Key Takeaways
In this article, you’ll learn:
- The current challenges facing rural healthcare leadership
- Why rural hospitals struggle to overcome today’s challenges
- How rural hospitals can turn challenges into opportunities
- How rural hospitals can find the right partnerships to build future success
The State of Rural Healthcare and Why Leadership Matters
For rural healthcare leadership, successfully turning challenges into opportunities requires the ability to prioritize, embrace change, and leverage innovations. By addressing barriers to change head-on, rural healthcare leadership can build a collaborative, transparent, innovative environment. Forward-thinking healthcare executives understand that improving patient outcomes, advancing care, and creating sustainable systems require a patient-centric approach and a willingness to evolve. This mindset drives adaptation, even in the face of today’s biggest healthcare challenges, including:
- Workforce shortages
- Rising costs
- Complex patient needs
- Access to care issues
In rural healthcare, finding solutions to problems and turning obstacles into stepping stones can be the difference between life and death. Economic, environmental, and social factors often put the health of rural residents at greater risk than residents living in urban areas, especially in relation to the top four leading causes of death in the US:
- Heart Disease
- Cancer
- Unintentional Injury
- Chronic Respiratory Disease
One in five Americans—or 20% of the population—relies on rural healthcare. In this high-stakes environment, driving the growth and innovation needed to turn challenges into opportunities is a tight rope act critical to the survival of rural healthcare facilities and the people they serve.
Key Challenges Facing Rural Healthcare Systems
Experts across the healthcare industry agree that, as a sector, rural health is struggling. The most common obstacles in rural environments are well-known and often discussed among rural healthcare leadership. These include:
- Reduced access to care due to longer travel distances for primary, emergency, and specialized care
- Lower rates of health insurance coverage, creating a cost barrier for patients and payer mix challenges for hospitals
- Fewer primary care providers and specialists available in rural areas
- Hospital closures cause job losses and decrease economic activity in rural areas
The 2014 RUPRI Health Panel report on rural healthcare is over a decade old yet remains a cornerstone of information and data regarding rural health challenges. The now recycled and restated discussions regarding the challenges facing the rural health sector are widely accepted today, but the conversations are slow to yield actual change. For rural healthcare leadership teams that are ready to take the next step, looking at the old challenges in new ways is essential.
Turning Obstacles into Opportunities
As with any problem-solving process, it is helpful to begin by breaking a big problem into smaller pieces. Here are the three categories innovative healthcare executives are using to look at the larger issues in rural healthcare delivery:
- Operational Barriers to Progress. In the operational bucket of challenges are issues that can impact the culture, the turnover rate, and the ease of hiring for an organization. Some examples of operational roadblocks include poor organizational communication, lack of clear organizational goals, and functional silos. One of the most common struggles in improving operations is a resistance to change dressed up as an adherence to accepted practices. Rural hospitals that fall into the old stand-by of “this is how we have always done it” may be stuck in a self-made rut, unable to move forward.
- Financial Pressures and Negative Margins. More than 45% of rural hospitals are currently operating with negative margins. In this type of financial limbo, even small decisions or setbacks can have major consequences. This can make healthcare leaders hesitant to change or to set a new course.
- Workforce and Cultural Struggles in Rural Hospitals. A lack of rural health leadership and recruitment challenges are hot topics in rural health that deeply impact personnel, culture, and organizational growth potential. Also driving decreased productivity and lack of innovation in rural hospitals is a 20% employee turnover rate, low employee morale, and a lack of upward career opportunities for team members.
While these three categories encompass many of the biggest challenges facing rural healthcare, there are also three main areas of opportunity for rural healthcare organizations. These are:
- Education and Continuous Learning. This category includes both the rural patient population and the rural healthcare leadership, clinical team members, and staff members at rural hospitals. Lower levels of health education within rural communities can create communication challenges between patients and providers, often making patients reluctant to seek care. Community involvement in improving health education can enhance the patient/provider relationship and improve overall health outcomes. For hospitals, continuous learning for team members, growth opportunities within the organization, and ongoing process improvements through learning about best practices will keep the rural hospital moving forward.
- Technology, Infrastructure, and Development. Development reflects opportunities to address infrastructure, technology, and growing future leaders. Organizations intent on creating future success will look to implement plans to improve failing infrastructure. A hospital with a failing infrastructure will continue to experience roadblocks to patient care. Technology is advancing at a rapid pace, and successful hospitals will make a plan to keep up. For rural healthcare facilities, technology could be the answer to reaching more patients and bringing the resources of larger facilities to small towns. Development also presents opportunities for rural healthcare leadership and team members. Employee programs for continuing education, leadership mentoring, and performance improvement are proven to enhance organizational culture and increase employee retention.
