CEO for a day: What clinician executives would do and why

Hospital and health system CEOs have a lot on their plates as they tackle an array of financial and workforce challenges. 

Becker's reached out to clinical leaders to see what they would do if they were CEO for a day — and why.

Kathy Baker, PhD, RN. Chief Nursing Officer for UVA Health (Charlottesville, Va.): If I were CEO for the day, I would make sure every employee in the organization knows how much they are appreciated for the amazing care they provide to patients and families. 

Cori Loescher, BSN, RN. Chief Nursing Officer and Vice President of Patient Care Services for Brigham and Women's Faulkner Hospital (Boston): As CEO for the day, I would establish a scholarship and loan forgiveness program for the employees of the organization. Healthcare workers were at the forefront of the pandemic and are now leaving the profession in record-breaking numbers. This "great resignation" has impacted hospitals tremendously, and we have been relying on temporary workforces to replace the gap in our crucial employees. This strategy has been an interim solution for professional, clinical and technical positions but not readily available for other critical areas of the hospital such as environmental, nursing assistants and food service workers, as well as many entry-level positions. Hospitals across the nation continue to struggle to attract the best and brightest in healthcare, and supporting them in their education while continuing to develop the skills they need to become the best clinician or healthcare worker is vitally important to our work going forward. 

What is needed is a plan that will attract employees at all levels of the organization. I believe a scholarship and loan forgiveness program will foster commitment and retention of hospital staff. Understanding that education is crucial for career growth and financing that education in today's fiscal environment is nearly an impossibility for many. Scholarships and loan forgiveness provides a foundation to this strategy to support employee development. Scholarship programs would afford entry-level employees to begin their careers on the frontline with the opportunity to find their area of passion and to be financially supported while they attain career growth and achieve their professional dreams. Employees who have already financed their education will be attracted to the institution with the commitment of working for their employer while the burden of their loan debt is reduced. "Growing our own" by investing in our employees will be the short- and long-term solutions that healthcare institutions will need to put in place to survive today, tomorrow and into our new normal. 

Carmen Shaw, DNP. Assistant Vice President of Enterprise Nursing for Atrium Health (Charlotte, N.C.): If I were CEO for a day, I would ensure three strategies are in place.

First, I would have a clear, inclusive feedback platform between me, as the CEO, and front-line workers. I believe front-line teammates should have a voice in organizational changes, especially if it impacts them. In nursing, we call this shared governance.

Secondly, I would create more opportunities for teammates to maximize their individual talents regardless of their title, level or tenure within the organization. Teammates need to feel they are directly contributing to the overall mission and vision of the organization.

Finally, as CEO, I would ensure that there are career progression programs available for teammates. Teammates want to grow and grow fast, and they are willing to put in the work.

All these strategies directly influence teammate engagement and a sense of belongingness, which is key to retaining a strong workforce.

Machelle Allen, MD. Chief Medical Officer for NYC Health + Hospitals (New York City): NYC Health + Hospitals strives to address a longstanding and well-documented history of healthcare disparities in New York City and beyond. People of color experience higher rates of chronic disease and premature death than white people, and they have worse outcomes across a variety of health measures, including infant mortality, maternal mortality, and overall physical and mental health status. Research has shown that workforce diversity in the healthcare field leads to better clinical outcomes and financial performance when serving patients of color and vulnerable groups — the population NYC Health + Hospitals disproportionately serves. Numerous studies have shown that when there is greater racial, ethnic, language and cultural diversity among providers, and a higher concordance with patient populations along these lines, patient compliance and satisfaction improve and clinical uncertainty is reduced. Research by Alsan, Garrick and Graziani in Oakland, Calif., and published in the American Economic Review demonstrates that Black men are more likely to take preventive health measures recommended by Black physicians compared to white physicians.

It is imperative that NYC Health + Hospitals increase its workforce diversity to better reflect the communities we serve — recognizing that a major barrier to achieving this goal is the structural racism and unequal opportunity throughout the educational continuum. This inequality in the educational continuum has led to an underrepresentation of racial and ethnic groups among medical school matriculants and consequently the physician workforce. Today, 69 percent of our patient population is Black and Latino, whereas 22 percent of our physicians are Black and Latino. Our aim is to have our physician demographics mirror our patients’.

To bridge this gap, and to build upon the work done by our current CEO, Mitchell Katz, MD, in diversity and inclusion, a multipronged physician workforce career pathway framework must be developed. NYC Health + Hospitals recently launched MOSAIC – a program designed to engage, recruit, mentor, train and hire Black and brown doctors. We will target students in middle school all the way through graduate medical education. MOSAIC's Visiting Scholars Program will offer these aspiring physicians clinical rotations at our public hospitals so they can get hands-on experience in everything from emergency medicine to plastic surgery, and with the support, mentoring and academic development so they can eventually be leaders in our healthcare system.

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