The Weekly Wrap, HealthLeaders' new video series, brings you a quick look at what we're covering around the healthcare industry.
Looking for a quick review of what’s hot in the healthcare industry?
Our Weekly Wrap video recaps the latest news and analysis that HealthLeaders covers each week and features health system, hospital, pharma, and payer executives.
New episodes will be released each Friday.
Subscribe now to HealthLeaders YouTube channel to catch all the episodes. Don’t miss out!
Check out our featured story, podcast, and event for the week:
The Weekly Wrap, HealthLeaders' new video series, brings you a quick look at what we're covering around the healthcare industry.
Looking for a quick review of what’s hot in the healthcare industry?
Our Weekly Wrap video recaps the latest news and analysis that HealthLeaders covers each week and features health system, hospital, pharma, and payer executives.
New episodes will be released each Friday.
Subscribe now to HealthLeaders YouTube channel to catch all the episodes. Don’t miss out!
Check out our featured story, podcast, and event for the week:
The Weekly Wrap, HealthLeaders' new video series, brings you a quick look at what we're covering around the healthcare industry.
Looking for a quick review of what’s hot in the healthcare industry?
Our Weekly Wrap video recaps the latest news and analysis that HealthLeaders covers each week and features health system, hospital, pharma, and payer executives.
New episodes will be released each Friday.
Subscribe now to HealthLeaders YouTube channel to catch all the episodes. Don’t miss out!
Check out our featured stories and event for the week:
The Weekly Wrap, HealthLeaders' new video series, brings you a quick look at what we're covering around the healthcare industry.
Looking for a quick review of what’s hot in the healthcare industry?
Our Weekly Wrap video recaps the latest news and analysis that HealthLeaders covers each week and features health system, hospital, pharma, and payer executives.
New episodes will be released each Friday.
Subscribe now to HealthLeaders YouTube channel to catch all the episodes. Don’t miss out!
Check out our featured stories and podcast for the week:
The Weekly Wrap, HealthLeaders' new video series, brings you a quick look at what we're covering around the healthcare industry.
Looking for a quick review of what’s hot in the healthcare industry?
Our Weekly Wrap video recaps the latest news and analysis that HealthLeaders covers each week and features health system, hospital, pharma, and payer executives.
New episodes will be released each Friday.
Subscribe now to HealthLeaders YouTube channel to catch all the episodes. Don’t miss out!
Check out our featured stories and podcast for the week:
The honorees consist of physicians, nurses, pharmacists, finance leaders, attorneys, and administrators, who will convene at the UpNext Exchange in Austin in March 2023.
The future challenges facing the healthcare industry will require leadership that is entrepreneurial, eager to embrace complexity, and above all driven by a renewed sense of purpose. Those qualities sum up the inaugural group of 30 executives who will be featured in the 2023 UpNext program, announced today by HealthLeaders Exchange.
UpNext will celebrate and connect the best and brightest of healthcare’s future leaders. Honorees will be invited to convene and share their insights at the UpNext Exchange, March 2-3, 2023, in Austin, Texas.
The UpNext program is meant to energize hospital and health systems to empower leadership development, career advancement and succession planning. Healthcare has seen high rates of executive turnover as the industry recovers from the pandemic and a downturn in provider operating margins.
Still, there are indications that more needs to be done to bolster the next generation of leaders. A 2022 Healthcare Trends Survey released by B.E. Smith and AMN Healthcare in October found that of the more than 600 executives surveyed, only 20% said they were on an advancement track, a number that has declined in recent years.
The 2023 UpNext group represents a diverse skill set, with physicians, nurses, pharmacists, finance leaders, attorneys, and administrators represented. The organizations range from a 35-bed rural community hospital to a large regional health system with more than 80,000 employees.
HealthLeaders Exchange asked a few of the 2023 group their thoughts on the industry’s future, their own passion for healthcare and what they hope to gain from the program:
The industry is facing big challenges. Is there one you are specifically looking forward to tackling and why?
