Effective Succession Planning for Healthcare Governing Boards

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Governance effectiveness calls for having succession plans in place that ensure continuity in leadership and sustainability in performance of the organization.

By Brad Clarke, MPH, Senior Consultant, and Erica Osborne, MPH, Principal, Via Healthcare Consulting

A foundational practice of successful governance is having the right people at the table who effectively represent the needs of patients and community members and ensure that the organization is enabled to provide high-quality care.

In the past, filling seats of members who retired or whose terms expired might have happened by chance or reliance on “knowing someone who would make a good trustee.”

But the healthcare environment that we must navigate today is evolving quickly, and simply “knowing someone” is no longer an effective strategy. Trends in the growth of non-acute care settings, consumerism, and patient experience, to name a few, plus long-time issues like health inequity that have risen to the surface in the wake of COVID-19 necessitate boards and councils comprised of a mix of skills, competencies, experiences, and demographic diversity.

Boards do not want to be caught off guard by member exits. Delays in finding successors can stymie decisions and halt productivity. Succession planning smooths the process for replacing exiting board members and eases the transition as new members take up the mission. New members refresh the board’s expertise; they fill in the gaps in experience and background and help to ensure diversity of perspectives and ideas. A carefully thought-out process for selecting new board members also helps to ensure stability in the performance of the organization.

Guidelines for Planning

Overall, the selection process for new board members must be systematic, transparent, fair, and accountable. When appropriately planned and implemented, replacing exiting board members should result in an efficient transition.

Our recommended guidelines for succession planning include:

1. Appoint authority.

An authority, such as the governance or nominating committee, should be appointed to develop and oversee the succession planning process.

2. Prepare for vacancies.

Filling the seats of board members whose terms have expired should not be a last-minute exercise. Members’ term expiration dates should be tracked in a chart that is regularly reviewed by the board or appropriate committee.


3. Develop a process and timeline.

The process should outline the key steps to recruitment and selection, responsible parties, and a timeline for filling a soon-to-be vacated seat. We advise starting the process no later than four months prior to the seat being vacated.

4. Define optimum board composition.

Replacing a board member represents an opportunity to add new skills and experience. Each community is unique, so the type of necessary skills, competencies, experience, and demographic make-up will vary from one board to another. The governing body should define its optimal composition by identifying the attributes that will best support the needs of the organization and the community. These attributes should be reviewed at least annually to keep pace with community changes and organizational needs.


5. Identify needed attributes.

Each board should have an attributes matrix, a document that compares the skills, competencies, and demographic diversity of the current board with the set of attributes defined in the board ideal composition. This process will identify the gaps in attributes and point the way towards the types of candidates that should be recruited.

6. Set board composition goals.

The goals should be based on the gaps in attributes that were identified from the matrix.

7. Develop a candidate profile.

The profile should list ideal qualifications sought in the board member that is to fill the upcoming vacancy.

8. Identify recruitment sources.

Existing board members often refer candidates, but recruitment should not be limited to these sources. Appropriate sources will depend on the attributes being sought. Professional associations, religious and non-profit community-based organizations, emergency responders, and the local business community should be considered as viable sources for candidates. Outside search consultants might also be an option in cases where available sources are limited.

9. Maintain a list of candidates.

A readily available list of qualified candidates will provide flexibility and allow for a more responsive recruitment process. This may include candidates previously considered as well as viable candidates identified during the course of the year.

10. Formalize a process.

Once finalized and agreed upon by the board, these steps should be documented in a succession planning process to collectively focus efforts and ensure consistency in filling seats.

Road Map for Managing Risk

We know that with all the immense work involved in community governance, developing a succession planning process represents yet another project. Succession planning is not just about making sure a vacant seat is filled quickly with a highly qualified member, but also managing the risk that change will have negative consequences on the work of the board and, ultimately, the performance of your organization.

We’ve all navigated through rough waters these past few years and can’t predict when the next storm will come. Ensuring that a board is well equipped to perform at the highest level will provide a foundation of support and stability.

Questions for Boards to Consider

  1. How prepared is our board to fill vacant seats?
  2. What are our processes for replacing members whose terms will expire or who unexpectedly leave their roles?
  3. When was the last time our succession planning policy was reviewed and updated?
  4. How well does our succession planning policy help us to effectively and efficiently fill seats?
  5. What kind of leadership development opportunities are available to our current board/council members?

Gain Clarity with Expert Support – Board Succession Planning

Navigating the complexities of health care can be daunting. By partnering with Via Healthcare Consulting, organizations benefit from expert support and customized solutions tailored to their specific needs. With over 25 years of experience in healthcare governance, ViaHCC offers invaluable insights and guidance to enhance organizational effectiveness. From strategic planning to board development, Via empowers healthcare leaders to overcome challenges and transform their organizations. Book a call today to unlock the benefits of working with Via Healthcare Consulting.

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