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Fresh Insights on Interim Leadership: Strategies for Success

B.E. Smith Team | July 07, 2017


The annual B.E. Smith Interim Intelligence Survey is complete and once again provides a wealth of insights from hundreds of current and former interim healthcare leaders as well as the organizations that utilize them. Adding additional context and breadth to the Interim Intelligence Survey is data derived from a separate survey B.E. Smith conducted earlier this year of nearly 300 healthcare executives. This white paper presents significant findings and several recommendations to guide organizations in understanding the opportunities, considerations, and success strategies for Interim Leadership.


Interim Intelligence Index - Client 1The Interim Intelligence Survey provides particularly timely knowledge given that interim employment continues to play an increasingly robust role in talent management. A trend that is being driven by a number of relevant industry forces. The healthcare labor market is highly competitive across the board, and turnover is a growing issue. For the past few years average overall turnover for healthcare employers is around 19%, but the rate is increasing.1 Similarly, hospital CEO turnover has held steady at 18% annually for the past three years. While down slightly from the record high of 20% in 2013, it still remains at elevated levels. It is also important to note the impact CEO turnover has on an organization, causing departures in other leadership roles and trickling down through the workforce.

Adding to the complexity are findings from B.E. Smith’s 2017 Leadership Intelligence report. According to the report, 60% of healthcare executives said “finding quality candidates” was the biggest challenge their organization faces when filling an executive vacancy. Providing leadership during the vacancy was second, with 26% of healthcare executives citing it as the primary challenge for their organization. An increasing number of healthcare organizations are finding that Interim Leadership is a valuable, and flexible tool to help cope with both of these challenges.


Interim Intelligence Index - Client 2B.E. Smith research shows healthcare’s competitive and rapidly changing environment is prompting three broad strategic scenarios in which healthcare providers are successfully utilizing interim management:

  • Replacement of an incumbent executive for a variety of reasons
  • Bridging the gap when filling a leadership vacancy
  • New position creation, often the result of new and emerging leadership role requirements


Given the role interim management plays in addressing so many urgent needs, it is no surprise that it is quickly becoming the tool of choice for healthcare providers. In fact, 79% of healthcare executives in the
Interim Intelligence Survey were aware of the model. There is also widespread agreement that the two defining hallmarks of interim management are engagement length and ability to provide bridge leadership
while a permanent replacement is recruited. Duration of engagements most commonly cited by respondents was three months to a year. Interestingly, the highest percentage of interims surveyed believed six months was the ideal assignment length.

Interim Intelligence Index - Client 3Healthcare executives who have used Interim Leadership in the past specifically mentioned the more strategic contributions of the management tool. These executives valued the ability to foster leadership as well as meet “situational needs.” Healthcare executives who have not previously used Interim Leadership have a much different perspective. These executives tend to perceive interim work more tactically, connecting the service to specific responsibilities or tasks such as process improvement.


While interim leaders carry a traditional image of a temporary placeholder, the reality is they are actively deployed today against a wide range of precise organizational needs extending well beyond the conventional recruiting bridge role. In fact, meeting a specific need was the top reason mentioned for utilizing an interim leader, selected by almost 30% of survey respondents. Drilling down on these specifics revealed an interesting array of activities:

  • Helping pursue a particular goal to which the interim brings relevant skills and experience.
  • Driving short-term change in advance of the permanent hire. As one leader put it, “The interim is able to make difficult transitions in order to set the permanent placement up for success and a fresh start."
  • Reorganization, often a replacement or vacancy scenario prompts significant departmental and functional changes, and interim leaders can help manage the process smoothly.
  • Thinking through changing roles. Interim leaders frequently occupy positions during periods when uncertainty exists about the role and responsibilities and structure are being reconsidered. Interim leaders can help clarify the role during their tenure.


Interim Intelligence Index - Client 4B.E. Smith’s Interim Intelligence Survey and other related surveys also investigated the benefits organizations seek through the interim model. As shown in Figure 1, the two leading benefits included leveraging an interim leader’s extensive experience and quickly filling the leadership role. Supporting comments described the high value derived from an “expert leader who needs minimal training” and who possesses the ability to “hit the ground running.” Additional statements best captured several of the other highly ranked benefits:

  • “Allows for fresh views and perspectives to be brought to the organization.”
  • “Creates organizational stability during periods of recruitment and onboarding replacement staff.”
  • “Prevents burnout of current managers who are already overloaded.”


