Bench Depth: Ensuring Quality Continues After “They” Leave, Part 2

Succession Planning

Bench Depth: Ensuring Quality Continues After “They” Leave, Part 2

By: Jennifer Milton, BSN, MBA, CCTC

Part One addressed the identification of potential succession issues and can be found here.  This second part focuses on solutions. 

There are no firm rules to follow when putting a succession plan in place. It can start as easily as calling a small informal executive meeting between the two or three key center/program leaders and running through the exercises above to just start a dialogue as to the depth on your bench. So, let’s get started on a few thoughts:

Identify existing talent.
Although general recommendations are to come up with a department-by-department, location-by-location breakdown of the talent you have right now, I would narrow your starting point to the answers we identified in the last post in the series….
* Who are the individuals  you most rely on to make your center hum?
* Who is in charge when they are out?
* Do not forget your own role. Who is your second in command?

Identify gaps.

This step basically compares the list of people that cover key roles when those staff are out and coming to an understanding of where required skills – those which support financial, regulatory compliance, process, operational continuity and long-term objectives – are lacking.

It’s likely you will discover some roles where the second in command is talented at the actual job, but not so good at managing people.  You may realize that if they had to permanently be shifted to a lead role, you might lose some other team members. Or perhaps a MD who would step in to lead has dazzling surgical skills, but lacks political skills and has difficulty handling strategic discussions with hospital leaders. Perhaps you will find roles where you or the transplant administrator are the only back up, as no one else has been trained.

Make a plan.
Once you have thought about the people on the bench, the role you could need them to fill one day, and their strengths and weaknesses for that future role, your attention should shift to grooming them.

A simple way to get started is to review their last written evaluation. Do they already have improvement goals in place that help bridge some of the identified gaps? If not, consider meeting with them to discuss their value and future at the center.  Rather than a performance improvement plan, provide them with a future improvement plan. This is the ideal group of staff to send to national conferences, where they can connect more deeply with their profession and peers.  Ensuring that “number-ones” delegate projects to “number-twos,” and providing them with the guidance and support needed to be successful, is also critical to this grooming process as well.

Physician Case Logs.
Although this may sound like a minor issue, Case Logs can be a nightmare when needed under duress. And I will save you discovering this on your own (as I have already done so…and done so while under duress) – case logs maintained for ASTS do not fully correspond to details required by OPTN. Plus, many physicians have lost their own logs or never retained a copy.

Consider putting a process in place to collect and validate logs during the recruitment of transplant physicians and surgeons.  For those not meeting OPTN criteria through fellowship, add a step updating/confirming currency annually, which is particularly important in lower volume programs. If you have MDs who meet criteria post-fellowship, their logs should be reviewed to track experience that demonstrates they always meet post fellowship/experience pathways. Remember this includes observed or performed transplants, donations with data, and UNOS numbers and phases of care where indicated.

Do it more than once.
Evaluate the entire succession planning program on a regular (usually annual) basis.
* Are the ‘second in commands’ being given opportunities to grow?
* Did they accomplish future improvement plans?
* Are delegated projects being completed well and on-time?  What barriers prevented this from happening?
* Are they getting opportunities to be in charge for a few days/weeks?

Succession planning is a must-have for transplant centers’ long-term success and continuity in their leadership/key-role workforce. Other staff in the center may be quite capable of stepping into a key role, but if there is no succession plan and those individuals are not groomed, trained or prepared to do so, then it is possible they are being set up for failure.  Be careful to avoid thinking of “Succession Planning” as “Replacement Planning.” In fact, if a second layer of staff and MDs are being groomed, provided opportunities to lead, tackle key projects, and having their weaknesses addressed and improved – these are the exact same qualities of excellent RETENTION programs. Strong capable staff in primary and backup roles result in not only better prepared transplant centers, but simply better transplant centers.


What do you think?

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