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Third Quarter, 2010: Thoughts on Succession Planning...

Cox, Susan A. MS, RN, CPEN, PHN

doi: 10.1097/JTN.0b013e3181f51f00
President's Message

Correspondence: Susan A. Cox, MS, RN, CPEN, PHN, Rady Children's Hospital & Health Center, 3020 Children's Way, Mail Code 5085, San Diego, CA 92123 (



Recently a dear friend and colleague announced her retirement from the role of trauma program manager. I was very happy for her and excited that she would be transitioning to a new phase in her life with fewer deadlines, less structure, and much more flexibility. When I asked her about how she felt on her last day at work, she said, “I have really mixed feelings—happiness and excitement about many new opportunities and challenges, but also sad and with some regret that I didn't do a better job of mentoring someone to take over when I retired. I feel like I'm dropping the ball for our department.”

As I drove home that evening, I reflected on the challenge of finding replacements for some of our complex trauma nursing leadership roles. I evaluated what I have done in regards to succession planning and concluded that I haven't done enough. I suspect that some of you are in the same situation and have thought little about it. I decided to review the literature specific to succession planning in nursing leadership and clinical care. I found several relevant articles that were helpful to me. They may be helpful to you also. I have summarized two of the articles and included the others in the reference list at the end of the article.

The first article addressed the perceptions of US hospital CEOs related to succession planning. Collins,1 with the assistance of subject experts, created a survey that was mailed to a randomly selected group of 1000 CEOs from a nationwide database of 6000 hospital CEOs. The response rate was 18.4%. When asked whether they strongly agreed, agreed, were neutral, disagreed, or strongly disagreed, the surveyed CEOs responded to the following statements:

  • “Leaders are born, not made.” Thirty-five percent agreed or strongly agreed and 44% disagreed or strongly disagreed.
  • “Champions for succession planning should be upper level managers or administrators.” Ninety-one percent agreed or strongly agreed.
  • “Externally recruited leaders are less likely to succeed than internally promoted leaders.” Sixty-two percent disagreed or strongly disagreed.
  • “Internally promoted leaders are more likely to succeed than externally recruited leaders.” Eighty-three percent either were neutral or disagreed.

Some of these data would indicate that, as a group, the US hospital CEOs surveyed do not particularly believe that internally recruited leaders are more effective than externally recruited ones. Learning the views of your own CEO with regard to leadership and succession planning is included in step 1 of a process outlined in the second article I have referenced. Shirey2 details a systematic 5-step approach to clinical leadership succession planning and thoroughly discusses concepts related to the steps that include the following:

  • Assessment of the organization and its commitment and vision with regard to succession planning up to and including the CEO.
  • Identification of an appropriate individual for the targeted role matching fundamental skills sets to the role.
  • Development of the selected individual with great emphasis on mentoring, coaching, and training aligned with a partner mentor.
  • Specific and focused plan for implementing leadership development efforts with formal outcomes metrics.
  • Evaluation of the individual's successful outcomes and dissemination of the results.

I found this article thought-provoking and somewhat unique with a focus on development of clinical leaders. In conclusion, I believe that all of us need to provide for some degree of succession planning. The concept and processes can easily be tied to existing leadership development courses and strategies within our organizations. We will leave our positions more satisfied if we have made provisions for successors who are well prepared to assume the roles and responsibilities we have (with mixed feelings) vacated.

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1. Collins S. Succession planning: perspective of chief operating officers in US hospitals. Health Care Manager.2009; 28(3):258–263.
2. Shirey M. Building the leadership development pipeline: a 5-step succession planning model. Clin Nurs Spec. 2008; 22(5):214–217.
© 2010 Society of Trauma Nurses