It was shortly after 8:30 AM when the rumor of a key resignation began to spread through the hospital. It was “hump day,” Wednesday, and as members of the senior leadership team wrapped up their morning operations council meeting, there was the hope that the ride into the long holiday weekend would be uneventful.
For the Chief Medical Officer, sitting in his office reading a letter of resignation, there was a deep sense of unease. The upcoming holiday was now the last thing on his mind. The news, that his star senior director responsible for quality and case management was resigning, and her last day on the job was 30 short days away, was devastating. His assistant buzzed his intercom; the CFO was on the line. “Is it true? What’s our plan? This is serious, potentially disastrous,” he said without waiting for a reply. “I just saw the boss, he has already heard. Bad news travels fast.”
That this key employee was leaving was bad enough. That she had been poached by a fierce cross-town rival added insult to injury.
The CMO felt a sense of dread. It got worse when his assistant called to say the CEO would like to meet for coffee in 30 minutes. Coffee was not the reason for the meeting.
He was right. There wasn’t a coffee mug in sight as he was ushered into the CEO’s office.
The CEO allowed the CMO to share the bad news, and then quickly followed with a series of questions:
The CEO knew the answer when he saw the CMO wince. Grooming talent had not been a high priority. They had been focusing on reducing length of stay and enhancing the quality of care for the last 18 months. This sudden departure of the CMO’s star employee was not even close to being on his radar. In his job for two years, with a full plate of other priorities, the CMO barely knew the second-in-command in these two critical areas.
The number two in the division would be named the interim senior director, the CMO reported, but a national search would have to be conducted because that individual was not strong enough for the job, he told the CEO.
Six months later the search languished. The national pool of talent was thin, and the competition was intense. The hospital’s length of stay was creeping up and there were signs that the laser focus on quality of care was slipping. The CFO was only too happy to remind the CMO that this resignation was inflicting real financial pain. (Disclosure: we were involved in a similar national search and we were not successful).
This pre-holiday crisis did not happen because the CMO was somehow negligent. It happened because the culture of the organization did not attach a high degree of importance to developing their talent. An enteprise-wide talent mapping initiative was shelved several years earlier because it was seen as an excessive expense, not an investment that would produce measurable value.
Consider this: healthcare employees, particularly the up and comers in the Millennial generation, want to belong to an organization where they can make a real contribution to their community. They want to embrace the organization, to know they are valued for the job they do today, and for the contribution they can make in the future. They know that training and mentoring will enable them to step up when a sudden resignation occurs.
© 2014 John Gregory Self
After spending several days in Las Vegas speaking to the American Academy of Medical Administrators, the bitter cold with snow and sleet in Dallas is more than a little jolting. Reviewing some notes in my Journal, I ran across several entries that were equally unsettling.
Tom was the manager of a blood bank within a large lab of a major medical referral center located in the Northeast U.S. He told me that he was recruited there two years ago and while he enjoyed the complexity of the work and camaraderie of working with his capable team, he was frustrated. It wasn’t the money – they paid him well and the benefits were the best he ever had. Nor was it the urban lifestyle; he liked living close to the best restaurants, museums and concert venues. His life outside work was great.
At work, he felt stuck. He was not getting any useful feedback on his performance or any support he sought to become a better manager. His boss, the Director, seemed incapable of providing ongoing feedback much less meaningful, in-depth guidance during the annual performance review. Every annual review session seemed rushed, always on the final day, or even a week late.
Unfortunately, Tom’s experience is not that far out of the ordinary. It would seem that in addition to problems with quality of care and patient safety, hospitals have a problem providing their employees with meaningful feedback regarding their performance. It is a recurring problem I hear from the northwest to the southeast, from California to New England. This is a shame because improving employee evaluations is not that complicated or expensive. It is sort of like the other broken part of most healthcare human resource departments – employee orientation that usually amounts to two days of listening to how you can get fired.
For the life of me I cannot figure out why hospitals continue to rely on the old fashioned orientation session to “onboard” a new employee given the evidence of alarming turnover rates, but I do understand how the hit-or-miss employee evaluation programs continue: a combination of poor training and weak supervisors who lack the real depth of experience and/or critical thinking skills that are necessary to deliver an insightful performance evaluation. No one taught them.
The bad news is that this is the same reason hospital employee performance evaluations were so bad 38 years ago.
© 2014 John Gregory Self
John filed this post from Las Vegas where he keynoted the opening session for the American Academy of Medical Administrators annual conference and led a career management workshop.
LAS VEGAS – As clients intensify their focus on finding the best available talent, they are zeroing in on the candidate’s quantitative accomplishments as much as, and in some cases more than, years of experience. The same can be said for a candidate’s references.
In the old days candidates could get away with three to five references that would say favorable things about them. It was the equivalent of “don’t ask, don’t tell.” The interviewer would ask questions and the reference, who may or may not have had recent knowledge of the candidate’s performance, would typically give positive answers. I have had more than a few healthcare executives admit that they do not like giving adverse reference reports, even for people they terminated, because they did not want to hurt their career going forward.
In this emerging new healthcare economy, where reducing costs, improving quality, and enhancing safety and patient satisfaction, healthcare executives have little appetite for making a hiring mistake. The cost is high and the pain is real.
Today, recruiters are intensifying their questioning of a candidate’s references regarding specific performance metrics on which the client’s selection process is based. Moreover, clients prefer a 360-degree reference profile – interviews with a superior, a peer, a subordinate and another colleague, all with specific knowledge of those issues. In the first round of reference checks, personal references are irrelevant to the client and should never be included unless there is an extraordinary issue involved. The personal reference can talk about what a great person you are, how involved in the church, the golf club and your children’s baseball team, but rarely to your performance as a manager or leader or financial expert. They don’t usually know you in that role.
The goal of the process is to find and hire the right person for the job. Increasingly, in a decade where healthcare reform and transformation will change the health services landscape, that goal will be more difficult, if not impossible, to achieve without a highly structured recruiting process that measures a candidate’s experience and verifiable record of performance against the specific needs of a client.
Here are three important tips a candidate should remember:
© 2014 John Gregory Self