Leadership at children’s hospitals: New titles for changing times

Transformative times call for transformative leaders. Chief transformation officers, in particular. And possibly chief integration officers, chief strategy officers, chief research officers, chief medical informatics officers, chief investment officers, chief organizational development officers, and chief performance improvement officers.

Not to mention executive vice presidents of external affiliations, innovation, digital health, interoperability, standards, sustainability, and family-centered care.

These titles and others can be found on the leadership rolls, or in the recruiting strategies, of children's hospitals across the United States. Their rise and recruitment reflects the increasing challenges of healthcare delivery for our most vulnerable patients, as well as the expectations of government agencies and the economic pressures that follow these challenges.

Meeting Unique Needs
Children require unique healthcare that involves their parents from diagnosis through recovery and is delivered in creatively designed environments. From brightly decorated (non-scary) elevator cars to tiny "pill cameras" for internal testing and measuring, children's hospitals need to cover all the bases when it comes to patient experience.

Leadership must be attuned to these special requirements, which seem to evolve continuously due to new discoveries in children's health and —thanks to the Internet and social media —more-informed and engaged parents. Research, strategy, and innovation to accommodate a child's-eye view all call for leaders who can bring those areas of expertise.

These areas are the purview of chief transformation officers or chief innovation officers, sure-handed drivers who can review and revise any business service or program as necessary to keep the organization moving ahead.

Money Matters
Because they handle such medically complex cases, children's hospitals could take a substantial financial risk from the Affordable Care Act (ACA), as noted in a research letter published online December 28, 2015 in JAMA Pediatrics.

The advent of ACA is expected to mean reduced federal payments and more readmission penalties. The researchers note that ACA may not adequately adjust for low-income patients (many families rely on Medicaid) or patients with severe health conditions (complex cases often require readmission). The impact on children's hospitals could be adverse because they serve high proportions of these patients.

Additionally, children's hospitals are not immune from reimbursement changes from volume to value-based payments. Creative ideas for new revenue sources, including preventive medicine, stand ready for exploration. With this in mind, executives with keen eyes for performance improvement, sustainability, and finance will be highly sought.

This is the domain of chief investment officers and chief financial officers, as well as "chief performance improvement officers" and similar titles. Their responsibilities revolve around the implementation, planning, and reporting of performance information. They also facilitate the sharing of operational successes among directors throughout the hospital.

Considering Consolidation
Because the care of a child is a family affair, parent and pediatric care often intersect. That calls for either more internal resources or greater coordination with adult healthcare providers.

Leadership will need to decide whether that coordination comes in the form of partnerships or affiliations with general acute-care providers, or possibly partnerships with competitors. In each case, the idea is to boost volumes to support strong healthcare offerings and attract sought-after doctors during a time when pediatric doctors and nurses are at a premium. Bringing together more patient data also can support evidence-based population health efforts, which are key aspects of Accountable Care Organizations.

In this environment, leadership areas including integration, affiliations, interoperability, digital health and informatics are highly valued. Titles include "chief integration officer" and "chief organizational development officer". The chief integration officer in some hospitals is a re-imagination of the chief information officer role. These "new" CIOs look for ways to apply current and disruptive technologies to the enterprise's overall strategic plan. The organizational development officer, meanwhile, creates and assesses action plans for organizational development and ensures that essential resources are in place to complete those plans.

Turnover at the Top
Changing times bring new perspectives to the forefront. In today's healthcare industry, including children's hospitals, turnover in executive ranks is being driven by retirements and consolidation. These changes can be opportunities to reshape administrative roles, recruit new executive titles, and restructure organizations to maximize efficiencies and economies of scale.

Ideal leaders can wear many different hats during the course of a workday. And duties can blend the abilities and responsibilities of a variety of titles. Like general acute-care and other specialized providers, forward-looking children's hospitals are seeking leadership to meet all the challenges that modern healthcare will bring to bear. The drive is on for leaders who are strong in organizational development and, yes, transformation.

About the Author
James "Jim" King III is a senior partner, chief quality officer, and the leader of the Children's Hospitals practice for the executive search firm Witt/Kieffer.

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.

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