HIMSS 2014 uncovers high turnover rate of hospitals' CEOs
According to circulated discussion at the HIMSS Tradeshow this year, and a recent report by the American College of Healthcare Executives, Healthcare CEOs are burning out fast.
The report surveyed working CEOs within the American Hospital Association’s pool of 4,500 hospitals and the collected data on these high-level positions results in one common denominator: turnovers rates are at an all-time-high. These turnover rates are not only negatives in terms of each hospital’s respective supply chain and executive management, but at a time of drastic change within the healthcare industry, the increased stress worsens the system as a whole.
The numbers don’t add up
Over the past decade the hospital CEO turnover percentage has tended to fluctuated between 14 and 18 percent, which is why analysts were perturbed to find the turnover average of 2013 to be such an outlier. However, with such drastic ongoing industry changes some kind of change was to be expected, but not to this degree. There was an estimated 20 percent turnover bump in 2013, which is the highest reported rate since the ACHE started the survey back in 1981.
When asked about the reasons behind the bump in turnover ratings, ACHE President and CEO Deborah Bowen and senior partner of Witt/Kieffer Donna Padilla, took the question head on stating that an aging population, consolidation and drastic changes in the healthcare system were the reasons for the increased percentage.
Padilla continued to comment on the issue by saying, “I think CEOs who have been in the role for 10 or 15 years are asking themselves, do I really want to re-sign?” she said. “I don’t think there’s the ability to ‘hang on’ for two or three more years; there doesn’t seem to be a gentle slide into retirement.”
Product of the environment
The survey also took into account those who left positions unwillingly; mergers and acquisitions proved to be the reason behind a number of turnovers in CEOs across the country. In most cases, a merger or acquisition will result in the restructuring of the executive management staff due to a range of possible factors, as Padilla discussed in her response to this possibility:
“In the independent hospital getting acquired example, we’ve seen where moving into a larger system, the CEO either isn’t equipped or doesn’t want to work in a larger hospital,” Padilla said. “Or a hospital decides they want someone else.”
When changing the executive level hospital personnel, businesses run the risk of changing hospital culture, displeasing working personnel, disappointing patients and time and money to train the new associate.
As previously reported by researchers at the University of Oklahoma, “research found that many CEOs thought their departure had a negative effect on medical staff relations, hospital culture and employee morale, and some said it affected strategic planning and development of new services.”
Although necessary at points in time, having high CEO turnovers will negatively impact the long-term reputation of your hospital for personal and professional reasons, as well as increase the transition time required between maintaining high-functioning management teams.
Recruitment is key
In order to mitigate or hopefully avoid high CEO turnover rates and to ensure a smoother transition in unforeseen circumstances, recruitment is vital to your organization. The CEO position at your hospital provides stability within the medical community and is the face behind the care to all of those who are a part of your organization.
Padilla comments again on the importance of recruitment by saying, “To avoid having to hire someone in the interim, or risk having a vacancy in the top spot, hospital boards should be looking a few years out and engaging in succession planning,” she said.
Also, be sure to look to physicians when considering applicants for this position. It may seem like an obvious choice, but often hospitals overlook these highly-qualified candidates simply because they haven’t had administrative experience. Executives like Padilla and others have found that sometimes physicians make better hospital CEOs, since they have the medical know-how and understand their patient demographic.
The role of tech in public healthcare
Patient backlogs, aging populations, increasing amounts of data, the COVID-19 pandemic and a workforce experiencing burnout are just some of the challenges the world's hospitals are experiencing.
Switching to cloud-based digital systems provided by a third party, like electronic health records (EHR) and e-prescriptions, is an obvious solution. According to Peter Springfield, Cloud Product Manager at Node4, all healthcare providers will need to make this change eventually. "Over time, as legacy technology gets older and the demands placed on it increase, storage systems often can’t keep up" he says. "There comes a point for every healthcare organisation when existing IT simply won’t meet its needs anymore. Instead, healthcare facilities need full, near-instant availability of data to make effective decisions and provide good patient care."
Patient data must be readily accessible when needed, stored in a regulation-compliant environment, while remaining cost effective. But how does a paper-based hospital with an overstretched workforce manage this process, while keeping data safe from cyber attacks? By finding a company that can provide the right solution, and working in partnership with them.
Moving to the cloud
The challenge in healthcare, Springfield says, is that many organisations have siloed pools of data stored in separate repositories. "Often, these systems don’t scale well and don’t have the security protections necessary to meet today’s requirements."
"Cloud-based storage can scale as high as required. The best cloud vendors also assure high availability and good performance. And because organisations pay only for the capacity they use with cloud-based storage, costs can be lower. As a result, the cloud model also allows healthcare organisations to store and access all data associated with a specific patient, procedure or business unit in one place."
Another option is to choose Storage as a Service (STaaS). "This is where a third-party provider owns and manages the storage infrastructure, while the healthcare facility can dictate rules on storage, retention and access, along with service level requirements. This structure means that healthcare facilities can access storage on-demand, paying only for the amount they use, without worrying about buying, managing and maintaining physical devices."
Most healthcare providers are choosing a hybrid model, which allows them to use the cloud for everything except the most sensitive data. "Because security and privacy are critical issues for healthcare organisations, the temptation is to keep everything on-premises" Springfield says. "While that can make sense for especially sensitive workloads and applications because it provides tighter controls, it may not be viable for the longer term, as the amount of data that must be managed and stored continues growing."
Keeping patient data secure is not just crucial for the patients, but for the healthcare provider too. Ransomware attacks - where a hacker demands money in exchange for not releasing private data - have risen dramatically in recent years, particularly since the COVID-19 pandemic began. In 2020 alone these rose by 55%, costing almost $21 billion in downtime.
Healthcare providers' inhouse IT departments may not have the knowledge or the resources needed to combat sophisticated attacks, making it necessary to partner with trusted cybersecurity companies.
"Healthcare organisations are moving away from doing everything themselves and doing a lot of outsourcing in the cloud" says Terry Ray, Senior Vice President at cybersecurity firm Imperva. "They may have been running Cerner as their electronic medical record system for 15 years for example, but many are now shifting to say, "why am I running Cerner? Why don't I just pay Cerner to run Cerner? They can enter their data into Cerner's EMR and let it be their problem."
"The field is getting larger and larger, and the enterprise and scope of what needs to be secured is getting bigger" he adds. "You can't have gaps in security. Organisations must look at everything."
While security and data storage are two typical areas where public healthcare providers lean on the tech sector, another has been emerging since the pandemic: telehealth. As well as providing access to doctor appointments during the successive lockdowns caused by COVID-19, telemedicine can help deliver healthcare to remote or rural locations that lack health facilities.
Virtual care solutions are wide-ranging, from Vodafone supplying the connectivity for IoT devices that help elderly people living on remote Greek islands to monitor their diabetes, to TytoCare's portable device that enables doctors to travel to remote regions and examine the heart, lungs, throat, and body temperature of patients using artificial intelligence.
Busy doctors' surgeries are using digital platforms to help them triage patients - such as eConsult, a digital platform used by the British National Health Service (NHS) in primary and emergency care to assess which patients need to urgently speak to a clinician.
As with all tech solutions, security and data privacy are vital. "The potential for technology to improve healthcare is almost limitless" Springfield says "The key is remembering where it starts and ends - with data."
- This article appears in the August issue of Healthcare