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2018

Hospital Executive Succession Planning Strategies

Janet Tingling
Walden University

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 Walden University

College of Management and Technology

This is to certify that the doctoral study by

Janet Tingling

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Peter Anthony, Committee Chairperson, Doctor of Business Administration Faculty

Dr. David Moody, Committee Member, Doctor of Business Administration Faculty

Dr. Rocky Dwyer, University Reviewer, Doctor of Business Administration Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University
2018
 Abstract

Hospital Executive Succession Planning Strategies

by

Janet Tingling

MBA, Davenport University, 2014

BS, City University, 2001

Doctoral Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Business Administration

Walden University

February 2018
 Abstract

Approximately 50% of New York City hospitals lack succession planning as baby

boomers transition out of the workforce into retirement. The potential loss of knowledge

capital could affect leadership development and corporate stability. Guided by the

transformational leadership theory, the purpose of this single site case study was to

explore successful strategies executive-level leaders used to facilitate succession planning

within their hospital. Three hospital executive-level leaders from a single site location

participated in a semistructured face-to-face interview and provided data that assisted the

analysis. Four themes emerged from the data analysis through a word cloud format that

showed the most commonly used words and phrases from participants’ responses to

interview questions and review of company succession planning documents. The themes

were organizational strategies used to promote executive-level succession planning,

encouraging peer-mentorship, knowledge sharing strategies, and talent management. The

findings revealed that the participants’ organization lacked formal succession planning

strategies, but policies were in place that promoted in-house training and development to

prepare the next generation of executive-level leaders. The findings of this study can

contribute to positive social change by providing a work-related environment that

embraces knowledge sharing and leadership development to increase leadership

performance, income, and productivity, to ensure a better quality of life for employees

and to improve the healthcare of patients and the community served.

Hospital Executive Succession Planning Strategies

by

Janet Tingling

MBA, Davenport University, 2014

BS, City University, 2001

Doctoral Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Business Administration

Walden University

February 2018
 Dedication

For your undying love and support throughout the years, I dedicate this doctoral

study to my late mother, sister, and brother whose tireless support and encouragement

was a shoulder of strength that kept me motivated throughout this journey. Additionally, I

would like to extend this dedication to my family, friends, colleagues, and doctors

especially Dr. G, who went beyond the call of duty to ensure that I get the best medical

care. A big thank you to everyone who believed in me even during the lowest points of

my life when I felt like I was walking alone and God was nowhere in sight, but that is the

time when he was carrying me through my darkest hours.

 Acknowledgments

I thank God for giving me the insight, knowledge, resilience, and tenacity to

embark upon this doctoral journey and complete the program within a set timeframe. To

my committee chair, Dr. Pete, I am thankful that the program director assigned you as my

chair, based on your level of ingenuity, student-centered approach, accessibility, and

attention to detail, which improved my learning curve and overall performance. To my

second committee member, Dr. Moody, and my university research reviewer, Dr. Dwyer,

words cannot express my heartfelt gratitude and appreciation for your continuous

guidance, support, and patience throughout the doctoral journey. All three committee

members provided valuable knowledge and insight that assisted me in completing the

doctoral program successfully. Thank you, all and God bless you for making my dream a

reality.
 Table of Contents

List of Tables ..................................................................................................................... iv

List of Figures ......................................................................................................................v

Section 1: Foundation of the Study......................................................................................1

Background of the Problem ...........................................................................................1

Problem Statement .........................................................................................................2

Purpose Statement ..........................................................................................................2

Nature of the Study ........................................................................................................3

Research Question .........................................................................................................4

Interview Questions .......................................................................................................4

Conceptual Framework ..................................................................................................5

Operational Definitions ..................................................................................................6

Assumptions, Limitations, and Delimitations................................................................7

Assumptions............................................................................................................ 7

Limitations .............................................................................................................. 7

Delimitations ........................................................................................................... 8

Significance of the Study ...............................................................................................8

Contribution to Business Practice ........................................................................... 8

Implications for Social Change ............................................................................... 9

A Review of the Professional and Academic Literature ..............................................10

Transformational Leadership Theory for Succession Planning ............................ 12

Succession Planning.............................................................................................. 20

i
 Mentoring and Succession Planning ..................................................................... 24

Leadership Readiness............................................................................................ 26

Leadership Shortage.............................................................................................. 27

Knowledge Transfer.............................................................................................. 28

Absence of Succession Planning .......................................................................... 30

The Benefits of Succession Planning .................................................................... 32

Recruitment of External versus Internal Leaders.................................................. 33

Barriers and Risk Associated with Succession Planning ...................................... 35

The Importance of Retaining Human and Intellectual Capital ............................. 37

Summary ............................................................................................................... 38

Transition .....................................................................................................................39

Section 2: The Project ........................................................................................................41

Purpose Statement ........................................................................................................41

Role of the Researcher .................................................................................................42

Participants ...................................................................................................................43

Research Method and Design ......................................................................................45

Research Method .................................................................................................. 46

Research Design.................................................................................................... 47

Population and Sampling .............................................................................................49

Ethical Research...........................................................................................................51

Data Collection Instruments ........................................................................................53

Data Collection Technique ..........................................................................................55

ii
 Data Organization Technique ......................................................................................57

Data Analysis ...............................................................................................................57

Reliability and Validity ................................................................................................59

Reliability.............................................................................................................. 60

Validity ................................................................................................................. 60

Credibility ............................................................................................................. 61

Confirmability ....................................................................................................... 61

Transferability ....................................................................................................... 62

Transition and Summary ..............................................................................................62

Section 3: Application to Professional Practice and Implications for Change ..................64

Introduction ..................................................................................................................64

Presentation of the Findings ........................................................................................65

Applications to Professional Practice ..........................................................................73

Implications for Social Change ....................................................................................75

Recommendations for Action ......................................................................................76

Recommendations for Further Research ......................................................................78

Reflections ...................................................................................................................78

Conclusion ...................................................................................................................79

References ..........................................................................................................................81

Appendix A: Interview Protocol ......................................................................................109

iii
 List of Tables

Table 1. Frequency of Primary Themes from Data Collected from Interview ..................67

iv
 List of Figures

Figure 1. Figure Succession Planning Process ..................................................................20

Figure 2. World Cloud and Phrases ...................................................................................66

Figure 3. Graphical illustration of Frequency versus percentage occurrence ....................73

v
 1
Section 1: Foundation of the Study

Background of the Problem

Succession planning at the executive level promotes long-term survival for most

metropolitan hospitals and produces a pool of highly qualified employees for future

leadership positions (Kim, 2012; Titzer, Phillips, Tooley, Hall, & Shirey, 2013). A higher

percentage of urban hospitals fully embrace the culture of succession planning compared

to their rural counterparts, because they acquire more private funding and experience

fewer recruiting challenges (Kim, 2012). This type of dichotomy in succession planning

between urban and rural hospitals can cause a more pronounced financial instability in

urban hospitals in the sudden absence of a hospital’s executive-level leader (Kim,

Thompson, & Herbek, 2012).

Succession planning requires more in-depth research because it causes significant

disruption in leadership when executive-level leaders refuse to train senior-level

managers for executive positions before key leaders exit the workforce (Birk, 2013). The

purpose of this study was to identify successful strategies executive-level leaders used to

facilitate succession planning at a New York City (NYC) hospital to prevent disruption of

leadership transitioning that can affect the replacement of key leaders within the

organization (Liang, Liu, Wu, & Zhang, 2012). Fifty percent of hospitals fail to

implement succession planning at the executive level to prepare future successors for

leadership positions, so it is important to learn how executive-level leaders are preparing

to solve the unplanned departures of key executives (Kim, 2012).

 2
Problem Statement

A lack of succession planning in the NYC healthcare industry was responsible for

an inadequate level of readiness in the event of a major leadership crisis (Schulz &

Enslin, 2014). Approximately 50% of NYC healthcare facilities lacked internal training

and development programs to groom potential successors (Santora, Sarros, Bozer,

Esposito, & Bassi, 2015). The general business problem was that without effective

succession planning, knowledge attrition increases the cost and time spent in vetting new

successors to transition into executive-level positions. The specific business problem was

that some healthcare executives have limited strategies to facilitate executive-level

succession planning within their hospitals.

Purpose Statement

The purpose of this qualitative single case study was to explore the strategies

executives used to facilitate executive-level succession planning within their hospital.

The specific population was three upper-level hospital executives located in a NYC

hospital, who have a record of accomplishment in facilitating corporate succession

planning, enabling employees to become leaders within their community who could

influence positive employee engagement, and increase creativity, and productivity (see

Patidar, Gupta, Azbik, Weech-Maldonado, & Finan, 2016). The findings from this study

served as an educational tool for executive-level hospital leaders and stakeholders to

promote awareness about the importance of retaining corporate talent, which benefited

the community served by the hospital, and can incentivize caregivers to remain on the job

delivering quality care to patients.

 3
Nature of the Study

I selected a qualitative method because my intent was to identify and explore

successful strategies hospital executives use to facilitate succession planning. Arghode

(2012) defined quantitative research as the collection of numerical data for statistical

testing of a theory or hypotheses. I did not test a theory or hypothesis; therefore, a

quantitative method was inappropriate for my study. Mixed method researchers integrate

qualitative and quantitative techniques into a single study (Sparkes, 2015). Because I

proposed doing a qualitative study without the need for quantifying, a mixed method

approach did not fit the purpose of the study.

Qualitative research includes case studies, phenomenology, ethnography, and

narrative designs (Marshall & Rossman, 2016). Case study researchers use a collection of

data derived from different theories and concepts observed through real life experiences

to develop an in-depth description of a phenomenon (Cater, 2012). I used a case study

design to explore strategies hospital executives used to facilitate succession planning. The

phenomenological approach is used to focus on identifying the meaning of participants’

lived experiences (Chan & Walker, 2015). I did not explore lived experiences of

participants, so a phenomenological design did not fit the purpose of my study.

Ethnographers focus on understanding groups’ cultural behaviors through researchers’

interpretative experiences (Mishra, Gupta, & Bhatnagar, 2014), however observing a

culture did not fit the purpose of my study. A narrative design refers to data gathering

through documented stories (Petty, Oliver, Thomson, & Stew, 2012). Because I did not

explore personal stories, the narrative design did not fit the purpose of my study.
 4
Research Question

What strategies do NYC hospital executives use to facilitate succession planning

successfully within their hospital?

Interview Questions

The following interview questions provided insights into solutions associated with

hospital succession planning at the executive level in NYC.

1. What strategies do you use to facilitate executive-level succession planning

within your hospital?

2. What strategies did you find worked best to facilitate executive-level

succession planning within your healthcare facilities?

3. How did your executives respond to your various executive-level succession

planning techniques?

4. How do you assess the effectiveness of your organization’s executive

succession planning strategies?

5. What, if any, method of organizational preparedness is in place to facilitate

executive-level succession planning?

6. What has been your experience with organizational barriers in the selection of

a potential successor?

7. How did your organization address the key barriers to implementing your

succession planning strategies?

 5
8. What, if any, executive-level succession planning strategies are in place to

prepare for a demographic shift in the workforce as senior employees

approach retirement age?

9. How, if at all, did your organization address the demographic shift in the

workforce to facilitate succession planning?

10. What additional successful strategies do you have to facilitate succession

planning at the executive-level in larger NYC hospitals?

Conceptual Framework

The conceptual framework for this study was the theory of transformational

leadership. James Macgregor Burns (1978) first introduced transformational leadership

theory to highlight the importance of leaders adhering to core corporate values through

shared vision and motivation during the transitioning of power to a new successor. Bass

(1985) later characterized the four tenets of leadership theory as (a) inspirational

motivation, (b) idealized influence, (c) individualized consideration, and (d) intellectual

stimulation. Transformational leaders influence corporate decision-making and

knowledge management, while transactional leadership is a belief rooted in the exchange

of rewards based on subordinates’ performance to fulfill the needs of their leader (Bass,

1995). Bass and Avolio (1993) determined that leaders exhibiting both transformational

and transactional leadership styles promote organizational success. Transformational

leaders are strategic planners who communicate their shared vision and goals with

employees to improve corporate sustainability (Lutz-Allen, Smith, & DaSilva, 2013;

Onorato, 2013). Hence, executives employing transformational leaders should recognize

 6
and mentor potential leaders who share the same vision for success by developing and

deploying strategies for executive-level succession planning.