“The fundamental conception of the provider-patient relationship has been tested in many ways during the pandemic. My organization works diligently to optimize our patient relationships in an environment with elements such as the workforce, public health restrictions, and societal stressors are ever-changing.” -- Eric Crowder, Associate General Counsel, Luminis Health, Annapolis, MD
“The healthcare industry is evolving daily, but staffing shortages are real and will be a big challenge for the industry going forward. As leaders we must work together to continue to find innovative care options for the communities we serve. Developing a mature and nimble digital strategy will be critical to doing more with less, and will help attract the best and brightest staff and clinicians.” -- Lauren Hardison, VP of Strategy and Consumerism, UnityPoint Health, Des Moines, IA
Pictured: Leaders part of the HealthLeaders Exchange UpNext 2023 roster.
Why did you pick healthcare as your calling?
“I can’t ever remember not wanting to be a doctor, even as a kid, and I think that the reason I felt so drawn to healthcare was (and remains) a desire to make people feel better. I also love a good puzzle and problem-solving, and healthcare provides the opportunity to apply creative problem-solving whether in direct patient care, or in developing innovative solutions to tackle challenges faced by healthcare systems.” -- Jacqueline Naeem, MD, Senior Medical Director, Parkland Health, Dallas, TX
“Healthcare chose me, and I am thankful for that every day. I come from very meager beginnings. My mother raised us three kids on her own, working two to three service jobs just to keep a roof over our heads and a little food on the table. When I turned 17, I enlisted in the United States Marine Corps and left for boot camp. I thought I was going to conquer the world. The Marine Corps taught me that I was not as tough and not as important as I thought I was. The Marine Corps also taught me discipline and that I needed to become educated. After completion of my tour, I returned home and started community college. I had no idea what I wanted to do with my life. I did miss the uniform and joined the National Guard during my freshman year of undergrad. My Marine Corps military occupational specialty did not transfer and I had to be retrained. I asked the recruiter what specialty training they had that would fit into the summer between freshman and sophomore year. He said “combat medic.” I became a combat medic and found my love for medicine.” -- Corey Cronrath, MD, Executive VP for Care Delivery, Marshfield Clinic, Marshfield, WI
What are you hoping to learn or take from the UpNext program?
“I am looking forward to making new connections share my experiences and learn from theirs as well. I am excited for the program to help continue my personal and professional development and bring those learnings back to my organization to mentor others.” -- Mika Taylor, VP, Finance and Optum Partnerships, John Muir Health, Walnut Creek, CA
“I am hoping to learn from the perspectives and experiences from the other participants and interact with leaders whom I may otherwise not have had the opportunity to meet. This is such an exciting program and opportunity. I cannot wait to get started!” -- Jacqueline Naeem, MD
HealthLeaders Exchange UpNext 2023:
Sharla Baenen, COO, Bellin Health, Green Bay, WI
Stephen Bello, Regional Executive Director, Northwell Health, New Hyde Park, NY
Jose Romo, VP Operations, HonorHealth Shea Medical Center, HonorHealth, Scottsdale, AZ
Heather Rowenhorst, VP Finance, Asante, Medford, OR
Carolann Stanek, BSN, RN, CAO for Eisenhower’s Orthopedic Service Line, Eisenhower Health, Rancho Mirage, CA
Mika Taylor, VP, Finance and Optum Partnerships, John Muir Health, Walnut Creek, CA
Wanda Walker Hodges, DNP, MS, RN, CRNA, Director of Nursing for Perioperative and Surgical Services, University of Maryland Medical Center, Baltimore, MD
AnneMarie West, MBA, BSN, RN, NE-BC, Central Division Executive Director, Clinical and Professional Practice, Providence, Portland, OR
Michele Wingate, CFO, UT Southwestern Medical Group, UT Southwestern Medical Center, Dallas, TX
A new program connecting up-and-coming healthcare leaders launches with the UpNext Exchange in Austin, Texas in March 2023.
The Great Resignation has not spared healthcare, with the top levels of hospitals and health systems seeing retirements and resignations of executives at an accelerating rate. That shift is also opportunity, as healthcare organizations have stacked their leadership teams with up-and-coming talent that will take the industry in new directions.