- Recruitment and Retention for Long-Term Stability. The team of employees is the heart and soul of any healthcare organization. However, vast improvements in recruitment and retention are necessary to keep rural health employees in place. The opportunity to improve recruitment for rural hospitals is a huge growth area for the industry. Building a lasting pipeline of qualified candidates would create a healthy, secure future for any rural community. Some proven strategies for expanding talent pools in rural areas include student loan repayment programs, flexible scheduling, and sign-on bonuses. While these tools may help boost recruitment, having a national reach is the most important part of any healthcare search for a rural hospital. In a healthcare executive search for a rural area, a national reach is crucial because the local candidate pool is often insufficient. Recruiting nationally is necessary to gain access to candidates with the expertise, experience, and leadership qualities needed to manage complex rural healthcare challenges.
A Strategic Framework for Rural Health Transformation
For rural healthcare leadership to transform challenges into opportunities in rural health, each obstacle must be thoroughly understood and addressed. Each solution must be detailed and focused on the long term. To drive true change, leaders must reframe difficulties as chances for learning and growth. While the best practices for adopting a growth mindset are not unique to the healthcare industry, they do apply to the current state of rural healthcare.
Reframing Challenges for Growth. It is helpful to look at a situation for what it can teach, rather than the problems it causes. For example, more than 65% of rural areas face a shortage of primary care physicians. This is clearly a problem for rural residents; however, what does this problem mean? Why are physicians leaving rural areas? Exploring the reasons behind the challenges in rural healthcare will create a greater understanding of the underlying forces driving the status quo.
Building a Future-Focused Strategy. Once a rural hospital’s challenges are identified and the root causes are understood, it is time to create a strategy. The plan for driving change should be future-focused, have trackable benchmarks, and take into account the operational, financial, and personnel imperatives specific to that organization. Rural healthcare leadership may incorporate innovation into their strategy, as well as problem-solving. Innovation topics in rural health include leveraging technology, such as AI and telehealth, and utilizing social media to drive community engagement.
Tracking Results. Implementing problem-solving strategies takes time. Establishing a timeline at the beginning is important for understanding and tracking success. For example, if a rural hospital implements a mentoring program to support employee growth and engagement, it will be important for rural health leadership to set goals for the program, track participation, and monitor outcomes for each participant over a set period.
Learning from Setbacks. There are always setbacks during a time of change. When new obstacles appear or a solution is unsuccessful, it is time to return to the data. Just because one attempt fails does not mean things should go back to business as usual. There are lessons to learn and improvements to make throughout the journey. When there is a setback, how can the leadership team bring their efforts back to driving improvements in education, development, and recruitment?
Seeking Support. Rural healthcare leadership teams need to find meaningful support throughout the process. Outside organizations, rural health resources, and healthcare experts can provide critical insights, offer proven problem-solving strategies, and share successes from other organizations.
Partnerships that Strengthen Rural Healthcare Delivery
For resource-constrained healthcare organizations in rural communities, professional partnerships can pave the way for them to offer more accessible, higher-quality care. Through collaboration, healthcare delivery organizations can reduce costs, share expertise, and improve health outcomes. Because of these opportunities, a growing number of rural health leadership teams are creating strategic alliances with other healthcare organizations, vendors, and industry experts. For example, a rural hospital can expand services by partnering with a technology expert to enhance their telemedicine services.
When considering a new partnership, rural healthcare leadership teams should carefully discern the right fit. The partner organization should align with the hospital’s challenges, strengths, and future plans, as well as have the ability to help the healthcare facility meet its operational, financial, and patient care goals. To identify if a partnership may bring positive benefits, here are some things a rural healthcare leadership team should consider:
- What support does the rural hospital need the most?
- What services does the potential partner organization offer?
- What mutual benefits can be gained through a partnership?
- What resources can the potential partnership organization provide?
- What areas of expertise does the organization bring to the table?
- What is the partner’s track record of success when working with rural healthcare delivery organizations?
At Kirby Bates Associates, our unique experience in rural healthcare gives us the expertise to help their leadership teams build a better future. To learn more, contact us today.
FAQ
- What are the biggest challenges facing rural healthcare leaders today?
Severe workforce shortages, significant financial instability, and a patient population with complex needs, all exacerbated by geographic isolation and a lack of infrastructure.
- Why are rural hospitals struggling to recruit top talent?
Due to a combination of geographic isolation, limited financial incentives, and a lack of professional and infrastructure resources compared to urban areas. Factors like lower pay, heavy workloads, burnout, and the urban-centric nature of medical training also contribute to the difficulty in attracting and retaining staff.
- How can rural hospitals overcome today’s challenges?
Rural hospitals can overcome challenges by improving financial stability through optimized billing and strategic partnerships, enhancing workforce through innovative training and recruitment, and leveraging technology to expand services and improve efficiency.