I have been reflecting as 2022 winds down, realizing that as healthcare IT leaders prepare for a new year, there will be many headwinds facing our future path. Although it's been almost three years since the COVID-19 pandemic hit, leading healthcare IT organizations has never been more challenging.

What worked for many years in terms of leading technology teams is often no longer enough in today's new healthcare setting. The skills, traits and experience that made leaders successful in the past continues to change direction and evolve as the fallout from the great resignation and remote working impact the workforce.

I'd like to share, from my experience, several strategies that IT leaders may benefit to focus on as we move into 2023 and beyond to maximize retention and productivity.

Assuming that you have a healthy organizational culture, having your finger on the pulse of the environment and setting your sights toward prioritizing efforts to continue thriving is of utmost importance. Also, it's going to be important to recognize the difference between a "forced" culture and an "inspired" culture.

Forced cultures are never sustainable. Between onboarding new people to replace those lost in the turnover of the "great resignation" and establishing a remote or hybrid work environment, the challenge is not a trivial one.

In today's world, I find a need to focus on being innovative in this area. Although it was sometimes difficult to navigate the past while staff was in the office every day, people can still observe and embrace the culture.

A few thoughts to offer for your own reflection: How do you instill your culture (the shared beliefs, values and attitudes) in new employees? How do you maintain it with staff that may not come to the office often? The key aspect of building or shaping the culture is that it must be defined and articulated as much as possible.

More than ever before, this must be incorporated into your onboarding and annual review processes. Organizational or cultural "fit" is going to be more important than ever before. Mistakes made in this area will be costly in terms of time and money. Hiring managers will need to vet this closely in the recruiting process.

Recognize that much of this cultural challenge will fall on the middle managers that are interfacing with the frontline staff regularly. We will need to prepare them for establishing connection points with the team and the culture of the organization. This is going to require time and effort on the leaders of the organization to set the course and the pace, while recognizing and rewarding behavior that helps create the desired environment. As Peter Drucker once said "culture eats strategy for breakfast."

Once you find a way to keep your culture front and center, it is imperative to focus more than ever on employee engagement. Strong organizations know that measuring employee engagement is critical to have a high performance workforce, and the results speak for themselves.

So how do you keep staff actively engaged when they might not be in the office often, or if they are working from some remote location? The old days' management by walking around no longer works in some aspects of healthcare IT.

Since we have settled into a new normal where these traits are concerned, it is once again going to be important as a leader to get innovative and focused. How do you create that line of sight for your teams to recognize the meaningful work that they do? How do you ensure that they stay engaged with so many distractions occurring at remote work environments?

I think it's going to be important to get a baseline assessment of staff engagement and then work on programs to maintain or drive more engagement. In this new era, leaders will need to stress and make it a priority to find ways to encourage engagement and reward its behavior as well.

Assuming that you can maintain your strong culture and keep your team engaged, you still need to be focused on employee retention. All of that work can be for naught if your key employees can be recruited away, either by local competitors or far-away technology companies. Employee retention has never been easy in healthcare IT, and the challenges are now amplified.

I tend to think of these tensions in terms of "shoves and tugs." What are the things that your employee base view as "shoves" – the things that drive down their motivation and productivity? What are the things that make them frustrated and take a call from a recruiter? Identify these things and eradicate them as quickly as possible.

What are the things that your employees view as "tugs" – the things that make them want to stay at your organization? Identify these and push to roll them out even more broadly. Listen to the people on your teams. Find ways to poll the employees in your organization who are plugged into the pulse of the organization.

There is no one-size-fits-all approach, but you can find the common themes that will really get your workforce to see your company as a "destination" organization. The payoff is that, now, it not only becomes easier to retain key employees, it becomes easier to recruit as needed.

I mentioned the need for investment in middle management. These are the managers and directors that sit between your executives and your frontline managers. I want to really stress how important this group is when it comes to all of the things that are key to creating a high-performance, sustainable IT organization.

At the end of the day, these are the emerging leaders that can execute flawlessly on projects while operationally keeping the foundational systems up and running around the clock. These middle managers are the glue to the organization. It is helpful to be mindful that, when people leave an organization, they often leave because of their manager.

In today's world of fighting for the best and the brightest employees, don't give them a reason to leave. Pay employees at the market rate, keep them motivated and engaged and make sure their managers understand the key role they play.

While the headwinds are strongly pushing against healthcare IT leaders heading into 2023, there are plenty of opportunities to chart a steady course and arrive at your desired destination.

• Recognize that you are going to have an evolving remote workforce. Work to create the right balance for your team.

• Set and manage the team around expectations for working remotely.

• Build scorecards to measure and reward productive behavior.

• Look for opportunities to promote your strong staff, internally, into management and ultimately leadership positions.

Also, identify and reward the employees that feed your culture positively. They will become your cultural "lighthouses," who make it easier to spread word and demonstrate the right behavior.

Also, ensure that your management team is looking for signs of burnout. It is important to reduce ambiguity more than ever before with a remote workforce. Make sure that, as a leader, you are deliberate, articulate and accountable.

These tactics will help to keep your culture alive and well. Your team will recognize the efforts and thrive, so that you can focus on the next wave of leadership opportunities and challenges.