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This article captures discussion from the 2014 Advisory Council Meeting. The Advisory Council is a distinguished group of HR leaders that meets yearly at the American Hospital Association to discuss pressing topics in the field.

The effect of healthcare reform on recruiting and retaining talent looms large. There’s a heightened sense among savvy hospital leaders about: What’s next? How do we plan for it? And, where will the talent come from to lead us there? Recent studies by the American Hospital Association and consulting firm SpencerStuart, along with feedback from senior healthcare recruiters, confirm these attitudes. Like you, they don’t just want to fill positions but rather hire quality teams that can lead their organizations through these tumultuous times.

Alignments that move more hospitals into health systems, encourage more physician groups to affiliate with hospitals and create more value-based payments will increase within the next few years.¹ While most CEOs believe their current senior management team has the skills needed to manage change (68% versus 32%)², an analysis shows critical talent gaps in leading non-traditional health partnerships, managing community and population health management, managing transformational change, having advanced financial expertise, and possessing skill in innovative or strategic planning and data analytics. While training is closing these skill gaps, most organizations must turn to external hiring.²

Where’s the traditional C-suite in all this? Forty percent of them have expanded in the past three years, as organizations re-evaluate their clinical staff and reorganize into service lines.² Now, chief medical and nursing officers have broader and more operational responsibilities, financial officers advise on risk and strategy and CEOs are focused externally, overseeing operational activities such as population outcomes and coordinating inpatient care with physician offices and non-acute services.² SpencerStuart, a C-suite recruiter, is seeking two vice presidents of population health management, a heartening trend since many officers and managers tasked with their hospital’s integration, patient engagement, population health, innovation or transformation are rarely represented in senior management teams. In the meantime, C-suite leaders feel the hurt in matrixed situations of dyad and triad reporting relationships.

Hiring managers are busy training the willing—and trying to recruit the rest. Some are attempting to fill up to 900 positions a month. Some face up to 70% staff turnover in the next three years, a “retirement tsunami.” And, others wish their board and leaders would view their organizational structure in a way they believe healthcare should be viewing itself—more horizontal than vertical. As a Florida chief human resource officer (CHRO) stated, “The management system doesn’t work and that’s why healthcare doesn’t work.” CHROs need a seat at the leadership table to influence hiring that meets the strategies of the organization, to bring in more thought leadership, to “lead, not lag” on helping set operational expectations for their organizations.

If all that doesn’t keep you up at night, consider how much the recruiter role itself is changing. As traditional C-suite positions evolve to take on broader strategic and operational roles, CHROs find themselves coping in the same matrixed organizations in which they’re trying to fill leadership positions. One large health system CHRO just had benefits director added to her workforce planning and recruitment title, giving her three responsibilities in three separate buildings of her organization.

¹ Redefining the H Survey, American Hospital Association, conducted in February and March 2014.

² Building the Healthcare Leadership Team of the Future, SpencerStuart, presented to AHA Career Center Advisory Council Meeting, June 19, 2014, from a survey fielded April 13, 2013.