Group Presentation Christus Spohn I. II. III. IV. Outline Problem a. Effective Staffing Under Numerous Constraints i. Short Staffing 1. Have too much staff/don't have enough staff 2. Work standard (cutting/adding) 3. Hiring staff that doesn't fit Spohn's Mission 4. Behavioral Study ii. Consolidating 1. Merging department/regions/hospitals 2. Reducing staff iii. Benefits 1. Kudos Bank 2. Insurance (health/dental/eye/etc.) 3. Pay 4. Bonuses (yearly raise) iv. Standardization 1. Policies 2. Procedures 3. Processes 4. Equipment 5. Miscellaneous Potential Solutions a. Town Hall Session b. Employee Satisfaction Survey c. Restructured Health Care System Presentation Outline a. Introduction i. Group ii. Company Background iii. Problem b. Short Staffing c. Consolidating d. Benefits e. Standardization f. Potential Solutions g. Conclusion Theories a. Expectancy - Raises b. Equity Theory - Inequity - Lab Tech's paid less than Nurses c. Negative Punishment - Rewarding A but hoping for B - finishing Health Stream (Continued Education Assignments) by the deadline. Answering the call The CHRISTUS Legacy In 1866, Texas, an incredibly large state, was on the brink of burgeoning growth. The entire state was under a single Catholic Diocese with Claude Marie Dubuis serving as Bishop. During long, tiring journeys on horseback throughout the state, Bishop Dubuis came in contact with illness, disease and poverty of staggering proportion. He turned to his native France to those who were suffering. seek help for In his homeland, he issued a call for Religious Sisters to immigrate to Texas. In a letter to his friend, Mother Angelique, Superior of the Monastery of the Order of the Incarnate Word and Blessed Sacrament in Lyons, he wrote, "Our Lord Jesus Christ, suffering in the persons of a multitude of the sick and infirm of every kind, seeks relief at your hands." Mother Angelique found three young sisters to answer the Bishop's call. On September 23, 1866, the three nuns received the habit of the new congregation-and the names, Sister Blandine of Jesus, Sister Joseph of Jesus, and Sister St. Ange. Two days later they left for Texas. On their voyage across the ocean aboard the steamship Tybee, they endured weeks of 15- to 20-foot seas and a hurricane, but arrived safely in Galveston on October 25, 1866. Here in this growing city of immigrants and commerce, the three founded the Congregation of the Sisters of Charity of the Incarnate Word. On April 1, 1867, they opened Charity Hospital, the first Catholic hospital in Texas. Only a few months later, Galveston was stricken with a major yellow fever epidemic, the worst in the history of the city. At the hospital, the three sisters worked day and night for their patients. As newcomers to Galveston, they were more susceptible to the disease than were those who had weathered earlier epidemics, but that did not cause them to spare themselves. By the end of the hot summer, the epidemic had taken the lives of 1,150 residents including that of Mother Blandine, the superior of the small congregation of three. Sister Ange also was stricken with yellow fever but recovered. Four more sisters who had been educated in Lyons arrived to join Sister Joseph, who then became the Superior. Together, the sisters cared for the sick, the aged, and orphans. Eventually, the name of Charity Hospital was changed to St. Mary's Infirmary. The increase in the congregation's membership and the urgent need throughout Texas resulted in an expansion of the sisters' works. In May of 1869, a cholera epidemic in the growing city of San Antonio prompted Bishop Dubuis to seek help from the Galveston sisters. Three sisters responded, Mother Madeleine, Sister St. Pierre and Sister Agnes. In March, 1869, they left Galveston by stagecoach for San Antonio, traveling more than 280 miles on roads that were essentially nothing more than wagon ruts. When they arrived, they found that one building intended for their use had burned to the ground. Undaunted by the tragedy and fortified by their faith, the sisters set out to rebuild the burned hospital. With arduous effort, the two-story adobe structure was completed by the end of the year. Their hospital consisted of wards and private rooms for the sick, a small chapel, and apartments for use as a convent. It was named Santa Rosa Infirmary. In a letter published in the San Antonio Daily Herald on November 18, 1869, Mother Madeleine gives the public an insight to the hospital which was soon to open, "We hope to meet the wants of the patients entrusted to our care by providing for them healthy rooms, good food and attentive nursing; and for this reason we take the liberty to solicit not only the assistance of the authorities entrusted with the welfare of the poor, but also the kind offices of the physicians of this place." She closed her letter by declaring, "The hospital will be open to ill persons without distinction of nationality or creed." And so, in the cities of Galveston and San Antonio, the sisters established self-supporting orders. For this reason and because the vast distance between the cities was so great, the Congregations in Galveston and San Antonio became independent foundations. In 1872, Mother St. Pierre succeeded Mother Madeleine as superior for the Sisters of Charity of the Incarnate Word in San Antonio. In 1928, the Generalate of the Galveston Congregation moved to the Villa de Matel in Houston. Over the next century, the two religious congregations continued to grow, and formed large, independent health systems serving the needs of communities in five states. In 1999, to strengthen their ability to reach out to those in need and provide the best in health care, the two systems became part of CHRISTUS Health. Sharing a common heritage and ministry, their mission-now the Mission of CHRISTUS Health-to extend the healing ministry of Jesus Christ, flows from the founding call and vision of Bishop Dubuis: "Our Lord Jesus Christ, suffering in the persons of a multitude of the sick and infirm of every kind... seeks relief at your hands." On the Banks of the Neches: An 1896 Beginning in Beaumont The CHRISTUS Legacy Upon the request of Father M. P. McSourley, the Sisters of Charity of the Incarnate Word of the Diocese of Galveston agreed to establish a hospital in Beaumont, Texas, in 1896. Hotel Dieu was constructed on the banks of the Neches River and opened in 1898 with accommodations for 24 patients. At that time, Beaumont had a population of 9,000. In 1901 the Lucas oil gusher at Spindletop brought thousands of newcomers to Beaumont, creating a dramatic need for more hospital space. Consequently, a second building was erected, adding 36 beds. A final addition to the frame structure in 1907 brought the total bed capacity to 80. In 1915, the red brick Hotel Dieu, a familiar Beaumont landmark, was dedicated, boasting 