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Posted May 14, 2018

Healthcare Succession Planning 101

By Jackie Gaines, MS, RN

Succession planning may sound like an uncomfortable topic; however, CEO and senior executive transitions are a natural part of turnover. A succession plan prepares an organization for departures (whether planned or not) and ensures vital roles are always filled. I have the privilege of partnering with senior executive teams and boards of directors to establish successful succession plans, and, as a former CEO, I offer my firsthand experiences to ensure a smooth transition.

When organizations broach the topic of succession planning, I typically hear two schools of thought: “We’re going to name a current member of the executive team who knows the organization and can quickly step into the role” or “We’re going to give the position to her because she’s been with us the longest.” The flaw in this thinking is that longevity and familiarity with an organization do not automatically qualify someone for the role of CEO.

Think about your organization a year ago. Did you predict the changes, new processes and industry challenges you are facing today? While setting organizational goals for the years ahead is a necessary part of strategy, healthcare is changing so quickly that predicting exactly what problems our leaders will be asked to solve, even a year from now, is difficult.


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Selecting top leaders should be a detailed, intentional process. A key component of the process is to screen multiple candidates from both inside and outside your organization and continually identify internal candidates during mid-year or year-end performance evaluations. This process allows leaders to assess skills and create a high-performer “pool” for the next leadership position. If you don’t have enough qualified internal employees in the pool (we suggest three to four strong candidates), then it’s important to start recruiting immediately.

If your board of directors or a search committee oversees the interviewing and selection process, take time to train them on proper protocol before scheduling interviews. Training is particularly important with community boards because members may not have experience hiring a senior executive and know what they can legally ask during the interview.

At Studer Group, we coach the importance of using behavioral-based interview questions. The leaders at our partner organizations routinely credit better candidate selection to the implementation of behavioral interviews. To ensure leaders or board members find the right fit for crucial roles, tweak standard questions to identify certain skillsets. For example, “Describe a time when you did not have all the information you needed to make a completely informed decision. What did you do?” Behavioral- based questions force candidates to move from hypothetical to experiential examples. Rather than “yes” or “no” answers, candidates must share real examples of when they displayed leadership behaviors.


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As you build a pool of strong internal leaders, make ongoing training and development a priority. By investing in your employees, you not only improve their skills, you also deepen their relationships with you and your organization. Years ago, I was offered a CEO position three thousand miles away from my hometown where I had lived and worked my entire life. It was a risk to move my family away from our comfort zone to a place where we didn’t know a soul. However, the regional CEO relieved my anxiety by making it a point to train and develop me as a leader. More importantly, he built a personal relationship with me, invested in my success and supported me every step of the way. He and his wife even showed up at the finish line when my husband and I ran our first marathon together.

As you think about succession planning, remember that you are identifying the best candidate for a crucial role, and the right type of leader for that role may change as your organization evolves. Continue to train, develop and build lasting relationships with your internal top performers, and keep an open mind about who might be the next top leader at your organization.

If you’d like to learn more about our approach to succession planning, please email partnerships@studergroup.com.

Jackie Gaines, MS, RN, is a high performing senior executive, national speaker and best-selling author with more than 40 years of sustained leadership experience and accomplishments with major health systems and organizations. She has dedicated most of her career to the advancement of quality health care programs, particularly those focused on the care of the poor and underserved.

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