Contract Management:
Preparing Tomorrow's Leaders
Through Succession Planning From
the Provider Perspective
Betty J. Noyes, RN, MA, Kimberly McNally, Sharon Tourville,
and Pati Robinson
Seminars for Nurse Managers, Vol 10, No 4
(December), 2002: pp 240-243
"The papers were signed. Our hospital would finally begin
merging with a neighboring community hospital. Most every- one was anxious about
the future. We had heard the horror stories and seen the personal losses of our
colleagues across the country during similar mergers. The loss of jobs, the loss
of identity, was all too real.
I had positioned myself to be 'indispensable.' I had covered
numerous functions. I had held on to everything I could. No one could do my job.
I was ready for a new and bigger position. I would be the new Vice President for
Patient Care.
Unfortunately, that was my downfall. I was too busy. I had
not focused on the very thing that would have moved me into the position. My
team was not prepared to take on new challenges. I had been managing details and
doing things but I had not demonstrated that I could effectively lead people. My
managers lacked the skills, the experience, or the recognition as leaders. I had
no one prepared to step up to my job. I was not going to be the VP of anything."
This story is not uncommon in today's rapidly changing health
care environment and could have been prevented with a well-prepared succession
plan. Succession planning supports individual careers but also is an essential
component for talent management and overall organizational effectiveness.
Clinical and financial outcomes are linked directly to the effective development
and utilization of the talents of managers and employees.
There are two main components to succession planning:
-
Development of an overall organizational strategy with targeted
emphasis on specific roles and skill sets and
-
Creation and implementation of personalized plans for each
targeted individual and group.
Development of Organizational Strategy
The first step to understanding what skills and people talent to
develop is to obtain clarity on the purpose and vision of the future
organization. It is important to not just replace current skill sets, but to
ensure that people have skills for the future. Therefore, succession planning
should be a major component of the strategic planning process for an
organization. Business and organizational development literature reports that
the foundation of effective succession planning systems are individualized
development plans that are aligned with the business strategy of the
organization.
"At Children's Hospital of Michigan, we begin with the
future," says Sharon Tourville, Chief Operating Officer. "We approached
succession planning with the same intensity and passion as we do other large
projects. Are we moving into being a major player in the community or are we
looking to create a national or international presence? How will we measure our
success? What are the steps we are going to need to take to get there, and what
is our timeline? We identify the skills we will need and the knowledge we will
need to develop."
An organization's clinical and financial outcomes are linked
directly to how fully the talents of its managers and directors are developed
and utilized. Leadership is the single most essential ingredient to excellence
in clinical outcomes, financial return, employee retention, and satisfaction.
Linking succession planning with the strategic planning process ensures that an
adequate supply of leaders will be available to meet the organization's future
needs in an effective and resilient manner.
Creating and Implementing Personalized Plans for Individuals
and Groups
Once the future needs and skills of the organization are
defined, high-potential individuals should be identified and assessed. At
Children's Hospital the selected employees are included in the conversation
about what is needed to prepare for the future. The immediate supervisor must be
engaged in the process as well.
Then individual plans are developed so timelines for readiness
can be identified. This forces upper management to learn early in the process
whether a future vacancy could be filled internally or externally.
An effective development plan includes practical skill-based
formal education supported by a mentorship program internal and external to the
organization.
"During the last 3 years, we have trained over 200
participants in 8 organizations," says Betty Noyes of Noyes and Associates, a
health care consulting company. "We have found that managers and directors are
well intentioned but lack the skills to handle the responsibilities expected of
them. Burn out can be compounded by the diminished amount of time available to
accomplish the increasing level of tasks required. The ripple effect on staff
retention is measurable. Staff nurses recount that the reason they most often
leave their position is poor management."
Noyes and Associates developed a leadership program to provide
content and build self-confidence at all management levels by evaluating 150
common responsibilities of health care managers. These were further refined into
12 main categories that linked organization strategic initiatives and the daily
life of the unit/department leader.
These categories are:
-
Managing personal effectiveness
-
Financial management skills
-
Communication/ conflict management skills
-
Human resource skills: leading and optimizing employee
performance
-
Strategies for case/care management
-
Preceptor development
-
Facilitating process improvement
-
Coaching: helping others be their best
-
Information systems technology
-
Managing teams
-
Labor relations, and
-
Presentation skills
To provide proper training, these modules should be one or 2
days in length, spaced at least one month apart. That allows time for practice
and application and is a realistic expectation of the participant to be detached
from their unit. More than 2 days puts an undo strain, and super saturation is
not sustained learning.
Another critical element is the need for each session to engage
the student in group activities, discussions, or role-playing. Learning is in-
creased through student involvement, and there is an added benefit of team
building.
The credibility of faculty also is imperative. Faculty should
have a background in health care and have the mission of bringing credible
content to the participants. Humor and laughter always are encouraged. Post
program connections are maintained in several ways; advanced classes in selected
topic areas, internal sponsored convention, and Web-based continuing programs
are under development. The momentum must not be lost. E-mail and telephone
contact with the faculty is encouraged and supported from the beginning.
We recommended a 3-prong approach at Children's," says Noyes.