Operational Definitions

Best practice: A highly recommended business practice based on the past and

current success rates experienced by experts in the field (Winship, 2012).

Disruptive innovation: The retention of human and intellectual capital to reduce

training and development cost of a new hire while improving performance and

productivity (Gobble, 2015).

Employee engagement: The employee’s self-efficacy and commitment to job

performance based on clarity in duties, shared corporate vision, and strategic planning

(Singh & Sharma, 2015).

Knowledge gap: The absence of corporate internal mentoring that promotes a loss

in knowledge retention during the transitioning of power (Ngomane & Mahlangu, 2014).

Knowledge sharing: Individuals with the ability to process knowledge deem

valuable to the organization are encouraged to share it with a fellow employee (Durst &

Wilhelm, 2012).

Leadership readiness: Modeling strategic planning for leadership progression

through mentoring and in-house corporate training and development programs (Schulz &

Enslin, 2014).

Retention of human capital: Motivating and educating talented employees with

the necessary skills and knowledge of an effective leader to maintain a high level of

corporate performance (Desai & Jayakrishnan, 2014).

 7
Retention of intellectual capital: Formally recognizing and mentoring internal

talent to lead and maintain corporate knowledge that is relevant to the growth of the

organization (Patidar et al., 2016).

Assumptions, Limitations, and Delimitations

Assumptions

Assumptions are plausible statements that the researcher accepts as the truth

based on their interpretation of the fact (Mesel, 2013). I used three assumptions in the

collection and analysis of the data. My first research assumption was that NYC

executive-level healthcare leaders favored the appointment of internal successors over

external successors based on Durst and Wilhelm (2012), who stated that internal

successors perpetuate the cultural values and ingrained leadership style of the

organization than their external counterpart. The second assumption pertains to study

participants being forthcoming and honest in their responses and not objecting to a

recorded session. Third, I assumed that participants are knowledgeable on the importance

of tacit knowledge retention in succession planning. After completing the study, I

confirmed that my assumptions were accurate.

Limitations

Limitations are potential weaknesses or deficiencies in the research design, data

analysis, or information gathered during the interview (McDonald, Gan, Fraser, Oke, &

Anderson, 2015). The first limitation was the sample size of the targeted population. The

second limitation pertained to conducting a single site case study that might not be

indicative of other NYC healthcare facilities. I conducted interviews with a selected

 8
sample size of three executive-level leaders with authority to enforce succession-planning

programs within their hospital to avoid a leadership crisis in the sudden absence of a key

leader.

Delimitations

Delimitations are investigative boundaries researchers use to narrow the scope of

the research design (Dean, 2014). The delimitations of this study were (a) study location,

(b) sample size, and (c) population sample. This single site exploratory study was the

focus of successful strategies executive-level leaders’ use to facilitate and mitigate

challenges associated with succession planning within a NYC hospital. Therefore, the use

of a smaller pool of participants at a single site location carried an inherent risk of the

results not being indicative of other NYC hospitals.

Significance of the Study

Contribution to Business Practice

The importance of succession planning is to retain knowledge capital, talent, and

leadership development at the executive level to mitigate challenges associated with the

transfer of power to ensure organizational sustainability (Kim, 2012). For an organization

to remain competitive in an evolving healthcare industry, leaders need to develop

strategies that foster knowledge retention and corporate skills to avoid the cost of external

recruitment and training to maintain a competitive edge (Shaari, Areni, Grant, & Miller,

2014). Efficacious succession planning at the executive level builds loyalty, trust, and

leadership development that contribute to organizational success.

 9
Senior executives approaching retirement age are encouraged to participate in

succession planning to support the development and retention of skilled employees for

future leadership positions to increase workplace morale, employees’ satisfaction, and

corporate stability (Kim, 2012). The results of this study might contribute to effective

business practices if healthcare leaders implement new strategies to identify the most

qualified replacements to ensure a continuation of effective leadership. Catalyzing

organizational commitment, talent management, and transparency in career advancement

by executive-level leaders are strategies that could influence the long-term success of an

organization (Raftery, 2013). Succession planning is critical at all levels of the hierarchy

to prevent internal conflicts and a loss of productivity that could negatively affect the

longevity of the organization.

Implications for Social Change

The loss of skilled workers through retirement, resignation, illness, or sudden

death could adversely affect the career growth and development of employees (Flatt,

Harris-Boundy, & Wagner, 2013). Executive-level succession planning could foster the

retention of talent thus enhancing employees’ quality of living and continuous quality of

service to the community (Patidar et al., 2016). Practical knowledge gained from the

implementation of succession planning could benefit the community served by the

hospital and incentivize caregivers to remain on the job delivering quality care to

patients.
 10
A Review of the Professional and Academic Literature

The review of the literature on succession planning includes a wide range of peer-

reviewed scholarly articles from various databases that included ABI Inform Global,

EBSCO, ProQuest, PubMed, CINAHL and Academic Search Complete, Business

Source. One hundred and ninety-three peer-reviewed articles are referenced, which

included 87% peer-reviewed scholarly journals resources from 2014 through 2017.

I used keywords such as qualitative succession planning, hospital chief executive,

healthcare culture, leadership transitioning, and knowledge transfer in different search

engines were strategies I employed to increase results. I also incorporated the use of

Boolean terms such as AND and OR to strengthen the results of the search and the

relevance of the articles displayed.

Succession planning is the grooming of talented employees to replace key leaders

within an organization, especially during a sudden restructuring crisis to prevent

disruption in corporate productivity, financial sustainability, and workplace morale

(McMullen & Warnick, 2015; Titzer et al., 2013). Succession planning is one of the best

healthcare practices to prepare leaders to transition seamlessly into top executive level

positions to maintain the organization’s cultural mission and vision for corporate success

(Kipkirong-Tarus & Aimes, 2014). The dynamics of the healthcare industry warrants the

need for the retention of human capital to preserve corporate knowledge as aging

executive-level leaders’ transition from the workforce into retirement (Kaehr-Serra &

Borzillo, 2013; McDonagh & Paris, 2012).

 11
The healthcare industry is facing an unprecedented high turnover rate of

executive-level leaders, which costs companies more than double the executive’s annual

salary to recruit a replacement (Enslin & Schulz, 2015). This cost for external recruiting

shows the importance of succession planning at the executive-level within NYC

hospitals. The systematic failures surrounding the lack of succession planning are the

retention of knowledge capital and the internal grooming of future leaders to maintain

corporate sustainability. As a researcher, I organized the themes into nine categories to

give the reader an in-depth overview of hospital succession planning at the executive

level. The themes include:

1. Succession planning

2. Importance of mentoring

3. Leadership readiness

4. Knowledge transfer

5. Absence of succession planning

6. Benefits of succession planning

7. Recruitment of external versus internal leaders

8. Barriers associated with succession planning

9. Retention of human and intellectual capital

 12
Transformational Leadership Theory for Succession Planning

Burns (1978) first defined transformational leadership as a construct that

revolutionized the way leaders inspire followers to exceed corporate goals through shared

values that align with those of the organization. Burns asserted that effective leaders use a

transformational approach to change the beliefs and values of followers (Yahaya and

Ebrahim, 2016). Trottier, Wart, and Wang (2008) and Men (2014) supported Burns’s

theory that relates to transformational leaders motivating and challenging followers to

align their values, goals, and vision with those of the organization to optimize

performance. The development of transformational leadership theory relates to a self-

determined motivation that empowers employees to work selflessly to improve

organizational performance (Gilbert, Horsman, & Kelloway 2016; McCleskey, 2014).

Therefore, the emergence of a shared vision between followers and leaders not only

creates an extraordinary purpose that energizes and engages followers but also represents

the real objectives of transformational leadership, which is to motivate followers.

Bass (1985) modified Burns’ transformational leadership theory to describe four

interrelated components that emerged from transformational leadership, which includes

(a) inspirational motivation, (b) idealized influence, (c) individualized consideration, and

(d) intellectual stimulation. Inspirational motivation is the ability of leaders to

communicate an ideological belief that influences the thoughts and perception of

followers (Holstad, Korek, Rigotti, & Mohr, 2014; McCleskey, 2014). Idealized

influence refers to leaders governing in an ethical and charismatic manner that not only

inspires followers but also earns their trust and admiration (Bass & Avolio, 1993;
 13
McCleskey, 2014). Individualized consideration is applying recognition that supports the

career growth and productivity of potential employees (Holstad et al., 2014; McCleskey,

2014). Intellectual stimulation relates to leaders exhibiting and promoting creativity

through the development of new problem-solving techniques for solutions to everyday

business problems (Bass & Avolio, 1993; McCleskey, 2014). Bass and Avolio (1993)

posited that transformational leaders are individuals that promote change within their

environment. Bass concluded that transformational leaders inspire followers to contribute

to organizational goals to maintain the longevity of the corporation.

Transformational leadership evolved from the great man theory of leadership,

which is representative of nineteenth-century charismatic, influential male leaders with

innate leadership abilities that shaped the history of organizational success and led to two

dichotomous styles of leadership the transformational and transactional leadership

(McCleskey, 2014). Lawlor, Batchelor, and Abston (2015) explained that the absence of

transformational leadership in business could lead to a working environment that lacks

structure, function, and the charisma needed to empower followers to accept the process

of change. Transformational leaders influence corporate decision-making and knowledge

management, while transactional leadership is a belief rooted in the exchange of rewards

based on subordinates’ performance to fulfill the needs of their leader (Bass, 1995). Bass

(1995) viewed transformational and transactional as the preferred leadership style

although the latter is contingent upon rewards.

Contrary to transactional and transformational leadership, the laissez-faire model

lacks an effective style of leadership based on the absence of corporate decision-making,

 14
which is essential to maintaining a viable organization (Yahaya & Ebrahim, 2016). Choi-

Sang, Lim-Zhi, and Tan-Wee (2016) noted that the laissez-faire leadership style

represents a passive approach toward performance-based work ethics surrounding the

delegation of work-related tasks and astuteness in leadership, which demotivates

employees. Therefore, transformational leaders’ charismatic style of leadership motivates

followers to perform at high level based on a shared vision and mission for success,

unlike the laissez-faire leadership model.

Transformational leaders are individuals that exemplify a high level of social and

ethical standards that transcend through their articulation and execution of vision for

organizational change to followers, which is in contrast to transactional leaders who

prefer working toward existing corporate objectives to improve efficiency (Andersen,

2015; Bass, 1995). The late CEO of Apple, Steve Jobs, and Anne Sweeney, former

president of Disney both represent exemplary transformational leaders who publicly

communicated their vision for success by energizing followers and legitimizing what

their vision would look like if it became a reality. Tim Cook, Apple's new CEO,

embraced the legacy of the late Steve Jobs and still strives to inspire followers’ by being

a transformational leader like his predecessor.

Similarly, the co-founder of Southwest Airlines and the founder of Virgin Airlines

both embraced the culture of succession planning by grooming a team of talented leaders

to replace outgoing executives to maintain a competitive edge in the Airline industry

(Long, Johnson, Faught, & Street, 2013).

 15
Despite the success of GE, Apple, McDonald’s, Southwest, and Virgin Airlines in

using succession planning, the external hiring of a new president for Intel Corporation

Businesses and Systems Architecture Group led to the abandonment of Intel succession

planning practices, which led to the departure of top executives (Kim, 2016). Similarly,

Rogoway (2016) stated that the discontinuation of succession planning at Intel

Corporation led to a massive economic downfall that adversely affected Intel’s profit

margin leading to the departure of top executives and a breakdown in corporate morale.

Therefore, transformational leaders are the support system for organizational success and

sustained growth through employee engagement.

Transactional leadership theory supports transformational leadership theory

despite their opposing leadership styles where the former use rewards and punishment to

increase performance while transformational leaders are visionaries of change who

inspire and empower followers to excel beyond the goals of the organization

(McCleskey, 2014). Similarly, Burns (1978) asserted that the interpretation of any

leadership style could be either transformational or transactional. Bass (1995) agreed with

Burns that transformational leaders influence followers to share their mission and vision

for success to develop positive social change, which justifies the relevance of

transformational leadership without the initiation of punishment.

Transactional and transformational leadership theories are mutually beneficial to

both foreign and domestic organizations because they improve organizational efficiency

and employee engagement. Joo and Lim (2013) proposed that leaders should spend less

emphasis on rewards for performance and more efforts on establishing personal growth
 16
and leadership development. Furthermore, Keung and Rockinson-Szapkiw (2013) posited

that transformational leaders play a significant role in clarifying modern-day

understanding of effective leadership. However, in Europe and Chicago, I encountered

many small and medium size businesses that practiced both transformational and

transactional leadership to facilitate succession planning.

