Success in the hospital business looks markedly different today than it did even 10 years ago. While healthcare organizations have always strived to provide exceptional medical care, hospitals are being rewarded and sometimes penalized on metrics that, until recently, were not directly linked to the bottom line, such as patient satisfaction and quality of care.
Increasingly stringent metrics translate into higher demands on clinicians, administrative staff and the executive team, which may fuel disengagement and dissatisfaction. Hospital leaders today and in the future will need to possess a wider range of competencies and experiences to effectively manage the workforce amid increasing pressure from changing policies and regulations.
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However, the emergence of younger generations into the workforce complicates this imperative. The majority of hospital board members and executives are baby boomers or traditionalists, while the general workforce and a new class of leaders are saturated with Gen-X'ers and especially millennials. In fact, the PewResearchCenter found that in 2015, the 53.3 million people aged 18 to 34 comprised the largest segment of the U.S. labor market.
While generational differences don't connote variance in work ethic or drive, younger professionals tend to have different values and priorities than their more seasoned counterparts. For instance, millennials who observed dedicated, successful baby boomer executives make their career their life's focus have generally resolved to develop greater work-life balance earlier in their careers. They also desire work environments characterized by collaboration and teamwork, not the traditional top-down system of management. Further, they expect regular and meaningful communication with their leaders, according to Pam Sime, managing director and leader of the HR Consulting and Interim Leadership practices of Integrated Healthcare Strategies, a division of Gallagher Benefit Services.
Healthcare leaders must be aware of the differences between the generations and understand the need to adjust their leadership styles and even governance structures accordingly.
Many systems have already embarked on this transformation. The traditional "command-and-control" silo of leadership that traditionally defined the C-suite has started to evolve into matrixed management systems that leverage teamwork and influence. Hospitals and health systems are creating and devoting new leadership positions to address objectives such as patient engagement and innovation, and executives are becoming more comfortable with risk.
To successfully guide their organizations through the uncertain future of healthcare delivery, hospitals must consider the necessary qualities of the leader of the future. Consider the following five important competencies for future leaders.
1. Leaders must be "fabulous" communicators, according to Susan O'Hare, RN, MSN, managing director and senior advisor of the Total Compensation and Rewards practice at Integrated Healthcare Strategies. In fact, communication is perhaps the most broad-reaching and important leadership competency, as it relates to all facets of leadership.
Communication also has a direct impact on workforce engagement, according Roger Samuel, managing director and practice leader of Gallagher MSA Search, another division of Gallagher Benefit Services.
In the past, command-and-control leadership styles, in which the CEO was often a somewhat anonymous presence behind the C-suite door, were effective for business models based on driving patient volume. However, a closed-off CEO will not be able to improve workforce engagement in the value-based care era.
"CEOs are starting to connect the dots — an engaged workforce will do a better job of driving quality and creating positive patient experiences," said Mr. Samuel. "Effective leaders are paying more attention to scores tied to employee engagement and realizing what qualities they need to maintain high engagement levels: transparency, collaboration and a focus on communication."
Mr. Samuel added that millennial workers typically desire and appreciate more frequent communication regarding their own performance. Check-ins and performance reviews can't be just once a year. "Constant feedback and recognition are key," he said.
In years past, the strongest communicators were charismatic public speakers, according to Ms. O'Hare. While skillfully relaying public messages is still an important competency, today, workers expect — and demand — more consistent and meaningful communication with the organization's leadership.
Now, in a multi-generational workplace, leaders must identify different preferred communication styles and move fluidly between them. Emailing, face-to-face meetings and even engaging on social media platforms like Twitter are important modalities of communication.
The ability to connect with the workforce via effective communication underpins a leader's commitment to a collaborative work environment. This is particularly pertinent as healthcare continues to develop team-based care models, in which communication is fundamental to effective coordination of care.
2. They must provide adequate support to leaders in new roles. New titles — such as chiefs of patient experience, technology, innovation and diversity — have emerged at hospitals and health systems across the nation. The individuals brought on to lead these initiatives are likely experienced and qualified in their domain. However, they are often left floundering for support.
