Recruiting Great Leaders to Rural Hospitals

By Jim King, Senior Partner, Chief Quality Officer

[Note: This article originally appeared in the December 2014 issue of the Health Care Leader, the newsletter of the Minnesota Hospital Association. Permission to reprint has been granted.]

In simpler times, rural hospitals rarely competed with urban or even suburban ones for top leadership talent. Administrators tended to gravitate towards those communities or cities that felt like home to them.

This isn’t so true anymore. Many urban and suburban facilities and systems boast resources and compensation packages far beyond what rural healthcare facilities can offer, luring executives who might otherwise look for a small-town engagement.

Jim King

Jim King

Meanwhile, the standalone, community-based hospital is quickly becoming a thing of the past, as technology and financial necessities have pushed rural facilities to forge alliances with urban or regional health systems. From a leadership recruiting standpoint, alliances are a good thing. Executives can stay rural while also staying connected with colleagues nationwide, career development opportunities, cutting-edge technologies, and so forth.

The trick for rural hospitals to recruit great leaders is to a) position the organization for success and so that it is attractive to these leaders, and b) to know what types of leaders to look for.

Boards and Positioning

What do boards need to do to position the organization for success? A few of the qualities they must exhibit include:

  • A willingness to partner. For rural hospitals to attract strong leaders, they need to be open to developing key partnerships around clinical services with larger systems, assuming they don’t have those relationships already. Boards drive this activity, and they need to be willing to, for example, explore participation in clinically integrated networks as part of a population health strategy.
  • The right size and composition. Boards need to be a manageable size to be agile and effective, while also maintaining a breadth of skills (especially in areas such as technology and finance) to allow them to address today’s healthcare needs.
  • Financial savvy. I’ve seen several cases where, in good faith, boards have put their financial trust in the CEO and CFO only to get burned. This approach just isn’t comprehensive enough in this day and age, and boards have to recruit their own financial talent, ask tough questions of their leadership team, and carefully study the broader industry economic landscape.

Strong Candidates

Even if boards position themselves and the organization to attract top leaders, they must know which candidates are the right fit for CEO and other positions. These candidates will be those that have a strong mix of the following qualities:

  • Strategic vision. These are individuals who relish a challenge and have a clear, progressive vision for what small-town facilities can achieve when applying their resources and efforts creatively.
  • Passion. This almost goes without saying, but a rural executive has to have an unbridled enthusiasm for the community and its people.
  • Proven success. Enthusiasm is welcome, but today’s rural healthcare leaders need to have a track record of helping transform an organization from volume to value in the wake of healthcare reform.
  • Financial stewardship. Some would say “financial wizardry,” but the critical skill rural health executives must have in this regards is not magical but a shrewd understanding of how to tap into much-needed capital. That could mean strategically partnering with larger systems (while maintaining a healthy measure of independence) or leveraging healthcare reform to access government funding for electronic health records or meaningful use compliance.
  • Collaborativeness. The success of rural health executives hinges upon their ability to connect with board members (typically pillars of the local community) as well as physicians and key staff.
  • The ability to recruit. The CEO and C-suite leaders are fundamentally the chief recruiters for a rural facility, and clinicians and support staff will look for reassurance that they will be an integral part of fulfilling the organization’s mission—to support quality care and the health and well-being of the local community.
  • Technological savvy. Rural healthcare won’t survive unless it maximizes technology to its advantage. A rural executive must have a fundamental appreciation for the power of technology and its ability to provide access, cut costs, and so on, and must understand that the investments that will matter for rural facilities in the future are more about technological infrastructure than bricks-and-mortar facilities.

Recruiting rural healthcare leaders is about creating the right environment, and then going after the right leaders for your organization.

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