How to Prepare Interim Hospital Executives to Lead the Change

By T. Douglas Lawson, MHA, FACHE, President, Baylor Regional Medical Center at Grapevine &  Kate Fenner, RN, Ph.D., Compass Clinical Consulting

A growing number of hospital and health system CEOs are turning to interim executive talent to fill temporary vacancies in leadership, achieve significant change in a department or mentor in-house managers.

During a transition period in clinical leadership at Baylor Regional Medical Center at Grapevine (Texas), the hospital sought an interim executive. The medical center worked with Compass Clinical Consulting to place an interim employee and found that the process allowed for a more seamless transition—for staff and leadership alike.

Compass Clinical Consulting surveyed 25 seasoned interim executives and directors for their perspectives on interim work. Their responses confirmed what we, as employers of interims, have learned—that preparation is the key to getting the most out of interim engagements.

To adequately prepare for an interim’s arrival and maximize return on investment, CEOs should focus on three critical elements of onboarding: on-site orientation and introductions, technological preparation, and advance communication with key stakeholders.

On-site Orientation

When an interim arrives on a hospital’s campus, he or she must quickly assimilate into the organization. Perhaps the most crucial aspect of this integration is the adoption of the organization’s culture and values.

In the case of Baylor Regional Medical Center at Grapevine, interims are provided with an orientation to the hospital’s vision—to be the best place to give and receive safe, quality, and compassionate care—and the circle of care that surrounds it. This orientation ensures that interims are aligned with the hospital’s values and can carry those forth in the management of their departments. When interims and staff are moving in the same direction, the likelihood of achieving specific goals increases.

CEOs must also familiarize interims with the organization’s physical layout and key personnel. As a first step to establishing this knowledge base, the interim should be given an accelerated orientation to the hospital’s facilities, including a tour. Tours allow interims to not only get the lay of the land but also establish visibility with hospital staff, building their identity and credibility within the organization.

Introductory meetings between the incoming interim and key managers, physicians, direct reports, and other staff within the interim’s assigned department are also essential. Our experience has shown that chief executive officers should spend time talking to the interim to establish values and communicate goals. This interaction ensures the interim will be a good fit for the senior executive to whom they will report.

For example, in the case of an interim operating room director, the CEO must ensure a positive relationship exists between the interim and the chief nursing officer because their successful relationship lays the foundation for a productive and successful interim engagement.

Technological Preparation

Introduction to the systems that the hospital uses to manage departments and deliver care is also essential. Qualified interims will know these types of information systems, but every hospital has its unique configurations. In most executive and director positions, some familiarity with the information technology used to monitor productivity, the revenue cycle, finances, or quality will be required.

This type of preparation is even more crucial as more hospitals implement electronic medical records (EMRs). Familiarity with the hospital’s particular system is paramount. EMRs introduce a new element of care, one which requires a different type of technical ability from that needed before electronic records implementation. So as hospitals bring in interim executives and clinical directors, they must ensure the interims have a general supervisory knowledge of EMRs and other information technology used in executive decision-making.

 Advance Communication

To position an incoming interim for success, chief executives should communicate with their hospitals’ staffs to explain the rationale for using an interim executive, set expectations for the engagement and clarify the interim’s critical role in and value to the organization. Though there are many legitimate reasons to engage an interim—for example, as a catalyst to start necessary improvements or to keep operations running smoothly while the organization searches for the right permanent candidate—staff members often have questions: Why is it necessary to bring someone in from outside the hospital or health system? How will the interim function in the organization?

Chief executive officers can anticipate and even eliminate these questions in a number of ways. First, CEOs will want to keep their executive committees informed throughout the hiring process, regardless of whether an interim is being considered to fill a C-suite or department director vacancy. This communication allows the committee to plan for the interim’s arrival as a group and control the message that managers and other staff members receive.

Second, the interim’s exact role within the hospital structure and level of authority to affect change should be explained. Is the interim a placeholder in an already high-functioning operation? Or is the interim expected to make changes to improve operations and prepare the organization for the new hire? Chief executive officers can use memos and meetings with staff to clarify the interim’s position and how he or she will work with relevant managers, staff, and physicians. Taking such measures will ultimately result in greater effectiveness and better working relationships.

Preparation Makes the Difference

Though the rationale behind hiring an interim executive or director is different for every organization, the ultimate goal is usually the same—to provide the highest-quality, most efficient patient care possible.

At Baylor Regional Medical Center at Grapevine, advance orientation, technological preparation, and communication with staff have maximized the positive impact of interim strategic engagements. These measures may not require extraordinary effort, but they go a long way toward ensuring success.

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