Situational leadership theory, also known as the life cycle theory, refers to the

skills and knowledge employees acquire on the job, and their willingness to work

independently in a self-motivated fashion to accomplished work-related tasks (Hersey &

Blanchard, 1988). Situational leaders should base their style of leadership on followers’

readiness, which is contrary to transformational and transactional leadership because

situational leadership style is more task-oriented while transformational and transactional

leadership theory is more people oriented (Hersey & Blanchard,1988). Consequently,

transformational leadership theory best correlates with my research study because it

refers to the identification and development of future leaders to facilitate succession

planning.

The intent of using the transformational leadership theory is to identify the gaps in

succession planning by examining the effects of transformational leadership in

facilitating succession planning. Rua and Araujo (2015) explored the effects of

transformational leadership on followers’ attitude towards organizational commitment

and job satisfaction to facilitate succession planning. Using an average sample size of 58

participants, Rua and Araujo’s indicated that transformational leadership style had a

positive effect on job performance but failed to improve organizational commitment to

 17
facilitate succession planning. Gilbert et al. (2016) contended that leadership style has a

synergistic and profound effect on corporate engagement and the development of future

leaders within the landscape of healthcare organizations. In addition, organizations that

embrace shared leadership values, and the delegation of power, could encourage

employees to work more collaboratively and take initiatives to improve organizational

commitment and success.

It is important for organizations to develop a culture that embraces succession

planning through the participation of career development programs to reinforce

employees’ engagement, increased morale, and a continuum in leadership. Swensen,

Gorringe, Caviness, and Peters (2016) espoused that organizations need to develop future

leaders with the same vision and mission for success that parallels the organization to

encourage collaboration, commitment, and a continuum in leadership. Swensen et al.

further stated that organizations across the United States invest over $13 billion dollars

annually on leadership development to yield more engaged and highly skilled future

leaders with the capabilities of combating unforeseen corporate challenges. Shaari et al.

(2014) explained that the link between leadership development and succession planning

is knowledge transfer that increases organizational performance and prepares potential

leaders for future executive-level leadership positions.

Strong leadership within an organization is the most important catalyst to drive

organizational performance and facilitates succession planning, which is critical to the

retention and development of talented leaders (Wilkins, 2014). Transformational leaders

play an unprecedented role in facilitating succession planning by developing a pool of

 18
talent leaders to assume future leadership positions to prevent a systematic failure within

the healthcare industry. The absence of succession planning in NYC hospitals could be

problematic as baby boomers transition out of the workforce into retirement (Santora, et

al., 2015). Executive-level leaders within the healthcare industries have a duty to identify

future internal executive-level leaders with the skill set and expertise needed to execute

the functions of their predecessor to maintain organizational stability. Pandiyan and

Jayalashmi (2016) proposed that executive-level leaders should mentor and train potential

executive-level leaders in different organizational capacities to develop future leaders

with the talent, strategy, and vision to lead without any disruptions in the organization’s

mission for success.

A lack of executive-level leadership could extend the gap between unraveling the

benefits versus implementation of succession planning, which could impede the

stratification and identification of future leaders within the healthcare industry (Marbury

& Mayer, 2013; Santos & Taijeron, 2015). Gobble (2015) and Kalra and Gupta (2014)

stated that disruption in corporate norms and values could increase the vulnerability of

the organization after the appointment of a new successor. Therefore, to maintain

organizational sustainability in the event an executive-level leader suddenly resigns, dies,

or becomes incapacitated, internal talent development programs are important to train

upper-level managers to become future executive-level successors.

Luthans’ PsyCap model is a performance measurement tool that some

transformational leaders use to motivate and influence followers’ behavior to facilitate

succession planning, which consists of four categorical stages: (a) hope, (b) self-
 19
efficiency, (c) optimism, and (d) resilience (Coggins & Bocarnea, 2015). Hope relates to

employees working cohesively as a team with a set goal to achieve organizational success

(Sahoo, Sia, Sahu, & Appu, 2015). Self-efficiency refers to the employee’s ability to

meet or exceed corporate goals when called upon to serve in an existing or new capacity.

Optimism involves an individual’s assertiveness in knowing their level of capabilities and

weaknesses before committing to a new task or position. Resilience is an individual’s

ability to overcome adversities, organizational conflicts, and transitional changes that can

occur during corporate succession planning.

Therefore, PsyCap model refers to the motivational propensity of transformational

leaders to promote positive change within the organization to maintain stability, which is

a measure of employees’ openness to accepting change and developing the skills needed

to facilitate succession planning. Grant (2012) claimed that transformational leaders not

only increase employees’ engagement but their overall work-related performance.

Similarly, Doh, and Quigley (2014) stated that empowering employees to lead through

the implementation of internal career training programs could improve organizational

performance and loyalty. Therefore, transformational leaders are exemplary individuals

who empower followers to excel beyond the goals of the organization through knowledge

sharing, teamwork, and in-house career development programs to facilitate executive-

level succession planning within their hospital.

 20
Succession Planning

Illustrated in Figure 1 is a graphical representation of succession planning and the

factors that are of relevance in developing and maintaining a non-disruptive transitioning

of power in the healthcare sector.

Figure 1. Succession planning process (OPM.Gov,2015)

Succession planning is an important business strategy used by corporate leaders to

identify, select, and retain qualified employees to ensure leadership continuity at the

executive-level (DuPlessis, Nel, & San Diego, 2013). The Census Bureau (2015) reported

that approximately 44.7 million Americans retired in 2013 with a projected population of

retirees totaling 98.2 million by the year 2060. Moreover, Boveda and Metz (2016) noted

that an estimated 76 million Americans are approaching retirement, and by the year 2022,

an additional 3.9 million workers will be among the group of retirees. In addition, the

Generation X population, which is approximately 80% of the workforce is also

 21
approaching retirement age, which makes the facilitation of succession planning a

priority to ensure a continuum in leadership (Boveda & Metz, 2016). Determining the

effectiveness of succession planning requires leaders within an organization to develop a

robust workforce at all levels of the corporate hierarchy where the articulation of job

expectations is evident and leaders demonstrate an unwavering willingness to cross-train

and support incumbent decision makers (Bogdány, Balogh, & Csizmadia, 2014). One

poignant aspect of succession planning is that it promotes leadership continuity through

career development and knowledge transfer to accommodate the changing dynamics of

the workforce as baby boomers transition from the workforce into retirement.

Developing talented employees for future leadership positions creates a unique

nexus between leadership development and employee engagement to boost corporate

performance and profitability (Marcoux, Guihur, & Koffi, 2016). As a result, most

experienced business leaders utilize the architectural framework of succession planning

to reveal gaps in leadership continuity and productivity (Chaturvedi, 2016; Duh, 2014;

Trepanier & Crenshaw, 2013). Assessing organizational talent and skills involves the

development of in-house strategies that identifies future executives with the expertise to

recognize opportunities and threats that can influence the company’s long-term

performance in the industry (Meneses, Coutinho, & Pinho, 2014). Therefore, the vetting

of new healthcare executive-level leaders requires careful preparation to ensure that the

incumbent shares the core values of the corporation, and displays the skill, and

knowledge needed to execute assigned tasks autonomously.

 22
Leaders who fail to implement succession planning expose their organizations to

risks in productivity, performance, and uncertainties in leadership continuity in the

absence of a highly skilled successor (Gans, 2016; West, Smithgall, Rosler, & Winn,

2016). Therefore, executive board members should take the preemptive step to invest into

succession planning to ensure stability in leadership, corporate core values, knowledge

transfer, and the maintenance of a high level of competency within their workforce

(Oladapo, 2014). Disruption in leadership continuity can lead to a decline in workplace

morale escalating to a loss in corporate productivity and profitability (Gans, 2016). The

absence of succession planning according to Dunham-Taylor (2013) could adversely

affect the organization’s overall productivity and profitability.

Cricelli, Greco, and Grimaldi (2014) stated that business leaders have a duty to

align corporate goals and vision with the needs of human and intellectual capital to

maintain a continuum in business performance and leadership. Grider, Lofgren, and

Weickel (2014) proffered, leaders secure their investment in employees by evaluating,

grooming, and motivating potential successors to prevent a disruption in the corporation

values, and knowledge capital to maintain a competitive edge in the healthcare industry.

Therefore, hospitals that employ and practice succession planning could retain a higher

percentage of talented employees through the retention of knowledge capital.

Succession planning prepares leaders for unexpected changes within their

workforce to promote continuity in leadership to ensure stability (Gibson, 2016). Failures

in succession planning due to a disturbance in the corporation core values, norms, and

policies could promote an atmosphere of instability and uncertainty in the long-term

 23
growth and performance of the organization (Checkland, McDermott, Coleman, &

Perkins, 2016). The United States 2016 presidential outcome revealed that rapid changes

in traditional norms and values could instill fear, instability, and unrest among Americans

who lack optimism in the leadership direction of their country (Rasmussen Reports,

2017). Similarly, effective leadership within the healthcare industry requires a level of

consistency in traditional corporate norms and cultural values to prevent an inexorable

turnover of executive-level leaders who fail to support the leadership direction of the new

incumbent (Oladapo, 2014). In addition, the decentralization of leadership function

within the healthcare industry has created a fragmented effort to promote succession

planning because there is not enough emphasis placed on leadership development and

competency to ensure long-term success (Warshawsky & Havens, 2014).

Failures in succession planning occur when there is a vacuum in future leadership,

and poor clarity, and direction in the incumbent governing practices. GE developed a

business culture based on the premise of an exhaustive business approach that identifies

and develops talented leaders for future leadership positions to foster business continuity

and long-term success (Onatolu, 2013). McDonald’s restaurant has a similar ingrained

corporate culture to GE where succession planning is a major component of their

business practices (Behn, Dawley, Riley, & Ya-wen, 2006). The smooth transitioning of

leadership within McDonald’s fast-food industry became evident in 2004, after the

passing of two CEOs within months of each other and the selection of their replacements

weeks later to avoid disruption in traditional business practices (Behn et al., 2006).

Southwest Airline's co-founder Herb Kelleher also embraced the culture of succession
 24
planning to promote organizational stability and profitability by creating a pool of

talented leaders to replace outgoing executives to avoid disruption in leadership (Long,

Johnson, Faught, & Street, 2013). Contrary to GE and McDonald’s ingrained culture of

succession planning, Intel Corporation abandoned their legendary practice of succession

planning after the appointment of an external president for their Client and Internet of

Things (IoT) Businesses and Systems Architecture group that led to a reduction in profit,

and the resignation of top executives within their organization (Kim, 2016; Rogoway,

2016). Therefore, succession planning not only promotes business continuity but a

continuum in leadership development and career advancement.

The process of succession planning can induce changes in policies and

management, which can affect workplace morale and confidence. However, disruption in

leadership could also promote the benchmarking of talent-management to encourage

leadership transitioning. Therefore, the retention of corporate norms and values helps to

reduce the loss of an unplanned or planned departure of key leader within the

organization (Sinkin & Putney, 2014). Moreover, leadership development from a pool of

talented employees is the caveat needed to facilitate succession planning.

Mentoring and Succession Planning

Mentoring and succession planning involves the grooming of talented employees

through internal training and development for a future leadership position (Pandiyan &

Jayalashmi, 2016). Numerous healthcare organizations have promulgated the benefits of

internal mentoring and have provided the necessary training tools for career advancement

(Kaehr-Serra & Borzillo, 2013). Mentoring is one aspect of succession planning that is
 25
not siloed because it builds a long-term legacy of leadership and knowledge retention to

prevent organizational disruption during the transfer of power (Ngomane & Mahlangu,

2014). Effective leadership requires adherence to a mentoring program to retain

knowledge capital and a continuum in leadership to facilitate succession planning.

Succession planning in the healthcare industry promotes a cultural model of

continuous leadership and development (Samei & Feyzbakhsh, 2015; Warshawsky &

Havens, 2014). Healthcare executives use this model to identify and develop talented

employees to increase retention and to ensure continuity in leadership if a key executive

suddenly resigns (Taha, Gajdzik, & Júlia, 2015). Establishing a corporate mentoring

program for healthcare executives is a guided career pathway that promotes leadership

progression based on the scope for advancement within the healthcare industry (Minnick

et al., 2014). Agarwal and Islam (2015) posited, organizations nationwide have realized

the importance of workplace mentoring and the value it attributes to the retention of

corporate knowledge and culture in a cost-effective fashion. Therefore, as the

demographics of the workplace continue to change, internal mentoring will ensure a

continuum of workplace competency and leadership development.

