PI/QI: Theological Reflections (5)

(This post is the third in a series on theological reflection on Performance Improvement/Quality Improvement. This material was first published in “Performance Improvement: Theological Reflections”, Chaplaincy Today, Vol. 16, Number 1 (Summer, 2000), and has been reedited for this setting. For future posts in this series or in the series on measurement for chaplains, please select the label "PI/QI" in the left hand column.)

Performance Improvement: Theological Reflections, Part 5

PI and the ministry of administration

Earlier in this paper I wrote of two pragmatic reasons that it was appropriate for us to reflect theologically on performance improvement: that it was an important and growing aspect of the health care environment, and that it was a tool potentially useful to us as professionals. However, there is a third and more basic reason. This is that our theological reflection is as much a part of our ministry of administration as it is of our ministry of direct care. In the process of being wise as serpents and innocent as doves, we come to recognize that without a good administrative foundation, our other ministries will be at best incomplete and at worst ineffective- or expendable.

Lawrence Holst spoke to this quite eloquently. He noted the concerns I spoke to earlier, as well as the general resistance many chaplains feel to administrative responsibility. However he also noted

If the hospital chaplain’s primary administrative responsibility is not to the patient but to a network of hospital administrators; and if his primary constituency does not usually experience or ‘consume’ clinical pastoral services, then this means that pastoral administration may provide that constituency with its only exposure to pastoral care [Holst’s emphasis].[1]

In essence, the chaplain’s most common ministry to and with administrators is in the practice of administration. Therefore, “…it is a legitimate expectation that chaplains will bring to their administrative tasks the values and convictions inherent in their faith.”[2]

In that perspective, it is important that we reflect on the language and philosophy of performance improvement in our role as theologians and even as maintainers of conscience and tradition in our institutions. Arguably, this is a part of our prophetic ministry. It speaks to the organizational ethics of our institutions and to the values lived out within them. Our ministry to our administrators calls for such reflection and, as I have argued, to particular issues such as performance improvement.

Performance improvement always involves change. While this is more immediately visible in the rapid, radical changes of reengineering, it is no less true in quality management. Performance improvement is a philosophy, reflecting a set of values. While these may not be in conflict with our faith traditions, they are stated in a different language. They will not translate automatically and should not be translated without reflection, either by us as chaplains or by our administrations. As practicing theologians, this reflection is a valuable ministry we can offer to our institutions.

[1] Lawrence E. Holst, “The Chaplain as Administrator”, in Lawrence E. Holst, ed., Hospital Ministry (New York: Crossroad, 1985), 178.
[2] Ibid., 180.

Next: a PI/QI language for clergy