout the hospital: housekeeping, nursing, surgery, guest services, and more.
“This is an opportunity for us to really come together across multiple disciplines in different areas, different shifts and different roles and responsibilities,” says Angela Lambert, the system’s senior director of mission integration and formation serving the greater Baton Rouge region, and a newer member of the choir. “But we come together to create one voice. It’s a ministry to each other. It’s a ministry to the team members that we serve and serve alongside of, and it’s a ministry to the community and the patients and families that we have a privilege to serve.”
Come as you are
Lambert has assisted Allen with appropriate song selections, and they often choose from choir members’ suggested favorites, or they mix things up for the occa-
Age-Friendly
From page 1
system need to do a better job responding to that.”
Decades of work
The New York-based foundation began focusing on improving care for older adults in the 1980s. It helped develop the field of geriatrics, funded the training of geriatricians and built up a network of geriatric centers of excellence.
Beginning about a decade ago, it came up with the Age-Friendly Health Systems idea, secured IHI’s partnership, conceptualized the 4Ms based on existing research, helped continue to expand the evidence base on the validity of the 4Ms, and then engaged health systems in creating the practices for and implementing the AgeFriendly Health Systems framework.
Aging experts say it’s important for health care providers to be prepared to meet elders’ needs, especially since the population of people aged 65 and over is the nation’s fastest-growing demographic. As this population ages, many of them are experiencing worsening health; and increasing numbers of elders have multiple, complex, chronic illnesses.
Growing movement
sion. “We’re literally trying to still perfect ‘Feliz Navidad,’” says Allen. “I kind of struggle when we get to the verses, but we sing it in its totality, just like it is.”
To respect everyone’s time, the choir only rehearses a couple of times before each concert, and each 30-minute rehearsal is scheduled during lunch. The singers get approval from administrators beforehand. Before performances, they’ll go over parts and cues.
They’re not perfect, but that’s OK, Allen says. “It’s more of a fun thing, because we keep God as the center. The main focus is God,” she says. “And when we come into any rehearsal, there’s no perfect person, only a perfect God. So everybody that sings, we are prepared for wrong notes, and we
laugh with each other and love on it and just prepare on how to improve.”
Lambert says the group is extremely welcoming.
“To know Cheryl, you meet her one time, and you feel like you’ve known her forever, and the entire team is incredible,” she says. “And I love how everyone really does bring their gifts and talents together. It creates this beautiful ensemble.”
In addition to singing, Allen plays the flute and saxophone. Their five children are all musical. The family attends a Baptist church, where Allen’s husband is a pastor.
When she learned Our Lady of the Lake had an opening for a gospel choir director, Allen found herself raising her hand.
“It’s God in action saying a need is here. And why not?” she recalls thinking. “So I stepped into the unknown, and there I
ber 2025.
CommonSpirit has launched an agefriendly pilot in its Lincoln, Nebraska, market, engaging facilities across the care continuum through “champion” staff members. Under those champions’ leadership, the facilities developed patient assessments related to the 4Ms, integrated those assessments into the electronic medical record, educated clinicians and other staff about having 4M conversations with patients, and then launched the system. Clinicians since have been assessing patients for the 4Ms and using that information to coordinate care that addresses identified needs.
CommonSpirit has developed a playbook for spreading the 4Ms systemwide.
Providence undertook a similar process, guided by a system-level steering committee. Providence adds a fifth “M” — malnutrition — to the framework.
found just a wealth of people that love and support. And that’s the real, true reason that we keep it going from year to year. It’s not even a labor.”
Solo spotlights
The choir has a core team of people who organize and lead its productions. Some vice presidents and administrators have been among those who sing solos. The choir invites people in the audience to sing along.
While the choir’s performances are streamed on the hospital’s closed circuit television station, some patients are well enough to come to watch. One time, for a Christmas concert, the rehabilitation unit brought down a young woman from northern Louisiana who was recovering from a stroke. She didn’t have family with her. In the middle of the performance, Allen asked if anyone in the audience wanted to sing.
The young woman reached up from her wheelchair and took the microphone and sang the traditional gospel song “I Love to Praise Him.” People sang along, and her nurses watched, flabbergasted.
