Aren’t There Any Cooks in the Kitchen? How to Access the Right Leadership Now!

With continual changes in reimbursement, regulation, and an increasingly competitive landscape for healthcare dollars, the emphasis on securing the right talent necessary to effectively lead a hospital’s clinical service lines has become heightened. This is particularly true as it relates to the few remaining strategic service lines in healthcare organizations that still offer a positive impact on a hospital’s bottom line. Three such service lines included on this short list are cardiac, vascular, and neurosciences. In fact, in Corazon’s experience, cardiac and vascular services alone can represent as much as 40% of a hospital’s bottom line. Unfortunately, a number of hospitals across the country continue to operate these and other service lines without the talent necessary to lead the way. As has been the case for some time, hospitals and health systems across the country have been struggling with staffing shortages. This fact, although troubling, is true at a time when a number of institutions are struggling to understand the impending effects of healthcare reform. If that’s not enough, there continues to be a shortage in the retention and a gap in the recruitment of hospital leadership; the same leaders that we look to for guidance and support when navigating these changing waters. As alarming as this may be, demographic trends point to a growth in this leadership shortage over the coming years. Organizations that are operating with ineffective service line leadership and those without a leader in place are certain to feel the effects of the gap in talent. Unfortunately for those organizations, the lack of the right leadership has a ripple effect across the organization. As it relates to key service lines, a gap in effective program leadership will cause a loss of direction, leading to a loss of momentum, possible decreases in morale, and an underwhelming financial impact upon the organization as a whole. We have found that when there is no service line leadership in place, whether due to an unexpected departure or cost-cutting initiative, another member of management assumes an additional role to their current one. Although this approach can offer a quick fix, it is likely to be ineffective even in the short run. It can be argued that this approach is no better than simply leaving the void in leadership. In either case, organizations run the risk of:

• Incurring losses in revenue and market share potential
• Increasing costs of care
• Confusing internal stakeholders (e.g., physicians, staff, etc.), and resulting dissatisfaction
• Declining quality of care offered
• Lacking focus on a strategic service line

With consideration to the risks above, a number of organizations are working to fill temporary talent gaps using interim management services. An effective interim solution affords healthcare organizations the benefits associated with the quick placement of experienced, flexible leadership that works to bridge the gap between a talent void and a permanent placement within the organization. Although interim solutions present an added cost to an organization, it has been our experience that the benefits of having the right talent in place far outweigh the costs. This is particularly true when an interim manager has the skills and experience necessary to successfully take on the role. A sure misstep when using an interim approach is simply taking the next person available to fill the role. Rather than using this flawed approach, we recommend working quickly to gauge the necessary skills required to be successful in the role, and THEN sourcing for an interim solution that matches this profile. Ideally, the interim candidate has access to the right resources to be effective in their role. These resources can come from within or outside of the organization. For example, when Corazon places an interim solution, the interim manager works with Corazon’s consultants to access resources necessary (e.g., current research, trends, etc.) to be effective in their role. As an example, consider the role of cath lab director. The costs associated in employing a person in this role typically amounts to the employee’s base salary, benefits, and possible incentive pay. Now, assume this position has become vacant due to the departure of a former employee. What do you do to fill the talent and experience void? Do you elevate the status of a member of the current staff or add the responsibilities to another director in the organization? With either approach, something has got to give. It is situations like these where Corazon recommends looking outside the organization to ensure momentum is not lost in the short term, while the recruitment for a permanent placement is underway. The cost of the interim solution is typically a daily rate and travel expenses with a short-term commitment. The daily rate typically incorporates a benefit cost that is likely now paid for by the individual working in the interim role.

Corazon Case Study

Recently, we had the opportunity to provide an interim cath lab director for an organization in the midwest. This organization provides diagnostic catheterizations, as well as primary and elective angioplasty without cardiac surgery on-site. This particular organization had experienced programmatic volume declines, physician partnering challenges, and overall staff moral issues. In a short time, the interim director of the cath lab accomplished the following:

• Conducted an unbiased cath lab assessment, including policy and procedure review, staffing patterns and competency, clinical outcomes review, and equipment and inventory control.
• Identified and addressed multiple opportunities for process and quality improvement in the cath lab, working in conjunction with the medical director, cath lab team, and hospital administration.
• Worked with the cath lab staff to revise the call schedule and helped to address several employee dissatisfaction issues that were present.
• In collaboration with the cardiologists, worked to improve relationships that resulted in an increase in procedural volumes.
• Addressed financial concerns related to inventory control and cost per case. Tight management of the financials led to the organization being able to decrease their loss per case, and placing them on a track to increase revenue by 13%.
• Began the process of succession planning by working with an existing employee, mentoring them to transition into the leadership position once the interim role was completed.

Upon completion of the assignment, the organization had improved customer service, resulting in an increased quality, higher employee satisfaction, and a positive contribution margin to the bottom line. With the right mix of skills and experience, the payoff of an interim solution will likely involve expense reductions through streamlined operations, increased revenues and market share, as well as effective leadership at the helm of your program. At the same time, the other members of your team that would have been pulled into this position can continue to focus on the needs of their current role. The actual return on investment of using an interim solution varies by role and from organization to organization. In most cases, it will involve ‘soft’ benefits that are difficult to quantify. A recent example of a Corazon-placed solution resulted in an additional $1 million in revenue in non-invasive cardiology alone. No matter what role the interim solution serves, we recommend working closely with your interim solution provider to quantify the results of this approach. Through a keen understanding of the positive impact of an interim solution, providers will be in a better position to justify this approach in the future. Jessica is an Interim Solution and Permanent Placement Recruiter at Corazon, Inc., a offering the full continuum of services in the heart, vascular, and neuro specialties, including consulting, recruitment, and interim management. To learn more, visit www.corazoninc.com, or call 412-364-8200. To reach Jessica, email jbarrick@ corazoninc.com