Corporate healthcare mentorship programs not only prepare leaders to become

future executive-level successors but also encourage career growth through job rotations

across the hierarchical ranks of the organization (Goldman, Scott, & Follman, 2015).

Mentoring according to Agarwal and Islam (2015) is one of the most efficient ways to

eliminate the knowledge and cultural gaps that commonly exist in succession planning

especially during the transfer of leadership. In addition, mentoring new leaders could
 26
minimize disruption in leadership continuity and knowledge capital, by systematically

identifying and retaining talented employees (Samei & Feyzbakhsh, 2015).

Prestia, Dyess, and Sherman (2014) posited, leadership readiness occurs when

leaders prepare potential successors for leadership positions through coaching and

mentoring programs to facilitate succession planning. Therefore, a more robust mentoring

program could promote career advancement that increases employees’ confidence, retains

talent, and reduces internal conflicts during the transitioning of power. In addition, the

legacy of knowledge capital passed down by former leaders represents an imprint of the

organization’s workforce.

Leadership Readiness

As baby boomers approach retirement age, organizations are trying to eliminate

the knowledge gap by implementing succession planning as a healthcare tool to maintain

continuity in leadership (Schulz & Enslin, 2014). In an era of technological advancement,

hiring freezes, and changes in the workforce demographics, it is important for leaders

within organizations to develop a strategic plan that involves knowledge retention to

promote leadership readiness that facilitates succession planning (Cole & Harbour, 2015).

Hospital executives like most lawmakers participate directly in the optimization and

implementation of policies and procedures to improve the governing of their healthcare

institution (Shaw, Asomugha, Conway, & Rein, 2014).

The structure of an organization at the healthcare executive-level requires a

hierarchical pattern of communication during the transfer of power to improve decision-

making and competency in leadership (Brennan, Conway, & Tavenner, 2014).

 27
Succession planning is essential when selecting a successor to govern and make critical

healthcare discussions that could influence the company’s longevity and performance

(Lorenzoni, Belloni, & Sassi, 2014). Reports showed that only 50% of healthcare

institutions practiced succession planning (Kim, 2012). This failure in leadership

readiness is often due to a lack of identification and development of internal talent to

shape the decision-making of future leaders to ensure organizational success.

Leadership readiness is critical to organizational change because it involves risk,

uncertainty, and discomfort when successors proceed to explore new options to manage

change (Boyd, Botero, & Fediuk, 2014). Boyd et al. (2014) further stated that there is no

one best way to prepare for leadership readiness. Al Shamsi, Dixon, Hossan, and

Papanastassiou (2015) determined, one organization’s leadership readiness approach may

not be a panacea for all healthcare institutions based on the constant changing dynamics

of healthcare facilities. Leadership readiness is a pre-requisite for assuming a leadership

position, which requires the new incumbent to be an expert in evaluating and formulating

justifiable decisions that punctuate the importance of hospital succession planning based

on knowledge and experience acquired. Therefore, leader readiness is a process of

continuous change that prepares future leaders with the training and knowledge needed to

construct a blueprint for corporate success.

Leadership Shortage

Finding a replacement for key leaders within an organization may present

challenges for the healthcare community because some organizations across the United

States fail to address the problem surrounding the shortage of qualified leaders (Walker
 28
& Forbes, 2014). Gray (2014) revealed the solution for retaining the skills and expertise

of key leaders within an organization is the early identification and grooming of talented

employees to eliminate the cost of external hire. Kumar and Moorthy (2015) reported that

employees’ feel empowered when they are recognized and mentored to work

autonomously for future leadership positions. Therefore, recognizing and routinely

identifying the best-fit candidates for internal leadership opportunities adds value to the

organization and eliminates the gap in leadership replacement.

Additionally, strategically designing a framework for leadership succession

planning might be instrumental in the grooming of talented employees with the

leadership skill-set needed to replace outgoing leaders. Cairns (2011) stated that years

ago organizational leaders were the only decision-makers in the selection and grooming

of a potential leader, which led to selection bias, the practice of nepotism, and

deterioration in corporate morale. Cairns further stated that effective succession planning

requires a thorough assessment of the potential leaders' current level of skills and

competence to ensure stability in leadership and corporate performance. Designing and

executing a well-developed program tailored to the grooming of executive-level leaders

maybe instrumental in retaining talented employees, promoting knowledge transfer and

preventing leadership shortage to maintain a competitive edge in a highly lucrative

healthcare industry.

Knowledge Transfer

Knowledge transfer is the ubiquitous sharing of knowledge acquired from leaders

within the organization through mentoring, training programs, and networking to improve
 29
the efficiency of the organization (Kao, Rogers, Spitzmueller, Lin, & Lin, 2014).

Knowledge transfer also enables the exploitation of existing knowledge from leaders to

promote a continuum in organizational success. Knowledge transfer is one of the most

important strategies used by healthcare executive-level leaders to facilitate succession

planning and foster a competitive edge (Shaari et al., 2014; Xu, Quaddus, & Gao, 2014).

Knowledge transfer is not necessarily a replication of knowledge but instead a

modification of existing knowledge to strengthening communication and skills gained

from outgoing leaders to a new generation of top executives.

To prepare skilled workers for future leadership positions tacit knowledge transfer

is an important tool used by leaders to maintain knowledge capital and facilitate

succession planning (Donate & Sánchez de Pablo, 2015). Patidar et al. (2016) claimed

that knowledge transfer acquired internally could promote innovation and a higher level

of performance. Therefore, knowledge transfer not only improves the productivity and

profitability of organizations but it also enhances the company’s core values.

Knowledge transfer according to Donate and Sánchez de Pablo (2015) is a

strategy organization leaders use as a measure to maintain productivity and efficiency.

Knowledge transfer is critical to facilitating succession planning, promoting

organizational efficiency, making informed decisions, and supporting role modeling

(Donate & Sánchez de Pablo, 2015). Pobst (2014) proffered that the sudden departure of

key leaders within an organization could adversely affect the transfer of knowledge to

potential successors. Hall-Ellis (2015) stated that leaders should forecast the approximate

departure of key leaders to facilitate succession planning and knowledge capital.

 30
Kamaruzzaman, Zawawi, Shafie, and Mohd Noor (2016) expressed, a disruption in

knowledge transfer could present challenges for potential leaders within the healthcare

industry because knowledge transfer is one of the most viable solutions to retaining

corporate talent and performance. Therefore, mentoring programs are critical to

knowledge transfer, which is a component of talent management used to influence the

long-term survival of an organization.

Absence of Succession Planning

The absence of succession planning could have a catastrophic effect on a

company’s financial sustainability. Succession planning is selecting the best fit for a

future leadership position. Santora et al. (2015) argued that the sudden departure of

executive-level leaders disrupts corporate continuity if the retention of knowledge and

skills is lost without identifying a possible successor who perpetuates the cultural values

of the organization. Durst and Wilhelm (2012) further stated that the succession of

internal employees builds trust, competency, strengthens corporate culture, and supports

leadership style decision-making. Therefore, the dangers associated with knowledge

attrition are instability in the workforce among leaders, which could affect the financial

stability and longevity of the organization.

Santora et al. (2015) favored internal over external successors because they

believed that outsiders could disrupt investors’ confidence in the company by not sharing

the same values and vision for success. Gandhi and Kumar (2014) stated that the

development of internal leaders is essential to the retention of business knowledge and

values to maintain a competitive edge in the industry. Therefore, the lack of succession
 31
planning can promote a gap in leadership between the implementation and the benefits of

succession planning due to the absence of in-house training and development programs to

groom future leaders.

Bowen (2014) stated that only 51% of hospitals surveyed conducted succession

planning despite having a 20% leadership turnover rate that promotes disruption in

management and leadership continuity. Patidar et al. (2016) also provided supportive

evidence that showed a staggering 55% out of 22,717 hospitals surveyed practiced

succession planning and the positive impact this implementation had on the company’s

financial performance and talent retention. Therefore, the absence of succession planning

could result in the selection of an ineffective leader and low corporate performance.

Bowen (2014) further stated that continuity in leadership first begins with the

hiring and grooming of top talent through internal training and development programs to

maintain organizational sustainability. Similarly, Patidar et al. (2016) favored the

retention of intellectual capital through internal training and mentoring of prospective

successors to facilitate succession planning. Therefore, the absence of capable leaders

within the healthcare industry could hinder the growth and viability of the organization in

the absence of succession planning (Dole, 2015). Therefore, leaders within healthcare

organizations should promote internal training and development programs to facilitate

succession planning. Furthermore, the absence of succession planning affects not only

corporate performance and retention of talent but also the workplace morale among

potential leaders.
 32
The Benefits of Succession Planning

Kim (2012) stated that succession planning promotes leadership continuity and

accountability to minimize risk associated with the sudden changeover of organizational

leadership. Succession planning also prepares the next generation of executive-level

leaders to assume the challenges of corporate restructuring to reduce workplace

disruption (Tabatabaee, Lakeh, & Tadi, 2014; Zepeda, Bengtson, & Parylo, 2012).

Marbury and Mayer (2013) noted, succession planning in-house mentorship programs not

only instills competence but it promotes training opportunities for middle-level managers

to assume leadership positions to ensure corporate sustainability.

According to Kim (2012), fostering on the job training is an excellent way to

improve productivity and stakeholders’ confidence in the financial health and stability of

the organization during the untimely departure of key leaders. Marbury and Mayer (2013)

further stated that companies failing to implement internal succession planning were

preparing to fail as senior leaders become eligible for retirement, and begin to exit the

workforce. In addition, external leaders bring their own culture and vision for success to

the firm that could threaten the viability of the organization.

The benefit of succession planning is that it serves as a contingency plan for the

immediate replacement of a key executive from a pool of talented leaders (Kim, 2012).

As senior executives approach retirement age, they are encouraged to mentor middle-

level managers for targeted leadership positions to retain highly skilled and qualified

workers (Kim et al., 2012). Succession planning is critical at all levels of the hierarchy to

prevent loss in productivity and internal conflict during the transitioning of middle-level
 33
managers to executive-level leaders. The loss of highly skilled workers by way of

retirement, resignation, illness, or sudden death can have a catastrophic impact on the

financial health, stability, and daily operations of a hospital facility.

The implementation of succession planning through proper internal training and

development programs could eliminate any corporate instability associated with the

departure of baby boomers from the workforce (Winship, 2012). Therefore, the benefits

of succession planning are the ability to groom and identify employees with the skills,

knowledge, and competency to assume a leadership position.

Recruitment of External versus Internal Leaders

Balsmeier, Buchwald, & Zimmermann, (2013) stated that there is a greater

demand for the hiring of external CEOs based on their impeccable reputation in boosting

performance, experience, and ingenuity in mitigating corporate risk. Thompson and

Flynn (2014) supported the theory that external leaders bring value and experience to an

organization by introducing innovative ways of thinking to improve performance

measures typically overlooked by a new successor. Therefore, external executive-level

leaders could interject new ideas and skills that could improve the firm’s performance

and profitability.

Another attribute of hiring an outside executive-level leader, according to

Balsmeier et al. (2013), is their lack of leniency in replacing underperforming internal

leaders who do not exhibit a vested interest in corporate values and goals. Thompson and

Flynn (2014) posited that there is also a significant financial risk associated with offering

extensive training and development programs to potential internal successors if they

 34
abruptly resign before contributing to the growth of the organization. Rachpradit, Tang,

and Khang (2012) reported that hospital executives found external successors preferable

because they are impartial and fearless in challenging the ability of the management team

to ensure consistency in productivity and financial stability. Moreover, the training of an

external leader could be shorter and less costly if already knowledgeable of the

organization.

Horner and Valenti (2012) stated that external successors are more suitable for

corporate executive-level positions because of experience gained over the years from

serving as a board member while overseeing the firm’s fiscal performance. This duality

in a function makes the hiring of external executives an asset to the corporation. Another

reason why leaders within an organization prefer external executives to internal

successors is that the firm overall performance reflects the brand the CEOs bring to the

organization (Flatt et al., 2013). Nevertheless, external hires require training to ensure

that the individual acquires the knowledge needed to maintain a continuum in leadership.

