5 big concerns for hospital CEOs in 2021

Hospital CEOs have faced a year like no other. They have battled an unprecedented COVID-19 pandemic, adjusting operations to safely care for patients and staff infected with the virus, while ensuring routine medical services remain available. 

Earlier in the pandemic, many CEOs made the tough decision to furlough workers so their organizations could remain financially stable as revenue decreased because of postponed elective procedures. They have been at the helm as their organizations pivoted toward virtual care and digital transformation as people stayed home during the public health crisis. They also faced growing pressure to show that their organizations were actively being antiracist and improving health equity in their communities. 

More than nine months into the pandemic, CEOs still face tough decisions as the virus continues to spread nationwide, prompting organizations again to postpone elective care. These decisions are most certainly expected to continue in 2021. 

Below are five of the biggest concerns for hospital CEOs next year, based on observations by the Becker's Hospital Review editorial team. 

1. Distributing vaccines  

Distribution of COVID-19 vaccines to healthcare workers will continue to be a challenge for hospital and health system leaders, especially as some employees turn it down. Institutions like Palo Alto, Calif.-based Stanford Medicine and Mount Sinai Health System in New York have faced criticism for how they rolled out the vaccine to their employees. Some health systems have also considered the vaccines' potential side effects that could sideline workers and create staffing shortages. To help reduce the risk of shortages, health systems are looking at various approaches, such as staggering the dates vaccines are given to workers and end-of-shift shots for workers.

2. Pandemic-fueled workforce shortages, mistrust

COVID-19 surges put hospital and health systems' staffing to the test. It drove demand for healthcare professionals while simultaneously sidelining workers exposed to the virus, exacerbating the issue. Healthcare workers have also protested during the pandemic, demanding their employers to boost staffing and access to personal protective equipment. Healthcare workers are among the first group getting inoculated, and this will likely continue to positively affect staffing levels into 2021. But hardships felt by hospital workers won't simply dissolve once the pandemic ends. In many cases, hospital and health system leaders will need to mend broken or tenuous relationships with their workforce. 

3. Trust in public health

Public trust in experts, not only in the medical field but across sectors, is eroding, according to a report in the Chicago Booth Review, a publication of the University of Chicago Booth School of Business. Polarization is one reason the gap between experts and nonexperts is widening, and physicians' frustration with conspiracy theories is growing. In a recent example, Anthony Slonim, MD, CEO of Renown Health in Reno, Nev., publicly defended Renown's alternative COVID-19 unit after a tweet shared by President Donald Trump falsely claimed it was "fake." The tweet is no longer available, but it was shared more than 28,000 times. Even as the pandemic subsides, hospital CEOs will face growing mistrust in public health coupled with an increasing presence of misinformation.

4. Equity and inclusion 

In the wake of the summer 2020 George Floyd protests, several executives from large health systems, including Oakland, Calif.-based Kaiser Permanente and Chicago-based CommonSpirit Health, used their platforms to deem racism a public health crisis and call for inclusivity. Many health system leaders vowed to prioritize equity and inclusion efforts at their organizations. In 2021, hospital and health system CEOs will face growing pressure from their workforce, boards and the public to hold fast to their commitments.

5. Bringing remote workers back to the office

As COVID-19 spread across the U.S. early this year, hospitals and health systems adjusted their workforce. Many administrative workers who could work from home were instructed to do so, and they have remained remote. But organizations must look at how they may bring workers back to the office in a post-pandemic world. Providence, a 51-hospital health system based in Renton, Wash., for instance, finalized a post-COVID virtual work strategy for administrative employees that sets July 1 as the earliest that remote administrative employees can return to facilities and offices, unless they can't work productively from home. A few employees will work on site daily, and a few will work from home daily, but most of Providence's administrative workforce will work anywhere from two to four days a week from home.

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