From Children’s Hospitals Today
By Kelly Church
The youngest working baby boomer in the U.S. will turn 55 this year. The youngest millennial will turn 24. The baby boomer generation was just that—a surge in newborns. Between 1946 and 1964, the number of births skyrocketed to 4.3 million per year versus 2.5 million prior to 1946. And now they’re retiring. About 10,000 boomers reach retirement age every day.
“The biggest challenge for hospitals isn’t just boomers’ retirements, but the loss of institutional knowledge,” says Armando Llechu, chief administrative officer at Golisano Children’s Hospital of Southwest Florida in Fort Myers. “These people have been with organizations for a long time. They understand the nuances of the communities they serve. When they retire, they’re taking that knowledge with them.”
With the final wave of millennials now entering the workforce and baby boomers making their exit, hospitals are focusing on the transition of power. It’s the responsibility of current leadership to prepare the future generation to take over.
At Golisano, Llechu identified his successor within six months of being hired. It’s a method he’s practiced for years—when he starts a new role, he identifies and trains a successor in real time, so operations run smoothly during transitions.
Tom Capizzi, vice president of human resources at Children’s Hospital of Orange County (CHOC) in Orange, California, agrees planning is key. “Build a succession plan and then a strategic recruitment plan. Think about your younger workforce and how you’re going to get them up to speed over the next five, 10 or 15 years.”
While many boomers stayed with an organization for 20 or more years, there’s no guarantee millennials will have similar tendencies. How can hospitals conduct succession planning in this type of environment? Find out what makes the next generation of leaders tick.
Offer more than money
Llechu is noticing millennials don’t necessarily accept a job from the highest bidder. Baby boomers weren’t far removed from the Great Depression—when they entered the workforce, they sought financial security. “Fast forward to millennials and Gen Z, and money isn’t a big driver,” Llechu says. “I speak to physicians coming out of training that no longer chase the biggest paycheck. They want an experience; they want work-life balance.”
Llechu says historically employers were able to encourage—or discourage—certain behaviors with money. It was a more “authoritative approach” to management, motivating employees by letting go of the bottom 10% or placing underperformers on improvement plans.
The upcoming generation responds to these tactics differently. “The competition for talent is so high today,” Llechu says. “If you’re going to browbeat someone on your team into doing something, they’re going to go home, jump on LinkedIn, submit an application and, before you know it, they’re going to resign.”
Younger generations view employment as a two-way street with management: They’ll give their best if it’s given in return. Job satisfaction and longevity are now more about culture and fit. Organizations are expected to create an environment that supports personal and professional growth.
Embrace new energy
“The great thing about having a new set of people is they bring an energy with them,” says Hossain Marandi, M.D., MBA, FACHE, president of Peyton Manning Children’s Hospital in Indianapolis. “Millennials and Gen Z are the new blood that allows us to be open to changes. They are open to ideas.”
Instead of forcing these inevitable leaders to adapt to a prior generation’s habits and procedures, hospitals should tap into their energy and strengths. Use it to the advantage of other hospital staff and patients. Marandi uses technology as an example—millennials’ tech-savvy minds can take a burden off other staff members who may not be as technologically inclined.
Marlene Miller, M.D., MS.c., pediatrician-in-chief at University Hospitals Rainbow Babies & Children’s Hospital in Cleveland, agrees the next generation of leaders has an affinity for technology but encourages them not to let it hinder their success. People skills are important in pediatric health care, and technology can cripple the human element that is essential to lead productive teams and develop personal relationships.
“There’s an ease to technology that can create a distance for successful team building, both with patients and families, as well as colleagues,” Miller says. “As we grow more technologically sophisticated, how do we keep people true to the mission so they stay happy in their roles?”
Focus on mentoring
Llechu describes step one of leadership development as ensuring the right people are in the right position. Traditional recruiting finds a person for a specific role, but that role may not support the individual’s strengths. Rather, help individuals find roles that satisfy their personal and professional journeys through internships and mentoring.
“Give people an opportunity to shadow and experience aspects of health care,” Llechu says. “Understand why they want to get into health care leadership. Help them get a flavor for what it means.”
At CHOC, mentoring plays a big part in how Capizzi gets the right person in the right role. He talks to students at local colleges to help them understand why pediatric health care, and ultimately leadership, could be their future. Capizzi also works with high schools, showing students what it means to have a career in health care.
