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7/30/2019 Health Policy Proposal
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Running head: UNIT 10 ASSIGNMENT 1 1
K. Monique Bloomfield
Unit 10 Assignment 1- Final Proposal- Healthcare Succession Planning
HS 8118
Dr. Chavez
June 17, 2011
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Table of Contents
Introduction----------------------------------------------------------------------------------- 4
Problem Statement------------------------------------------------------------------------- 4
Proposal Overview-------------------------------------------------------------------------- 4
Recommendations----------------------------------------------------------------- 6
Theoretical Support---------------------------------------------------------------- 7
Analysis and Evaluation-------------------------------------------------------------------- 9
Sociological Analysis--------------------------------------------------------------- 10
Socio-Political Analysis------------------------------------------------------------ 11
Implementation Process----------------------------------------------------------- 12
Proposed Succession Planning Scheme-------------------------------------- 13
Comparative Decision-Making--------------------------------------------------- 14
Cost-Benefit Analysis--------------------------------------------------------------- 14
Ethical Dilemmas--------------------------------------------------------------------- 17
Conclusion-------------------------------------------------------------------------------------- 18
References-------------------------------------------------------------------------------------- 22
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Abstract
This course project will introduce a new health policy proposal that the senior
policy analyst at the American Society for Healthcare Human Resources Administration
(ASHHRA) of the American Hospital Association will be advocating implementation for.
This policy will be regulatory in design in that it will be used to influence the actions,
behaviors, and decisions of those in leadership roles at mid-size to large healthcare
facilities. (Longest, 2010) Additionally, this policy is intended to maintain conditions that
permit markets to work well and fairly; it is a regulatory policy that will present rules
which will implement market-preserving controls within our seriously depleted U.S.
healthcare human resources industry. Succession planning is a strategic management
tool that is severely underutilized in the healthcare industry. It must become more
commonly used in this industry in order to assist with the issues of low retention, high
attrition, and lack of interest in the health care professions, especially the allied health
professions. This project component represents the draft of this essential policy
proposal.
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Unit 8 Assignment 1- Project Draft- Healthcare Succession Planning
Succession planning is one of the most utilized proactive business strategies in
all U.S. industries, except healthcare. According to a study conducted by the American
College of Healthcare Executives (2004) only 21% of 722 hospitals routinely engaged in
leadership-succession planning compared with two out of three for-profit companies in
other industries. Due to the catastrophic shortages that are occurring in healthcare
professions, especially nursing, succession planning has become more recognized as a
needed device for recruiting, retention, mentoring, administration activities, and
continuous forecasted succession planning frameworks. Comprehensive and effective
succession planning requires human resources to be deeply involved with the strategic
initiatives of the healthcare organization. Succession planning is a strategy or plan
which ensures that internal, qualified candidates are continuously identified and
available to take up leadership positions when vacancies occur. (Bonczek & Woodward,
2006; Schmalzried & Fallon, 2007)
Problem statement
Succession planning is a strategic management tool that is severely underutilized
in the healthcare industry. It must become more commonly used in this industry, for
technical as well as managerial positions, in order to assist with the issues of low
retention, high attrition, and the lack of interest in the health care professions, especially
the allied health professions. This policy will focus on creating an agenda for both
technical and managerial succession planning in healthcare.
I. Proposal overview
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Succession planning is an essential process that allows knowledge, intellect,
and skills to remain in an organization; the human capital is retained in organizations
that freely and purposely utilize this tool; it keeps the organization viable in the market.
More importantly, this practice sustains the quality of care healthcare consumers are
receiving. Most succession plans deal with executive leadership. This is a proposal that
extends to lower-level leadership throughout U.S. healthcare organizations as a way of
implementing a necessary retention and acquisition of healthcare workers strategy on a
national level. This proposal is also about developing talent and building sufficient
bench strength; technical succession planning. Without technical, as opposed to just
managerial, succession organizations place themselves in a greater capacity for losing
the essential knowledge base that is needed in order to develop strategically,
technically, continually, and in unison with the changes that occur in the organizational
and industrial environment of the times. Essentially, the proverbial knowledge pool has
to be maintained and filled.