175 beds. In 1942 a chapel and convent were added. Then a School of Nursing building and the Martin de Porres Annex were constructed in 1949. Hotel Dieu consolidated with St. Elizabeth Hospital in 1970, becoming St. Elizabeth East until operations ceased there in 1975. The present hospital was constructed to meet Beaumont's need for more modern facilities. This project was made possible by the benevolent efforts of citizens and the generosity of J. H. Phelan Sr. and his wife who donated their property. Through the years there has been expansion to meet the growing health care needs of the Southeast Texas community. Today CHRISTUS Hospital - St. Elizabeth is a 461-bed health care facility on a 40-acre campus. It has a staff of 2,500, making it the largest health care provider in Southeast Texas, as well as the largest hospital between Houston and Baton Rouge. It is the recognized regional leader in cardiology, oncology, neurology, pediatrics, general surgery, birthing, neonatal care, women's services, rehabilitation, imaging, occupational health services and emergency services. The hospital has the largest Neonatal Intensive Care Unit in the area, equipped with state-of-the-art technology. The hospital is designated as a level 3 trauma center and a training ground for family physicians through the CHRISTUS Hospital St. Elizabeth Family Practice Residency Program. The campus also includes the 65,000-square-foot W. P. Hebert Health and Wellness Center, Continence Management/Health Resource Center, and the Family Practice Residency Center. The American College of Surgeons has accredited the Mamie McFaddin Ward Cancer Treatment Center as a Community Hospital Comprehensive Cancer Program. CHRISTUS Hospital - St. Elizabeth has also established rural health clinics in several small surrounding communities. CHRISTUS Hospital - St. Elizabeth, CHRISTUS Hospital - St. Mary and CHRISTUS Jasper Memorial Hospital are members of the CHRISTUS Health Southeast Texas region. Establish Santa Rosa Infirmary The CHRISTUS Legacy In March of 1869, Sisters Madeline Chollet, Pierre Cinquin, and Agnes Buisson left Galveston for San Antonio by stagecoach. They traveled more than 80 miles on roads that were essentially nothing more than wagon ruts. When they arrived, they learned that one building intended for their use had burned to the ground. Undaunted by the tragedy and fortified by their faith, the Sisters set out to rebuild the burned structure. After eight moths of arduous effort, the hospital was finished and named Santa Rosa Infirmary. On November 25, 1869, Sister Madeline submitted an announcement to The Weekly Express informing the public that San Antonio's first private hospital would be open to "all persons without distinction of nationally or creed." On December 3, the day of the hospital's opening, the nine-bed hospital admitted eight patients. Santa Rosa Infirmary, has undergone many changes and additions since its inception. A clinical pathological laboratory was established in 1910. In 1918, Santa Rosa became the first hospital in Texas to devote a separate unit for the care of crippled children. In 1930, five years before it became the first Texas hospital to install air conditioning, the Santa Rosa Infirmary was renamed Santa Rosa Hospital. Gradually, the concept of a complete system of health care began to emerge. In effect, the Sisters of Charity of the Incarnate Word pioneered the idea of a total system of medical care that would offer the latest preventive, diagnostic and treatment facilities to care for the mind, body and spirit of all the inhabitants of San Antonio and South Texas. To this end, the Sisters opened a children's hospital in 1959. CHRISTUS Santa Rosa Children's Hospital is dedicated to the treatment of children who suffer from chronic illnesses and cancer. With a solid base of acute hospitals for children and adults, specialty centers and technological advances began to rapidly increase. Today, the people of CHRISTUS Santa Rosa Health Care reach out to the people of San Antonio with new medical technology and high standards of excellence, a mission of caring is planted firmly in the efforts of the founding Sisters of Charity of the Incarnate Word. St. Mary Hospital Grows from 1927 Port Arthur Request The CHRISTUS Legacy In 1927, the Sisters of Charity of the Incarnate Word were well known and highly respected for their hospital system. That year, city leaders from Port Arthur, Texas asked the Sisters to consider establishing a hospital in their city. However, the Sisters declined because Port Arthur already had a hospital, Mary Gates Hospital. In 1928, the supervisory board of Mary Gates Hospital, in need of better facilities, came to the Sisters themselves. The board offered to transfer the equipment of their hospital and a maintenance fund to the Sisters if they agreed to build a more modern and spacious hospital. The Sisters accepted the offer, with a promise from civic organizations to collect funds for the construction. Local benefactors offered land for the new building and ground was broken in 1929. St. Mary Hospital opened on May 1, 1930, with the transfer of 21 patients from Mary Gates Memorial Hospital. The new 150-bed hospital consisted of five buildings: the hospital, a chapel, laundry, a nurses' home and a power plant. The first superior was Sister Mary Eugene Purcell. In 1954, a new 50-bed unit was constructed. An intensive care unit was added in 1966 and a coronary care unit in 1967. In 1973, a five-story west wing was added which brought total patient capacity to 271 and added facilities for advanced service such as open heart and cardiovascular surgeries, special orthopedic procedures and hemodialysis. A new south wing was completed in 1983, increasing total patient beds to 278 plus 23 bassinets. The new building replaced all patient beds in the wing were built in the 1930s, relocated and expanded emergency services, provided all cardiac monitored rooms, established a catheterization laboratory and added a rooftop heliport. A specialized nursing unit was also built for the treatment of diabetes. In 1986, the hospital introduced outpatient pre-admission services, a dedicated nursing unit and advanced treatment rooms for cancer treatment and carotid artery Doppler and magnetic resonance imaging capabilities. Growth continued in 1989 with the relocation and expansion of a dedicated telemetry unit. The hospital also purchased The Cancer Center of Port Arthur, which rounded out its oncology services. In 1991, the hospital opened the St. Mary Hospital Professional Building, The Family Birth Center and The Children's Medical Center. The Extended Care Unit was relocated to make way for a 24-bed adult psychiatric unit, which opened in June 1992. In addition, Physical Medicine at Bishop Byrne Regional Wellness Center expanded