“They said (up until) that moment she could not hold a pencil, but in that moment, she held a microphone,” says Allen. “From that moment, we watched a miracle happen.
“That was just the confirmation that what we do, and all that we do matters to the patient in that moment. It’s just going to be God to show up again. And that’s what I have, that anticipation of the next concert: Lord, show up again.”
vhahn@chausa.org
She says a priority of theirs is to ensure that the care elders receive is in line with the goals those elders have.
Kindred at CommonSpirit notes that the age-friendly approach is the “right thing to do for patients and staff” and that the approach is relevant and appropriate for patients of any age — not just elders.
Rani Snyder, vice president of program for the foundation, says the movement has garnered much support, with nearly 5,000 facilities — including hospitals, outpatient clinics, federally qualified health centers, nursing homes and other sites — recognized as Age-Friendly Health Systems. More than 2,000 of those sites are deepening their commitment by providing data to IHI for research and measurement purposes. More than 4.6 million older adults have been reached with 4Ms care, according to IHI. Organizations also can achieve Age-Friendly Health System recognition based on reaching certain milestones. As of August, nearly 5,000 health care organizations had done this.
The Age-Friendly Health Systems lead-
ers’ goals are to increase the number of participants as well as the number of facilities contributing data on how many older adults have been reached. On its website, IHI provides resources to help facilities become recognized as Age-Friendly Health Systems, and it organizes “action communities,” or groups of facilities that undertake that process together. IHI hosts the spring action communities; and the American Hospital Association, another partner in the Age-Friendly Health Systems movement, hosts them in the fall.
Snyder says being age-friendly helps facilities “achieve the outcomes that are most important to them.” After implementing age-friendly practices, many participating facilities have seen cost of care, patient length of stay and hospital readmission rates decrease and patient satisfaction increase, she says.
Pilots, champions, playbooks
CommonSpirit and Providence St. Joseph Health are among the providers that have embraced age-friendly practices most extensively, says Indu Spugnardi, CHA senior director of community health and elder care. The two ministry organizations are among 30 health systems that are taking part in IHI’s first systemwide collaborative to spread the work. That collaborative began in April 2024 and concludes in Octo-
Suzanne Engelder, executive director of program development for the Providence Institute for Human Caring, says Providence is rolling out the age-friendly approach along with a strategy for measuring progress. Providence ambulatory care facilities in Oregon and Washington state have made the most progress implementing age-friendly practices. Providence hopes to expand the practices systemwide over the next several years. The system has more than 1,000 facilities in seven states.
Strategic alignment
Prentice Lipsey, CommonSpirit Senior Living president and CEO, says the approach is expected to lead to better health outcomes for all patients, especially those who are most vulnerable. He says the way age-friendly practices are implemented promotes unification among disparate facilities in a health system, and this can lead to less fragmented care. This in turn can make a system easier for patients to navigate, particularly for the many patients who have multiple chronic conditions, he says.
Kindred says, “It’s not an easy lift but it is so worthwhile — it’s an exciting journey.” She adds that age-friendly work “touches literally every aspect of our strategic plan.”
Patient focus
Lipsey notes that the age-friendly approach also is beneficial when it comes to health equity because the practices call upon providers to speak directly to patients about their goals rather than making assumptions. This helps to reduce patient harm, he says.
Dr. Matthew Gonzales, associate vice president, chief medical and operations officer for the Providence Institute for Human Caring, says Providence has made a multiyear investment in this work to ensure that older adults are well cared for and able to live their best lives. He says the vision is that by a decade from now, an older adult would be able to show up at any Providence location and receive care in line with the AgeFriendly Health Systems ideals.
Engelder notes that many of the people leading this work at Providence are geriatricians, and they are heavily engaged in implementing the age-friendly practices.
He says the work by nature prompts providers to increase their focus on and attention to preventative health and communitybased health and outreach.
