When a hospital needs an interim leader, speed and leadership fit are usually the immediate priorities. But there is another question worth asking before signing an agreement: What portion of the total assignment cost is the recruiting firm actually charging? The majority of experienced interim hospital executives work with multiple recruiting and staffing firms. They are not

Executive Perspective | Hospital CEOs Over the years, I've had the opportunity to work with hospital CEOs who have built some outstanding executive teams. One thing I've learned is that even the strongest leadership teams are vulnerable when a key executive unexpectedly leaves. Whether it's your CNO, CFO, COO, or another senior leader, losing the right person

Human Capital Perspective | CHROs and Talent Acquisition Leaders When a hospital loses a key executive, everyone understands the importance of finding the right replacement. But one thing I don't think hospitals always give enough consideration to is what that vacancy is costing them while they're searching. I'm not talking about recruiting expenses or the cost of

Nursing Leadership Perspective | Chief Nursing Officers When I talk with hospital CEOs and Chief Nursing Officers about their biggest challenges, nursing recruitment and retention are almost always part of the conversation. And while vacancy rates, turnover, and agency utilization are important measures, I've come to believe they don't always tell the whole story. You can fill

Financial & Operational Perspective | CFOs and COOs Surgical services are often among a hospital's largest revenue generators; they're also one of its most expensive and complicated operations. I've worked with enough hospital executives to know that increasing surgical volume doesn't necessarily mean improving profitability. You can have busy operating rooms, growing case volumes, and still be

For the last several years, most hospital expense conversations have focused heavily on labor. Obviously, there was good reason for that. Agency staffing, wage increases, vacancies, and overtime had a significant impact on hospital margins. But if CFOs and COOs continue looking at workforce expense as the primary place to improve margin, they may miss some of

Healthcare organizations are trying to do two things at the same time. Hire more carefully and hire faster.  The problem is that many hiring processes aren't designed to do either one particularly well. The healthcare labor market remains tight. Hospital employment was approximately 5.78 million in August 2026, and unemployment among people previously employed in hospitals was

Most CNOs I talk with are dealing with the same basic challenge. They are being asked to control labor expense while still dealing with a nursing workforce that remains difficult to recruit and retain. According to the American Hospital Association's 2026 Costs of Caring analysis, workforce spending represented roughly 60% of hospital expenses in 2025. Workforce costs

Hospitals have been talking about the move from volume to value for years. In 2026, that conversation became much more real for hundreds of acute care hospitals. The Transforming Episode Accountability Model, or TEAM, began January 1, 2026. CMS identified 720 participating hospitals, and the program runs through 2030. For those hospitals, accountability no longer ends when

When hospitals select an executive search firm, there are a handful of things they almost always look at. Who has the biggest name? Who has worked with similar hospitals? What does the process look like? What is the fee? All fair questions. But there is one question I think hospitals should be asking much earlier in the

When a hospital starts running out of capacity, the first conversation is usually about what needs to be added. We need more beds. We need another OR. We need more clinic space. We need another piece of equipment. We need more staff. And sometimes that is absolutely the right answer. But before a hospital spends millions of

There is something I think CNOs deal with all the time that doesn’t get talked about enough. A hospital metric moves in the wrong direction and everybody looks at nursing. CLABSI goes up? Nursing. Falls increase? Nursing. Patient experience drops? Nursing. Length of stay becomes a problem? Somehow nursing is in that conversation too. Now, I’m not