A new Board Chairperson asked the CEO of a mid-sized health system... "I see we have invested a lot to establish a new IT plan; a master facilities plan; and a record-setting capital plan. Where is our 'People Plan'? What are our strategies to invest to enhance the pride and performance of the human assets that represent almost 60% of our operating budget, and impact 100% of our success in quality and operational efficencies... our people?"
A good question. A question not being asked enough, nor talked about enough in the boardrooms of our nation's leading hospital and health systems.
Successful health care organizations can only improve and sustain their performance if they raise the bar on their talent management strategies. Enhancing talent management will not flourish unless it receives more serious attention in the boardroom and C-suite offices. Such attention is more likely if CEOs and senior HR executives are invited into the boardroom to engage Board leaders in broader and deeper "critical conversations"about these issues:
- The current shortages of mission-critical health professionals in medicine, nursing, and many other technician jobs;
- The large portion of our health professionals that will be retiring over the next 5-10 years;
- The long lead-time needed to attract in new clinical and leadership talent;
- The lack of clear investments to ensure our people (medical staff, employees, and managers) are able to practice in a culture that is patent centered, performance driven, and values based.
- We too often lack "The Long View" about sensible and structured ten year strategies for:
- Nursing and allied health professional recruitment and development;
- Medical staff recruitment and development;
- Physician leadership development;
- Modern web-based employee support systems;
- Executive and middle manager succession and career planning;
- The link between HR capital and capital for facilities, medical technologies, and IT; and
- The business case for more sophisticated talent management.
Boards need to be more effective, enthusiastic, and engaged in setting the strategic framework for the development and deployment of their organization's human capital. This enhanced sophistication can only happen, and be sustained, if CEOs and senior HR executives step up now to move their "People Strategy" onto the Board's radar screen.
Board engagement and a committed senior leadership team are essential to fostering a health system's shared vision, aligning organizational components so that the health system can best pursue this vision, and building a commitment to the vision at all levels of the organization.
To become a high-performance organization, a health system needs senior leaders who are drivers of continuous improvement and whose styles and substance are in accord with the way the health system sees its mission and its own character.
To create a workforce that shares this vision and is aware of the contribution that each employee and physician can, and must, make toward achieving it, the health system's senior leaders must work as a team to convey a clear and consistent portrayal of this vision throughout the organization by their words and deeds and the example they set.
Board leaders and career managers may bring differing values to the team, but they must work at building mutual understanding and trust, and at committing themselves to a shared set of goals for their health system. These coals can take years to achieve, so the health system must have a succession planning strategy that ensures a sustained commitment and continuity of leadership even as individual leaders arrive or depart. When planning for a health system's future, Boards and leaders should consider the following three questions:
- Defining Leadership. Has the health system defined the kind of Board and executive leaders it wants (i.e., their roles, responsibilities, attributes, and competencies) and the broad performance expectations it has for them in light of the Health System's shared vision?
- Teamwork and Communications. Do senior leaders pursue an explicit strategy to promote teamwork, communicate the Health System's shared vision in clear and consistent terms to all levels of the organization, and receive feedback from employees?
- Ensuring Continuity. Does the Board take steps to ensure reasonable continuity of leadership through executive succession and continuity planning?
The Boards of tomorrow's high performing accountable care organizations must be champions for modern Human Capital & Talent Management. Health care systems are unlikely to succeed unless they thrive in the "Talent War" of competition for excellent people to join the clinical, support, and leadership teams of our health systems.
We encourage client health and hospital systems to develop, and continuously enhance, modern systems and a culture for "Human Culture & Talent Management".
The strategic framework and budget for this human capital management should be shaped by the results of periodic self-assessments by the Board and CEO of the scope and nature of the organization's human capital arrangements, and innovative ways to enhance a culture that is:
- Patient centered;
- Performance driven; and
- Values based.
Simply stated, human capital means people: nurses, physicians leaders, allied health professionals, and managers. There are two key principles that are central to the human capital idea:
- First, people are respected resources whose value can be enhanced through careful investments and management.
- Second, an organization's human capital policies must be aligned to support the organization's "shared vision"- that is, the mission, vision for the future, core values, goals and objectives, and strategies by which the organization has defined its direction and its performance expectations for itself and its people. All human capital policies an practices should be designed, implemented, and assessed by the standard of how well they help the organization pursue its shared vision.
At most health systems, the lion's share of operating costs is devoted to its people. For this reason, employees traditionally have been viewed through the budgetary lens, and often seen as "costs to be cut" rather than as "assets to be valued and developed". However, high performance organizations in both the private and public sectors recognize that an organization's people largely determine its capacity to perform. These high performing organizations understand that the value and vitality of the organization, and its success in turbulent markets, is dependent on the value of its people. Enhancing the value of employees is a win-win goal for employers and employees alike.
The more the Board and senior executives of an organization recognize the intrinsic value of each person engaged in the service for the health of patients and communities; the more it recognizes that this value can be enhanced with nurturing and investment; the more it recognizes that employees vary in their talents and motivations, and that a variety of incentive strategies and working arrangements can be created to enhance each person's contributions to the organizational performance, the more likely the organization will be to appreciate the variety of employee needs and circumstances, and to act in ways that will make sense in both business and human terms.