and the cardiac catheterization service added digital cardiac catheterization procedures. Today, CHRISTUS Hospital - St. Mary Hospital and its Associates offer the people of Port Arthur the highest quality health care in one of the area's most modern facilities. Spohn Founded as Corpus Christi's First Hospital The CHRISTUS Legacy On July 25, 1905, Mother Cleophas Hurst and three Sisters from the Sisters of Charity of the Incarnate Word of San Antonio opened Spohn Sanitarium on Corpus Christi's North Beach. At the request of Arthur Edward Spohn, M.D., the Sisters journeyed there to staff and run the city's first hospital. Dr. Spohn, a native of Canada, settled in South Texas in 1876. Because Corpus Christi had no hospital, Dr. Spohn cared for patients in their homes and in a makeshift operating room at the Incarnate Word Convent. In 1897, he began a fundraising campaign to build a hospital in Corpus Christi. It took eight years to raise the $12,000 construction cost. The two-story frame hospital was built on North Beach, just 100 yards from the Corpus Christi Bay. Fourteen years later, a devastating hurricane destroyed the building, killing four people, including one Sister. Hospital supporters resumed their fundraising campaign. In 1923, a 50-bed Spohn Hospital at 1436 Third Street was dedicated. That facility is now known as CHRISTUS Spohn Hospital Shoreline. Over the years, Dr. Spohn's original efforts have spawned the CHRISTUS Spohn Health System, with six hospitals in Corpus Christi, Kingsville, Beeville, Kleberg and Alice. For more than 100 years, CHRISTUS Spohn has remained a faith-based, value driven organization dedicated to meeting the needs of the communities it serves. Doctor's Dedication Sets Foundation for CHRISTUS Schumpert The CHRISTUS Legacy CHRISTUS Schumpert in Shreveport, La. traces its history to 1894 when Dr. T.E. Schumpert, a Shreveport physician and surgeon, opened a 16-bed hospital. In 1898, Dr. Schumpert opened a nursing school at the hospital which degreed hundreds of nurses before it closed in 1955. In the early years of the hospital, Dr. Schumpert served as administrator while he maintained his busy medical practice. Eventually, it proved to be too much. So in 1907, when a group of Jesuit priests suggested that Schumpert contact the Sisters of Charity through the local Bishop, he quickly did so. Seven Sisters, headed by Sister M. Beatrice Ryan, arrived to operate the hospital and nursing school under a lease arrangement. A year later, realizing that he was critically ill with typhoid fever, Dr. Schumpert willed the hospital to the Sisters. He died a few days later in May 1908. The need for a larger hospital became apparent almost immediately and in 1909 the Sisters purchased a building site. Their 90-bed hospital complex was dedicated on May 16, 1911, the third anniversary of Dr. Schumpert's death. The new hospital featured four operating rooms, an obstetrical department and surgical emergency rooms. In 1957, the larger 342-bed T.E. Schumpert Memorial Sanitarium was completed. The towering 10-story facility was acclaimed as one of the most modern in the nation. With a staff of 650, the fully air-conditioned hospital included medical and surgical units, obstetrics, pediatrics, alcohol treatment, psychiatry and many other departments. The new hospital also featured the state's first cobalt unit for the treatment of cancer patients. The 1960s ushered in coronary artery bypass surgery and heart valve replacements at Schumpert -- the first in the region. The 1974 expansion, which was completed in 1980, expanded the facilities for surgery, laboratory, X-ray, emergency and special diagnostics. The Heart-Lung Physical Rehabilitation Building opened in 1982. That same year, Schumpert became the first hospital in the area to perform radial keratotomy, a technique for surgically correcting nearsightedness. Always devoted to improved patient care, the medical center announced a medical milestone in September 1984 with its first kidney transplant. In 1985, Schumpert dedicated its Eye Center, featuring the region's largest staff of ophthalmologists. The hospice program, which opened in 1985, was the first hospital-based hospice program in the Shreveport-Bossier City area that enabled patients to remain at home during the final stages of a terminal illness. Throughout the 1990s, the CHRISTUS Schumpert Health System continued to expand and brought a number of new programs to the area, including the Cancer Treatment Center, the Women and Children's Hospital, a number of minor and primary care clinics and a Pain Care Center. In the late 1990s, CHRISTUS Schumpert also established the CHRISTUS Schumpert Foundation, Grace Home, CHRISTUS Schumpert Bossier Healthplex Rural Health Clinic and CHRISTUS Schumpert Bossier Healthplex. The most recent expansions have been CHRISTUS Schumpert Bossier, a 169-bed community hospital purchased in July 1999, and CHRISTUS Schumpert Highland, a 160-bed acute care facility purchased Oct. 1, 1999. In 2006, the 80-bed CHRISTUS Schumpert Sutton Children's Medical Center opened within CHRISTUS Schumpert St. Mary Place. The facility includes a 22-bed inpatient unit, 40-bed neonatal intensive care unit and 16-bed pediatric intensive care unit. Early in CHRISTUS St. Joseph's History Sisters Struggle to Establish Paris Texas Hospital The CHRISTUS Legacy The origin of St. Joseph's Health System dates to 1896 when the Sisters of Mercy operated a 16-bed hospital in a boarding school near downtown Paris, Texas. But a lack of funds forced the Sisters to give up their mission in 1910. Determined that the hospital should not pass from Catholic sponsorship, Bishop John P. Lynch of Dallas purchased the property and later sold it to the Sisters of Charity of the Incarnate Word. After several months of agonizing labor and severe tests of faith, six Sisters reopened St. Joseph's Infirmary on Oct. 1, 1911. The two-story, 16-bed infirmary formed the nucleus of the later-day CHRISTUS St. Joseph's Health System. The Sisters of Charity of the Incarnate Word, founded in Lyons, France in 1866, had come to Texas at the request of the bishop of Galveston to "aid the sick and the infirm." These hardy predecessors of the Sisters arriving in Paris, Texas had traveled for several weeks over almost non-existent roads to San Antonio to establish a convent and infirmary in 1869. The Sisters who arrived in Paris in 1911 had responded to the need for quality health care in Paris, Texas. Almost immediately they began plans to replace the old, original wooden structure with a three-story brick building that would be totally self-sufficient. The Sisters made room in the hospital for both the sick and the homeless to help Paris take its first small step toward revival after a devastating fire. In 1964, a new addition raised the four-story