Pope Francis has approved a new three-year reform process for the Catholic Church, sending a strong signal he plans to continue in the post despite spending a month in hospital battling pneumonia.

The Vatican announced on Saturday that the 88-year-old pope had signed off on the reform plans from Rome’s Gemelli hospital earlier in the week. Francis has been hospitalized since February 14, his longest stay since his election as pope 12 years ago.

Reforms on the table include how to give greater roles to women in the Catholic Church, including ordaining them as deacons, and the greater inclusion of laity in governance and decision making.

The reforms have been examined through a structure called the Synod of Bishops, which has been the primary vehicle through which the pope has implemented his pastoral agenda during his papacy. In recent years he’s sought to involve Catholics from across the globe in the renewal process.

In October 2023 and 2024 two Vatican assemblies – which for the first time included female voting members – each met for almost a month of discussions and deliberation with a final document agreed by the pope.

That document left open the question of ordaining women deacons, who carry out all the functions of a priest bar celebrating Mass and hearing confessions. It also insisted that women be given all the opportunities that church law provides to act as leaders.

Francis’ latest decision extends the process by another three years and will culminate in an “ecclesial assembly” in the Vatican in October 2028. Unlike a synod of bishops, this will be a unique gathering of bishops, clergy, monks, friars, nuns and lay men and women.

By that stage Francis would be 91, so his move could mean that a conclave takes place while this reform initiative is ongoing. In that scenario, whoever is chosen as the next pope would be tasked with continuing the reform process Francis has started.

Meanwhile, the pope’s decision is also a response to those bishops and other senior leaders who have been quietly resisting the Argentine pontiff’s reform plans.

Cardinal Mario Grech, who leads the Holy See’s synod office, said the latest plans, which will include churches at the local level, “offer dioceses that have invested less in the synodal path an opportunity to recover the steps not yet taken and to form their own synodal teams.”

Since his hospitalization, the pope has signaled he’s still governing the Catholic Church, signing documents from the Gemelli hospital, meeting two of his most senior aides and appointing bishops.

On Saturday, the Vatican said that Francis is in stable condition and has made “gradual improvements” but still requires treatment at the hospital. The need for non-invasive mechanical ventilation — which Francis has been receiving at night — has reduced and he is expected to recover, according to the Vatican.

Nevertheless, Francis’ extended period hospital has been a time of high anxiety for the Vatican. At 30 days, it is his longest hospitalization, although is still behind John Paul II’s 55 days at the Gemelli.