On the contrary, some organizations favor internal successors because they are

already familiar with the firm’s culture, and vision, through years of grooming for an

executive-level leadership position (Horner & Valenti, 2012). In-house training and

development programs provide a plethora of resources and support to nurture a high level

of competency for prospective successors during the transitioning of power (Rachpradit

et al., 2012). The implementation of succession planning promotes stability in leadership

to overcome a myriad of challenges that typically produce barriers during the

transitioning of new incumbent (Rishel, 2013).

 35
Enslin and Schulz (2015) reported that the annual cost of replacing an executive-

level employee is approximately 250% of the executive’s annual salary. Therefore, to

reduce the cost of employee turnover, healthcare facilities adopted a culture that

embraced internal succession planning thereby increasing employees’ engagement,

retention of talent, and team loyalty (Duffy & Carlin, 2014).

Day et al. (2014) stated that the strength of future leaders is dependent upon the

skills and training they received internally to maintain a competitive advantage in a

lucrative healthcare industry. Enslin and Schulz (2015) further stated that succession

planning not only create a trusting relationship between executive-level leaders and

employees but it mitigates loss associated with employee retention by creating

transparency in career development and advancement through internal mentoring.

Barriers and Risk Associated with Succession Planning

According to Cole and Harbour (2015), rural healthcare facilities rarely practice

succession planning because of the limited funding, low salary, minimum staffing, and

the inability to recruit talented applicants at a competitive salary range. Barriers

associated with succession planning include the lack of identification and preparation of

future leaders, which could create a vacuum in leadership if executive-level leaders fail to

provide a lucrative career pathway for employees to excel within their organization

(Veazie, 2015). Businesses that often fail to groom employees for future leadership

positions assume the risk of hiring leaders that may not maintain organizational growth

and financial stability (Orner & Barr-Marinetti, 2016).

 36
Cole and Harbour (2015) stated that the government only attributed 3.3 cents of

their medical dollar to rural public healthcare facilities compared to 29.8 cents given to

private metropolitan healthcare centers. This type of misappropriation of government

funds has helped to deter applicants from careers in rural healthcare sector coupled with

an aging workforce that does not see the relevance of making succession planning a

business priority (Cole & Harbour, 2015). Evidence provided by McDonagh and Paris

(2012) showed that succession planning is critical to the longevity of healthcare facilities

based on a rapid 17% turnover of executive-level leaders every 4-years that increases the

financial vulnerability of the organization.

The high turnover rate of healthcare executives has also created a substantial gap

in supply and demand for talented employees. Therefore, employers have a duty to

identify and promote internal talent to ensure the retention of competent successors to

replace outgoing leaders (Enslin & Schulz, 2015). The lack of succession planning

promotes organizational barriers that involve limited retention of knowledge capital,

talent, and opportunities for career growth, which is a corporate legacy for future

successors (Miltner, Jukkala, Dawson, & Patrician, 2015).

Longenecker, Longenecker, and Gering (2014) stated that hospital executive-level

leaders frequently encounter unprecedented changes in healthcare policies and

technology that create financial barriers, in recruiting external talent, thereby making

internal training and retention of employees a cost-efficient catalyst for increased

performance. Talib and Rahman (2015) stated that employees’ resistance to change as

well as stakeholders concern about the longevity of the organization promotes internal
 37
barriers because some executive-level leaders fail to support a career path for internal

leadership progression associated with succession planning. Eliminating barriers and

risks associated with succession planning requires the implementation of talent

management drivers that identifies, selects, and creates future leadership opportunities for

talented middle-level managers to facilitate succession planning.

The Importance of Retaining Human and Intellectual Capital

Corporate succession planning provides a pathway for leadership development

and the retention of intellectual capital to ensure that healthcare facilities maintain a

competitive edge in a monopolistic industry (Patidar et al., 2016). A strong organizational

culture promotes the internal development of leaders with shared goals, vision, and a

wealth of corporate knowledge, to facilitate succession planning (Cricelli et al., 2014;

Onatolu, 2013). Therefore, the grooming of potential successors for future leadership

positions would narrow the knowledge gap needed to maintain corporate competency and

stability.

Patidar et al. (2016) further stated that human capital is having the knowledge and

skill-set of all facets of the firm’s daily operations to prevent disruption and instability

during corporate restructuring and the exiting of baby boomers. According to Birk

(2013), knowledge sharing among leaders and potential successors is the foundation for

developing trust and retention from a pool of talented leaders to ensure organizational

success. The retention of human capital is essential for organizational growth and

sustainability because it reduces the leadership gap for executive-level positions during

the transitioning of power by creating internal career opportunities and development

 38
programs (Desai & Jayakrishnan, 2014). Healthcare facilities that invest in human and

intellectual capital through internal development and exploitation of shared knowledge

decrease the firm’s exposure to failures in productivity and profitability associated with

the replacement of a new successor (Thompson & Flynn, 2014).

The retention of talent, according to Singh and Sharma (2015), is one of the

primary metrics surrounding the preservation of human capital that improves business

performance in a cost-efficient manner. Desai & Jayakrishnan (2014) further stated that

the implementation of succession planning supports one of the best corporate practices

that align employees’ career goals with corporate economic growth and restructuring to

prepare future successors for executive-level leadership positions.

Summary

The objective of this qualitative case study was to explore the importance of

executive-level succession planning and strategies use to prepare and retain talented

employees for future executive-level positions in a NYC hospital. DuPlessis et al. (2013)

proffered that leaders who embrace the practices of succession planning within their

organization will be able to identify and develop future leaders to maintain organizational

sustainability. This case study will reveal that the implementation of succession planning

prepares healthcare leaders for future executive-level positions. However, disruption in

talent retention and knowledge capital can affect the grooming of potential leaders if

succession planning was lacking in the healthcare industry. Therefore, corporate leaders

need talented employees with the knowledge and skills to not only replace outgoing

executive-level leaders but to maintain the retention of knowledge capital to improve

 39
performance. The benefit of succession planning is that it prepares employees for future

leadership positions and provides a more in-depth understanding of why leaders embrace

executive-level succession planning. If hospital leaders want to maintain organizational

performance and retain knowledge capital for future executive-level leaders, successful

strategies are necessary to facilitate succession planning.

The implementation of succession planning and mentorship programs within

hospitals may develop better selection criteria for future leaders to facilitate succession

planning. Being able to select from a talented pool of potential leaders promotes

leadership readiness and assurance that the absence of a key leader will not disrupt the

performance of the organization. The objective of the above conceptual framework was

to explore the efforts associated with the development of succession planning for

transformational leadership and the maintenance of organizational sustainability.

Succession planning and transformational leadership complement each other and have

similar characteristics that could improve workplace performance, cultural norms, and

employee engagement. Therefore, succession planning facilitates the identification of the

best fit from a pool of talented leaders and provides a greater opportunity for selecting

future leaders.

Transition

This study revolves around successful strategies executive-level leaders use in a

NYC hospital to facilitate succession planning to foster the retention of talent, improves

performance, and reduce external hiring cost (Durst & Wilhelm, 2012; Harvey, Parry, &

Vorbach, 2014). Succession planning is rarely practiced in most metropolitan hospitals

 40
although this strategy promotes corporate survival and minimizes the gap in executive-

level leadership (Kim, 2012; Liang et al., 2012). The lack of succession planning could

have a catastrophic effect on the financial health of an organization especially in the

sudden absence of a key leader based on the high reported turnover rate of healthcare

executives (Orner & Barr-Marinetti, 2016).

Researchers who examined the problems of succession planning offered solutions

that involve the hiring, and retention of talent, in-house training, and development

programs for leadership advancement (Flatt et al., 2013). This proposed case study

supports the problem and purpose statement and revolves around how NYC hospital

executive-level leaders view the implementation of succession planning. In addition, the

use of a healthcare institution's analytic framework at the executive-level promotes a

more in-depth examination of the barriers and financial risk associated with unsuccessful

strategies used to facilitate succession planning.

 41
Section 2: The Project

Succession planning allows corporate leaders to identify and retain qualified

employees for executive-level leadership positions (DuPlessis et al., 2013). In Section 1

of this study, I focused on the background, problem statement, purpose statement, nature

of study, research question, research methods and design. Transitioning to Section 2, I

provide descriptive details of the study, which encompasses the role of the researcher,

research methodology, participants, ethics, population sampling, and data collection to

determine the reliability and validity of the qualitative case study.

Purpose Statement

The purpose of this qualitative single case study was to explore the successful

strategies executives used to facilitate executive-level succession planning within their

hospital. The specific population was three upper-level hospital executives located in a

NYC hospital who have a record of accomplishment in facilitating corporate succession

planning enabling employees to become leaders within their community who could

influence positive employee engagement and increase creativity, and productivity (see

Patidar et al., 2016). The findings from this study served as an educational tool for

executive-level hospital leaders and stakeholders to promote awareness about the

importance of retaining corporate talent, which benefited the community served by the

hospital and can incentivize caregivers to remain on the job delivering quality care to

patients.
 42
Role of the Researcher

As a researcher, I had a duty to be reflexive when interviewing participants to

avoid biases and transference of emotions or thoughts that could interfere with the

authenticity of the data collection (Lyngsnes, 2016). However, the primary role of a

researcher is data collection through a semistructured, face-to-face interview in a

qualitative research study. The identification and elimination of biases are essential in

preserving the integrity of the data collected. Therefore, my relationship with participants

was to be an impartial facilitator who documents, digitally records, reviews, and

transcribes verbatim the participants’ viewpoints of succession planning within their

hospital without violating any ethical principles. According to Takyi (2015), researchers

have an ethical obligation to avoid over sensationalizing specific elements of the

interview to ensure factual reporting of data collected.

The Belmont Report code of ethics refers to researcher’s adherence to the

principles of beneficence, respect for person, and justice (Bromley, Mikesell, Jones, &

Khodyakov, 2015). Researchers have a duty to protect participants from harm by

ensuring that the benefit outweighs the risk and goal of the research study. Participants

were free to withdraw at any time during the study, but no participants withdrew from the

study. Respect requires treating each participant with courtesy, so I emphasized that

participating in the research study was voluntary with no monetary incentive (see

Judkins-Cohn, Kielwasser-Withrow, Owen, & Ward, 2014). Justice ensures the fair

selection of participants who voluntarily agree to participate in the study (Bromley et al.,

2015; Judkins-Cohn et al., 2014).

 43
Researchers have a moral obligation to maintain the integrity and quality of the

data collected in an unbiased fashion to achieve the goal of the research (Yin, 2014). In

this single site qualitative study, I avoided any form of coercion or the use of leading

questions during the interview process to mitigate biases that could compromise the

reliability and validity of the data analysis. In addition, I was cognizant of personal biases

or preconceived notions regarding the research study during the interview process and

transcript review to preserve the authenticity and credibility of the research data. The

purpose of this single site qualitative study was to identify strategies executive-level

leaders use to facilitate succession planning.

The interview questions could instill social change by providing new insights and

perspectives on how community business leaders are preparing to promote the practice of

succession planning within their community as a solution for retention of talent and

knowledge capital (Kim, 2012). In addition, the interview protocol enabled a structured

flow of relevant questions to each participant to eliminate biases, thereby enhancing the

richness of the data collection and analysis.

Participants

In this qualitative case study, I interviewed three hospital executives with

leadership responsibilities ranging from overseeing the daily operations of the hospital to

serving as an educator and coach for middle-level managers to facilitate succession

planning. Study subjects’ inclusion criteria involved serving in an executive role at a

NYC hospitalwith at least 5 years of leadership experience and a record of

accomplishment in retaining talented employees based on retention records. I excluded

 44
managers who were not a part of the executive leadership team because they might not be

directly involved in the facilitation of succession planning, especially during a leadership

crisis. Data collected from interviews provided varied opinions from participants,

promoting an in-depth understanding of the criteria pertaining to knowledge transfer and

the retention of talent within NYC hospitals (see Neuman, 2014). According to Yin

(2014), Ferrazzi and Krupa (2015), and Defeo (2013), researchers conducting qualitative

case studies have an obligation to ensure that participants are knowledgeable about the

research phenomenon to ensure accuracy and authenticity in data findings. I recruited

study participants using purposeful sampling to increase the richness of the data collected

from executive-level leaders with at least 5 years of leadership experience in the field of

healthcare.

