High rates of turnover in the healthcare C-suite have been documented for years. In 2017, hospital CEO turnover reached 18 percent, according to the American College of Healthcare Executives, and nurse officers also come and go with frequency. Many of today’s CNOs belong to the Baby Boomer generation, and those leaders, who began retiring in 2011, will continue their exodus from work life for years to come. This type of executive churn can disrupt operations and leave doubt about how well-managed the organization is.
While you may not be able to stop your CNO from retiring or seeking a position elsewhere, you can insulate your institution against unnecessary executive flux by developing a solid succession plan for your key nursing executive positions. To get started, make sure your plan answers these three key questions.
1. How do we identify the rising stars of nursing leadership in our organization?
If you visualize a succession plan as a funnel, the first thing you need to do is fill the top of the funnel with prospective candidates for nursing leadership roles. As these nurses move through the funnel over the course of time, some of them will wash out, move on or otherwise be removed from the process until you are left with a handful of top-notch candidates for various executive positions.
Your CNO succession plan, therefore, needs a viable strategy for identifying nurses who demonstrate leadership qualities. In some organizations, nurse executives work in partnership with human resources to develop standards for nurse management positions and routinely assess the talent available to fill those roles. Nurses who move into lower level management positions make excellent candidates to fill the top of your succession plan funnel.
2. Are our leadership development programs adequate?
After you identify candidates to fill nursing management roles, you must cultivate their success by offering formal and informal leadership development opportunities. Workshops and classes that teach supervisory abilities, informatics and other important skills can enable new nurse managers to grasp the practical side of their role, while positions on shared governance boards or executive committees can help them experience leadership from a systemic perspective. Regardless of how your organization approaches leadership development, the important thing is to have programs that confer real value to the people you seek to develop.
3. What is our contingency plan if our first choice doesn’t work out?
Succession planning for executive nursing positions like CNO should, ideally, begin years in advance and be maintained continuously. This means you likely can develop one or two candidates to succeed the current CNO when she or he decides to retire or move on to another position elsewhere.
However, you should make clear to your candidates that “a succession plan does not guarantee a trajectory to the top,” according to Kathleen Murray, MSN. Many factors can influence an organization’s hiring decisions, and the fact these individuals have been groomed for a specific job or range of executive positions does not imply they will be appointed when the time arrives. The same can be said from the candidate’s perspective: He or she may accept employment elsewhere before the CNO position becomes vacant or might ultimately decline the appointment for many possible reasons.
Your succession plan should cover these contingencies in detail. Perhaps you need to accommodate the possibility of an executive search for an external candidate, should the need arise. Or maybe you create a plan to continuously cultivate a certain number of candidates for various executive positions in order to account for any attrition that occurs. Regardless of how you approach contingency planning, be sure to include Plans B and C along with Plan A as you execute your succession strategy.
Succession planning for CNOs and other nurse executives confers many benefits to healthcare organizations. When you develop leaders from within, you reduce the loss of institutional knowledge, reduce disruptive C-suite turnover and provide for continuity of leadership. These benefits can provide your organization with stability and success for years to come.