How to handle your healthcare staffing crises and challenges?

One of the most difficult and ongoing challenges as a healthcare leader is recruiting and retaining skilled talent for your organization. It's inarguable.

Cost pressures, increasing healthcare rolls, reduced reimbursements, stiff competition for physicians and nurses, Baby Boomer healthcare professionals retiring at an accelerated rate – all take a toll on healthcare organizations with the incipient loss of skills, experience, and critical organizational and intellectual capital, making this challenge even more difficult, and critical.

When your hospital or health system has critical leadership vacancies how do you effectively;

  • Balance patient quality care and satisfaction with the budget?
  • Maintain CMS and TJC regulatory compliance standards?
  • Maintain hospital margins, which are already diminishing and under increasing pressure, when the cost associated with turnover (recruiting, replacement, and lower productivity) can have dramatic and profound financial implications?
  • Stay on plan for your strategic improvement goals?
  • Keep staff morale up, when leadership vacancies have increased employee workloads, responsibilities, and overtime hours to the stretching point?

It's hard to deliver quality care, and financial results for your community and hospital when your organization is understaffed has critical unfilled leadership vacancies or doesn't have the skilled providers to accomplish your mission – or even staff your operations.

Hospitals typically plan for a four-to-six month executive hiring process. It often takes longer. Why? Because it's imperative for you to find the right person for your organization. A leader with the perfect match of skills, capabilities, experience, cultural fit and proven results. But this intervening timeframe can lead to long-term negative consequences, including loss of focus on transformative care initiatives and strategic goals.

So, for creative and visionary healthcare leaders, what's the answer to this conundrum?

Interim Healthcare Leaders

Interim Healthcare leaders are highly skilled, experienced and dedicated senior healthcare executives. They can go anywhere in the country at a moment's notice to help a hospital or healthcare organization with an immediate need for leadership, either through a sudden termination or someone leaving with limited notice. They can hit the ground quickly and be effective, not just be a placeholder.

And, while an Interim Healthcare Executive fills a critical vacancy until the hospital finds the perfect replacement fit for their organization, they may also be tasked to fix urgent problems or tackle new quality initiatives.

Example: Let's Look at a Hospital in Crisis

Hospital traumas are as dramatic as patient traumas. Triaged responses apply equally.

A minor wound can be resolved without much drama. However, a serious issue requires dramatic solutions and resolve to preclude a death spiral; doing nothing is essentially a death warrant into the third category.
Let's focus on hospitals.

An Interim Healthcare Leader's Unique Role

Interim Healthcare directors and other senior staff can be very effective in stanching the effects of institutional trauma. They fill a unique role when:

  • Current executives are ineffective at overcoming a problem.
  • There is a void in the complement of leaders (unfilled position; extended illness; retirement, etc...).
  • A "sacred cow" leader needs replacing.

The interim must be active, visible, positive, influential, experienced, accountable, and communicative.

If the problem is minor, don't resort to the disruption of an interim. (Again, think triage). But, if serious, an interim is not just a body filling a slot – they are on-demand intellectual capital change agents.

Here's what an interim leader can do:

1. Assess the breadth, depth, and scope of the problem(s).
2. Without personal or institutional baggage, work with staff to develop action plans to counter the presenting problem(s), as well undetected or other non-compliant features.
3. Assess implementation through necessary corrective actions and help identify defects in existing processes.
4. Use the above as teaching moments and to introduce monitoring systems to prevent repetition.
5. Connect with Medical Staff, other clinicians, and administrators to communicate the urgency of changes and impact(s) of remaining static.
6. Become an integrator of culture among constituents and create opportunities for career growth and replacement of poor fits within the system.
7. Prioritize changes with an early focus on eradicating dangerous practices, make quick fixes on festering problems that are easily solved, look for high ROI modifications that remain within the institutional mission, and lead executives look towards longer-term impactful changes.

What You Need to Know

In short: the result will be better care, safer practice, financial stability, and appropriate staffing. Good interim healthcare leaders will get you there. Internal "more of same" won't create lasting change. Remember the old definition of insanity: doing the same thing and expecting different outcomes.

About the author

Hugo Aguas, MPA
Hugo Aguas has more than 35 years 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.


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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