hospital's capacity to 106 beds, with a floor space of 101,823 square feet. By the mid 1970's, a fifth floor was providing for three of the four wings. In 1977, a study of the obstetrical department at St. Joseph's showed that it had been underutilized over the past five years and operating at a substantial loss. Thus, the unit was replaced with a hemodialysis unit to respond to an urgent need for such service within the community. The 1980s brought numerous expansion projects to St. Joseph's, including a Home Health Program, a hospice program, the Tijerina-Dunnington Urology Clinic, the Sister Mary Eustace Farrell Aerofit Center, a 21-bed, guesthouse and the St. Joseph's Hospital Delta County Clinic - the first in a series of rural health clinics opened and operated by the hospital during ensuing years. The hospital also changed its name to St. Joseph's Hospital and Health Center and created the St. Joseph's Foundation. John D. Koobs, the first layman appointed president and chief executive officer of St. Joseph's, opened a new $1.5 million catheterization laboratory in 1991. Among CHRISTUS St. Joseph's other major 1990s projects was the purchase of PrimeTime, the system's program for seniors. Also, the CHRISTUS St. Joseph's Auxiliary funded heliport project for air ambulances. Other expansions to CHRISTUS St. Joseph's included a second cardiac catherization lab in March of 1999, and a new open MRI (magnetic resonance imaging) machine in the Red River Radiology unit. In 2003, Essent Healthcare purchased CHRISTUS St. Joseph's from CHRISTUS Health. Click here for a related news release. 90 Children 10 Sisters lost in 1900 Galveston Storm The CHRISTUS Legacy On Sept. 8, 1900, Galveston, Texas was struck by a hurricane of such destructive force that it remains one of the worst natural disasters in U.S. history. The water and wind killed more than 6,000 men, women and children. Among the dead were 90 children and 10 Catholic Sisters at the St. Mary's Orphanage. Only three boys and a hymn, "Queen of the Waves," survived from the orphan's home. Prior to the Great Storm, St. Mary's Orphan Asylum stood on a beautiful beach just three miles west of the city of Galveston. Established by the Congregation of the Sisters of Charity of the Incarnate Word, the orphanage was home to 93 children and the 10 Sisters who cared for them. The orphanage itself consisted of two large, two-story dormitories with balconies facing the gulf. Between the dormitories and the gulf were large sand dunes supported by salt cedar trees. On the morning of Sept. 8, 1900, rain fell and winds increased. The island community had experienced many gulf storms before, but this one was to change Galveston forever. Around noon Sister Elizabeth Ryan, who had gone into the city to collect provisions, returned to the orphanage. She had declined pleas from the Sisters at St. Mary's Infirmary, a hospital also founded by her Congregation, to stay there until the storm passed. By mid-afternoon, the waters of the Gulf had eroded the sand dunes and approached the front steps of the dormitories. The Sisters brought all the children into the girls' dormitory because it was the newer and stronger of the two. To calm the children, the Sisters had them sing "Queen of the Waves," an old French hymn. The water continued to rise, eventually entering the dormitories. The Sisters took the children to the second floor and continued to sing. By late afternoon, the water filled the first floor of the dormitory. In an effort to protect the orphans, each Sister tied herself to several of the children. They heard the crash of the boys' dormitory next door as it fell under 150 mph winds and a 20-foot storm surge. The Sisters and children sang once more before their own building, the girls' dormitory, collapsed. Three boys escaped the disaster of the orphanage: Albert Campbell, Frank Bulanek Madera and William B. Murney. The rest, 10 Sisters and 90 children, died in the storm. The bodies were found still tied together. Despite this great loss, the Sisters of Charity of the Incarnate Word continued their mission and one year later opened a new St. Mary's Orphanage within the city limits. It continued until 1965, when orphanages began giving way to foster homes. Today, the Sisters of Charity of the Incarnate Word have spread their ministry to communities throughout Texas as well as to Louisiana, Arkansas, Utah and California. The Congregation also maintains ministries in Ireland, El Salvador, Guatemala, and Kenya. On September 8, no matter where they are, the Sisters of Charity of the Incarnate Word sing "Queen of the Waves" to remember the Sisters, children and all those who faced the Great 1900 Storm. NASA Program Shapes CHRISTUS St. John History The CHRISTUS Legacy In 1972, Space Center Memorial Hospital opened outside of Houston to serve the 55,000 community members who lived near the NASA Manned Spacecraft Center. The goal of the new hospital was "to return to the people of our country the benefits in the form of health service dividends produced from space exploration." Unfortunately, the facility was closed in September 1974, only 13 months after it opened, by the Federal Housing Administration because the hospital was behind in mortgage payments. The hospital was unoccupied until the federal government took it over. In 1981, Congress passed an administration bill, part of President Reagan's budget-cutting proposals, that closed eight Public Health Service hospitals in the United States. The Houston-based Sisters of Charity of the Incarnate Word Health Care Systems was selected by the federal government to assume control of the U.S. Public Health Service Hospital in Nassau Bay, Texas, a suburb of Houston. The government chose the Sisters of Charity because of their reputation for providing quality care. The Sisters purchased the facility for $1. On Dec. 9, 1981, CHRISTUS St. John Hospital treated its first patient. The founding sisters of the hospital, Sister Clare Marie, Sister Frances Therese, and Sister Edwin Berry, worked night and day to build St. John Hospital into the quality health care facility it is today. The hospital opened to serve the needs of the community, merchant marines and workers for the Department of Defense as well as Vietnamese and American shrimpers. In 1982 CHRISTUS St. John Hospital was one of the first hospitals to have a layman, rather than a member of the Congregation, as administrator. Over the years, CHRISTUS St. John Hospital, located across from Johnson Space Center, has been under contract with NASA for provision of the medication kits for the Space Shuttle and for physiological testing for the space program. A $9 million expansion that was completed in 1989 debuted the concept of LDRP suites in the Center for New Life, enlarged the emergency department and improved diagnostic