Personnel shortages and staff burnout are among the most pressing workforce challenges hospital CEOs face, highlighting the need for alignment between human resources leadership and the CEO in shaping staff-related initiatives.
While the CEO typically makes the final decision on strategic, systemwide initiatives, the chief people officer or chief human resources officer plays a key role by providing data and insights during the evaluation process.
Working collaboratively, they can address HR-specific issues, such as recruitment, retention, well-being and employee engagement.
Larry Antonucci, MD, president and CEO of Fort Myers, Fla.-based Lee Health, and the organization's chief people officer, Mike Wukitsch, PhD, spoke with Becker's about how they ensure alignment between them on key priorities.
Ensuring alignment on priorities
One step Drs. Antonucci and Wukitsch have taken in the last few years is moving their offices to the same hallway.
"You would be surprised what a difference that makes in the ability to pop in when issues come up or questions arise," Dr. Antonucci said.
The executives also meet more frequently outside of their normal scheduled meetings, as needed, have open-door policies and text each other if there is an urgent issue.
Additionally, Lee Health has a chief executive leadership council. This team, which includes the president and CEO, COO, chief medical officer and chief nursing officer, among others, discusses organizational priorities and shares feedback with each other.
For example, council members shared feedback regarding Lee Health's decision to convert to a private nonprofit health system, Dr. Wukitsch said.
The Lee County Board of County Commissioners approved the conversion Oct. 28, after Lee Health's board of directors signed off on the agreement earlier that month. The system converted to a private nonprofit on Nov. 1 — a decision the system projects will realize $1 billion in additional net patient revenue over the next decade.
Dr. Wukitsch said that while Dr. Antonucci oversaw the process, others on the council were in communication and participated in the decision-making process regularly.
Navigating different perspectives
Drs. Wukitsch and Antonucci were asked to share an example of a time when they disagreed on a strategic initiative and how they navigated that disagreement to arrive at a resolution.
There is not a significant disagreement between Drs. Antonucci and Wukitsch on key priorities at the organization, according to Dr. Wukitsch. However, he acknowledged there are times they may disagree or have a different perspective.
"We adjudicate that by talking it out and try to reach consensus if there's an issue that we see that we have a different angle on," said Dr. Wukitsch. "I have to use persuasion. Larry sees the world from a different angle than I do. So, sometimes, it's, 'Let me share a different perspective on what's happening here.' And we generally reach a pretty good consensus on what we're seeing and what we're going to do about it."
Dr. Antonucci expressed similar sentiments.
"I don't see it disagreeing on major initiatives, but there are going to be areas where we may see things differently, such as if we were bringing in a senior leader, and we're talking about what compensation we are going to offer," he said.
"Mike may talk about what the market is and where the 50th percentile is, for instance, but I may have a different opinion based on a particular skill set or a particular need of the organization. We usually will talk through that and work those issues out. The key is an open dialog and open communication and trusting each other that we're always acting in the best interest of the organization. But Mike may not see some of the things that I'm seeing as it relates to the marketplace, for instance, with a particular town."
Using data to drive decisions
When asked how they use workforce data to guide major decisions and align priorities at Lee Health, Dr. Wukitsch pointed to the organization's use of a dashboard to aggregate data and monitor metrics like turnover, employee engagement and other key indicators.
Dr. Antonucci said he uses employee engagement data mainly to identify areas for improvement or opportunities. "Larry will provide input on the priorities to make sure there's alignment there in terms of things we want to work on that we've identified as opportunities," Dr. Wukitsch said.
They also monitor the recruiting landscape.
"We talk about that regularly in terms of hires and what's happening there to make sure that there isn't anything falling through the cracks," Dr. Wukitsch said. "It becomes especially important when filling positions for initiatives like our service lines and other things. But we look at it more longitudinally to say, 'Here's what's happening over time, anything abnormal that we're seeing, or any concerns that are out there.'"
Ultimately, Dr. Wukitsch noted that his role is to interpret the data, share his view on it and answer any questions.
Dr. Antonucci also pointed to the significance of using data to monitor labor costs, which he said is an issue addressed through collaboration among multiple executives.
"If you look at labor costs, obviously it's our biggest expense, so the role of the chief people officer is critical," he said. "And so we're constantly looking at our labor costs and the balance between our base staff, our overtime spend, our travelers spend, and how that affects recruitment."
Lee Health implemented an initiative on that issue — a system labor management council. Dr. Wukitsch leads the council, along with Lee Health's chief nursing officer, Jennifer Higgins, DNP, RN.
"Her issues and concerns will escalate up [to Dr. Antonucci], or if not, there's trust that we're getting the job done, that we're really watching those labor costs closely, new hires, where there might be issues and concerns," Dr. Wukitsch said.
Advice for other executives
Drs. Antonucci and Wukitsch shared their advice to other healthcare executives seeking to foster a strong partnership between the CEO and chief people officer or chief human resources officer.
"It's really about engagement and being personally engaged with your chief human resource professional," said Dr. Antonucci.
"You've got to be able to have open, honest conversations, and as a CEO, you want to be open to hearing the good, the bad and the ugly. And sometimes it's difficult, but I think empowering your team and empowering your chief officers to make bold moves and to make decisions always in the interest of the organization, and then support them when they make those moves. That's how I see it from my perspective."
Dr. Wukitsch emphasized the importance of "the people side of healthcare" both in terms of cost and the dynamics in the way that care is delivered, the effectiveness of the care and the experience that patients have through care.
"Recognizing that interrelationship of the financial, the technical, the human side of healthcare, and aligning those things, I think, has been — is still an opportunity for healthcare to increasingly understand and leverage," he said.
"I'm fortunate that Larry, as our president and CEO, gets that. And so frankly, it makes the job an easier job. I'm not having to demonstrate the value all the time. He gets that. It's really about making it happen and supporting the organization and business."