Purposeful sampling allows researchers to collect and effectively use information

rich data from experts in the field of study. (Duan, Bhaumik, Palinkas, & Hoagwood,

2015; Palinkas et al., 2015). Purposeful sampling applies directly to a qualitative case

study and refers to participants with the knowledge and skills to provide relevant insights

into the research question (Patton, 2015). I contacted one NYC hospital where I have an

existing connection with staffers to gain access via e-mail to top executive-level leaders

with the knowledge and skills to provide successful strategies used to resolve the problem

of succession planning within their hospital. The identified participants received a brief

synopsis of the study objective and recruitment procedures via e-mail inviting them to

participate voluntarily in the research study once I received Institutional Review Board

(IRB) approval. Signed consent forms received from participants is an agreement that
 45
establishes an explicit understanding of the nature of the study, Walden’s ethical

principles, and expectations with face-to-face interviews and review of documentation. I

encoded participants’ identifiable information and will retain in a separate encrypted

password protected computer file for at least 5 years after completion of the study before

destroying the data. Maintaining the confidentiality of participants promotes trust and

respect and ensures a vibrant and honest working relationship. It is imperative to establish

an adequate level of communication and flexibility between the researcher and

participant to promote a healthy working relationship (Smith, 2012; Yin, 2014). In

addition, I developed a rapport with participants by encouraging them to share their

perspectives on the research question openly and to respond freely without interruptions

to open-ended interview questions to increase the depth and breadth of the study. The

intent of this study was to reach potential participants who are leaders within their

organization for over a decade with direct involvement in successfully facilitating

succession planning within their hospital.

Research Method and Design

The purpose of this single site, exploratory qualitative case study was to identify

the strategies executives used to facilitate succession planning within their hospital. The

method and design provided insight pertaining to the research question. Therefore, I will

provide descriptions and justifications of the method and design used to conduct this

qualitative research study.

 46
Research Method

Researchers can conduct quantitative, qualitative, or mixed methods studies (Yin,

2014). Quantitative research enables researchers to collect and use numerical data for

testing of theories or hypotheses (Arghode, 2012). A quantitative method was not

appropriate for my study because I did not test a theory or hypothesis. Furthermore, a

quantitative approach lacks the thoroughness of a personal, in-depth face-to-face

interview. A qualitative method permits the use of semistructured, open-ended interview

questions to explore participants’ viewpoints, while a quantitative approach relies on

statistical testing of variables (Singh, 2015). Although a quantitative method captures

more data from participants, the richness of the data collected from a qualitative method

was more appropriate for this study. The mixed method is a combination of both

qualitative and quantitative (Yardley & Bishop, 2015); however, because I performed a

qualitative studywithout the need for quantitative data, a mixed method design would

have deviated from the explorative nature of my research study.

A qualitative method was the best choice for my research because it promotes

understanding and clarifies the interpretations of social business problems ascribed to a

selected group of individuals (Cibangu, 2013). A qualitative approach develops

knowledge and explanations of human behavior by using a diverse sampling method,

instead of the tailored approach used in a quantitative study (Marshall & Rossman, 2016).

The rationale for choosing a qualitative method was to provide a methodological

framework to explore successful strategies executive-level leaders use to promote

succession planning. Because succession planning is vital to maintaining a pool of

 47
talented candidates for future leadership positions, the intent of this case study was to

develop an in-depth understanding of executive-level succession planning strategies

using a qualitative approach. The qualitative approach allowed the collection of rich data

and the development of an understanding of the phenomenon under investigation.

Research Design

I choose a single case study design to explore the successful strategies executive-

level leaders use to facilitate succession planning. The uniqueness of this case study

design is that it allows researchers to gather data obtained from interviews, and

observations of participants to gain an in-depth understanding of the phenomenon under

investigation (Yin, 2014). A case study design is the development of an in-depth analysis

that focuses on a single experience (Sarma, 2015). The aim of this research was to use

data collected on the research problem to gain a better understanding of the phenomenon

based on the participants’ experience and viewpoint (see Janghorban, Roudsari, &

Taghipour, 2014). For this reason, a case study was the most suitable design to

demonstrate successful strategies executive-level leaders use to facilitate succession

planning.

I did not choose narrative, ethnography, or phenomenology research because they

were not suitable for my study design. The narrative approach describes data collected

from documented stories (Lohuis, Sools, van Vuuren, & Bohlmeijer, 2016). Because I

did not explore participants’ life history, the narrative design was unsuitable for my

study. Ethnography involves data collection from a specific cultural group by observation

or interaction (Houghton, Casey, Shaw, & Murphy, 2013). Ethnography was not suitable
 48
for my study because the focus of this design circumference around understanding a

phenomenon to improve business practices. Similarly, a phenomenological design refers

to participants’ lived experiences in the absence of strategic measures (Arbour &

Wiegand, 2014). I considered the use of a phenomenological design, but the focus of this

study was not on lived experience but on successful strategies executive-level leaders use

to facilitate succession planning; therefore, the phenomenological design did not fit the

purpose of my study.

Data saturation in qualitative research is the continuous collection of data until no

new ideas, themes, or concepts emerge to answer the research question (O’Reilly &

Parker, 2013). Marshall, Cardon, Poddar, and Fontenot (2013) stated that the richness of

the data collected is more important than the quantity because failure to attain data

saturation in a qualitative study could affect the quality and validity of the research study.

Yin (2014) proffered that more than two participants could enhance the richness of a

study. Therefore, to ensure data saturation, I conducted member checking after

completing the interview process to afford all three participants the opportunity to

review, append, and confirm the accuracy of data collected until no new information

emerges. According to Cleary, Horsfall, and Hayter (2014) justification of data saturation

occurs when the researcher can no longer gather any new information during the

interview process. Because there were no predetermined limits on identifying data

saturation, I reviewed and analyzed all notes and transcripts obtained from participant

interview using coding techniques to identify data saturation. In addition, I asked all three

participants the same open-ended interview questions to aide in achieving data saturation.
 49
Population and Sampling

The population I studied was executive-level leaders within a NYC hospital. The

participants consisted of a pool of three executive-level leaders with each having at least

5 years of leadership experience and a record of accomplishment in retaining talented

employees based on retention records. An exploratory single case study design is

appropriate if participants share the same level of experience and background(Yin, 2014).

Gentles, Charles, Ploeg, and McKibbon (2015) and Neuman (2014) stated that there are

no minimum or maximum participants required to achieve data saturation in a qualitative

study. Therefore, I used a sample size of three participants with at least 15 years of

combined experience and knowledge that relates to the research question to enrich

possibly the data collection efforts to attain saturation. Neuman further stated that

qualitative research refers to the depth rather than breadth to allow researchers the ability

to develop a comprehensive understanding of the phenomenon. Similarly, Palinkas et al.

(2015) stated that a qualitative method allows the researcher to gain an in-depth

understanding of a phenomenon. Therefore, I collected and analyzed data from each of

the three participants obtained during individualized face-to-face interviews until there

was a commonality in themes relating to the strategies executive-level leaders use to

facilitate hospital succession planning. The use of small sample size in qualitative

research allows the researcher to produce relevant and rich data that can add to the depth

and breadth of the study (Owusu-Bempah, 2014). Gathering and sampling of research

questions could play a pivoting role in determining the homogeneity and saturation of a

sample size (Dube, Roberts-Lombard & Tonder, 2015). Therefore, I used a qualitative
 50
data collection technique that involved the use of open-ended interview questions to

uncover any details about the phenomenon to understand the participant’s viewpoint. I

determined data saturation when participants failed to provide any new information or

themes relevant to the enrichment of the research question. No additional participants

were needed to achieve data saturation.

I used purposeful sampling with the intention of interviewing three executive-

level leaders. Fusch and Ness (2015) claimed that purposeful sampling relies on the

judgmental discretion of the researcher in selecting experienced and knowledgeable

individuals to address the research question. Furthermore, purposeful sampling allows

researchers conducting a qualitative study to gather rich information from participants

(Palinkas et al., 2015). Purposeful sampling also stems from the conceptual framework

and revolves around the research question that addresses not only the phenomenon under

investigation, but also the feasibility, reliability, credibility, and replicability of the study

(Duan et al., 2015). Purposeful sampling is useful in identifying and selecting cases filled

with data rich information (Palinkas et al., 2015). In contrast, the snowballing sampling is

more response driven in a hard to reach population and requires the use of a continuous

chain of participants for the researcher to complete the interview process to attain data

saturation (Siddiqui et al., 2016). Therefore, I conducted a face-to-face interview with

three executive-level leaders from a single hospital location using purposeful sampling to

explore the successful strategies executive-level leaders use to facilitate succession

planning within their hospital is ideal.

 51
The interview venue was a comfortable, familiar restaurant located in close

proximity to the hospital. Brewster (2014) and Yin (2014) contended, a private location is

the most desirable venue to conduct a professional interview to yield the richest

information, while maintaining the highest level of confidentiality. Therefore, I

conducted the interview in a quiet restaurant located in close proximity to the hospital to

minimize interruptions, to ensure confidentiality, and the rich transfer of information

from participants.

Ethical Research

The ethical principles that govern an informed consent are autonomy,

beneficence, and justice that falls under the guidelines and codes of the Belmont Report

(Bromley et al., 2015; Judkins-Cohn et al., 2014). The importance of implementing

ethical guidelines was to ensure that the content of the informed consent was free from

coercion, adheres to the rule of voluntary participation, and written in the native spoken

language of participants to promote understanding and protect vulnerable populations.

Cugini (2015) stated that researchers have a duty to inform participants of their role in a

research study. The identified participants received a written informed consent detailing

the intent of the qualitative research and their voluntary role as a participant via email

once I received IRB approval number 12-11-17-0569928. Consent received from

participants became an agreement that ensures I adhere to the ethical principles of the

study during scheduled face-to-face interviews and document reviews. The inclusion

criterion for participants in this qualitative research study was adult executive-level

leaders who used successful strategies to facilitate succession planning within a NYC
 52
hospital. Both male and female participants were eligible for the study. The exclusion

criterion was employees without any corporate decision-making capability.

The content of the informed consent outlined participant’s ethical concerns

regarding the research study theoretical risk of data breach, confidentiality, benefits, and

their right to withdraw at any time during the study. Judkins-Cohn et al. (2014) stated that

the IRB protects the rights of participants to withdraw at any time during a research study

to maintain the integrity of the study. Therefore, if a participant submits a written

withdrawal request, I would contact the participant to confirm withdrawal before

honoring the request.

There were no monetary incentives given since participation is voluntary. Qu and

Dumay (2011) argued that voluntary participation in a research study does not warrant

the need for compensation. In addition, to strengthening the reliability and validity of the

study, the removal of incentives was necessary to ensure the richness of the data

collected. To make sure that I adhere to Walden’s IRB ethical standards and protection of

participants from harm or breach of confidentiality, I maintained strict security measures

to protect participants’ privacy. First, I assigned each participant with consecutive

alphanumeric codes starting with P101 through P103. Petrova, Dewing, and Camilleri

(2016) claimed that the use of numeric research codes could eliminate the necessity of

identifying participants by name. I was the only person who had access to participant

personal identifier, which I kept in a separate location from the participant’s coded data.

All data received was password encrypted on a protected site on my computer and an

external hard drive. Taking evasive actions to protect participants’ identifiable

 53
information could minimize the risk of a research study breach of participant’s

confidentiality. According to Greenwood (2016), maintaining the privacy and

confidentiality of participants in a study-related research could minimize harm.

Therefore, as the only person knowing who the participants were, I maintained

confidentiality.

Judkins-Cohn et al. (2014) proffered that researchers should strive to protect the

confidentiality and rights of participants. I kept all study data obtained for a period of 5-

years, after completion of the study, and then destroy all files by deleting all information

from my laptop and hard-drive and shredding all hard copies to protect the identity of

participants and their organization. Empowering participants with the option to offer

voluntary informed consent after reading and fully comprehending, the nature of the

study, improves the credibility and reliability of the data.

Data Collection Instruments

The data collection for this qualitative research case study entailed interviewing

three executive-level leaders within a NYC hospital, reviewing strategies used to

facilitate executive-level succession planning, and records of internal leadership

transitioning. Yin (2014) stated that researchers are the primary data collection

instrument in a qualitative study. I was the primary data collection instrument for the

semistructured face-to-face interviews and document analysis. The data collection

consisted of open-ended face-to-face interview questions and web documents related to

the study. Yin, further stated that supplement documents acquired from participants

enrich the information gained from an interview. Similarly, Cleary et al. (2014) claimed
 54
that the interview process in a qualitative study is one of the best ways to obtain rich data.

