Leadership has its own retention problem

Amid staffing shortages and dipping engagement levels, workforce retention is top-of-mind for many healthcare leaders. But oftentimes, the problem extends beyond frontline employees and into management — even C-suites. 

In the first 11 days of September, Becker's recorded 11 executive exits from hospitals and health systems. The trend keeps pace with CEO turnover rates tracked monthly by executive coaching firm Challenger, Gray & Christmas; 100 hospital CEOs left their roles between January and August, a 56 percent increase from the same time period in 2022. 

There are several reasons why an executive might pass off the reins, especially in today's challenging market. System combinations and reorganizations can spur job cuts (and tensions); many leaders who postponed retirements during COVID-19 are announcing them now. Some are choosing to leave healthcare entirely, opting for a less tumultuous industry. 

John Couris, CEO of Tampa General Hospital, noted the trend in an August interview with Becker's.

"It breaks my heart to see the turnover in the CEO ranks," Mr. Couris said. "It really does, because for the first time in my career, I have seen and I'm hearing CEOs say, 'It's not worth it. I'm out. There's a better way to earn a living. I'll go to venture capital. I'll go to private equity.'" 

But instability up top can trickle down, weakening the organization as a whole, according to Mr. Couris, who recently decided to extend his contract with Tampa General another decade. He agreed that, to some extent, his loyalty to the organization is setting an example. 

"I'd submit to you that you need consistency and longevity to manage through the [industry's] turbulence," he said. "It creates a calmness and a sense of security in the organization that allows people to innovate and drive toward the organizational imperatives." 

If consistency drives calmness, steady middle management is imperative to reduce workplace angst. A recent analysis from McKinsey & Co. found that strong middle leadership is linked to positive outcomes, from improved financial performance to talent development — but middle managers are eyeing the exit, too. Fifty-five percent of managers are actively seeking a new role, according to a recent Gallup poll; only 31 percent report being engaged at work. 

The COVID-19 pandemic knocked the wind out of management, and it has been difficult to help them regain their footing, Linda Aldred, longtime chief human resources officer at Houston-based Texas Children's, told Becker's. Her team specifically asked frontline leaders what they needed from upper management. 

"What we heard from them is they've lost their confidence to be leaders at times, that the workforce and the world has shifted so dramatically, particularly in healthcare," Ms. Aldred said. "Every day, we're telling a frontline leader to do something different during the pandemic: 'Tell people to wear masks, tell people to come through this entrance, tell people they have to have their temperature taken, tell people that we have to put them out for a short time and sign up for a volunteer pool because we don't have employees, tell them they have to come back.'"

"There's so much messaging and so much pressure that we put on these people day to day," Ms. Aldred continued. "And what we heard was, 'I desperately want to do the right thing. I'm not sure I am. And sometimes I don't have confidence in what you need me to be doing or the messages I should be delivering.'" 

Acknowledging the individual needs of middle managers — nixing the "one-size-fits-all" mentality and spending resources on a wide variety of development, coaching and mentorship plans — has helped Texas Children's to meet leaders where they are. Identifying their unique leadership styles and talents can help ease the burden of acting as a liaison between frontlines and C-suites. 

"We are building a lot of programs around your individual path as a leader, because I think that's what it'll take," Ms. Aldred said. "Yes, we're all leaders, but we're all individuals."

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