Since leaving the Navy, Rick Roche has spent his entire career in healthcare human resources. Currently, Rick serves as Chief People Officer at Grady Health System in Atlanta.

Grady Health System in Atlanta, Georgia, is a premier public healthcare provider, renowned for its world-class trauma, stroke, and burn care. Anchored by Grady Memorial Hospital, one of the largest hospitals in the U.S., Grady delivers exceptional emergency, outpatient, and specialty services. Partnered with Emory and Morehouse Schools of Medicine, Grady is a leader in medical education and research, dedicated to transforming lives and providing top-tier care to Atlanta’s diverse community.

Key takeaways

• The best healthcare CHROs do things very differently and they distinguish how they view the HR function. They act as impartial consultants and trusted advisors to other C-suite executives.
• Having a new senior leader come in from outside the organization can be disruptive, so Grady’s succession plan focuses on developing its most talented people and preparing them to fill future C-suite vacancies.
• Gen Z has a totally different perspective, but their perspective is correct. You have to accept that there are different ways of doing things and meet them halfway.

Q & A with Rick

Judy Kirby: Rick, you have had a long and impressive career in healthcare HR. You have led HR for Children’s Hospital Medical Center in Cincinnati, University Health Care System in Augusta, Georgia, Memorial University Medical Center in Savannah, The Health Care District of Palm Beach County, and the University of Miami Health System. You have been here at Grady as Chief People Officer since 2020. How did your career in this industry get started?

So, I borrowed a sport coat and went on the interview at Shriners Hospitals for Children in Cincinnati, which was a burn facility. Before I started the interview, I asked for a tour because I had never been around burnt children, and I knew couldn’t work there if it made me uncomfortable. I also just wanted to have a look around this very opulent looking hospital. I’d never seen anything like it.

On the tour I was able to goof around with the children quite a bit and when I went back down to HR they said, “When can you start?” I said, “Oh, you must not have got the note from Dr. Donnelly. This was really meant as a practice interview for me. I just started as an undergrad. But they said, “We know, but here we care about people who care about our patients.”

I was taking 24 hours of classes at the time but they told me I could come and go as I pleased throughout the day. They didn’t call it flexible scheduling back then. So, I worked about 30 hours a week in HR and 24 hours on the weekends in housekeeping there at Shriners.

After I graduated I got promoted to Director of HR at Shriners in Boston and I’ve been in HR in some form ever since. So, it was Irish luck that got me into it and kept me here.

JK: What an interesting story! So, you’ve seen a lot of changes in the industry over the course of your career. How do you think the CHRO role will evolve over the next three to five years, and how do you see the responsibilities changing?

RR: As a discipline I think that we’re probably not quick enough presenting change to our organizations. In HR, historically, the people are really good at service and really good at HR, but we haven’t been great at advising on what the future looks like, particularly as it applies to people. I think that’s going to be more prominent in the future. HR has to be able to provide a point of view on where the business is heading and how it can be best managed from the people side.

The COVID pandemic is a great example. For the most part, in HR, we managed a very difficult situation really well and gave good advice to our fellow leaders. But we should have been talking about remote work and hybrid working three to five years prior to the pandemic. I think that that’s going to be our role as HR leaders, really helping our organizations adapt. We have to see the future better and adapt to changing environments more quickly.

JK: I saw an article recently about how a lot of organizations are firing their Gen Z staff because they can’t adapt well to the culture. What is the experience with Gen Z at Grady?

RR: I think you have to have leadership courage, and above all, you have to hire the right people. Gen Z has a totally different perspective. And that is not a criticism at all. Their perspective is correct, it’s just different. But we have to meet them halfway, and really educate people about our culture, and acclimate them to it. You can’t force it. You can’t force someone who’s been working remotely 100 percent into working on-site 100 percent. You have to accept that there are different ways of doing things, which brings me back to my previous point: HR needs to be ahead on this rather than reactive. We need to be working on what’s going to be happening in a year, in two years, and three years from now.