Succession planning can mean, any effort designed to ensure the continued
effective performance of an organization, division, department, or work group by making
provision for the development, replacement and strategic application of key people over
time. (Rothwell, 2000b,p.47 ) Most succession planning within organizations is focused
on preparing for the departure of upper-level management, those who are in top
positions that give them the authority to make decisions, mobilize resources, and direct
others to take action. However, this policy proposal recommends that healthcare
organizations focus on more than just the succession of management. This proposal
recommends the succession planning of technical positions as well, in order to preserve
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and enhance specialized knowledge, learned from experience, across the horizontal
chart of the organization chart. According to Rothwell and Poduch (2004) technical
succession planning means, any effort designed to ensure the continued effective
performance of an organization, division, department, or work group by making
provision for distilling, preserving, maintaining, and communicating the fruits of the
organizations institutional memory and unique experiences over time. (p. 407)
Consequently, technical succession planning is a form of knowledge management
(Smeltzer & Bonello, 2004) the theory of which will bring more light and emphasis to the
proposal, in conjunction with the Human Capital and Organizational Development
theories, later on.
Recommendations
This health policy proposal is a declaration for a national mandate that will cause
the implementation of structured succession plans in all healthcare organizations which
employees 50 or more personnel. The plans must include an emergency plan, standard
plan, and anticipatory plan. The emergency plan will be referred to should unforeseen
circumstances such as death of a leader occur within the organization. The standard
plan will be utilized when leadership takes a different position that is either internal or
external to the organization. The anticipatory plan is used when an organization is privy
to the retirement date of a healthcare leader. This plan will also be initiated when the
evaluation of the internal and external organizational environment deems it necessary to
prepare for changes.
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Additionally, it is recommended that the succession planning process begin with
the development of preliminary replacement charts (Flynn, Mathis, Jackson, & Langan,
2007). These charts will: 1) ensure that the right individuals with sufficient capabilities
and experience to perform the targeted jobs are available at the right time; 2) show the
backup players for each position; 3) identify positions without a current qualified
backup and; 4) identify who could take over key jobs if someone leaves, retires, dies
unexpectedly, or otherwise creates a vacancy.
Finally, it is suggested that the organization makes successorship, the process of
selecting those interested in and qualified for the possibility of being trained as a
successor, open and known throughout the organization. Having the process of training
for potentially obtaining advanced positions, shows that the organization encourages
self-development of its employees and is will to encourage and provide employees with
the resources and encouragement that is often times needed in order for them to
pursue self-development as stated in The Receivables Reportin 2005 and as is
recommended by many other research sources that are too numerous to name in this
proposal. However, in referring to any paper written about human capital development
succession planning and encouragement of employees are on top of every
organizations list that has a vested interest in the subject matter.
Theoretical support
The expected objectives for this new policy are:
to make healthcare organizations more accountable for the level of staffing that
they require in order to keep the quality of healthcare provisions optimal.
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to enforce proactivity and forward-thinking
to provide the necessary funding for job retention, recruitment, mentoring,
administrative duties, and continuous forecasted succession planning
frameworks.
to revitalize the healthcare industry and make it more appealing to current-day
generations.
Another essential and to many organizations, the primary reason for having a
succession plan is for the development of knowledge management. There have been
fundamental changes in the structure of organizations which have led to massive
increases in productivity. Along with the need to continue production has been the
desire of organizations to improve upon and maintain the companys knowledge base.
The tenets of Knowledge Management are to (KPMG, 1999):
1. support innovation, the generation of new ideas and the exploitation of the
organizations thinking power
2. capture insight and experience to make them available and usable when, where,
and by whom required
3. make it easy to find and reuse source of know-ho and expertise, whether they
are recorded in a physical form or held in someones mind
4. foster collaboration, knowledge sharing, continual learning and improvement
5. improve the quality of decision making and other intelligent tasks
6. Understand the value and contribution of intellectual assets and increasing their
worth, effectiveness and exploitation
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Knowledge management can contribute to organizational goals for reducing
process/service development time, employee satisfaction, profitability, cost reduction,
waste reduction, consistency, and organizational branding (Smeltzer & Bonello, 2004).