It is that next generation that HealthLeaders Exchange will recognize with a new program. UpNext will celebrate and connect the best and brightest of healthcare's future leaders. The UpNext inaugural group of 35 leaders will be announced in early December. Honorees will be invited to convene and share their insights into the future direction of the industry at the UpNext Exchange, March 2-3, 2023, in Austin, Texas.
Turnover has been the leadership story of the year in healthcare. A Challenger, Gray & Christmas report in May found that CEO turnover across industries had accelerated 18% year over year. In that same analysis period, hospital CEO exits increased 80%, from 20 to 36.
In healthcare leadership, evolution is a constant. But there is some added significance to leadership development this time, says Kurt Barwis, president and CEO of Bristol Hospital, and former member of the Board of Governors of the American College of Healthcare Executives.
"We've come through one of the most difficult times and seem to be emerging in an environment that will forever be changed," Barwis says. "Staffing, financial challenges and our ability to reliably predict prevail."
The overall labor crunch in the industry adds additional fuel to the need for leadership development, he adds.
"Recruiting and retaining staff only happens with consistent and committed leadership, now more than ever our focus has to be on identifying, mentoring and developing future leaders."
UpNext will celebrate and connect 35 emerging leaders from hospitals, health systems, medical groups, and other providers. UpNext will include leaders in administrative, finance, clinical, and tech roles who are positioned to move the industry in new directions.
"The work we do at HealthLeaders allows us to get to know all of these brilliant leaders who are just a few months or few years away from their turn leading the industry," says Jim Molpus, executive director of HealthLeaders Exchange. "The talent level is the strong first impression whenever we connect with these leaders, but what also comes through is a sense of energy around change."
Pictured: Kurt Barwis, president and CEO, Bristol Hospital.
The UpNext program will continue through 2023, with interviews, podcasts, virtual meetings, and research through the HealthLeaders Exchange.
"We don't want to just celebrate them for a single day on social media," Molpus says. "These are the leaders who will be making decisions on future mergers and on shifting the clinical experience. They will hire the next generation of doctors and nurses. They will buy the next generation of EHR. They will figure out how to apply AI. We want to know how they think."
Healthcare executives across the country are invited to nominate emerging leaders from their healthcare systems by going to the nomination page through Nov. 30. UpNext members will be recognized in a feature story on HealthleadersMedia.com and announced via social media platforms in December. The UpNext Exchange will feature leadership workgroups and the opportunity to learn from and interact with program sponsors.
Barwis, who is also a member of the HealthLeaders CEO Exchange, is encouraged by what he sees in the emerging leaders he interacts with.
"Interacting with post-graduate fellows and early careerists all the time has convinced me that they generally embrace change and will use their creative energy, drive and determination to overcome challenges and obstacles."
And the industry they face certainly won't be the same one we see now.
"They may not take us to the 100% value/risk-based payment system we will live in now, but they will find ways to bend the cost curve, innovate, and partner," Barwis says. "And they'll do all of that while also delivering extraordinary, highly reliable outcomes."
For more information about nominating an emerging leader or questions about the event, please contact Exchange@healthleadersmedia.com.
Finance executives from healthcare organizations across the nation met up this summer to participate in HealthLeaders' Healthcare System of the Future virtual roundtable discussion to talk about their organizations' financial standing, strategies for maintaining margins across sites of care, and planning for a sustainable trajectory. The following are highlights from the discussion.
Where does your organization stand financially?
Several financial executives explained where their organizations stood as they emerge from the economic strife caused by the COVID-19 pandemic.
Denise Chamberlain, CPA, MAEd, CFO at Edward-Elmhurst Health in Naperville, Illinois, said, "We think we've turned the corner. We measure our results, excluding subsidies, each month to see where we’re going [so we can keep] going forward when those subsidies aren't here anymore. So, we’re looking at our volumes and our revenues and our expenses."
