By building a highly competent and innovative leadership team, hospital trustees and senior executives can achieve their strategic priorities and move their organizations toward the value-based second curve of health care. The American Hospital Association and executive search firm Spencer Stuart recently conducted a survey of hospital and care system senior executives, along with more than 25 one-on-one interviews, to examine how the shift toward the second curve is affecting the leadership, talent, strategic priorities and organizational models of health care organizations.

Overcoming Capability Gaps

Survey respondents, while expressing confidence in their current executive team, identified several gaps in their respective organization's and leadership team's capabilities. Nearly half of all respondents identified experience in leading nontraditional health partnerships and managing community and population health as skills missing in their organization. Other gaps cited were experience in transformational change and change management as well as advanced financial expertise, innovative thinking and data analytics.

To overcome these gaps, health care organizations are creating leadership positions for innovation and strategy. In the survey, 44 percent of respondents said their senior management team includes a chief strategy officer, but only 8 percent reported having a chief innovation officer. Many health care organizations are diffusing the responsibilities for innovation and strategy across their leadership team, though this can be difficult to balance among the normal day-to-day responsibilities of a leader. As one senior leader observed, "The day-to-day management is so hard that to ask those same people to think about how they can put themselves out of work and be that kind of 'creative' is almost impossible."

Along with emerging titles and roles, survey results showed that traditional health care roles are changing. Chief medical officers are becoming more focused on operations and strategy. Chief nursing officers are emerging as the chief clinician and patient advocate, while chief financial officers are increasingly providing advice on risk, insurance and clinical issues related to strategic decisions. Chief operating officers are becoming the integrators in chief, overseeing a range of operational activities both internally and externally.

Recruiting, Developing Senior Leaders

Health care organizations traditionally have recruited leaders from within the health care sector. Now organizations have to consider candidates from outside the field to meet expanding and more diverse responsibilities. In the interviews, senior health care executives cited retail and customer insight experience, enterprise risk management experience and insurance expertise as capabilities that their organizations are looking to find. Additionally, the survey found that nearly 80 percent of health care organizations are offering in-house, customized programs for senior managers to develop and enhance their existing skills, such as data analytics, strategic planning and staff engagement.

With the new demands on hospitals and care systems, trustees and senior executives must work together to adapt their organization's leadership roles and management structures and provide high-quality, seamless care delivery across the continuum.

To view the report "Building a Leadership Team for the Health Care Organization of the Future" and the survey results, visit

Thomas Duffy, M.P.H. (, is a program manager and Cynthia Hedges Greising ( is a communications specialist, both with the Health Research & Educational Trust, Chicago.