imaging capabilities. On Jan. 23, 1998, the hospital unveiled its new street name and address. Hospital Boulevard was renamed St. John Drive in an official proclamation from the mayor. The hospital's founding sisters were forever memorialized in the new street address, since the "3" in 18300 was chosen to represent the three sisters. CHRISTUS St. John Hospital has always been committed to the CHRISTUS Mission of extending the healing ministry of Jesus Christ through community involvement and programs. The hospital is responsible for establishing Point of Light Clinic, school-based clinics and Project Gabriel in the Dickinson and Nassau Bay areas. CHRISTUS St. John Hospital also received national attention with the development of its parish nurse program. CHRISTUS St. John Hospital continues to offer quality acute care health services, has added specialties to serve the community, actively recruited top physicians to fill the needs of Nassau Bay residents and remains solid in the mission of mercy envisioned by its founding sisters 20 years ago. CHRISTUS Stehlin Foundation Works to Combat Cancer The CHRISTUS Legacy The CHRISTUS Stehlin Foundation for Cancer Research, a nationally recognized leader in cancer research located in Houston, has been a part of CHRISTUS Health since 2006. The legacies of the two entities go back much farther, however, as the Sisters of Charity of the Incarnate Word, sponsors of CHRISTUS Health, partnered with Dr. John S. Stehlin in 1968 to support his research to battle cancer more effectively. Dr. Stehlin, a surgical oncologist and founder of the research organization, decided to practice solely at CHRISTUS St. Joseph Hospital in 1968 due to his deep respect and affection for the Sisters of Charity of the Incarnate Word. He established the Stehlin Foundation for Cancer Research in 1969. Frustrated with the traditional approach to cancer treatment, he developed a tri-partnership concept between clinician, research scientist and patient, in which everyone works together to provide the best overall treatment. The CHRISTUS Stehlin Foundation conducts research that can be applied directly to improving the treatment of the patient with cancer. All research is clinically oriented. Since 1969, the Foundation has launched innovative, life-saving research and treatments for patients with cancer, including the development of a promising family of anticancer drugs, the Camptothecins. CHRISTUS Health looks to provide continuity and institutional support for the Foundation as they continue this important Camptothecin research. For more information about the CHRISTUS Stehlin Foundation for Cancer Research, please visit their website. Our Mission, Values, and Vision Our Mission: WHY WE EXIST. To extend the healing ministry of Jesus Christ. Our Core Values: WHAT WE BELIEVE IN. DIGNITY Respect for the worth of every person, recognition and commitment to the value of diverse individuals and perspectives, and special concern for the poor and underserved. INTEGRITY Honesty, justice, and consistency in all relationships. EXCELLENCE High standards of service and performance. COMPASSION Service in a spirit of empathy, love, and concern. STEWARDSHIP Wise and just use of talents and resources in a collaborative manner. Our Vision: WHAT WE ARE STRIVING TO DO. CHRISTUS HEALTH, a Catholic health ministry, will be a leader, a partner and an advocate in the creation of innovative health and wellness solutions that improve the lives of individuals and communities so that all may experience God's healing presence and love. Our Name and Symbol: WHO WE ARE. CHRISTUS is Latin for "Christ," and proclaims publicly the core of our mission. OUR NAME choice also recognizes the heritage of our two congregational sponsors, the Sisters of Charity of the Incarnate Word in Houston and San Antonio. Jesus Christ is the Incarnate Word, the Word of God made flesh. It is, therefore, only fitting that it is in another form of His name that our health ministries are called together. OUR SYMBOL Reflects the healing ministry of Jesus Christ - a combination of a medical cross and a religious cross. The flowing banner on the cross is a common symbol of the risen Christ, while the royal purple signifies Christ. The flowing banner also conveys a sense of motion as we move forward into a new era of service to our communities. CHRISTUS Integrity CHRISTUS Integrity Programs foster high standards of care for CHRISTUS patients. Some Integrity programs address government initiatives, while others are completely CHRISTUS-focused. Ethics We Practice. Ethical and Legal Responsibility Business and Organizational Ethics Patient Rights and Patient Care Click on a link below to learn more about CHRISTUS Integrity Programs. Diversity and Inclusion CHRISTUS Health has long recognized the importance of diversity and inclusion. These fundamentals not only underpin our core mission, they also guide our interaction with patients, associates and the communities we serve. To guide and champion these efforts, the Office of Diversity and Inclusion focuses on training and education, recruitment and retention, equity in care, community partnership and supplier diversity and creating accountability across the board. At CHRISTUS Health, we define diversity as "everyone and everything with no one and nothing left out." We recognize the worth of each unique human being, and respect personal differences because they strengthen us collectively. We care about every person who is part of our mission. Our definition of inclusion is "engaging all who participate in our mission." At CHRISTUS, we believe it is critical that each person is able to contribute their best talents, skills, abilities and experiences. We are committed to fostering and encouraging growth and opportunity for all. Creating an inclusive environment is directly linked to our performance, profitability and success. Our mission here at CHRISTUS Health is to extend the healing ministry of Jesus Christ for ALL. Our patients' receive treatment that includes caring for each part of their total being. We strive to ensure each patient gets culturally and linguistically competent care tailored to their unique needs. Through our continued focus on excellence, we embrace CHRISTUS' sacred name and seek to create a culture in which our mission and core values are truly exemplified, ensuring that the lives of those we serve are sustained and strengthened by the care we provide. Unique individuals united in the spirit of excellence . . . united in a mission of healing. That's CHRISTUS Health. Diversity and Inclusion Memo from Ernie Sadau ----(IS A YOU TUBE VIDEO) Diversity and inclusion aren't new ideas to us at CHRISTUS Health. Their importance was instilled in us by the Sisters of our Sponsoring Congregations, who remind us that every person is a creation of