Staff Development

Succession Planning as a Strategic Initiative

November 18, 2018 7:42 pm

Seeking to build their bench, leading healthcare organizations recognize the value of integrating succession planning into their organizational strategy.

Succession planning promotes greater organizational stability by helping leaders prepare for the “what ifs,” says Jill Hewitt, MEd, FABC (pictured at right), director of talent assessment and succession planning at Christiana Care Health System in Wilmington, Del.

At Christiana Care, leaders are working on a succession management strategy that delves deep into the organization, identifies key roles, and provides targeted interventions to develop future leaders, Hewitt says. 

This process combines intuition with analytics to assess and nurture talent. For example, Christiana Care uses psychometric assessments and 360-degree feedback to help leaders create customized development plans that support their aspirations to potentially pursue higher positions.

Besides ensuring continuity of leadership at Christiana Care’s two hospitals and other facilities, Hewitt says, succession planning has the potential to improve employee engagement. “Employees learn how their motives, values, preferences, and strengths align with various career paths,” she says. “As a result, employees are better positioned to identify roles that will leverage their strengths and enable them to find joy and meaning in work.”

Mapping the Future

During the past four years, senior leaders at Carilion Clinic in Roanoke, Va., have been working with board members to make succession planning part of the vernacular.

Carilion Clinic’s current strategic plan outlines several initiatives, including talent development and succession planning, to build the workforce of the future. As part of the succession planning process, management shares with the fiduciary board a spreadsheet of the organization’s senior vice presidents, executive vice presidents, and chairs, and identifies up to three potential leaders for each position. “It is very comforting to me as a CEO and to our board to know that there are people being groomed for a position,” says Nancy Howell Agee (pictured above, on the left), president and CEO. In cases where there is not a natural successor inside the organization, the plan names at least one individual who might serve in an interim capacity.

Succession planning is also embedded in Carilion’s annual performance evaluation process for all 13,000 employees and physicians. During these reviews, managers use a nine-box talent matrix to evaluate employees’ potential and performance. They also use performance management software to review and update profiles that list employees’ skills, interests, and achievements.

“We have an expectation for every layer of management that your job is to consider how you are developing your team and what happens if you are not here,” says Agee, who began her career at Carilion as a nurse. This expectation helped Carilion earn a 2018 “Best Organization for Leadership Development” (BOLD) Award from the National Center for Healthcare Leadership.

Focusing on ‘High Potentials’ and Physicians

Another 2018 BOLD Award winner, Northwell Health in New Hyde Park, N.Y., has developed two programs to build the talent pipeline within the organization. 

Its one-year High Potential Development Program, offered through the health system’s Center for Learning and Innovation, is designed for non-clinicians and clinicians—other than physicians—who have the potential to become associate vice presidents and vice presidents. Only 20 to 25 are accepted each year from approximately 70 candidates, says Kathleen Gallo, RN, PhD, senior vice president and chief learning officer (click on the exhibit below for an illustration of the program’s curriculum).

Northwell also has a two-year physician leadership program that accepts 20 physicians from approximately 50 submissions each year.

Once admitted to the programs, participants complete personality, emotional intelligence, conflict management, and 360-degree assessments. Throughout the year they attend four to six single-session daytime courses taught by Northwell staff, including the CEO. Courses include case studies and collaborative projects on topics such as organizational culture and behavior, healthcare finance, and conflict resolution. 

In some classes, enrollees in both programs work side by side, often for the first time. “One intangible effect of the programs is the collaboration and relationship building that has taken place across all of the health system,” Gallo (pictured at right) says.

Since 2008, more than 471 leaders have graduated from the High Potential Development Program. Sixty percent have been promoted to higher leadership positions (some to the top roles in their hospital), and another 13 percent have received a lateral promotion with an increased span of control and budgetary responsibility.

Of the 103 participants in the physician leadership program, many have received high-profile promotions, including six chairs, 11 medical directors, three associate medical directors, eight program medical directors, and four service line leaders. 

Gallo believes the success of these programs stems from having manager participation across Northwell’s 23 hospitals. Candidates are nominated and then sponsored by their supervisors as they progress through the program. “This can’t be an initiative that is buried in HR,” she says. 

Lessons Learned

Experts offer the following suggestions to help healthcare organizations build their bench.

Don’t focus solely on the C-suite. “It’s important to identify top and emerging talent throughout the organization, not just among leaders,” Christiana Care’s Hewitt says. She recommends that hospitals and health systems train managers to identify hidden talent and conduct career conversations with their direct reports.

Make team building a priority. Agee says one of her organization’s current challenges around succession planning is finding leaders who can work collaboratively in teams—not just side by side. That is why Carilion provides opportunities for clinical and nonclinical staff to hone their team-building skills in a new simulation lab, which includes an operating room, emergency department, and trauma bay. In the lab, experts in the science of human factors study how people interact with their environment and each other, and offer constructive feedback.

Northwell has a similar focus on team building through games and other activities in its leadership development programs.

Create an administrative fellowship. In 2003, Northwell launched a fellowship to develop a leadership pipeline of candidates from graduate programs. This year, Gallo expects to have 150 applicants compete for three positions. During these one-year fellowships, recent graduates complete four rotations across the enterprise and work on high-profile projects. They also travel to the state capital and Washington, D.C., to learn more about healthcare policy. Forty past fellows are employed by Northwell in roles such as senior administrative director, senior vice president, deputy executive director, senior program manager, and assistant counsel in the legal department.

Make sure your coaching programs are strong. Each year, Northwell invests $2 million to $3 million to hire external coaches for enrollees in its physician leadership and High Potential Development programs. Gallo believes the investment has improved retention and engagement in the organization.

Underscoring the Board’s Rule

Even though most board members understand their role in developing the succession plan for the CEO position, they may feel less comfortable getting involved in succession planning for other key positions in the organization, says Andrew Garman, PsyD, CEO of the National Center for Healthcare Leadership in Chicago. Yet board members need to understand what they can do to ensure stable senior leadership.

“Succession planning allows the board to create greater specificity around the future so they can start to flesh out a more vivid picture—not just of the organization’s needs, but also of the capacity of current and emerging leaders to move the agenda forward,” Garman says. 

Too often, organizations tend to focus only on near-term goals. “When organizations have more discussions about succession planning and talent pools, they can plan in a more sophisticated fashion for various future scenarios,” he says. “But this really is a discipline that requires ongoing, methodical attention.”

Laura Ramos Hegwer is a freelance writer and editor based in Lake Bluff, Ill.

Interviewed for this article: Nancy Howell Agee , president and CEO, Carilion Clinic, Roanoke, Va.;  Kathleen Gallo, RN, PhD, senior vice president and chief learning officer, Northwell Health, New Hyde Park, N.Y.; Andrew Garman, PsyD, CEO, National Center for Healthcare Leadership, Chicago; Jill Hewitt, MEd, FABC, director of talent assessment and succession planning, Christiana Care Health System, Wilmington, Del.


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