New CHRO in Healthcare? Your First 90 Days Playbook

The Stakes Have Never Been Higher

Stepping into a CHRO role in healthcare is one of the most challenging leadership transitions in any industry. You're inheriting legacy systems, entrenched cultures, and a workforce under unprecedented pressure—all while expectations for transformation have never been higher.

This playbook will help you navigate your first 90 days strategically.

Days 1-30: Listen, Learn, and Build Relationships

Week 1: Establish Your Presence

Your first week sets the tone. Resist the urge to immediately "fix" things.

Priority Actions:

• Meet with your CEO to align on expectations and priorities
• Schedule one-on-ones with every C-suite peer
• Introduce yourself to your direct reports individually
• Begin reviewing organizational data (turnover, engagement, compliance)

Weeks 2-4: Deep Dive Discovery

Now it's time to understand what you're really working with.

Stakeholder Listening Tour:

• Interview department heads and key physician leaders
• Meet with union representatives if applicable
• Hold skip-level meetings with HR team members
• Gather frontline perspectives through rounding

Data Analysis:

• Turnover trends by department and role
• Time-to-fill metrics and recruitment effectiveness
• Employee engagement survey results
• Compliance audit findings
• Compensation market position

Key Questions to Answer:

1. What does the organization believe HR's role should be?
2. Where are the biggest talent risks?
3. What's working well that we should protect?
4. What's the HR team's morale and capability level?

Days 31-60: Assess and Strategize

Synthesize Your Findings

By now, you should have enough information to identify patterns and priorities.

Create an Assessment Document:

• Current state of each HR function
• Organizational culture observations
• Immediate risks requiring attention
• Quick wins available
• Longer-term transformation needs

Build Your Coalition

Transformation doesn't happen alone. Identify your allies.

Key Relationships to Cultivate:

• CFO (your partner in demonstrating HR ROI)
• CNO (your connection to the largest workforce segment)
• CMO (your bridge to physician engagement)
• COO (your operational alignment partner)

Develop Your Strategic Framework

Don't create a 50-page strategic plan. Instead, develop a clear framework.

The 3x3 Approach:

• 3 strategic priorities for the year
• 3 quick wins for the first 90 days
• 3 foundational capabilities to build

Days 61-90: Act and Communicate

Execute Quick Wins

Quick wins build credibility and momentum. Choose wisely.

Good Quick Wins:

• Fixing a broken process everyone complains about
• Resolving a long-standing policy inconsistency
• Improving a high-visibility candidate or employee experience
• Launching a visible recognition initiative

Bad Quick Wins:

• Anything requiring significant budget approval
• Changes that affect physician compensation
• Major technology implementations
• Restructuring HR positions

Communicate Your Vision

Your 90-day mark is the time to articulate where HR is headed.

Key Messages:

• What you learned in your listening tour
• Your vision for HR's role in the organization
• Initial priorities and why they matter
• What you need from stakeholders

Set Up Your HR Leadership Team for Success

If you haven't already, this is the time to assess your team.

Evaluate:

• Do you have the right roles?
• Do you have the right people in those roles?
• What development do they need?
• Where are the gaps you need to fill?

Common First 90 Days Mistakes

Mistake 1: Moving Too Fast

You don't yet understand the full context. Premature changes create resistance.

Mistake 2: Moving Too Slow

Analysis paralysis signals weakness. Balance learning with action.

Mistake 3: Ignoring the HR Team

Your team knows where the bodies are buried. Failing to engage them alienates your most important resource.

Mistake 4: Promising Too Much

Overpromising and underdelivering destroys credibility. Under-promise and over-deliver.

Mistake 5: Going It Alone

Seek counsel from peers, mentors, and trusted advisors. The CHRO role can be isolating.

Your 90-Day Checklist

• [ ] CEO alignment meeting completed
• [ ] All C-suite peers met individually
• [ ] HR team one-on-ones completed
• [ ] Stakeholder listening tour finished
• [ ] Data analysis completed
• [ ] Assessment document created
• [ ] Quick wins identified and initiated
• [ ] 90-day vision presentation delivered
• [ ] HR team assessment completed
• [ ] Year-one priorities established

Navigating a CHRO transition? ImpactCare provides executive coaching and advisory support for new healthcare HR leaders.