According to Davenport, DeLong, and Beers (1998), knowledge management and
related strategy concepts are promoted as important and necessary components for
organizations to survive and maintain their competitive keenness. It has become
necessary for managers and executives to address Knowledge Management (Goodman
& Chinowsky, 1997) seeing that is it now seen as a prerequisite for higher productivity
and flexibility in both the private and the public sectors (Martensson, 2000)
II. Analysis and Evaluation
There are many perspectives from which an analysis of succession planning can
be derived and defined. The definition mentioned previously in this policy reflects a
perspective that is focused on filling lateral or technical positions, which is the premise
of this policy proposal. However, what if succession planning was looked at from a
depleted leadership pipeline perspective as is exemplified by Charan, Drotter, and Noel
(2011) who explicitly state that, the demand for leadership has risen while the supply of
leaders has not kept pace. (p. 2) They emphasize how the requirements for leadership
have changed dramatically and most organizational development strategies are not
equipped for the dynamics of change and the chaos that may accompany it. Examples
of chaotic changes include: mergers, acquisitions, downsizing, delayering, globalization,
and the Internet, which all are causing a substantial change in organizations by
invalidating the importance of some job positions that may be considered crucial in an
organization. Essentially, from the pipeline perspective it is important for organizational
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strategic business plans such as succession planning to include provisions for future
possibilities. This alternative definition for succession planning considers future
possibilities (Charan, Drotter & Noel, 2011):
Succession planning is perpetuating the enterprise by filling the pipeline with
high-performing people to ensure that every leadership level has an abundance
of these performers to draw from, both now and in the future. (p. 207)
This policy will focus on creating an agenda for both technical and managerial
succession planning in healthcare. In keeping in line with the dynamics of the
healthcare industry this policy will also focus on making it a point that organizations
create their plans by first thoroughly evaluating their unique environments.
Sociological analysis
Organizations need realistic and accurate information on the capabilities and
talents of their current staff in order to know the striking force of their human capital. If
the talent, skills, and knowledge pool is weak then an organizations ability to withstand
a drastic change such as retirements, job cuts, job layoffs, military conflicts, and loss of
personnel due to competition, will falter. (Pynes, 2004) According to Pynes (2004), To
be competitive, organizations must be able to anticipate, influence, and manage the
forces that impact their ability to remain effective. In the service sector, this means they
must be able to manage their human resource capabilities. (p. 390) Forty-two percent
of the 15.7 million individuals working for state and local government in 1999 were
between the ages of 45 and 64 years old.( Carroll & Moss, 2002)Two-fifths of state and
local government employees will be eligible to retire in the next 15 years. (Ehrenhalt,
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public attitudes, concerns, and opinions; the preferences and relative ability to
influence political decisions of various groups interested in the problem of the
way it is addressed; and the positions of involved key policymakers in the
executive and legislative branches of government. Each of these factors can
influence whether a problem is addressed through policy and the shape and
scope of any policy developed to address the problem. (p. 67 )
Implementation process
strategies. Like with any policy: federal, organizational, international or likewise,
continuous monitoring and updating must occur depending on the external and internal
environmental changes that occur. The formulation of the policy is just the first step of
many. After formulation is the implementation stages which is a huge determinant for
whether or not the policy fits into the environment of the organization or nation that it
was intended to serve. Therefore, it is imperative that top leaders of healthcare
organizations get to present their opinions about what would be needed in order for this
initiative to be successful. Essentially, the first strategy would be a reemphasis on the
problems in the current healthcare industry. The second strategy would be to present to
top healthcare leaders the importance of this new policy and how it would address the
problems the industry is facing. Next a presentation of data that argues for the
implementation of this policy and that is supported by policy development theory will be
analyzed and synthesized. Finally, an implementation strategy will be suggested to
healthcare leaders on a local and national level. The further the research progresses for
this new policy implementation the more strategic the organization will become thus
leading to the development of a calculated policy development
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Proposed Succession Planning Scheme
Figure 1. Succession Planning Scheme adapted from Succession Planning:
An Idea Whose Time Has Come, by P. Ibarra, 2005, Public Management,
87(1), p. 20. Copyright 2005 by ICMA.
Determine or
Forecast Future
Service Needs
Develop Action
Plan for
ImplementingHuman Resources
Strategies
Identify Critical
Positions and High
Potential
Employees
Identify the
Competencies That
Will Move the FirmForward
Conduct a
Complete Gap
Analysis
Select training and
Development
Activities: Based onFinancial Resources
Assessment
Select EmployeeEvaluation
Methods:Determine
continued Interest
in Program
Executive
Leadership or
Management
Involvement
Continuous Quality
Improvement:
Monitor and
Evaluate Each
Component of the
Plan Strategically
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Comparative decision-making
According to several resources, strategies and tactics that promote effective
succession planning for healthcare management positions are: 1) early and frequent
identification of successor candidates; 2) demand for forecasting and gap analysis for
future role and key position needs; 3) intentional formal and informal mentoring and
coaching; 4) exposure to career broadening future role development competency
opportunities; 5) resource dedication for leadership development, including formal
education for new competency development; and 6) serious evaluation when desirable
successor candidates who are high performers leave the organization. (Roddy, 2004;
Charan, 2005; Blouin, et al., 2006; Flynn, et al., 2007; Kappia, Dainty, & Price, 2007)
In understanding the different strategies that are or should be utilized in a
succession planning program it is essential for organizations to understand that this kind
of business strategy cannot be limited to only top-level management. These tactics
must also be implemented throughout all positions that require the need to fill key
positions.
