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How Hospitals Ensure Career Development Is More Than On-the-Job Reactions

Analysis  |  By David Weldon  
   December 01, 2021

The growing labor shortage in healthcare is forcing many providers to work long hours and put in extra effort. In the process, many healthcare workers are receiving rapid career development.

(Editor's note: This is the fifth article in a series on the healthcare labor market from the CFO perspective.)

There is no debating that the COVID-19 pandemic has caused significant disruptions in the healthcare workforce. Probably the most disturbing trend is that between 2019 and 2020, job vacancies increased by up to 30% for various nursing positions, and by 31% for respiratory therapists, with shortages expected to persist.

That has resulted in a huge increase in responsibilities for those still employed in the field. And that increased workload has dramatically changed the picture for career development efforts. For many healthcare systems, there is little time to focus on formal career development programs. But for many healthcare workers, new job opportunities are endless.

The talent shortage changes the rules for career development

Quite simply, the top issues and challenges around career development for healthcare professionals today are time and resources.

"The nationwide talent shortage is one of the very biggest challenges that we face overall, and it impacts career development in several ways," explains Denise Chamberlain, executive vice president and CFO at Edward-Elmhurst Health, a $1.7 billion health system in the suburbs of Chicago.  "Folks are so busy and so short-staffed that it's hard to do anything but get the most urgent work done. On the other hand, opportunity has arisen for people to step up and take responsibility for additional projects or to lead from the front as a trainer of new employees."

This is perhaps an unforeseen benefit for healthcare workers. Still, they might not see it in the moment, since so many are required to work long hours and put in extra effort. In the process, many healthcare workers are getting a lot of career development, just not from a formal program, Chamberlain explains.

"New leadership opportunities are there for the taking at every level," Chamberlain stresses. "Since the beginning of the pandemic, employees at every level stepped up and took responsibility for projects, new processes, training, and new roles outside of their basic responsibility. All of this was career development. In the moment, you might not think about it like that. Reflecting back, our employees learned and grew at such a rapid pace and flexed and developed at every turn. I'm sure the same is true for the industry."

Limiting formal programs to leadership development

In better times, Edward-Elmhurst Health would place a lot of emphasis on a formal career development strategy. Edward-Elmhurst Health has two acute care hospitals, one behavioral health hospital, and over 70 ambulatory sites. The health systems employs more than 10,000 workers.

These days, formal career development efforts are more likely targeted to leadership development.

"We never took our foot off the gas in terms of the design and building of leadership development programs. Even in the face of cost cutting during the pandemic, we always kept our eye on the future—we knew we wanted a workforce intact afterward and moved forward," Chamberlain says.

The reality is a bit different for rank-and-file.

"We have been hesitant to even ask our workforce to spend extra time in any type of career development activity, since many are already working overtime," Chamberlain acknowledges. The challenge for the health system will be to soon find ways to harvest the development that employees have learned 'on the job.'

Workers want acknowledgement of, and compensation for, their extra efforts

As Edward-Elmhurst Health and other healthcare systems figure out the best ways to formally act on this on-the-job learning, they had better not wait too long. Recent studies have found that a majority of healthcare workers are at risk of flight. The two top reasons cited by workers who are planning or pondering a job change are more compensation and better opportunities.

Health workers continue to go the extra mile. Many say they want acknowledgement of those efforts built into their job assessments, and they want a paycheck that reflects the additional contributions.

In the meantime, another area where Edward-Elmhurst Health hasn't eased up is in its succession planning.

"We have invested in succession planning over the past few years," Chamberlain explains. "The effort includes career discussions, a rating of talent potential, and an Assessment and Development Plan (which includes identified strengths, development needs, competencies, next roles, and developmental actions) for all directors and above. It also includes creating "bench charts" (identification of successors and readiness timing) for critical roles throughout the organization, as well as the identification of emerging talent (i.e., below director)."

These succession plans are consulted first when managers are considering candidates for open roles.

"One of the many benefits of this work is that it helps inform us of where the needs or weaknesses are in development across the enterprise, so we can consider this when designing new development training and plans," Chamberlain says.

Career development success starts by asking workers what they want

The pandemic has completely changed the rules for managing a workforce, so health systems shouldn't assume that the ways of old are the ways of gold. Edward-Elmhurst Health leaders recognize this, and surveyed staff this summer on exactly what they would like in revamped career development programs.

"We know specifically what they have asked for," Chamberlain stresses. "They want recognition for their development and growth efforts, and they want it on a day-to-day basis from their direct leadership. They want more skills development and more training."

At the management level, Edward-Elmhurst Health is instituting an intensive, custom leadership development program to give every leader the tools they need to lead exceptionally well, learning how to lead themselves, their people, and the business, Chamberlain says.

"Each leader gets a personal assessment and coaching session prior to starting the program. We're focusing our formal development efforts on our leaders, so that they can better develop our front line," Chamberlain says.

"As a CFO, I feel strongly that every leader (at any level) needs a basic understanding of how a health system makes money, and why it is important that we do so," Chamberlain says. "Here at EEH, I'm contributing to our leadership development program with a training module on leading the business based on my book, Money to Care: Hospital Finance for Non-Financial Hospital Leaders."

In addition, Chamberlain says CFO support for the funding of official programs is also important.

"Development is fundamental for retention and reducing turnover. Turnover is terribly expensive and good leaders are priceless. There are truly few investments we can make in our people that would not have an ROI if we do them sincerely and well. We can actually save money by investing in development," Chamberlain says.

Developing a program that focuses on the new roles and responsibilities

For CFOs and other healthcare leaders that want to bolster their career development programs, Chamberlain offers several tips.

For starters, "this might be least obvious to some and extremely obvious to others … listen to people, and then act. Ask questions of your staff, listen to what they need, and then deliver on that development opportunity," Chamberlain says.

Second, development can be offered in the form of training, or it can be about providing the space and tools an individual needs to grow. Perhaps that means taking charge of a new program or implementing a process improvement. Maybe it means sponsoring a diversity, equity, and inclusion initiative.

"Development is individual, and we have to listen to understand what each individual needs and meet them there," Chamberlain says. 

Third, health organizations should develop career tracks internally for staff that enable them to acquire new skills, more responsibilities, and improved opportunities without leaving their current employer.

Toward that end, Edward-Elmhurst Health has formed partnerships with local community colleges. These programs enable a worker to enhance their skills and become certified in their role or beyond.  For example, a patient care assistant technician can become certified, and then go on to become a nurse and do a residency all without leaving Edward-Elmhurst Health.

Finally, Chamberlain stresses that career development programs that produce real results, help with recruiting and retention, and is affordable, starts with a commitment at the top.

"Senior leadership must prioritize this work: develop a plan, put the money in the budget, hold themselves accountable to delivering it, including making it a priority of your time. People see whether or not you walk the talk, or never actually do anything," Chamberlain says.

Denise Chamberlain is a HealthLeaders Exchange member. The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at To inquire about attending a HealthLeaders Exchange, email us at

David Weldon is a contributing writer for HealthLeaders. 


The COVID-19 pandemic has dramatically increased the workload for many healthcare workers, and with that, the nature of individual 'development.'

For many healthcare systems, there aren't workers for even the minimal requirements, and therefore, little time to focus on formal career development programs.

Many healthcare workers have stepped up and created new projects, programs, and training, and have greatly expanded their skills and qualifications.

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