Apgar gave nurses a way to rate the health of babies at delivery: "Ten points meant a child born in perfect condition. Four points or less meant a blue, limp baby."

This simple score, devised by an unlikely person-she had never delivered a baby, as a doctor or even as a mother-"turned an intangible and impressionistic clinical concept-the condition of new babies-into numbers that people could collect and compare."

And doctors, being both compassionate and competitive, wanted to boost Apgar scores for their newborns. So they began giving babies oxygen or warming them. They switched from giving mothers general anesthesia to spinals or epidurals. They began using prenatal ultrasounds and fetal heart monitors. And what a change: instead of one in every thirty babies dying at birth, today it's one in every five hundred. Virginia Apgar's score is saving the lives of over 100,000 American babies every year.

We need an Apgar score for the church.

As pastors, we care deeply about the health and vitality of our congregations. But how can we grasp congregational health? To use Gawande's words, it's "an intangible and impressionistic" concept. We need a measure that's simple, clear, and life-giving.

Problems with the prevailing metric

Through most of the twentieth century, the prevailing statistic for churches was the number of members. But as younger generations no longer formed their identity in relation to institutions-political party, labor union, fraternal organization, church-membership gradually told less about a congregation's real state. A long-established downtown congregation, for example, might have hundreds on the membership rolls but only a handful in worship.

So beginning in the early 1960s, some denominations began to report on worship attendance, and by about 1975, attendance had become the most widely accepted way to measure a congregation's vitality. Go to any pastors' convention and you'll soon be asked, "How big is your church?" or more crudely, "How many are you running?"

Attendance has hung on now, for almost 50 years, with only minor tweaks. In the 1980s, as well-known congregations added Saturday night services, people began counting "weekend worship attendance." In the 1990s, as churches added video venues and multiple sites, the count expanded like a baby boomer's waistline-"weekend attendance in multiple sites and venues." In the 2000s, with the addition of web campuses, it's not considered cheating to add to your count website viewers of online services. But we're still hoping attendance will tell us something essential about the health of our congregation.

Why does attendance hang on? First, it's simple. An usher with one bad eye can get the number for you.

Second, attendance, unlike membership, means the same thing everywhere.

Third, it's meaningful: Size determines the size of church staff and correlates with annual giving, which is the most influential factor in a senior pastor's compensation.

Finally, size confers social status, speaking engagements, and book contracts. As C. S. Lewis pointed out, medieval people were fascinated by light, but we moderns (and even avowed postmoderns are building on modern rubble) are fascinated by size.

Size even has scriptural support. Proverbs 14:28 states an immutable law of leading human organizations: "A large population is a king's glory, but without subjects a prince is ruined." So don't expect attendance to easily yield its proud place to budget, baptisms, or blog traffic.

And yet. We can't shake the feeling that measuring a local church by weekly attendance is at best insufficient and at worst misleading. What's wrong with it?

The missionally minded question attendance's very premise: It may measure a church's ability to be attractional, but what does it say about its ability to be missional? Many leaders are calling for a radical shift, from counting how many people are in the church service, to counting how many church people are in service. Why not measure the drop in the local community's teen pregnancy rate or the number of wells dug in sub-Saharan Africa?

Isn't there something malodorous in the fact that church attendance clings closely to what Americans value-bigness and money? The radical message of Jesus flips those on their back and honors the tiny (think pearl), the hidden (think yeast), and the willing-to-decay (think grain of wheat).

Even the pastor with a dog-eared copy of The Effective Executive has to admit that attendance focuses on one activity in the Christian life (gathering together, Heb. 10:25) rather than the more-important outcome-conversion or obedience or perseverance or maturity (Matt. 28:20). Peter Drucker pointed out decades ago that "All nonprofits have one essential product: a changed human being." As much as we wish church attendance led inexorably to life change, we know that's not the case.

We need to move beyond measuring churches primarily by attendance. We need a new measure. We need an Apgar score. I'm just crazy enough to propose not just one, but two possibilties.

For the rest of the story go here: http://www.christianitytoday.com/

----Kevin A. Miller is assistant pastor at Church of the Resurrection in Wheaton, Illinois, and publisher of Leadership.