Is an interim healthcare leader right for your organization?

Hugo Aguas, MPA, Director of Interim Services, and Kate Fenner, PhD, RN, Managing Director, Compass Clinical Consulting - Print  | 

In Part 1 of this series on Interim Healthcare Leaders, we covered healthcare staffing crises and challenges that can be caused by critical leadership vacancies.

Delivering quality care and financial results for your community and hospital is difficult at best when your organization is understaffed, has critical unfilled leadership vacancies, or doesn't have the skilled providers. (Part 1:How to handle your healthcare staffing crises and challenges?)

Part 2 of the Interim Healthcare Leader series covered how to avoid the negative impact of job vacancies in critical positions and take on complex, time-consuming quality improvement and safety projects with interim healthcare executives, directors and managers. (Part 2: Why use interim healthcare leaders?)

This article discusses how to evaluate if an interim healthcare leader is right for your organization.

The Reality
Senior executives and clinical and departmental directors are a critical team at any hospital. They are the leaders who drive the organization to function and to become better. But, unfortunately, there are times when one or more of these executives or directors gets promoted within the system, becomes suddenly ill, leaves to pursue different career options, or is terminated.

Interim healthcare leaders can fill key clinical and executive positions, which allows your hospital (or department) to begin the transition and make forward progress while the search for a permanent replacement is started.

Interim managers, directors, and even C-suite positions are best filled only after careful consideration. Effective interims, people who perform interim work as a career, as opposed to those just seeking to fill time and maintain an income between permanent positions, are not inexpensive. Not all vacancies merit the investment of resources required.

So, when do you contract for an interim and when do you use an internal appointment or even leave a position vacant? Here are a few considerations that should weigh into any calculation:

Is the position vacant because of beneficial turnover?
Did the previous person leave at the request of the organization?

If yes, there is an opportunity to use an interim to address what may be a suboptimal performance in the area of responsibility.

Was the loss of the previous person considered unregrettable turnover?

If so, an experienced interim will be able to quickly assess needs and opportunities, plan for change, and implement improvements, without the concern a permanent person might have about pushback and payback.

Is the position mission critical?
Do you risk ineffectively completing operational or strategic objectives with a suboptimal replacement in the role?

If the area of responsibility is a high-volume, high-revenue, or potentially high-risk area, using an experienced interim to bridge gaps during recruitment can prevent loss and maintain proper functioning to accomplish organizational goals.

In addition, in the absence of a strong and experienced leader, employee disengagement and diminishing results in the patient experience can occur. Without direction, employees often feel lost and abandoned. This is when productivity diminishes, and there are more chances for errors such as patient safety issues and/or regulatory noncompliance with CMS or The Joint Commission. This can also be the time when the good employees start thinking if they should look for employment elsewhere. This creates uncertainty, concern, and unneeded turmoil.

Requires sophisticated understanding and experience?
Does the position require a sophisticated understanding of a highly technical area or services such as perioperative services, women's services, or infection control?

The risk of using someone not thoroughly steeped in the clinical or regulatory requirements of a specialized area is too great compared with the investment in an interim with an aptitude of technical knowledge and experience to maintain or attain operational objectives.

Is the vacancy the result of a sudden departure or an unexpected illness or death?
The trauma and turmoil associated with a sense of abandonment or loss may require the steady hand of an experienced interim, someone from the outside who doesn't have a history of attachment to the previous person and can coach staff through the transition while the right candidate is searched for to fill the position.

The decision to use a professional interim for a vacant hospital management or leadership position is complex. The direct cost of the interim is but one factor in the cost-benefit equation.

Sometimes the cost of not using an interim is potentially much higher, whether through loss of revenue, departmental chaos, customer dissatisfaction, or elevated risk.

Factoring in the considerations listed above can help in making a decision about the investment in an interim.

Once you've weighed the reasons for using an interim healthcare leader, if you're still in doubt, err on the side of conservatism and go with an interim, and test the change potential there. The assignment can always be terminated early; the costs of failing to address operational or management challenges are too high compared to the cost of paying for an interim.


"Is a healthcare leader right for your organization," is an excerpt from "The Healthcare Executive's Guide to Effective Interim Leadership," by Hugo A. Aguas, MPA, and Kate M. Fenner, PhD, RN.

About the authors

Hugo Aguas, MPA
Hugo Aguas has more than 35 years of experience in human resources management in large health systems, teaching and research hospitals, and community hospitals, as well as experience managing hospital operations in several clinical and support services departments. As the Director of Interim Services at Compass Clinical Consulting, Hugo develops strategic partnerships with hospital and health system clients, identifying and placing skilled interim healthcare executives, clinical directors, and managers to help clients meet both short- and long-range objectives. Before joining Compass, Hugo spent more than ten years as Assistant Vice President, Human Resources at Inova Alexandria Hospital and Inova Fairfax Medical Center, where he managed all facets of the Human Resources function and had operational oversight of several clinical and support departments.

Hugo earned his Master of Public Administration from Golden Gate University in San Francisco and his Bachelor of Science in Psychology from Loyola University in Los Angeles. He is a member of the American Society of Healthcare Human Resource Administration and the Society of Human Resource Management.

Kate M. Fenner, PhD, RN
Kate Fenner understands hospital leadership. First as a nurse and later as an education leader and consultant, Kate has immersed herself in the regulatory and operational issues that face today's healthcare organizations.

As Managing Director and CEO of Compass, Kate has led and participated in dozens of mock surveys to help healthcare organizations meet the standards and expectations of regulatory bodies such as the Joint Commission, the Centers for Medicare and Medicaid Services, and State Departments of Health, and guides hospitals and health systems through accreditation and regulatory compliance response and recovery efforts.

A regular keynote speaker throughout the country, she authored a leading college text on law and ethics in healthcare, co-authored other texts on a variety of healthcare issues, and currently, serves on the editorial board of the Journal for Nursing in the 21st Century.


The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.