Camille Haycock is CommonSpirit senior vice president of patient experience and executive sponsor of the Age-Friendly Health Systems initiative. She says that the groundwork that the age-friendly providers are putting in place now will lead to better health care for all. “It hits all of us,” Haycock says. “We have loved ones we’re caring for who need this. But everyone will need this type of care eventually.”
Gonzales of Providence adds, “We’d love to have even more partners in this.” jminda@chausa.org
The choir at Our Lady of the Lake Regional Medical Center, part of the Franciscan Missionaries of Our Lady Health System, performs during the hospital’s living nativity.
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Dr. Derek Williams, a physician at a Providence St. Joseph Health clinic in Hawthorne, California, sees a patient. Providence is implementing Age-Friendly Health Systems practices at its facilities across the continuum of care, including throughout its clinic network.
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Joseph & Mary’s Home
From page 1
a medical respite facility called Joseph & Mary’s Home. It provides unhoused residents with private rooms and medical services for up to 90 days. But the care goes far beyond healing. Joseph & Mary’s Home, a ministry of the Sisters of Charity of St. Augustine and the Sisters of Charity Health System, works with residents to ensure they’re released into permanent, stable housing.
“We often say our job is to get people back to health and forward to housing,” says Beth Graham, executive director of Joseph & Mary’s Home. “We view housing as essential to health, stability and long-term wellness.”
Joseph & Mary’s Home recently took stock of its men’s facility, known as Joseph’s Home. In its current three-story space, the sole elevator can barely fit one wheelchair. Nine of 11 rooms are on the second floor, and the only handicap-accessible bathrooms are on the first. Earlier this year, Joseph & Mary’s Home launched a capital campaign to move the facility.
“The old location has served us well,” Graham says. “But we are seeing a constant uptick in the median age of our residents, and more and more physical disabilities.”
Changing lives
In the 1990s, one of the sisters was a social worker at a Sisters of Charity Health System hospital. She told the others about the many unhoused patients who had nowhere to go after hospital discharge.
“She kept talking about how they had no ability to get well,” says Sr. Judith Ann Karam, Sisters of Charity of St. Augustine congregational leader. “No environment that would enable them to take their medications, to eat right, to get the sleep they needed.”
Working together, the sisters and the hospital system identified the grounds of a former Sisters of Notre Dame convent in downtown Cleveland as a suitable shelter location. With financial help from the U.S. Department of Housing and Urban Development, Joseph’s Home opened in 2000 as an 11-bed transitional facility for men, a common model at the time. Along with private rooms, residents received meals and some medical supervision and participated in educational and goal-setting activities and an ongoing recovery program. But there was no steady emphasis on finding permanent housing, so the model kept residents in place, sometimes for a couple of years, and prevented new people from moving in.
In more recent years, the care model at Joseph’s Home has shifted to a medical respite that follows the National Health Care for the Homeless Council’s Standards and focuses on integrated, whole person care and long-term stability.
In 2022, Mary’s Home opened in what had been a Catholic school on the same grounds as Joseph’s Home. It offers 10 beds for women. Both the new women’s
and the existing men’s residences — by then designated as medical respite facilities — adopted the goal of finding residents permanent housing. Upon settling in, residents engage with social workers to locate income, including from Social Security, disability, veterans’ and Supplemental Nutrition Assistance Program benefits, as well as from jobs. A donation program helps with deposits and first month’s rent when residents are able to move out. Even after residents leave, staff check up on them periodically to ensure their payments are current and they’re doing well, overall.
“From our understanding of Catholic social teaching, we want to meet the needs of the individual,” Sr. Karam says. “But we also wanted to systemically change a person’s life.”
‘Tremendous success story’
Joseph & Mary’s Home takes in about 100 people each year. They must be over 18, and their unhoused status verified by the Cuyahoga County Centralized Coordinated Intake agency. But not every unhoused person wants help. Some who’ve become used to instability balk at the idea of respite care, according to Joseph & Mary’s Home Medical Director Michael Seidman.
Seidman thinks back to a woman he calls J.K., who suffers from chronic obstructive pulmonary disease. He met her through a mobile medical unit that visited the shelter where she stayed for many years. Living in crowded conditions, she constantly picked up viruses. Even a cold exacerbated her breathing difficulties.