God, and all have value and deserve respect. As CHRISTUS Health, we provide equitable care--the same high quality, compassionate care to everyone--because it is part of who we are. This isn't sentimental theology or a mandate to meet a certain quota, it is a sacred call to honor the integrity and dignity in every person we come in contact with, from our coworkers to our patients, physicians, volunteers, and residents. But even though these ideas are part of our Catholic heritage, they are quickly becoming essential from a business standpoint as well. It is undeniable that health care is changing rapidly and moving more quickly than ever. CHRISTUS Health must find new ways of operating, of doing more with less, and of providing care of the highest value so we can serve all those who need us and continue to live out our mission. It is impossible to build a new future, to create a new path, by doing what we have always done; we must invite new ideas and different perspectives to the table to truly become a "lead changer" in health care. Our commitment to diversity and inclusion will provide us with the resources, skills, talents and ideas that will be essential to building a bright future for our patients and our Associates. Ernie Sadau, Chief Executive Officer Homework for Chapter 5 (modified questions from the end of the chapter) [13 points possible] 1. Why are the concepts of own and cross-price elasticities of demand essential to competitor identification and market definition in the cigarette industry? (2 points possible) The own price elasticity shows the percentage change in a firm's sales or demand of good when there is a 1% change in its price. And the change in the demand would tell about the market and competitors. For example, when the price of cigarette changes, the demand for cigarette will be influenced. If the price increases, some customers may keep buying cigarette and the others may buy its substitutes from other firms such as ecigarette. By observing these changes, the firms may measure the markets and identify its competitor. The cross-price elasticity of demand may measure the degree that a product may be substituted for each other. When the number xy is positive, it means that consumers will purchases more good Y when the price of good X increases. And goods X and Y would be substitutes. So if the customers buy more e-cigarette when the price of traditional cigarette increases, and the xy is positive, they are substitutes for each other. Knowing the substitute would help the firm indicate competitors and identify the market. For example, Reynolds realizes e-cigarette would be substitute for cigarette, then it hopes its merger with Lorillard would bring about more segment of the market, in both areas of strength for this industry. 3. How would you characterize the nature of competition in the craft-beer industry? Are there submarkets with distinct competitive pressures? Are there important substitutes that constrain pricing? Given these competitive issues, how can a craft-beer provider be profitable? (3 points possible) The craft-beer industry is in monopolistic competition. In such situations, new firms may easily enter this highly competitive market in which there are many producers offer products that are similar substitutes. And the prices are in average level. Moreover, each firm has its own kinds of craft-beer which are produced in different receipts. Customers are fond of some special craft-beer kinds of these firms and they keep buying them even though if the price increases, for example, the craft-beers made from Cascade hops. There are some submarkets in this industry. Some people just want something reasonably tasty. So the local craft-beer sales may be very successful on a local level and continue to be profitable without expanding their distribution. The main reasons are the favorites and habit of customers who like draft-beer. Although craft-beer has many substitutes such as wine, alcoholic beverages,... but it is also hard for them to replace craft-beers. So the substitutes may not effect the craft-beer prices significantly. Given these competitive issues, a craft-beer producers still may get profits. They need to increase the quality of its products, follow the right receipt and ingredients to maintain the loyalty of its current customers. The craft-beer producer also may try to research and develope news receipt which could bring the special flavor for beers, to attract more new customers. It also may offer new bundles of services, promotion, gifts, or discounts when selling beers to customers. 4. How does industry-level price elasticity of demand shape the opportunities for making profit in an industry? How does the firm-level price elasticity of demand shape the opportunities for making profit in an industry? (2 points possible) The industry - level price elasticity of demand indicates the percentage change in quantity demanded per percentage change in price when all firms simultaneously change price. So the firms' abilities to profit would be limited from the increase or decrease in price. And it would shape the profit opportunities where firms tend to have their pricing behavior be more likely to a monopoly structure. The firm - level price elasticity of demand shows the percentage change in a firm quantity demanded per percentage change in price that firm makes but other competing firms do not. This elasticity may provide the possible benefits a firm could get when changing price and stealing business from competitors. The larger the elasticity is may lead to the price cut of a firm. So this elasticity may shape the opportunities for making profit in an industry. When firms have a greater degree of elasticity of demand, the price wars are likely to happen and may lead to a decrease overall profits eventually. 7. Numerous studies have shown that there is usually a systematic relationship between concentration and price. What is this relationship? Offer two brief explanations for this relationship. (2 points possible) There is a positive relationship between price and concentration. The higher the concentration is, the higher the price tends to be. If the concentration is high, the price would be decided by a few top firms in the industry. Because these firms take the biggest market shares in this industry and they have more market power and pricing power. Because they know that they take important roles in the market, they would like to increase the prices. Moreover, the high concentration may lead to collusion. While in a market with many small firms having similar market share, every firm has the same role. So they would like to keep the low or average price to compete with the others, because increasing the price would make them lose customers. 