Cost-benefit analysis
The costs and benefits of the proposal will be specific, they affect a single group,
which alone bears the projects favorable or harmful outcome. (Gupta, 2011, p.86)
According to Gupta (2011) the easiest projects for lawmakers to accept are those that
benefit specific groups of people while distributing costs over a large, diffuse population.
This is referenced as pork-barrel legislation, where appropriations of public funds by
Congress (or other legislative assemblies) for projects that do not serve the interests of
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any large portion of the country's citizenry but are nevertheless vigorously promoted by
a small group of legislators because they will pump outside taxpayers' money and
resources into the local districts these legislators represent. (Johnson, 2005, p.1)
Examples of this kind of legislation include: appropriations bills for dams, bridge and
highway construction and job-training centers.
This proposal can be judged synonymously with a job-training center; more
specifically as an, at-the-job-training center. With succession planning being a business
strategy it provides benefits that are essential for any organization upon implementation.
These benefits do not come without costs to the organization. The following is a listing
of potential benefits and costs of succession planning in healthcare organizations.
(Bolton & Roy, 2004, p. 589-590; Blouin, McDonagh, Neistadt,& Helfand, 2006)
benefits.
Provides good return on investment by decreasing recruitment and orientation
costs and minimizing time-to-fill for vacancies
It enhances the ability to achieve orderly transitions (Redman, 2003) and
maintain productivity levels
Provides for the systematic development of new and emerging leadership
competencies called for by technological and cultural changes
As an open process, it promotes the continual development of the leadership
potential in rank and file, and encourages staff ownership of their own
professional growth
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Recruitment and retention are enhanced because it identifies opportunities for
growth and establishes a policy of promoting from within
It creates a culture that supports career advancement and instills worker loyalty
It demonstrates a commitment to career development and professional
advancement and is a powerful employee retention strategy
It ensures continuity of services, helps the bottom line, and gives a competitive
edge in the market place
It provides intentional formal and informal mentoring and coaching
Ensures resource dedication for leadership development, including formal
education
costs.
Time and resource commitment for the ongoing growth and development of staff
Funding continuing education (internal and external)
Funding matriculation in degree granting programs
Funding leadership advancement programs
Recognizing and rewarding competency achievement
Essentially the argument for mandate of the implementation of a sound business
strategy such as succession planning is simple. Based on the return in investment of
having readily available successors in a tight labor market, eliminating recruitment and
orientation expenses, maintaining productivity at times of turnover, and responding
quickly to market demands adds up to significant dollars being saved. According to NAS
Recruitment Communications (2010) healthcare management is the FTE (full-time
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employee) occupation with the longest average time-to-fill of 78.9 days in 2009. The
average recruitment expense per hire includes the total fixed and variable recruiting
costs divided by the number of positions filled. Recruiting costs include advertising,
employment and advertising agency fees, travel, office rental, equipment, staff salaries
and benefits, relocation costs, and other costs associated with a new hire (NAS, 2010).
The average recruitment expense per FTE hire in 2009 was $2,302 (2010).
Ethical dilemmas
Healthcare organization leaders must make themselves willing and able to step
aside and allow new leaders to emerge. If an organization is one for accepting the
challenge of implementing a succession plan into its organization then there has to be
open communication about the process. An organization cannot say that they believe in
and is in support of a succession plan if they feel it necessary to keep the ideas,
structure, organization and the potential successors out of the communication loop.
(Levett & Guenov, 2000)
Additionally, the assessment of potential successors must be fair; the standards
for judging potential must be consistent across the board of potentials. According to
Charan, Drotter, and Noel (2011) standards for judging potential can rest on the
employees:
Exhibits operating, technical, and professional skills that are extremely required
Exhibits managerial skills that are expected at the next highest organizational
level
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Demonstrates leadership skills that are expected at the next highest
organizational level
Regularly works a building new skills and abilities
Demonstrates fire in the belly
Is oriented towards total business results, not just focused on the success of own
area (p. 212)
These standards must be addressed for all potentials for succession within the
organization. This standard process could be by way of utilizing a tool called combined
potential-performance matrix. According to Charan et al. (2011), this tool is useful for
gaining snapshots of a leadership layer. Companies can determine, for instance, that
their functional managers do not have many highly promotable people at this level and
they had better remedy the situation. (p. 216) Whatever process is decided upon,
leaders must make sure that all candidates are tested, evaluated, and compared in the
exact same manner. As with any other function in healthcare, it is a professional and
ethical duty to behave in a manner that is respectable and admirable. Tomorrows
leaders are looking at the examples made by today s.