“But she knew the shelter, and she was comfortable there,” Seidman says.
J.K., 68, frequently ended up in the hos pital. Being discharged to a shelter with no medical supervision made it difficult for her to keep up with her medication regimen. After one hospitalization, a nurse told her about Mary’s Home, and she agreed to try it. There, she not only recovered but thrived, especially enjoying her art therapy sessions. She began making drawings with hearts and flowers for her caregivers.
PeaceHealth, Providence join sheltering efforts
In July, Providence Alaska and community partners opened Q’et’en Qenq’a–Providence House, a supportive housing and recuperative care facility in Anchorage for people ages 55 and older experiencing homelessness. Q’et’en Qenq’a means “Elder’s House” in the Dena’ina language. The facility includes 45 supportive housing units, six recuperative care units, and wraparound services on-site provided by community agencies.
“Almost from day one, they worked with her on housing,” Seidman says. “It was like, ‘OK, you’re here now; where are you going to go next?’”
J.K. wasn’t sure about making another change, but with encouragement, she finally found an apartment that suited her needs. She also located a friend from the shelter who had a car and could drive her to the grocery store. “A tremendous success story,” Seidman says.
While she’s only been in her apartment for a couple of months, J.K. is poised for a long-term positive outcome. Of the 67% of Joseph & Mary’s residents who move out into stable housing, 90% remain in their new homes six months later.
“Yes, we work on getting people to their medical appointments and follow up to ensure they take their medicine — and all that’s very important,” Seidman says. “But it’s also the respect people feel when they come to Joseph & Mary’s Home that’s therapeutic.”
A growing need
It takes about $1.4 million to operate Joseph & Mary’s Home every year. Seventy percent comes from individual gifts, foundation or corporate grants and event revenue, and 30% from grant contracts with public sector funders.
A capital campaign known as A New Home for Healing supports renovations for the new Joseph’s Home. Helping to inspire community support is a matching gift of $150,000 from the Sisters of Charity of St. Augustine. To date, the campaign has
raised more than $2.5 million.
“We’re very grateful for the support of the community, city, county and state,” says Graham. “And that they recognize people experiencing homelessness with serious medical issues need a safe place.”
The new site for Joseph’s Home is in the same building as Mary’s Home, a onestory structure. Renovations include a main doorway capable of handling multiple wheelchairs as well as gurneys. Every restroom will have roll-in showers with handheld shower heads and seats. Each room will include an adjustable bed. Halls and doorways will have handrails, knobs will be lever-style and signage will include Braille. Construction began Nov. 11; completion is expected in summer 2025.
Statistics suggest the need for medical respite facilities is growing. Between 2022 and 2023, federal data shows the number of unhoused individuals in the United States increased 12% for a total of nearly 724,000 on any given night — roughly the population of Denver.
Baby boomers — those 64 and older — are driving the trend, says Dr. Timothy Barnett, president of Cleveland Clinic Lutheran Hospital, which frequently refers unhoused patients to Joseph & Mary’s Home. As this large generation ages, there are statistically more people living on the streets or in shelters. At the same time, Barnett says, social services that help people access medical care and nutritious food are dwindling.
“Also, because of the two to three years where we had deferred care or non-care because of the pandemic, we’re now seeing people with more advanced medical problems,” he says.
Homelessness in and of itself accelerates aging, according to a 2019 University of Pennsylvania study. Researchers found that housing instability — and its attendant lack of health care access — can age a person 20 years beyond their chronological age.
A new chance
One hundred thirty-three cities, predominantly on the east and west coasts, offer some form of respite care, according to the National Alliance to End Homelessness.
Joseph & Mary’s Home is the only facility of its kind in northeast Ohio.
“I want to emphasize just how important it is for a vulnerable population with true medical issues to recover and get support,” Barnett says. “And then, to work on getting permanent housing options to give them a new chance in life.”
Beth Bennett, a community health worker intern, meets with residents of Mary’s Home in Cleveland to discuss housing applications. Like Joseph’s Home, Mary’s Home is a medical respite facility. Joseph & Mary’s Home operates both facilities.
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