Lack of consistency in hospital leadership, paired with poor succession planning, has left an unstable foundation for hospital culture to thrive as we end the 2010 decade. The combined turnover of CEOs, CNOs and CFOs have created a perpetual revolving door at the C-suite. According to a recent report by the American College of Healthcare Executives, hospital CEO turnover was 18% in 2017. Consolidation of healthcare organizations, retirements fueled by the baby boomers, and innovations in models of care are some of the factors influencing C-suite turnover.
Churn in the C-suite can have a negative impact on financial performance, organizational development and employee engagement. C-suite turnover creates a toxic environment of competing priorities that can distract organizations from providing high levels of patient care.
Despite the factors influencing C-suite turnover, hospitals still have a powerful tool to maintain the organizational culture and provide excellence in patient care: your nursing staff. Through empowering your front-line staff to lead, your hospital can establish a culture that can withstand the impact of C-suite turnover on culture and patient care.
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For example, a 2018 study presented at the American Nurses Association Conference from Overtake Hospital Medical Center in Bellevue, Wash., identified a decrease in staff morale due to consistent leadership changes. Overlake this as an opportunity to restructure its unit-based shared governance council in 2015. For the next three years, it asked its nursing staff to identify their interests and passions, in which it became clear that some nurses were in positions that held no interest to them – which contributed to the disengagement. AS a result of these findings, these nurses were given ownership of projects that interested them, and they provided peer to peer education.
At the evaluation process in 2017, Overtake Hospital Medical Center identified:
- a 25% increase in staff engagement
- zero FTE openings
- a Silver Beacon award
- the established culture of inquiry increased due to staff bringing forward questions and ideas and following through with evidence gathering, planning and implementation of practice changes
Through this evidence-based example, hospitals can maintain their established culture by:
- involving staff as leaders in projects that contribute to an increase in morale and engagement
- continuing to encourage certification to advance their role in nursing
- promoting staff ownership of unit practices
Enforcing these practices will provide a strong foundation in succession planning and stabilizing culture within the nursing practice. Starting your nurses in leadership roles early will make them accountable and enforce them to maintain the hospital culture. These nurses will be poised for growth and conditioned to take on a future leadership role within your organization.
Although C-suite turnover will continue with retirements, mergers and those looking for better opportunities, you can help offset the negative ramifications by successfully engaging your nurse staff to lead.
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