Hospitals do not do enough to prepare for top-level vacancies, train and track future leaders or adopt measures to promote cultural diversity, results of a survey of healthcare executives show.
The results, from a National Center for Healthcare Leadership, or NCHL, survey of roughly 260 hospital executives, offer a less-than-flattering snapshot of how hospitals evaluate and train top executives and cultivate employees with potential to succeed them. The Chicago-based NCHL drafted the mail and Web survey, completed in October 2007, to let hospitals score their performance and compare results against others inside and outside healthcare. The survey was offered to all U.S. hospitals.
The findings underscore other surveys that show few hospitals plan for turnover at the top, and the industrys executive ranks fail to mirror the nations increasingly diverse population. Turnover among hospital chief executive officers has hovered around 14% to 16% in recent years, according to figures from the American College of Healthcare Executives, but the ACHEs 2004 survey of free-standing hospitalsthe most recent data availablefound just 20% planned for succession (April 9, 2007, p. 6). And a 2002 ACHE survey found far fewer blacks, Hispanics, American Indians and Asians reported having high-level management jobs than whites (Aug. 20, 2007, p. 16).
Planning for turnover among medical, nursing and administrative leaders scored poorly among executives surveyed by the NCHL. When asked to rate performance on a scale from 1 not at all to 7 a great deal, succession plans for medical leaders scored an average of 3.6; for nurse leaders, 4.2; and administrators, 4.5. For questions on whether succession plans include talent management for doctors, nurses or administrators, results were similar.
In the minority is Lehigh Valley Hospital and Health Network, Allentown, Pa. The 711-bed hospital first targeted nurses for leadership development in 2003 and has since expanded its efforts to other professionals, including pharmacy. The two-year program includes evaluation, mentoring, education and on-the-job experience, and efforts are intended to provide employees with professional development and to groom future leaders, said Terry Capuano, Lehigh Valleys senior vice president of clinical services, who oversees its leadership development program among nurses.
Those kinds of things pay you back severalfold, Capuano said. Lehigh scored the distinction of being named a premier employer by Fortune magazine in 2008 and 2007. We certainly have talent in here, she said. If we recognize it and cultivate it, we will be a stronger organization.
The NCHL survey found mixed results for 16 questions on leadership learning and development. Executives expressed confidence that senior managers offered sufficient resources for development efforts. Respondents agreed that coaches and mentors were encouraged and supported, but when asked if hospitals took formal steps to promote mentoring, scores dropped off.
That discrepancy was apparent elsewhere in the survey, said Marie Sinioris, the NCHLs president and chief executive officer. When asked to comment on the value of leadership development, respondents stressed its importance. They acknowledged it, but theyre not doing it, she said. The NCHL will administer the survey annually to track progress, she said.
Executives cited multiple priorities that compete for time and money needed to invest in leadership development as a critical factor stunting leadership development initiatives, she said.
Sinioris acknowledged the pressures, noting executives outside of healthcare face similar stresses, but have invested heavily in training. Theres a return on investment, she said, particularly in a competitive labor market where talented job-seekers expect employers to invest in their careers. Healthcares high-risk services make it more imperative that the industry cultivate skillful, effective leaders, she said. The consequences of error are significant.