Michaelson, Mckerron, and Davison (2015) argued that an in-depth semistructured

interview provides understanding of participants’ experiences.

I used face-to-face interviews to address probing questions relevant to the

overarching research question to gain an in-depth understanding of the phenomenon. Use

of open-ended questions in semistructured interviews elicited strategies executive-level

participants use to facilitate succession planning. Yin (2014) noted that interviews carried

out by researchers were essential to explore participants’ knowledge and perception of

the phenomenon. The leadership transitioning records and peer-reviewed journals

provided answers to the research question, and insightful information on participants’

strategic preparation to ensure a continuum in leadership at the executive-level.

Standard research protocol recommends obtaining participants’ permission before

recording an interview (Yin, 2014). I requested written permission from all three

participants to record the interview, which was confidential and later encoded. I

conducted member checking by email with each participant after the completion of the

interview process to ensure that my interpretation of responses received from the

participants were accurate. Cole and Harbour (2015) noted that verification of

information collected from participants increases the accuracy of the analysis. Neuman

(2014) asserted the member checking adds credibility to the research findings. Moreover,

verification of analysis of the transcribed documents by participants confirmed the

reliability and validity of the study (Harvey, 2015; Sarma, 2015). I enhanced the validity

and reliability of the collection instrument by interviewing only executive-level

 55
participants with the authority, knowledge, and experience in facilitating succession

planning. Additionally, the interview protocol served as an administrative guide for the

interview process to ensure consistency, reliability, and validity of the data.

Data Collection Technique

A semistructured face-to-face interview was the data collection technique I used

for my qualitative case study. Wiederhold (2014) determined a semistructured face-to-

face interview was the ideal data collection method for a qualitative study. I scheduled all

three separate meetings at a restaurant located in close proximity to the hospital at a

mutually agreed upon time. Each interview lasted for 30-40 minutes. I reminded each

participant that I would be taking handwritten notes and audio recording the interview

session to ensure the accuracy of data after receiving participant permission by way of an

email stating “I consent”. The audio recording served as a checkpoint for the duration of

each interview. Ridder, Piening, and Baluch (2012) stated that researchers enhance the

quality of their data collection by way of hand written notes, videotaping, and audio

recording. In addition, I restated the research and interview questions in an open-ended

fashion before the commencement of each interview and during the interview to avoid

any deviation from the questions and to enhance the richness of the data received.

Strengthening the data collection technique required reviewing the company’s website to

determine what matrix the organization used to establish succession planning and the

number of executive-level vacancies filled by internal promotions from a pool of

qualified employees. The information gathered from the company’s website served as a

pattern of explanation to validate or refute the data obtained for this study from
 56
participants. At the conclusion of each interview, I thank participants for their time and

effort in assisting with the data collection for my study and immediately terminated the

recording.

The advantage of a semistructured face-to-face interview was the ability for a

researcher to visualize participants’ facial cues, body language, and vocal intonation to

determine the clarity of questions asked and having the capability to rephrase questions to

affirm understanding or alleviate uneasiness. Cole and Harbour (2015) promulgated that

rephrasing questions during an interview enhances the clarity of the response. One of the

disadvantages of the face-to-face interview was that the researcher’s nonverbal cues

could unintentionally influence the participants' responses affecting the reliability and

validity of the study. Cole and Harbour, further stated that the researcher’s body language

could affect the participant's response and behavior during an interview. Additionally,

some participants felt uncomfortable responding in a face-to-face fashion despite the

assurance that all information obtained was confidential and decoded after transcription

to ensure confidentiality of responses.

Member checking involves the researcher reviewing data transcripts including

handwritten notes and providing a summary to participants to solicit feedback on the

authentication of the analysis (Cole & Harbour, 2015). Member checking allowed me to

validate my analysis of participants’ responses and validate the data collection technique.

Participants each received an email request to review and confirm my analysis of their

interview to ensure accuracy and to enhance the validity of the study.

 57
Data Organization Technique

The data organization technique that I employed consisted of using alphanumeric

codes to identify each participant such as P101, P102, and P103 to maintain the secrecy

of each participant’s identity. I stored all raw data in a designated encrypted folder

labeled Walden University Research Study Participant (WURSP), which included

participants’ consent forms, audio recordings obtained by approval, and an interview

protocol. Implementing a coding system to protect the disclosure of participants’ identity

was one of the ways to maintain confidentiality (Yin, 2014). I stored all participants’

encrypted files on a password protected computerized database and backed up on an

external hard drive that I stored securely in a locked file cabinet that only I have access.

Maintaining the confidentiality of interviewees’ information by de-identifying data

received and securely storing the information prevented the risk of disclosure (Mealer &

Jones, 2014). I used NVivo 11 to transcribe and compile each participant’s interview

session for data analysis. Yin (2014) noted a Computer Assisted Qualitative Data

Analysis Software (CAQDAS) is one of the most efficient ways to store and arrange data

obtained from an interview. I safeguard all information gathered, transcribed, and

analyzed for at least 5 years after completion of the study, after which I will permanently

destroy the data.

Data Analysis

Data analysis is the interpretation of recorded data used to organize and

systematically combine data from different sources to test and support the procedural

findings of this research study. Yin (2014) revealed that data analysis includes
 58
compilation, disassembling, and reassembling of data using the analytic software.

Methodological triangulation is the use of multiple sources during data collection to

explore a phenomenon to attain data saturation (Fusch & Ness, 2015; Garcia & Gluesing,

2013). I performed data analysis using methodological triangulation to compare data

collected from interviews, and journal articles to determine the possibility of a common

trend that related to the successful strategies executive-level leaders use to facilitate

succession planning within their hospital. Qualitative research includes the organization,

interpretation, and replicability of raw data (Yin, 2014).

I used NVivo 11 data analysis software to amalgamate data patterns within

responses received from participants and documents analysis. NVivo 11 was a software I

used in my qualitative research study to organize, code, and sort related data to aid with

analysis (Johnson, 2015). Johnson further claimed that NVivo 11 has the capacity to

identify themes based on the analysis of imported data content. Therefore, I used NVivo

11 to assist with the identification of commonalities within data that was not easily

isolated from the transcripts manually. The data analysis for this study began with the

transcription of handwritten notes and verbatim textual documentation of audio recording

to obtain an in-depth understanding of the phenomenon under investigation. I analyzed

the data collected from the interviews that relate to strategies executive-level leaders use

to facilitate succession planning within their hospital to determine how this information

applies to this study. I only conducted data analysis on responses gathered during the

interview process and my review of company documents. The names of the participants

and company did not appear in this study to maintain confidentiality and adherence to the
 59
ethical standards of the IRB. Additionally, I used NVivo 11 to assist in the management

of data and the development of themes obtained from the face-to-face interviews and

analysis of company documents. NVivo software provides analysis, coding, storage, and

the identification of themes to acquire an in-depth understanding of the phenomenon

(Johnson, 2015; Yin, 2014).

I focused the results of the data analysis in this study on the conceptual

framework consisting of transformational theory, in the context of executive-level

succession planning; and further performed a thorough interpretation of themes. Johnson

and Campbell-Stephens (2013) stated that data evaluation correlates with the

interpretation of themes. Therefore, my data evaluation process included the comparison

of themes with current journals and the conceptual framework. The analysis of the

themes coupled with the participants’ experiences and existing literature provided

valuable insights on the importance of executive-level succession planning.

Reliability and Validity

The reliability and validity of research study findings required the use of an

appropriate research method and data collection tool to ensure consistency and accuracy

in data measurement (Noble & Smith, 2015). The reliability and validity of a qualitative

research study necessitated a high level of trustworthiness based on the dependability,

creditability, transferability, and confirmability of the research study (Cope, 2014; Yin,

2014). Therefore, I maintained consistency in documentation and analysis of data to

ensure the reliability of the research. Additionally, I employed member checking to

validate the veracity of the data collection.

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Reliability

Determining the reliability in qualitative research required a degree of precision

and consistency in questions asked during each interview to enhance the trustworthiness

of the study (Havenga, Poggenpoel, & Myburgh, 2014; Sarma, 2015). Study results that

were replicable using similar methods strengthen the reliability of the research instrument

(Leung, 2015). Achieving data saturation improved the reliability of the study by using a

standard interview protocol (see Appendix A) for each participant to eliminate bias,

promote a level of consistency in questions asked, and taking detailed notes to enrich the

dependability of the research study. Marshall and Rossman (2016) stated that member

checking ensures the accuracy of the data collected. Therefore, participants reviewed my

analysis of responses, which strengthened the validity, and reliability of the data, thereby

supporting the dependability of the study findings.

Validity

Determining data validity requires congruence in findings to establish a level of

trustworthiness in the study (Marshall & Rossman, 2016; Leung, 2015). Marshall and

Rossman, further stated that validity refers to the accuracy of analyzed data. I determined

the integrity of the application of method used and decided that the methodology

supported the results of the data. Validity in a qualitative research relates to the

credibility, transferability, and confirmability of the study’s data (Cope, 2014; Yin,

2014). Therefore, I asked probing questions and conducted member checking to validate

the reliability of the study.

 61
Credibility

Credibility is synonymous to internal validity and is relevant in establishing a

level of trustworthiness and accuracy of a study phenomenon in qualitative research

(Morse, 2015). Credibility also involves observation, member checking, and triangulation

(Marshall & Rossman, 2016). I conducted member checking to enhance the accuracy of

data recorded. Participants each received my analysis of their responses for review and

feedback to determine the accuracy of data. Noble & Smith (2015) contended,

harmonization of the researcher’s interpretation with that of the participant establishes

credibility. Yin (2014) and Carter, Bryant-Lukosius, DiCenso, Blythe, and Neville (2014)

stated that methodological triangulation is a valuable data collection tool that uses several

methods to validate the research study. I conducted a single site qualitative case study,

therefore; methodological triangulation was the most suitable approach to integrate

multiple sources of data within the interview protocol (See Appendix A), transcribed

notes, review of company documents, and member checking to validate the study.

Confirmability

Yin (2014) claimed that confirmability strengthens the validity of a research

study. Noble and Smith (2015) argued that confirmability revolves around the

participant's viewpoint and the objectivity of the research study and not shaped by the

researcher. However, the researcher acting as the data collection instrument in a

qualitative study has the autonomy to interpret the data, determine consistency,

trustworthiness, applicability, and objectivity (Marshall & Rossman, 2016). Therefore, to

achieve confirmability, I avoided interjecting or using non-verbal cues during the

 62
interview process and remained objective throughout the data analysis to reduce biases,

which could affect data saturation and the overall validity of the study.

Transferability

Transferability refers to the researcher's ability to use the results obtained to assist

other researchers with similar interest (Bengtsson, 2016). Transferability is also the

degree at which the findings in a qualitative study are transferable to other groups or

institutions (Cope, 2014). Transferability or external validity refers to the appropriateness

of the research when adopted into a new setting (Burchett, Dobrow, Lavis, & Mayhew,

2013). I emphasized the population, geographic location, and demographics of my study

to create a rich description of the literature and to promote potential duplication and

transferability. Although succession planning at the executive-level in a NYC hospital

was the focus of this research study, the findings from this study may apply to other

healthcare facilities as a benchmark to implement strategies to facilitate succession

planning within their hospital. Furthermore, the data that I provided might allow readers

to retrieve the necessary information to assess the transferability and conclusion to

different aspects of healthcare succession planning beyond the immediate boundaries of

the problem relating to executive-level succession planning.

Transition and Summary

The overview of this qualitative single case study was to explore the strategies

executive-level leaders use to facilitate executive-level succession planning within their

hospital. The participant were executive-level leaders of a NYC hospital. Explanation of

the Belmont codes of ethics, including confidentiality, consent forms, and participants’
 63
willingness to enroll was a part of the IRB regulations discussed. Additionally, I analyzed

data collected during each semistructured interview and stratified the information into

codes and themes. Maintaining the confidentiality of participants’ information by de-

identifying data received and securely storing the information in an encrypted

computerized database for 5 years, after completion of study could prevent the risk of

personal disclosure. Explanation of interview protocol and the reliability and validity of

the data was verifiable through member checking. Section 3 includes the presentation of

findings, applications of business practice, and social change impact. Section 3 concluded

with the recommendation of facts for future studies, and my reflection of strategies

executive-level leaders use to facilitate succession planning.