9. The following are the approximate U.S. market shares of different cigarette companies: Altria, 47 percent; Reynolds American, 26 percent; Lorillard, 14 percent; Imperial, 5 percent; total for all other brands, 8 percent. Assume \"all other brands\" each have less than a onepercent share. (a) Compute the Herfindahl for this market, showing how you arrived at this number. (1 point possible) HHI = 472 + 262+ 142+ 52= 3106 (b) Suppose that Reynolds American were to acquire Lorillard, as it has announced - BUT suppose Reynolds American is planning to not sell off any Lorillard brands. Compute the post-merger Herfindahl, showing how you arrived at this number. (1 point possible) HHI = 472 + (26+14)2+ 52= 3834 (c) Would federal antitrust agencies be likely to become concerned to see a Herfindahl increase of the magnitude you computed as [(b) - (a)], as well as the projected SSNIP, and challenge the merger? Explain why or why not. (2 points possible) The merger would bring a very high concentration in this market. The federal antitrust agencies definitely will regard this merger as a serious issue hard not to be concerned. The difference between before and after the merger is so big (3834-3106= 728). This merger would lessen the competition in this industry and potentially bring about the monopolization. And the federal antitrust agencies have right to stop this acquisition if they may prove these would become true. Then the two firms will be costed very high for this issue. Before any merger or acquisition, it usually is necessary to obtain opinions and ideas from the federal antitrust agencies. ANSWERS Question 1 In the situation of own price elasticity of demand, it is determined whether a good or service faces stiff competition with its substitutes. This is done without disclosing what the substitutes constitute. Substitutes can be identified by measuring the cross-price elasticity of demand between the products. The higher it is, the higher the chances are consumers to substitute one commodity for another when the price of one is increased. Hence own and cross price elasticity contribute to competitor identification and market definition. Question 3 The nature of competition among small food companies can be characterized as perfect competition as the firms sell identical products, have relatively small market share and characterized by freedom of entry and exit from the market. There might be some submarkets in terms of different marketing and structural features which may include distinct distribution channels and effective promotion methods. There are also few important substitutes as commodities are identical. It can be profitable by undertaking advertising and specialization in the production process. Question 4 Price elasticity of demand is the percentage change in quantity demanded of a commodity as a result of changes in price. Industry level price elasticity of demand influences the level of profits that any given firm makes in the industry. If the firm's product is elastic, a price increase will reduce the total revenue of the firm thus reduced profits. If the product is unit elastic then a rise in price will leave the total revenue unaffected hence the profits level will remain constant. If the firm's product is inelastic then a price increase will lead to an increase in in revenue hence profit. The opposite changes will occur when price decreases. Conclusively, when a firm is thinking of opportunities and maximizing profits price elasticity must be taken into consideration. Question 7 The relationship between concentration and price is that highly concentrated industries behave as oligopolies with attendant problems of pricing coordination, with expectations of different reactions to price changes. Also, there is limited pricing; where firms in the concentrated industry enjoy increasing returns to scale and tend to keep their prices low to discourage entry into the market. Question 9 a) Herfindahl index is defined as the sum of squares of the market share of firms within industry. Altria- 47% Reynolds- 26% Lorillard- 14% Imperial- 5% Other bands- 8% Get the summation of squares of each HHI= (Share)2 With % as whole numbers and not fractions: (47)2+ (26)2 + (14)2 + (5)2 + (8)2 = 2209+ 676+ 196+ 25+ 64 Therefore HHI = 3170 b) Post-merger HHI = (47)2+ (26+14)2+ (5)2+ (8)2 = 2209+ 1600+ 25+ 64 = 3898 c) Consider the difference between (b) and (a) 3898- 3170 = 728 The federal antitrust agencies will definitely be concerned with increase in the magnitude of the HHI because the merger has increased the HHI 728. Mergers that increase the HHI by more than 100 points must be challenged. Homework for Chapter 5 (modified questions from the end of the chapter) [13 points possible] 1. Why are the concepts of own and cross-price elasticities of demand essential to competitor identification and market definition for companies in the food industry? (2 points possible) 3. How would you characterize the nature of competition among small food companies? Are there submarkets with distinct competitive pressures? Are there important substitutes that constrain pricing? Given these competitive issues, how can an organic frozen foods producer be profitable? (3 points possible) 4. How does industry-level price elasticity of demand shape the opportunities for making profit in an industry? How does the firm-level price elasticity of demand shape the opportunities for making profit in an industry? (2 points possible) 7. Numerous studies have shown that there is usually a systematic relationship between concentration and price. What is this relationship? Offer two brief explanations for this relationship. (2 points possible) 9. The following, adapted from a merger case in 2014, were the approximate U.S. market shares of different cigarette companies: Altria, 47 percent; Reynolds American, 26 percent; Lorillard, 14 percent; Imperial, 5 percent; total for all other brands, 8 percent. Assume \"all other brands\" each have less than a one-percent share. (a) Compute the Herfindahl for this market, showing how you arrived at this number. (1 point possible) (b) Suppose that Reynolds American were to acquire Lorillard, as it has - BUT suppose Reynolds American did not sell off any Lorillard brands [unlike the actual deal]. Compute the post-merger Herfindahl, showing how you arrived at this number. (1 point possible) (c) Would federal antitrust agencies be likely to become concerned to see a Herfindahl increase of the magnitude you computed as [(b) - (a)], as well as the projected SSNIP, and challenge the merger? Explain why or why not. (2 points possible) Homework for Chapter 5 (modified questions from the end of the chapter) [13 points possible] 1. Why are the concepts of own and cross-price elasticities of demand essential to competitor identification and market definition in the cigarette industry? (2 points possible) The own