Realizing the substantial benefits of interim leadership clearly depends on attaining the unique objectives set for the engagement. One survey respondent noted the situational nature of such objectives stating,
“Not all interim assignments are created equal; each has its own set of goals and scope.”

So, how do healthcare originations who utilize Interim Leadership define success? For the overwhelming majority of executives in the Interim Intelligence Survey it is simply, “getting the job done.” More specifically, they measure success by accomplishments achieved towards the targeted objectives of the interim engagement. However, respondents also identified these other key requirements:

  • Efficient and effective onboarding of interim leader with established goals at start of engagement.
  • Achievement of objectives “with little or no guidance."
  • Performed in a culturally-sensitive fashion that is collaborative and gains organizational buy-in. One leader described it as “willingness of the interim to listen and deliver what is expected, not just what they want to deliver.”

The survey results highlight a critical element shared across many successful interim engagements. The importance of identifying targeted objectives in advance of the start of the interim engagement.


How organizations track progress of objectives in an interim engagement varies, but most use a combination of quantitative and qualitative tools. Some providers use periodic formal progress evaluations. Others rely on informal monitoring and even “observing the day to day interactions with staff.” Measurement standards are equally varied, befitting the diverse nature of interim assignments. Healthcare executives reported examining specific milestone/outcomes measures, assessing the effectiveness of the interim leader’s work, the satisfaction or engagement of the interim leader’s staff and peers, and overall process and structure of the interim leadership engagement.

Interim Intelligence Index - Client 5


B.E. Smith’s interim employment model is unique to the industry, which typically centers on individual contractors. B.E. Smith employs all interim leaders, eliminating specific operational responsibilities and reducing financial risk on our partner healthcare organizations. More specifically, B.E. Smith manages the interim leader’s medical insurance, 401K, and taxes. This model consistently generates high approval marks from the interim leaders. B.E. Smith’s Interim Intelligence Survey found 85% of interim leaders were satisfied with B.E. Smith and more than 90% were likely to return and to recommend B.E. Smith to colleagues.

Interim Intelligence Index - Client 6This year’s survey probed satisfaction levels and perceptions of client hiring organizations to provide additional context. Overall, 85% of B.E. Smith clients described being highly satisfied or satisfied with their Interim Leadership experience. An equal percentage would utilize the firm again for future Interim Leadership needs. Consistent with the desire to find interims who can bring the right expertise quickly to an organization, the three factors garnering the highest satisfaction were:

  • Speed of interim placement
  • Professionalism of B.E. Smith staff
  • Level of interim preparedness

The survey highlights the significant benefits B.E. Smith’s employment model provides over utilizing an independent contractor. The support provided to the interim, the speed of placement, as well as the reduced responsibilities on the healthcare organization are just several reasons B.E. Smith is the industry’s preferred provider for Interim Leadership.


The Interim Intelligence Survey also provides healthcare organization with best practices when utilizing Interim Leadership. These three recommendations will help ensure the engagement is a success.


Interim Intelligence Index - Client 7Different healthcare organizations need leaders who bring different skillsets. Some providers may require an interim leader who is a change agent to push against prevailing culture, while other organizations may seek an interim leader who provides more stability, develops strong relationships with staff, and gains buy-in. For this reason, matching the interim leader to the organization’s culture is imperative.Discuss institutional norms and policies with the interim leader. Also help prepare the way for the interim by delineating the interim’s role to current staff.


The premium placed on interim leaders meeting expectations underscores the need for organizations to establish clear goals before the engagement begins. Ensure alignment exists with the interim leader. Since engagements often last for a year or more, remain vigilant about the objectives and agree on changes when needed. Once again, broad internal communication of the interim’s mission is vital to inducing consensus.


Increased levels of turnover and a shortage of experienced executives has created a highly competitive healthcare workforce market. As a result, the recruitment cycle is lengthening for many organizations.Leaving key leadership positions vacant or filling them internally with less experienced staff increases risk to the organization. Interim Leadership bridges the gap, and enables organizations to evaluate the position as well as the skillsets needed in a future leader. Interim Leaders are also a valuable onboarding tool, mentoring up-and-coming leaders or assisting recently hired talent in the transition to the new role.


The 2017 Interim Intelligence Survey provides a fresh set of lenses through which to view interim leadership. Clarity on goals, benefits, best practices, and more emerge from the findings and guide the way
toward success in utilizing this important workforce strategy.


  1. Compdata, Compensation Data Healthcare 2015 survey.
About the Author

B.E. Smith Team

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