One thing I see with hospitals is that they usually don’t have a shortage of plans. They have plenty of plans.
There is a strategic plan. There is a physician recruitment plan. Finance has a capital plan. Nursing has a workforce plan. Operations is working on capacity. Somebody else is looking at community needs and where access needs to improve.
Individually, every one of those plans may make perfect sense.
The problem is they don’t always make sense together.
And quite frankly, that is where I think the CEO has one of the harder jobs today. Somebody has to look across all of it and ask a pretty basic question: Can we actually do everything we are saying we are going to do?
Take something as simple as growing cardiology.
Maybe there is a clear need in the market. Patients are leaving the community for care. The numbers look good. The board likes the idea. You find a cardiologist who wants to come.
Great.
But now keep going.
Do you have the imaging capacity? Do you have cath lab coverage? Can you recruit the nurses? Is anesthesia available? Do you have clinic space? What does it do to the OR? Does the hospital have the capital required to support the service correctly?
All of a sudden, what looked like one growth decision is connected to six other decisions.
That is the part I think sometimes gets missed.
Hospitals are under too much financial and workforce pressure right now to allow every department to optimize its own piece independently. If strategy says grow, nursing says we can’t staff it, operations says we don’t have capacity and finance says the capital is committed somewhere else, somebody has to reconcile those things before the organization gets too far down the road.
The same thing happens with access.
Hospitals have services they need to maintain because the community depends on them. Behavioral health is a good example. Obstetrics can be another. The emergency department is obviously another.
Some of those services are incredibly important to the mission of the organization, but that doesn’t automatically mean they are financially easy to operate.
So the question for a CEO isn’t simply, “Does this service make money?”
It may be, “If we are committed to providing this service because our community needs it, what has to happen elsewhere in the organization to make that sustainable?”
That is a very different conversation.
I also think hospitals need to be careful about how they define whether a strategy is working.
We tend to celebrate activity.
- We opened the clinic.
- We recruited the physician.
- We bought the equipment.
- We launched the program.
Okay. But did it actually work?
Did access improve? Did patients stay in the system? Did the service generate the volume expected? Can we staff it without relying on expensive temporary labor? Did the investment create downstream volume the hospital can actually accommodate?
Those are the questions that tell you whether you have growth or whether you just have more activity.
To me, the best executive teams are increasingly looking at all of this together.
- Physician recruitment is capacity planning.
- Workforce planning is growth planning.
- Capital planning is access planning.
They really aren’t separate conversations anymore.
And that has implications for the executives hospitals hire.
A leader can be very good inside a particular silo and still struggle when every major decision affects another part of the organization. The executives who are increasingly valuable are the ones who can sit with nursing, finance, physicians, and operations and understand what each decision means to everybody else.
When we evaluate executives, this is one of the things I like to understand. Don’t just tell me you grew a service line. Tell me what you had to solve to make that growth work. What was the staffing issue? What did finance push back on? Where did physician alignment come into play? What happened operationally?
That tells you much more about somebody than their title ever will.
And this is also where a healthcare recruiter who understands the hospital business can add perspective. Sometimes the person who has solved your particular problem is sitting in an organization that doesn’t look exactly like yours on paper. If you only look at title, size and geography, you can miss the experience that actually matters.
The goal isn’t another strategic plan.
Most hospitals already have one.
The goal is making sure the growth plan, workforce plan, physician plan, capital plan and access plan are all describing the same future.
Because if they aren’t, sooner or later the CEO is going to be the one trying to figure out which plan wins.