price elasticity shows the percentage change in a firm's sales or demand of good when there is a 1% change in its price. And the change in the demand would tell about the market and competitors. For example, when the price of cigarette changes, the demand for cigarette will be influenced. If the price increases, some customers may keep buying cigarette and the others may buy its substitutes from other firms such as ecigarette. By observing these changes, the firms may measure the markets and identify its competitor. The cross-price elasticity of demand may measure the degree that a product may be substituted for each other. When the number xy is positive, it means that consumers will purchases more good Y when the price of good X increases. And goods X and Y would be substitutes. So if the customers buy more e-cigarette when the price of traditional cigarette increases, and the xy is positive, they are substitutes for each other. Knowing the substitute would help the firm indicate competitors and identify the market. For example, Reynolds realizes e-cigarette would be substitute for cigarette, then it hopes its merger with Lorillard would bring about more segment of the market, in both areas of strength for this industry. 3. How would you characterize the nature of competition in the craft-beer industry? Are there submarkets with distinct competitive pressures? Are there important substitutes that constrain pricing? Given these competitive issues, how can a craft-beer provider be profitable? (3 points possible) The craft-beer industry is in monopolistic competition. In such situations, new firms may easily enter this highly competitive market in which there are many producers offer products that are similar substitutes. And the prices are in average level. Moreover, each firm has its own kinds of craft-beer which are produced in different receipts. Customers are fond of some special craft-beer kinds of these firms and they keep buying them even though if the price increases, for example, the craft-beers made from Cascade hops. There are some submarkets in this industry. Some people just want something reasonably tasty. So the local craft-beer sales may be very successful on a local level and continue to be profitable without expanding their distribution. The main reasons are the favorites and habit of customers who like draft-beer. Although craft-beer has many substitutes such as wine, alcoholic beverages,... but it is also hard for them to replace craft-beers. So the substitutes may not effect the craft-beer prices significantly. Given these competitive issues, a craft-beer producers still may get profits. They need to increase the quality of its products, follow the right receipt and ingredients to maintain the loyalty of its current customers. The craft-beer producer also may try to research and develope news receipt which could bring the special flavor for beers, to attract more new customers. It also may offer new bundles of services, promotion, gifts, or discounts when selling beers to customers. 4. How does industry-level price elasticity of demand shape the opportunities for making profit in an industry? How does the firm-level price elasticity of demand shape the opportunities for making profit in an industry? (2 points possible) The industry - level price elasticity of demand indicates the percentage change in quantity demanded per percentage change in price when all firms simultaneously change price. So the firms' abilities to profit would be limited from the increase or decrease in price. And it would shape the profit opportunities where firms tend to have their pricing behavior be more likely to a monopoly structure. The firm - level price elasticity of demand shows the percentage change in a firm quantity demanded per percentage change in price that firm makes but other competing firms do not. This elasticity may provide the possible benefits a firm could get when changing price and stealing business from competitors. The larger the elasticity is may lead to the price cut of a firm. So this elasticity may shape the opportunities for making profit in an industry. When firms have a greater degree of elasticity of demand, the price wars are likely to happen and may lead to a decrease overall profits eventually. 7. Numerous studies have shown that there is usually a systematic relationship between concentration and price. What is this relationship? Offer two brief explanations for this relationship. (2 points possible) There is a positive relationship between price and concentration. The higher the concentration is, the higher the price tends to be. If the concentration is high, the price would be decided by a few top firms in the industry. Because these firms take the biggest market shares in this industry and they have more market power and pricing power. Because they know that they take important roles in the market, they would like to increase the prices. Moreover, the high concentration may lead to collusion. While in a market with many small firms having similar market share, every firm has the same role. So they would like to keep the low or average price to compete with the others, because increasing the price would make them lose customers. 9. The following are the approximate U.S. market shares of different cigarette companies: Altria, 47 percent; Reynolds American, 26 percent; Lorillard, 14 percent; Imperial, 5 percent; total for all other brands, 8 percent. Assume \"all other brands\" each have less than a onepercent share. (a) Compute the Herfindahl for this market, showing how you arrived at this number. (1 point possible) HHI = 472 + 262+ 142+ 52= 3106 (b) Suppose that Reynolds American were to acquire Lorillard, as it has announced - BUT suppose Reynolds American is planning to not sell off any Lorillard brands. Compute the post-merger Herfindahl, showing how you arrived at this number. (1 point possible) HHI = 472 + (26+14)2+ 52= 3834 (c) Would federal antitrust agencies be likely to become concerned to see a Herfindahl increase of the magnitude you computed as [(b) - (a)], as well as the projected SSNIP, and challenge the merger? Explain why or why not. (2 points possible) The merger would bring a very high concentration in this market. The federal antitrust agencies definitely will regard this merger as a serious issue hard not to be concerned. The difference between before and after the merger is so big (3834-3106= 728). This merger would lessen the competition in this industry and potentially bring about the monopolization. And the federal antitrust agencies have right to stop this acquisition if they may prove these would become true. Then the two firms will be costed very high for this issue. Before any merger or acquisition, it usually is necessary to obtain opinions and ideas from the federal antitrust agencies