"All of these roles focus on transforming healthcare delivery. They're positive and disruptive," said Ms. O'Hare. "But CEOs are bringing these people in and saying they're going to transform the organization without thoughtfully articulating to the rest of the leadership team how to create the infrastructure to support them."
Too often, these high-potential leaders are left out to dry. "It's important to remember they're not an island," said Ms. Sime. "They're a catalyst for change, but they're not solely responsible for change."
3. They must be tech-savvy. The CIO is no longer the only executive responsible for understanding technology's role in the hospital. "The CEO and the whole executive team need to understand the power of technology and how to innovatively integrate it into the organization," said Ms. Sime.
For instance, EHRs have a tremendous impact on physicians' daily lives. The arduous process of data entry is a significant contributor to physician dissatisfaction and frustration, yet documentation is integral for maintaining accurate medical records and billing. Therefore, it is in CEOs' best interest to understand how EHRs have systemwide consequences and come up with solutions for improving their use.
Another important technology-related competency for CEOs is extracting value from data. They have the tools to produce raw data, but they don't necessarily possess the means to create valuable, actionable insights from it. "Many organizations say they are swimming in data, but they're not quite sure how to utilize it," said Ms. Sime. "They don't know what information to screen out and what they need to improve. The leadership must take the lead role in defining what is important and what metrics drive strategic planning."
4. They must become comfortable with risk. Healthcare is not known for its ability to change as quickly as other industries, but change is occurring at a faster pace than ever before, according to Ms. Sime.
"It's critical that leadership has the ability to not only see and understand change, but to be decisive in the face of a lot of unknowns and innovate for future success," said Ms. Sime.
Ms. O'Hare, who previously served as senior vice president of specialty hospitals for one health system, recalled the arduous meetings spent analyzing plans and strategies.
"Organizations today have to be able to take some risk," she said. "The risk tolerance we had was minimal. We couldn't afford to make a lot of mistakes. A case could be made that in some ways we were actually rewarded for being risk-averse."
Transformation requires risk, though striking the right balance can be tricky. "It's hard to be risk tolerant given the standards for compliance with regulations," said Mr. Samuel. "There are consequences if a risky decision goes bad."
5. A broader range of experiences will be an asset for new leaders. The traditional hospital executive who rose through the ranks of finance or operations and spent an entire career inside hospital walls may not be the prototype for the future, according to Mr. Samuel. "While core leadership qualities will remain relevant, change leaders need to have different experiences," he said. "Care is no longer concentrated inside hospital. It is expanding, with the help of technology, into wider networks of care that include the ambulatory and post-acute setting."
Some hospitals have recruited executives from other industries with the hope that a resume full of different experiences and a fresh perspective on issues in healthcare would spur change and innovation. While this is certainly possible, Ms. Sime, Ms. O'Hare and Mr. Samuel agree these appointments are rarely successful.
"Healthcare is a very complex environment that requires knowledge of a lot of processes, compliance, and frankly, dealing with people's lives," said Ms. Sime.
An outsider inherently lacks the credibility necessary to wage influence over medical staff, according to Mr. Samuel, which is integral to effecting any change in care delivery. Ultimately, if a hospital is seeking someone with different kinds of experiences, a candidate with multi-industry experience that includes healthcare is ideal.
Conclusion
Taking care of the hospital workforce is equally important as taking care of patients, because staff's wellbeing has a direct impact on the quality of care they provide. Younger generations of workers have eclipsed the number of working baby boomers and Gen-X'ers, and the younger generation has different ideals when it comes to their lives at work. In many ways, these differences place higher standards on the leadership to improve their communication skills — something that will ultimately benefit them in every capacity of leading the organization.
Healthcare leaders of the future also need to develop a better relationship with technology and understand how to use it to inform strategy. They will need to create support systems for new leaders and become more comfortable with risk. Keeping in mind these important competencies will put hospitals and health systems on the tracks to success.