And Carlos Bohorquez, CFO at El Camino Health in Mountain View, California, said, "We've rebounded well from the pandemic, but that being said, I see a lot of headwinds related to revenue. We're having conversations with the payers, and the year-over-year increases we saw historically are a thing of the past. … Part of my conversations with the leaders of our organization is explaining why we've done historically well, financially speaking, but also educating the leaders about why we need to manage variable expenses and gradually become more efficient without compromising care and quality."
Staffing: A cost concern
An issue that is challenging financial leaders and was exacerbated during the pandemic is controlling costs around staffing shortages.
Anthony Colletta, CPA, CFO at Westmed Medical Group in Rye Brook, New York, said, "One of the challenges that we're going to have to deal with is this transition from furloughing staff to not having enough staff. That's become our biggest focus and that's going to be a delicate balance that we're going to have to handle as we're trying to control costs, but we know we are going to have to invest in our labor force. … We're going to invest in benefit programs, competitive compensation, and make sure we're at or above market. Those are all going to cost money. We're going to have to find savings elsewhere to ensure that we can address those issues."
Providers and payers: The shift toward value-based care
Healthcare providers found themselves working more closey with payer organizations during the pandemic to work out reimbursement. Financial executives discussed how they see the collaboration between payers and providers working in terms of shifting to value-based care models.
"I'm not convinced that [value-based care strategies are] ever going to arrive passively. There are too many tectonic plates that have to arrive to make a fundamental business model shift from fee-for-service to value. … It's incumbent on all healthcare providers—ambulatory, integrated delivery systems, and inpatient systems—to evaluate and develop an opinion on the business plan outlook of a true, purposeful, forceful shift driven by the providers into a value-based care strategy," says Brandon Clark, executive vice president of corporate development at Equality Health in Phoenix.
Freeing yourself from traditional methods, measurements, paradigms, and ideas may help in achieving nursing recruitment and retention goals.
Editor’s note: This excerpt is from HCPro’s book, Nurse Manager’s Guide to Retention & Recruitment, Chapter 11: "Power of Metrics." For more information, go to https://hcmarketplace.com/nurse-managers-guide.
Changing the Paradigm
Traditionally in healthcare, we have measured turnover and vacancy rates of staff as a measure of workforce stability, and we monitor those metrics for developing problem-based interventions. A better and more appreciative way to measure stability is to change the focus to retention and loyalty rates as a broader measure of true stability that offers a prospective ability to predict organizational health. Leading from an appreciative perspective doesn’t mean ignoring the negative; it means the opposite: working to increase stability by leading with strengths and managing the negative.
An appreciative model of leadership has been referred to as appreciative inquiry, appreciative intelligence, or appreciative leadership. Essentially, an appreciative approach is about building on strengths to overcome weaknesses through an intentional framework that emphasizes the positive and manages the negative and is value driven. The Corporation for Positive Change (2016) believes there are five elements to an appreciative leadership model that individuals need to be successful:
To know they belong
To feel valued for what they have to contribute
To know where the organization or community is headed
To know that excellence is expected and can be depended on
To know that they are contributing to the greater good
Freeing yourself from traditional methods, measurements, paradigms, and ideas may further help in assessing the reality of a changing situation. Matt Miller in his book The Tyranny of Dead Ideas (2009) challenges us to look deeper into what appear to be commonly accepted ideas or thoughts, which may actually prove to be myths. In his book, he dispels what he calls “dead ideas” about everything from schools being local matters to “your company should take care of you,” using data trends. The challenge is to understand what our dead ideas in nursing recruitment and retention may be, including negative or neutral measures.
Clipper, Cianelli, Freeman, Goldstein, and Wyatt (2016) propose a new set of competencies for nurse leaders that includes “divergent thinking, failure tolerance, agility/flexibility, risk taking and autonomy and freedoms.” These emerging competencies enhance the changing role of nurse leaders in creating environments that support innovation, boundary spanning, collaborative practice, and cultures of respect.