III. Conclusion
This project will represent the creation of a new health policy that will focus on
mandating the implementation of succession planning within healthcare organizations
which employ 50 or more personnel. All required organizations must have emergency,
standard, and anticipatory planning strategies in the overall policy. This policy will be
advocated for through the eyes of a senior policy analyst at the American Society for
Healthcare Human Resources Administration of the American Hospital Association.
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In our increasingly competitive business climate, where consumers are
being more informed, becoming more involved with the decision making process of their
care, and therefore, are expecting the knowledge of their healthcare providers and care
management teams (providers, nurses, radiologists, phlebotomists, laboratory
technologists, physical therapists, etc.) to be top-notch and on top of their game.
Todays healthcare consumers are demanding high quality in all respects from their
chosen healthcare entity. In knowing this, it would be in the best interest of healthcare
organization management to have an implemented plan for the retention of the
knowledge that is incorporated and has added to the reputation of its health care
dynamic. According to a federally funded coalition entitled Building Engineering and
Science Talent (BEST), we are entering a quiet crisis based on the fact that American
colleges and universities are not graduating enough scientific and technical talent to
step into research labs, software centers, science policies offices, and high tech start
upsthere is going to be a shrinking workforce, and an unprecedented labor shortage.
(Roddy, 2004, p. 487)
The limitation of this proposal is essentially the scope at which succession
planning is viewed. There are organizations that feel succession planning is just the
process of selecting the next chief. They are eluded to the fact that succession
planning, if done thorough and as a component of the organizations strategic pl an,
extends in to areas as leadership development programs, mentoring networks,
performance assessment, governance theory, aligning organizational goals with human
capital, and overall building the internal leadership pipeline. (Blouin, et al., 2006;
Charan et al, 2011). When the pipeline is nonexistent it cause the organization to shift
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their sole focus to external sources of candidates and bypassing the internal
prospective, which is a process that has been shown to lower success rates.(Charan,
2005; Byham & Nelson, 1999).
Additionally, this limitation extends into what an organization is financially
capable or able to do. In thinking about succession implementations that could be made
at the a large, multi-faceted, metropolitan hospital in comparison to a 150-bed suburban
community hospital the scale is slammed in the direction of the large metropolitan
hospital. There are going to be differences amongst hospitals as to what is needed,
required, and works with the cultural environment of that organization. This allocation of
funds would have to take into account these essential limitations of this proposal.
The strength of this proposal comes from the literature that is in support of
succession planning. This business plan has traveled across several different paths;
that of family-owned businesses right into large healthcare systems. This is a business
strategy that is highly recognized and recommended in the field, especially with the
bleak outlook that has been forecasted in the healthcare industry regarding the loss of
the essential knowledge pool of the organization.
A subsequent strength is the blatantly overt support that the cost-benefit analysis
put forth; the benefits significantly outweigh the costs of what it would take for an
organization to step up and put more manpower into developing a succession plan that
would be incorporated into the strategic plan of the organization. Pork-barrel legislation
shows that legislators are already more apt at passing this kind of law because it allows
for funding to go into the areas that they represent. In classifying it as an at -the-job-
training center this should be considered more favorable because the needed
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resources at already within the healthcare facility. There would be no need to pay rent
for a building space, the hospital would be it. There would be no need to pay additional
salary dollars, the succession plan would be implemented right into the strategic goals
of the facility; therefore, the additional activities and duties could be considered lateral
duties. The primary need for funds would be contingent upon the succession plan
design that is utilized. If training is to occur externally instead of internally costs will rise.
If external trainers were utilized instead of the internal knowledge pool costs would rise.
If the organization decides that training should take place before or after work hours
instead of incorporating the training on the job then costs will rise.
Essentially, organizations have to thoroughly review, analyze, and map-out their
financial responsibilities and be creative and open-minded to the idea of planning for the
foreseeable and unforeseeable future. The support shows that legislation is for the
development of human capital (with ulterior motives of course, but nonetheless
supportive) with regards to accepting proposals for job training centers. This proposal is
exactly for a program like that. The only difference is it will be within an organization,
that would have to decide on their own if they are willing to take the time to develop an
on-the-job-training plan.
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