JK: Looking back on your own journey, what career advice do you have for rising HR professionals interested in becoming a CHRO one day?

RR: The CHROs I have admired did things very differently, and they distinguished how they view HR. The opportunity they gave me at Shriners is an example. Allowing flexible scheduling was very unique at the time, and they didn’t even use the term culture yet. But that HR leader distinguished how she applied HR philosophy to the organization.

The best HR professionals I have been around do things differently. They don’t look at just compensation or benefits, or recruitment. They don’t look at the functions of HR independently. They have a broad philosophy. In healthcare, we’re guilty of doing everything the same way. All the hospitals in the country have almost the same benefits and almost the same compensation structure. We don’t distinguish ourselves as an industry or as a hospital, or as an entity. But the best CHROs think about it differently and distinguish their HR functions from their competitors.

JK: Have you been able to do that at Grady?

RR: I believe so, yes.

JK: Can you give an example?

RR: One example is that we eliminated HR policies. We went from 600 policies written by attorneys telling our employees how we don’t trust them and how many ways we could fire them, to 12 pages of guidelines that tell our employees how much we care about them and how much we trust them. We didn’t do that just to distinguish ourselves. It was a strategy specifically designed to change the work experience at Grady.

JK: What has been the outcome of that HR policy change?

RR: Three years ago our turnover was 40 percent. Healthcare norms right now are at 21 or 22 percent, I believe. Last year our turnover rate came in at 12 percent, and we’re a large, inner-city hospital in a challenging neighborhood. It is challenging to get here and we’re a safety net hospital, so we deal with a lot of mental health patients. It’s a challenging work experience. And having just 12 percent turnover during a time of growth – we’ve grown by 3,000 employees in the last 3 or 4 years – that’s certainly an indicator that the changes we have implemented are working.

JK: Are there any other examples of how you have done things differently?

RR: Yes, but I want to preface this by saying that I do not take any kind of pride or enjoyment in firing people. But in my first three years here we let about 1,200 people go. We did this during a pandemic and a staffing shortage. To provide some perspective, in the three years before I arrived, Grady let something like 60 to 70 people go.

We have a very simple premise: In order to work here, you have to demonstrate the ability to be an exceptional colleague and deliver exceptional service. And if you don’t possess both of those skills, we won’t hire you, and you can’t work here. Parting ways with those 1,200 employees over three years was a direct reflection of that philosophy. Our idea was that people who are not good colleagues or do not provide good service to our patients and their families, are not enhancing the work experience. If we replace them with people who are good at those two things, the patient experience and employee experience are going to be enhanced, evidently and obviously, and I think that has happened.

JK: How was it first perceived, though, by the organization?

RR: Not well. People may have thought I was crazy, and I don’t blame them. In healthcare, they weren’t accustomed to that. They saw it as radical and I think some still do. But at the time Grady was not viewed as a great place to work. To change that required drastic steps.

JK: Do you have any other career advice to share for HR leaders in healthcare?

RR: I have always thought it is important to conduct myself as a third-party consultant. Even when you’re deeply ingrained in the organization, I think that others leaders should see HR as an impartial, objective consultant to help them with their operation. HR has to be a trusted advisor to the other C-suite executives. If you can’t do that, it will be difficult to succeed as a CHRO.

JK: Succession planning is a responsibility of all senior executives. Can you talk a little about the status of your succession plan and the organizational approach you’ve taken?

RR: There is nothing more disruptive than having a senior leader come from outside the organization with a different approach to the work experience and how they deal with people. So, we have built a succession plan for our V-level roles.

The objective is very simple: give people an opportunity to develop into the next level to replace a C-suite person and give us the ability to promote our vice president-level people from within. With that in mind, we do a gap analysis. So, if there are five skills necessary to be a chief people officer, I do a gap analysis with my senior leaders and then help them fill in the gaps so that when I do leave, they are prepared to take my position.

