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Bridging the Leadership Gap: The Hidden Crisis in Healthcare Infrastructure

In the continuation of his conversation with Peter Martin, Cref Regional President Patrick Murphy takes a sobering look at another deep-rooted issue threatening healthcare systems across the country: the collapse of infrastructure—both physical and organizational.

“The people working on that infrastructure are going to keep going south, and the buildings themselves are going to continue to deteriorate.”

Patrick points to cities like Boston as ground zero for this erosion, where aging buildings and staff burnout are compounded by a thinning leadership bench. The problem isn’t just deferred maintenance; it’s a vacuum in mentorship, knowledge transfer, and mid-level leadership.

“We’ve cut costs so much. We’ve gotten rid of managers. We’ve gotten rid of supervisors. So you have directors and employees… and there’s nothing between them.”

This flattening of facility teams has removed a crucial rung in the ladder, the very people who were once groomed to become tomorrow’s directors. Without that bridge, there’s no path forward. No leadership pipeline. No continuity.

And the valley between those who run systems and those who support them on the ground? It’s getting wider.

Patrick likens it to building a bridge where the two ends are drifting farther apart every day:

“So, it’s going to continue to be harder and harder.”

It’s a structural challenge—both literally and figuratively—and Cref is tackling it head-on through talent development programs that aim to restore and strengthen that critical bridge.

Because if we don’t invest in growing the next generation of facility leaders, we’re not just risking poor maintenance; we’re risking system failure.

It’s not enough to solve today’s problems. We have to plan for a future that includes people to carry the torch.

If you’re interested in hearing more from Patrick Murphy on the aging workforce challenge in healthcare facilities, click here to watch the full interview.

The Aging Issue

Hospitals are facing a tough reality: aging employees, aging buildings, aging infrastructure—with no clear bench behind them.

This isn’t just a maintenance issue. It’s a leadership challenge.

At Cref, we help healthcare systems get ahead with interim support, workforce development, and strategies to preserve critical institutional knowledge.

Let’s solve the aging crisis—together.

Learn how Cref helps hospitals turn crisis into opportunity.