"First, determine what skills would be needed in 2003 to 2005 and teach those
basics to the front-line and 'want-to- be' managers-directors. Then teach
enhanced mentoring skills to the executive team members, which would give them
the opportunity to work closely with the manager level so that talent could be
identified and grown. Finally, implement an action learning component so that
the managers and mentors have to the opportunity to learn and grow together
while completing significant work for the organization."
Children's Hospital of Michigan opted to name the overall
program Bettering the Best and position the program for multilevel succession
planning. Under the leadership of Tourville, at the first mentoring group
session they coined the term Barrier Buster to describe the mentor's role. Other
mentoring sessions focused on role clarity between mentors and managers and
established multiple factors for success. The learning project provided a
structure for developing the mentor/manager partner and also presented the
opportunity for high-potential successors to be identified.
Learning Project
To encourage application of skills, a learning project should be
part of the program. Each participant should choose an organizationally approved
project to complete during the program. Learning projects ideally integrate with
internal initiative and quality assurance programs. The quality assurance
director typically provides oversight. The outcome of the learning project is to
illustrate the achievements of the participants.
The learning projects provide opportunity; for participants to
gain experience in finance human resources, stakeholder identification and
involvement. Learning projects provide practice in the use of process
improvement tools. The participants should present their projects in both
written and oral formats t their peers and the senior executive team on
completing the program.
Coaching and Mentoring
"Effective development plans should be C01 pled with
mentoring, coaching, job rotation, and stretch assignments," says Kimberly
McNally of McNally and Associates, a leadership-coaching firm. "Formal coaching
and mentoring initiatives accelerate the impact and benefit of leadership
training programs. Mentoring and coaching provide 'just in time" development
through one-to-one learning partner- ships to help leaders build self-awareness
and develop new skills to keep up with the demands of the changing environment."
Mentoring typically is provided by those in senior level
positions in the organization and focuses on the professional and personal
characteristics necessary for success. Mentors often help the emerging or new
leader to understand and navigate the organizational culture.
Coaching is a structured process of dialogue, inquiry,
discovery, self-observation, new practices, and support for the purpose of
building competence and confidence. Ideally, coaching is provided by certified
coaches (internal or external) who have significant influence but no direct
authority or responsibility over the leader's performance. Coaching is a
structured conversation that supports leaders to clarify their vision and
values, to identify business priorities, to improve work processes and
relationships, and take focused action. Leaders engaged in a coaching
relationship receive feedback and support to recognize and deal with blind spots
in behavior and work style.
Coaching can occur in person or over the phone and generally is
provided over a 6- to 12-month period. Coaching also can be delivered to an
intact group working on similar issues. To build a work environment that
supports ongoing development at all levels in the organization, it is important
to teach leaders how to identify opportunities for coaching and have coaching
conversations with their employees so that everyday work interactions can be
potential development experiences.
At Children's Hospital of Michigan, managers received training
in coaching skills as part of the management education curriculum. They were
provided coaching models and frameworks and taught the basic coaching skills of
active listening, asking powerful questions, and making requests. In addition,
they were guided to identify specific openings for coaching within their work
teams and practiced coaching their peers around real work issues.
The group of mentors from the executive ranks that were
identified to support the managers enrolled in the management education program
had a more advanced level of skill-based training. The mentors participated in a
facilitated series of meetings intended to clarify roles and responsibilities,
build mentorship skills, and support the overall succession planning efforts
under the tutelage of the Chief Operating Officer. As a result, the
relationships between the middle managers and executives were strengthened, and
a heightened aware- ness of the unique skills and contributions and day-to-day
challenges of all team members emerged.
Summary
"We never know… Fate has a way of showing up at the most
inopportune times. We had been planning for Ann's retirement for months. It was
going to be a loss. Not only was she a long- term employee and strong manager,
she could step in and lead anything. She would be sorely missed.
We knew who was going to cover each of her areas of
accountability. Sue would take one unit. John would manage the Dialysis Program.
We had completed a job analysis, and everything was covered. We had already
begun the shifting of accountabilities. September 2 was the big day. We had 3
months to go.
Then the big opportunity came. We had been working on the
merger for months before it finally happened. There was only one glitch. The
culture shift was going to be huge. We needed someone to lead the process. Of
course, who could do it better than Ann? She had been leading change for years.
She was a master.
She had the one skill for which we had no succession plan. We
had one person that we could call, and within 3 months she would be gone. We had
missed the mark. We had not completed our succession plan."
These real-life stories show how critical succession planning
can be to an organization. To do it well requires a clear vision of the
strategic objectives of the organization, focused development programs, and
continuous enrollment of both executives and employees within the organization.
Leadership training, learning projects, and creating a coaching environment also
are crucial elements of a successful succession plan.
References
- Betty Noyes, EN, BSN; MA, is President, Noyes and Associates Ltd,
Bainbridge Island, WA; Kimberly McNally, EN, BSN; MN; is Certified
Personal and Professional Effectiveness Coach and President, McNally &
Associates, Seattle, WA; Sharon Tourville, EN, BSN; MSN; is a Doctoral
Student, and Chief operating Officer, Children's Hospital of Michigan,
Detroit, MI; and Pati Robinson, is a freelance writer, Bain- bridge
Island, WA.
- Copyright 2002, Elsevier Science (USA). All rights reserved.
1066-3851/02/1004-0008$35.00/0
doi: 10.1053/snum.2002.35993
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