Proactive risk management and mitigation can seem counter to a culture of innovation that tolerates failure. In healthcare, we have low tolerance for failure due to the nature of our business: patient care. Innovation and risk management can and should live in the same space, as it is possible to hold these two realities concurrently. Innovation occurs on a continuum from incremental to disruptive innovation. Organizations may have low tolerance for innovation, as standardization, systemization, and reducing variances is the current philosophy and provides the framework for reliable care.
Changing the paradigm from problem-focused metrics and interventions isn’t easy for nurse leaders or for organizations; it’s hardwired into the industry on many levels. The first step nurse leaders can take to bring about this paradigm shift is to address their language and metrics. Instead of talking about turnover and vacancy, keep those measures but use the opposite language—retention and loyalty. For example, if you have a 9% turnover rate and a 7% vacancy rate, you can address them as 91% retention rate and 93% loyalty rate. Language is powerful, and it is human nature to focus more on the negative, especially when describing workforce outcome metrics. As nurses and leaders, we also tend to be problem, deficit, and variance focused, so changing the paradigm starts with you—introspection and then action.
From Data to Wisdom: Making Sense of It All
Changing the paradigm starts with you on many levels. You need to know the data in order to transform it to information, then knowledge (actionable information), and ultimately to wisdom (what did we learn from it?). Data sources abound, which is why we often hear “we are data rich, but information poor.” However, data can be hard to find, access, and understand, even internally within your organization. Information is power, and many people and organizations hold data close to the chest and limit access. In this age of transparency, it is necessary to have access to data, locally, nationally, and globally. Understanding our place in the global, national, and local community of data is crucial to decision-making and enhances our ability to make smart decisions.
Find out who keeps the data you need and how to get access to it. Most often, the data you need as a nurse leader come from finance (CFO), human resources (director of HR), quality/risk (quality director), and clinical data sources (chief nurse information officer or a nurse informaticist). Make it a point to know who these individuals are, and develop relationships with them before you need access to the data and outcome metrics from their departments.
External data can be more challenging to find, but it is becoming more accessible due to open records policies, public reporting requirements, and increased transparency. Most external data sources are aggregated, which offers some level of anonymity. Some of these sources include:
State level turnover data—state hospital association
Workforce data—state or national board(s) of nursing
Quality—state health departments
Financial data—hospital association
Data is most powerful when it can be turned into information. Most organizations have created and deployed dashboards of common metrics. These metrics may demonstrate relationships that exist and assist in decision-making for strategies, tactics, or deployment of resources. Dashboards assist leaders and the organizations in understanding movement toward goals or achievements of strategies by providing a view over time.
Consider sources of internal data for use or for a dashboard:
Finance—financial data, turnover cost data, salary data
Quality—clinical metrics, patient and population level data for impact, safety data
Human resources—turnover data, wages and benefits, retention data, employee engagement/satisfaction data
It is also advisable for nurse leaders to develop relationships with a nurse scientist, researcher, quality analyst, and/or biostatistician. All can be sources that help make sense of data for decision-making and action planning. Be careful to not fall into the “linearity” trap. Embracing the complexity of what we do in healthcare is a must, from clinical to human resource outcomes. Care, cultures, and outcome management are rarely linear, meaning if I do “A” and then “B,” I will get “C”. There are many other variables, and understandings that will help you design better interventions based on the data.
Complexity science is the science of systems and understanding that many components exist, interact, and change as a result of the relationships in dynamic and often unpredictable ways (Linberg, Nash, and Linberg, 2008). Complexity science also incorporates many fields of study into the science with micro, macro, and metasystems within the concept of complex adaptive systems. The truest value of embracing complexity as a nurse leader is the realization that what we do in healthcare is most often predicated on relationships and our holistic education as nurses. This gives us an advantage as we attempt to understand and work in complex environments. Creating and improving professional practice environments that are built on respect, caring, evidence, and civility that produce positive outcomes may be one of the best analogies for complexity.
Cole Edmonson, DNP, RN, NEA-BC, FACHE, FAAN, is a co-author of Nurse Manager’s Guide to Retention & Recruitment.
