The Role of the Hospital CEO Today

By Michael Garfield, MHA

The role of the hospital CEO has always been one that requires a wide span of knowledge and skillsets: effective communication, managerial ability, business acumen, a level of clinical understanding, etc. With the ongoing COVID-19 pandemic, the normal duties of this role have been altered and expanded as the healthcare space has had to adapt to this crisis, juggling many roles even more demanding and difficult.

It’s no secret that COVID has wreaked havoc on hospitals, from patient care to the procurement of essential supplies, and adapting to evolving political changes. Nearly two years later, supply chain logistics still occupy morning huddles. However, the biggest hurdle hospitals are currently facing is staffing. With no immediate relief in sight, the issue is predominantly in patient care roles such as nursing, patient care techs, cath lab, and the OR. However, the staffing shortages are expanding into other areas such as environmental services, food and nutritional services, central sterile etc. Given what service companies are paying now, many workers are opting to leave the stress of a hospital and work for companies outside the healthcare environment.

Major changes that the healthcare space has experienced recently include, but are not limited to:

• Continued shortages with nurse staffing
• Decreased staffing numbers in general, due to government options and better pay and balance outside of the industry
• Higher contract labor expenses for nursing and other ancillary positions
• Business decisions becoming more centralized and organizations dictating more of a role on capital equipment, policy, and business development
• The visibility of the CEO: less time spent in the community and looked upon by employees with more scrutiny during the storm of the pandemic.

While the landscape of this space has greatly felt the implications of the pandemic, it is up to leadership, and the hospital CEO, to determine how the organization can pivot to address these changes, communicate solutions, and prove resilient when faced with unforeseen challenges. The following three qualities are incredibly relevant for the hospital CEO to effectively lead amongst the turmoil of the pandemic:

1. Communication: How the CEO communicates today is critical. Communication needs to be more frequent and needs to be done personally. This includes going to employees, critical areas, and physicians to check in on how people are doing, listen to any concerns, and assure employees that things are being properly handled. Communication must be multi-dimensional meaning that all channels, from top down, are directly involved (i.e., the chief nursing officer is imperative in this crisis). The goal is to establish trust and credibility, thank them for their many sacrifices within the organization despite the chaos of COVID. Retention of staff and employees hinges on these efforts and paints the future as bright or bleak.

2. Visibility: It is important for the CEO and organizational leaders to take rounding seriously and are held accountable 24/7. It’s critical for the CEO to set a positive example for the entire organization, remaining physically visible to its many stakeholders. Visibility also includes learning what your key departments are seeing (i.e., if you are getting feedback from the OR, dress out occasionally to fully understand what that department is experiencing) and balancing attention between internal and external stakeholders. Being available and accessible makes a great CEO and sets positive work ethic standards and encourages employee retention in an industry in flux.

3. Forward thinking: Traditional CEOs typically don’t come from clinical backgrounds, but to operate effectively, it’s important to understand the various levels that operate below the executive level. Do not silo yourself away, but rather get knee deep, and engage in clinical terms and activities. In doing so, you can make more informed decisions in changing times. For instance, business development is still important but patient volumes are at record levels with COVID and most hospitals are at or close to diversion. Access into your facility through the ER, patient transfers from EMS and the limit on elective surgery are at a higher focus. Working with your medical staff leadership such as hospitalists, ER and surgeons is at the utmost importance.

Now, more than ever, the role of hospital CEOs is critical and being put to the test amidst the pandemic. Having a strong focus on the hospital’s current position, while also remaining forward facing, allows the CEO to make informed decisions. These facets optimize the balancing act of the CEOs many duties, contribute to the hospital’s success, and differentiate a good CEO from one that is great.