No one is guaranteed they will get the job, but they’re in a good position for that. This succession planning approach lends itself to continuity and sustainability in an organization over time. People tend to stay longer at the director or vice president level if there’s an opportunity to grow into a C-suite position from within or be developed for that level role, even if it means eventually going elsewhere. It’s a good retention tool for talented people, and that’s become a significant part of my job.

JK: When interviewing candidates for a job in today’s healthcare enterprise, especially senior leadership roles, how do you test for these attributes – being a good colleague and delivering excellent service? Are there any questions you ask or scenarios you ask them to describe?

RR: Before we hire someone, we have to believe that they’re going to be an exceptional colleague, that they will walk in every day thinking of the success of the people they work with and the people that work for them. The skill set and experience are easier to find but it’s those two things that are most important for us. And we use some formal testing to assess that.

One interview question is that we ask candidates to describe the most interesting thing they’ve done for a colleague, or the thing that they’ve done for the employees that work for them that they’re most proud of. Their answer gives you insight into someone’s perspective. We hear amazing stories but we also get answers that are not impressive. It helps you ascertain whether a person has been in an environment that highly values being a great colleague or providing great service. We want people who have come from that, or at least to the extent we can assess it, to have it in them innately.

JK: You mentioned culture and change. How are you changing the culture at Grady to one that prioritizes being a great peer and providing great service?

RR: You have to literally build it into the infrastructure of your HR organization. We’ve built our philosophy into everything we do, from recruitment through retirement. So, we hire with those two things in mind. When we welcome people into our organization, those two things are reinforced constantly. Also, our performance appraisal is one page, and we assess only an individual’s ability to be an exceptional colleague and be exceptional at service. When I got here, the performance appraisal was 18 pages.

JK: Let’s talk a little bit about technology, starting with generative AI. How do you think GenAI will affect your organization over the next three to five years?

RR: If I had the answer to that, I might become a high-paid consultant. What I do know is that it is imperative for healthcare leaders – HR in particular – to become educated on AI and all of its implications, particularly with people. I’m not an AI expert, though I try to read as much as I can about it because AI is going to force us to change much quicker than we have historically. Healthcare tends to change more slowly.

JK: Do you think physicians will get on board with it?

RR: They’ll have no choice. A recent study showed that AI predicted or diagnosed a particular type of cancer 17 or 18 percent more accurately than physicians, and there are multiple studies like that. Physicians need to embrace that AI is just an additional tool to ply their craft and not take it personally.

JK: From your experience, what does a really strong partnership between the CHRO and the CIO look like in a healthcare organization?

RR: People and innovation are joined at the hip and they have to move in sync with each other. In HR we have to know what our technology capabilities are, what the talent market looks like, particularly in the younger demographics – the things they’re interested in, things they’re trained on, skills that we need in healthcare. HR has to be connected with the CIO. I’m happy to say I have a great rapport with our CIO here at Grady, and he’s an exceptional colleague and a leader in his field as well.

JK: Did you have a mentor during your career who really helped you?

RR: Actually, I had a boxing coach who was a bit of a mentor to me, and he told me one time that, “You learn something from everybody in the gym.” And he said, “Don’t admire the people, but admire their characteristics,” and that always resonated with me. I’ve met a lot of people along the way, leaders and non-leaders, and I think you can take a lesson or a characteristic from each one and try to apply that as best you can.

JK: What do you like to do in your free time?

RR: I am a pretty regimented person. I’m up usually up before 4:00 AM every day and I get a good workout in one way or another. And I have a dog named Marvin Hagler, named after the great middleweight champion, and I see my grandsons on the weekend. It’s a pretty simple life.

JK: What kind of dog is Marvin?

RR: He’s an Irish terrier.

JK: Sticking with that Irish theme?

RR: Yes. A bit stereotypical there.