Career pathways and competency acquisition for hospital leaders

Context The evolution of patients' needs, the progressive ageing of the population, the recent COVID-19 pandemic and the changes it induced are amongst items that put high pressure on healthcare organisations. In this evolving scenario, emerging professional profiles must meet expectations by acquiring more and more specialised expertise. Managers must often face higher levels of organisational accountability and work in less individualistic and more “team-oriented” ways. New managerial and coordination responsibilities emerge. The research evaluates hospital CEOs training and career trajectories, as well as their competence profiles, to find the best fit to achieve successful results. Methods In collaboration with the International Hospital Federation (IHF), we have administered an e-survey to Hospital CEOs worldwide. The survey is made up of five sections: general information, training pathways, career pathways, competency relevance assessment and competency self-assessment. The 40 competencies under consideration were selected from the IHF's Global Competency Directory. The same survey was translated into four different languages to improve distribution (English, Spanish, Portuguese and Italian). Replies were anonymous. In addition to a descriptive analysis of the sample, the presence of different training and career pathways was assessed and matched to competency profiles through Anova tests. Tukey range tests highlighted which training/career characteristics mostly influenced competency acquisition. Results We have received 249 replies from hospital CEOs in 16 counties. Training and career pathways are variable and significantly associated to the acquisition of some key competencies. Moreover, communication and entrepreneurial skills are among those considered most lacking and should be prioritised in training programs. Gender may affect choices on the type of organisation in which to work and on career options (mixed career ladders). Discussion Understanding how to improve training and career pathways of CEOs to improve their skill mix is key in times of deep changes in the healthcare sector. This study focuses on a gap analysis, which is useful in identifying substantial differences between hospital CEOs' desired competencies and the ones that they have developed concretely. The analysis of top managers’ educational and professional backgrounds allows to map and compare training and career pathways across nations. This, in turn, 48 provides the bases for benchmarking activities across countries, with implications on the detection of best practices and on international mobility opportunities