Health system execs are pushing down decision-making authority

As regional health systems grow and need to become more nimble, the top leadership are looking for ways to decentralize decision-making and build a strong executive talent pipeline.

Change management isn't easy, but crucial for health systems to build a sustainable foundation for continued growth. Damond W. Boatwright, CEO of Hospital Sisters Health System based in Springfield, Ill., became CEO in June 2021, and since then has focused on revamping the leadership structure. The 15-hospital health system went from four divisions to two and a corporate system office, and flattened decision-making authority.

"We went through a model we call 'subsidiary,' which is we try not to centralize all the decision-making at the system office, but actually push that down to the lowest level possible to resolve the issue and find solutions to the problems themselves," said Mr. Boatwright during a session at the Becker's 11th CEO+CFO Roundtable, Nov. 13-15 in Chicago. "A lot of what we talk about with our leaders is being empowered, but to be empowered, you have to have a certain mindset to want to be empowered, and also at some point understand when to say you need help."

Executives and leaders with the ability to move forward with confidence and humility have been most successful within the flattened decision-making structure. But not everyone thrives right away.

"You hear [leaders say] 'we're tired of being micromanaged.' But as soon as you start truly giving them accountability around budgets, goals, objectives and performance, they say 'I'm not ready. Aren't you going to help me? I haven't been trained.' What we have to do is really put some serious time and attention around leadership development, connecting it specifically to the core competencies and skills that are required to achieve the strategic objective."

HSHS is leveling up leaders by defining the skill sets needed to succeed and investing "time and treasure" into leadership development to achieve core objectives, Mr. Boatwright said. He shares the strategic plan with the executive group and makes sure leaders are connected to the mission and strategy.

"It's not just words on paper, but it actually drives the tactics that we use to move forward in a meaningful way and then define what exactly skillsets are needed for the change itself," Mr. Boatwrigth said. He is taking leaders through an 18 month curriculum to set them up for success.

Cleveland-based University Hospitals is going through a similar transition to redesign the power structure for a more systemw approach to leadership. Instead of the top leaders at each hospital making decisions, University Hospitals is taking a service line approach to pair a clinical and administrative lead for the service line systemwide.

"Much like everyone else, we are trying to shift from a hospital-centric approach, and shifting to more of a system view," said Paul Hinchey, MD, COO of University Hospitals. "We are also trying to push our leadership and decision-making down the org chart as much as we can, and we're really trying to shift to a more patient-centric, consumer-centric focus; more service line, less hospital, more ambulatory, less hospital, and trying to decentralize that because we're an academic medical center."

The new structure has removed some power from the hospital CEOs and placed it with the service line leads.

"It's a tremendous amount of change to go from that very hospital-centric model, taking some of that control away from one group and giving it to a new group," said Dr. Hinchey.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars