Many healthcare executives choose to ‘go out on top.’ They have been a good leader, the organization is well liked, turnover is low, and feedback from all quarters is positive.

In this situation, it is tempting to immediately start a search for a new hire who is similar to the departing executive. However, it is more beneficial to take a step back to re-determine what’s needed for the future success of the organization. Taking the time to review the position’s responsibilities and workload often results in finding that future success requires different goals and skill sets than those needed to get to this point. Resistance to change will abound, but being patient here will reap benefits in the long term.

During this process utilizing a quickly-recruited interim executive allows the organization to successfully operate, and even grow, until the right person is found to fill the position permanently. The interim executive keeps other executive leaders from being overburdened, a situation that often results in more leadership vacancies, and acclimates all staff to the idea of change. Often the interim executive will continue work on a project basis for a short period once the permanent C-suite leader is on board, ensuring a smooth transition, with little, if any adverse effect on facility performance.

In scenarios in which performance has been mediocre, such as fairly frequent complaints, lukewarm participation in surveys with less than stellar reviews, and attracting good talent is possible but turnover is high, the transition strategy is different. Diagnosis of the issues via frank assessments and discussions with staff and remaining executives is critical, and this should not wait for the new executive to arrive. Begin by assessing the executive team dynamic and determine if there is a critical person driving the performance issues, and engage employees at every level in discussions about workplace culture.

Restructuring may be in order, and tensions may run high. It can be especially helpful to recruit an interim C-suite executive to make significant functional changes, manage difficult negotiations, and engineer any departmental reorganization. Often, after the interim exits, so do the negative feelings surrounding the reorganization. Essentially, the interim leader can navigate the tough transactions, and set up the permanent executive for success, and the organization for a fresh start.

When an organization has key areas consistently performing very poorly, they will likely have no community buy-in or business partnerships, and not be able to attract top talent.

The organization needs to be stabilized before a top-notch executive can be recruited. An interim executive with 20+ years of experience will be necessary to stabilize the organization and improve staff morale; and improve the ethics, diligence and intentionality of the organization. 

Start-up organizations, or those moving from a volunteer-board management to hired staff, or executing a new business plan, will have a variety of roles that will shift over time as others are hired - it is critical to clearly define job responsibilities. A seasoned interim executive will have experience dealing with unforeseen issues, and help ensure the first members and staff receive the best “executive” communication. The key focus should be on realigning the board’s role from daily operation to governance effectiveness. Once the interim leader gets the organization on its feet, recruitment of the permanent executive can begin.