CHOC offers an eight-week summer internship for college students and juniors and seniors in high school so young adults can immerse themselves in a hospital experience. It’s not designed to encourage students to become a doctor or nurse, specifically, but it shows them how hospitals work and the role they play in communities. “Several of those young adults are now in med school,” Capizzi says. “Two participants are working at CHOC. The investment in mentoring is critical.”
Develop leadership skills
Physicians are celebrated for their ability to identify and treat challenging illnesses; they aren’t always celebrated for their leadership skills. “We’ve been taught throughout medical school and residency it’s a one-person show,” Marandi says. “It’s all about your grades. It’s about you becoming the physician. Skills like delegating, relying on others and trusting others are things we don’t learn in medical school or in training.”
Children’s hospitals are bridging the education gap by developing training programs for growing leadership skills, exposing staff to the art of leading teams in a way their education never did. At CHOC, Capizzi developed the Excellence in Leadership program under the umbrella of CHOC University, the hospital’s in-house continuing education program.
It launched in 2019 as a program staff members can work through at their own pace. CHOC executives or professors from nearby University of California, Irvine; California State University, Fullerton; and Chapman University teach some of the on-site classes. Employees choose 18 to 24 classes from a catalog of courses. “It covers typical leadership soft-skill training, but some of it is about business acumen, giving them the skills a young leader can build on over time,” Capizzi says.
UH Rainbow Babies & Children’s Hospital is recognizing some employees may want to develop skills in leadership, while others may want to pursue grant writing or an MBA. From short programs to full-degree programs, staff members select courses based on their own interests and goals. The hospital is implementing targeted menus of leadership opportunities that range from coursework to experiential leadership opportunities.
Prevent burnout
Marandi compares health care to industries that experience a faster-than-average speed of change and higher levels of demand that lead to stress and burnout, like technology. Medical schools aren’t training students to cope with the demands of the workplace, placing the weight on hospitals to help employees.
“Providers leave the protective bubble of academia and step into the real world where the expectations are higher,” Marandi says. “We need to train them and create balance.”
Satisfied employees with long, successful careers typically have a pleasant home life. The two go hand-in-hand; when one is out of balance, likely so is the other. Younger generations are looking for roles that allow them freedom at and outside of work. Hospitals that strive for an improved work-life balance may need to think creatively for retention.
Allow experimentation
“Rules-based environments are less effective with younger staff,” Llechu says. “This new crop of young professionals are going to be the disrupters that potentially take health care out of where it is and advance us to a different place.”
Marandi sees the next generation as a blank slate, ready to be trained to do things in possibly a better way than generations prior. “One of the most devastating sentences I ever hear in our work is, ‘This is how we’ve always done it.’”
Health care relies on innovation to move forward. While it’s important for the new generation to be trained on current standard operating procedures, organizations must be open to new solutions to old problems. Younger generations welcome this challenge and are deterred by organizations that discourage new ideas.
“Some people say younger generations have less of a commitment to organizations and are more willing to try different things,” Miller says. “Employers must consciously think about how to make their organization the best place to work with day-to-day interactions and opportunities to grow.”
Get buy-in
For Capizzi, convincing senior leadership to invest in future leaders—with time and money—didn’t take much. Getting buy-in was easy with an understanding Capizzi’s efforts were for the future of the organization. The team agreed that CHOC University was a differentiator.
“I have this vision where we grow CHOC University, and it becomes a core capability that helps develop leadership for the future,” he says. “Then, if I’m doing it right, I’m doing less recruitment outside. I can keep turnover costs down. If I’m investing millions of dollars right now with turnover, I can apply it to career development and talent retention.”
The cost savings can be directed to other staff benefits that support retention. Capizzi is enhancing CHOC’s tuition reimbursement program. The goal is to remove maximums and encourage employees not only to participate in CHOC University, but also continue their educations outside of CHOC and relieve some of the cost burden of higher education.
“You have to be thinking about stepping out of the box to help your future workforce stabilize and stay,” Capizzi says. “That drives retention, which will drive long-term capability.”
As the next generation of providers set their sights on the future and current leaders transition out of the workplace, children’s hospitals need to address the knowledge gap. “Think about who’s going to be here for the provision of care,” Llechu says. “We need to create opportunities for experiences for these individuals, understand what they’re looking for and meet those needs.”