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Section 3: Application to Professional Practice and Implications for Change

Introduction

The objective of this qualitative single case study was to explore the strategies

executives used to facilitate executive-level succession planning within their hospital. I

conducted three individualized semistructured face-to-face interviews with hospital

executive-level leaders from a single site location in NYC. I used 10 open-ended

interview questions to engage participants and extrapolate information concerning their

understanding of the research question, as qualitative researchers often use open-ended

questions in their studies (Marshall and Rossman, 2016). I collected pertinent data that

evolved answers to strategies NYC hospital executives used to facilitate succession

planning within their hospital. I chose only executive-level hospital leaders to gain an in-

depth understanding of the strategies that guided succession planning at the executive-

level.

The interviews of each participant occurred in a mutually convenient and

comfortable location where participants felt relaxed and poised to respond to answers for

10 semistructured, open-ended interview questions (see Appendix A) to ensure

consistency in the data collection. Interviewing participants in a familiar and comfortable

location promotes better responses during a semistructured qualitative interview (Singh,

2015). I reviewed the hospital talent assessment and developmental planning policies that

aligned perfectly with the responses obtained from each semistructured face-to-face

interview that enriched the data collection technique. I completed each interview within
 65
30 minutes, and member checking revealed my analysis of participants’ responses was

accurate.

After transcribing data collected from the three participants, I uploaded the

information into NVivo 11 a CAQDAS qualitative software for coding and analysis. The

analyses coupled with methodological triangulation identified four emerging themes that

related to strategies executives used to facilitate executive-level succession planning

within their hospital. The themes identified were (a) barriers associated with effective

succession planning, (b) encouraging peer-mentorship, (c) knowledge sharing strategies,

and (d) talent Retention.

Presentation of the Findings

The overarching research question that served to guide this study was “What

strategies do NYC hospital executives use to facilitate succession planning successfully

within their hospital?” The findings from the study analysis revealed that the hospital did

not have an enforced succession planning policy. However, the participants all agreed

that their organization had policies and procedures in place to identify potential

successors, thereby making the transitioning process easier. According to Top, Akdere,

and Tarcan (2015), transformational leaders are strategic planners’ who ensure

organizational stability. Participants’ responses revealed that maintaining hospital

leadership continuity at the executive-level mitigates the risk of an unforeseen turnover of

key leaders.

Using data analysis and coding of themes, I identified four major emerging

themes. The first theme referred to the organizational strategies used to promote
 66
executive-level succession planning to support organizational stability. The second theme

referred to encouraging peer-mentorship to ensure the retention of knowledge capital.

The third theme related to knowledge sharing to avoid a knowledge gap. The final theme

involved talent retention to ensure the readiness of future executive-level leaders within

the organization. Figure 2 represents the most commonly used words and phrases

extrapolated from participants’ responses to interview questions. The context in which

these words were used was critical to identifying the four major themes that resulted from

the interview analysis of participants’ responses.

Figure 2. Word cloud and phrases

The findings of this research aligned with the key concepts of transformational

leadership theory identified by Burns (1978). Burns’s transformational leadership theory

was the conceptual framework used in this study to describe a style of leadership guided

by motivation, influence, and vision to instill change within followers. The concept of

transformational leadership theory applies to executive-level leaders’ ability to identify

and develop future leaders to facilitate succession planning within their hospital.
 67
Concealing participants’ responses during an interview promotes confidentiality

(Petrova et al., 2016). Therefore, to maintain the confidentiality of each participant, I

used assigned codes P1001 through P1003 to identify participant’s responses throughout

this section. The participants were two males and one female with over 30 years of

service combined. Reported in Table 1 is the four emerging themes derived from coding

and analysis.

Table 1

Frequency of Primary Themes from Data Collected from Interview

Emerging Themes Frequency % Frequency

Occurrence
1. Organizational strategies used to 34 43%
promote executive- level succession
planning

2. Encouraging peer-mentorship 15 19%

3. Knowledge sharing strategies 20 25%

4. Talent Retention 10 13%

Total 79 100%
___________________________________________________________________________

Theme 1: Organizational Strategies used to Promote Executive-level Succession

Planning

The first theme was organizational strategies used to promote executive-level

succession planning. The organizational strategies included leadership development,

 68
performance assessment, and aligning corporate goals with knowledge capital to build an

internal leadership pipeline to support succession planning. Leadership development is an

investment in human capital supported by growth strategies to capture organic

opportunities that promote the nurturing of internal talent. Santora (2013) argued that

leadership development of top executives is an investment in the organization's long-term

growth and success. The data findings of the first theme aligned perfectly with the

transformational leadership theory, the conceptual framework for the study.

Transformational leaders are responsible for maintaining organizational

sustainability through leadership development and strategic planning for long-term

success (Dabke, 2016). The results of the findings showed that participants recognized

the core importance of using leadership development programs within their organization.

Participants described their experience with the leadership program as an ability to

transform talented employees into future leaders to contribute effectively to the financial

health and stability of their organization. Dwyer and Azevedo (2016) posited that in-

house education acquired through knowledge sharing prepares leaders with a better

understanding of how to improve organizational outcomes. P1003 stated, “corporate

board leaders strategically linked leadership development programs to corporate goals to

motivate potential leaders to excel beyond the boundaries of their duties to pragmatically

prepare to assume the position of an outgoing leader.” P1001 noted, and P1002

confirmed, that the “process of succession planning did not really exist,” but they have a

policy in place that “mimics succession planning that identifies and selects talented

employees from a pool of potential leaders.” Results of the study indicated that
 69
transformational leaders engage in strategical thinking and leadership development to

groom talented employees with executive-level potential to match the goals, vision,

mission, and evolving strategies of the organization. According to Pradhan and Pradhan

(2015) and Swensen et al. (2016), leadership development predicated on the adoption of

new skills, organizational goals, and talent management grows future leaders. Each

participant acknowledged during member checking the importance of making succession

planning an official organizational policy to avoid a leadership crisis.

Another leadership development strategy used by a NYC healthcare organization

is performance assessment that allows executive-level leaders, stakeholders, and board

members to develop a performance metrics to determine individualized talents based on

the potential successor’s knowledge and skills. Performance assessment allows the

leaders of an organization to determine the bench strength or readiness of potential

leaders for critical executive-level leadership positions (Philpot & Monahan, 2017).

P1003 claimed, “performance assessment provided information on the effectiveness of

the mentoring and training program and the readiness of employees’ to work

autonomously to maintain or exceed corporate goals.” P1002 used the performance

assessment tool to “examine the performance appraisal strategy for potential leaders to

identify competency, knowledge, and skills.” While P1001used performance assessment

“to determine the potential leader annual productivity, innovation, business acumen, and

overall performance.” According to Cairns (2011) and Grider et al. (2014), healthcare

organizations linked performance assessment models to leadership development to

compare and contrast prospective leader’s level of knowledge and competency.

 70
Performance-based assessment may prepare aspiring leaders through collaborative efforts

to obtain the knowledge and skills needed to assume a leadership position (Hesli &

Turban, 2016). Developing a learning program that links corporate strategic goals with

knowledge capital develops talent and retains human capital. Developing internal career

opportunities that align corporate goals with knowledge capital reduces the leadership

gap for executive-level positions and increases the growth and sustainability of the

organization (Desai & Jayakrishnan, 2014). Review of the company’s leadership

assessment document, interview data, and organizational strategies provided unique

evidence of succession planning to promote executive-level leadership development and

creativity.

Theme 2: Encouraging Peer-Mentorship

Peer-mentorship requires executive-level leaders to use strategies that encourage

leadership development of talented employees through motivation, coaching, and

empowerment. Bass (1985) found that transformational leaders contributed to the

individualized growth and performance of future leaders through structured mentorship.

P1001 noted, “as leaders, we have the capacity and capability to mentor and cross-train

potential leaders through knowledge exchange, and skill develop but some senior

executives are resistant to cross-train future leaders because they fear compromising job

security.” P1002 and P1003 also shared their concerns about the reluctance of some

senior executives to train potential incumbent. P1002 stated, “to prevent a gap in

knowledge being transferred we encourage senior executives to adopt a more supportive

style of leadership to maintain the core values of the organization.” P1003 further stated
 71
“mentorship helps to groom potential leaders by providing constructive feedback that

could increase performance and facilitate learning.” Pandiyan and Jayalashmi (2016)

proposed that encouraging peer mentorship at the executive-level develops future leaders

with the talent, strategy, and vision to lead without any disruptions in the organization’s

mission for success. Executive-level leaders should seek to encourage knowledge

exchange to promote confidence and professional growth.

Theme 3: Knowledge Sharing

Knowledge sharing prepares healthcare leaders for the risk of knowledge loss

associated with an unplanned or planned departure of a key leader within the

organization. Retaining knowledge capital through in-house mentorship enrich

organizational talent and facilitate the process of succession planning (Yamkovenko and

Hatala, 2015). P1003 stated that “the sharing of knowledge by senior executives promote

organizational sustainability and prevent a knowledge gap that could threaten the

viability of the organization.” Tacit knowledge equips incumbent with the knowledge and

skills needed to assume a leadership position (Donate & Sánchez de Pablo, 2015). P1001

noted that “constant training and peer mentorship helps to maintain the culture, vision,

knowledge, skill, and success of the organization.” P1002 stated, “the capturing of tacit

knowledge is an organizational strategy to groom and retain a talented group of future

leaders.” Knowledge transfer acquired internally improves performance and innovation

(Patidar et al., 2016). All three participants recognized similarities in their style of

leadership with a transformational leader because they embrace creativity and

continuously motivate potential leaders to align their goals and vision for success with
 72
the mission of the organization. Patidar et al. (2016) concluded that knowledge transfer is

a transformational approach facilitated by executive-level leaders to manage knowledge

capital. Review of participants’ responses revealed that knowledge transfer acquired

internally increased innovation and performance.

Theme 4: Talent Retention

Retention of talented employees emerges from trust in leadership and job

satisfaction. Patidar et al. (2016) described talent retention as an eclectic strategy used to

develop leadership skills, knowledge, and corporate growth. Transformational leaders

correlate talent retention with job satisfaction, motivation, and effective leadership (Bass,

1985). P1001stated that “I provide a competitive benefits package, leadership

advancement opportunities, and an open-door communication policy, which seem to be

doing a good job of enticing and retaining skilled workers.” P1003 claimed, “the strength

of our organization helps to retain our employees because we create an environment that

not only fosters career advancement but effectively rewards the talent of our star

employees, which builds commitment and trust in leadership.” P1001 proffered that

“when employees feel visible, receives competitive compensation, and their talent is

effectively utilized it improves corporate trust, retention, and reduce the shortfall in

talent.” McManus and Mosca (2015) argued that grooming talented employees for future

leadership positions foster trust, commitment, and loyalty to the corporation. Therefore,

healthcare leaders need to develop strategies that promote employee engagement and the

empowerment of future leaders to build corporate trust through clear communication to

increase talent retention.

 73

Figure 3. Graphical illustration of frequency versus percent occurrence

Figure 3 represents the result of the themes from dataset collected from all

semistructured interviews. Although this study is not a quantitative analysis, I evaluated

the results of R² to show the frequency of themes that emerged from the analysis of the

semistructured face-to-face interview questions. The value of R² represents the accuracy

of the data collected. Additionally, the increased frequency of the themes illustrates areas

of vulnerability that could affect the facilitation of succession planning within a NYC

hospital.

Applications to Professional Practice

Hospitals are symbiotically integrating executive-level development programs

and succession planning strategies to ensure the smooth transitioning of future leaders.

As baby boomers transition from the workforce into retirement, a vacuum in leadership
 74
becomes evident in the absence of succession planning (Santora et al., 2015). Therefore,

investing in executive-level leadership development and succession planning best

practices for the purpose of identifying, grooming, and retaining top talent facilitate the

ascension of executive-level leaders to maintain organizational sustainability. Other

factors affecting the implementation of succession planning in healthcare facilities are (a)

mentorship, (b) knowledge sharing, and (c) talent retention. The purpose of this

qualitative single case study was to explore the strategies executives use to facilitate

executive-level succession planning within their hospital.

The findings of this single site case study revealed that the organization did not

have any formal succession planning policies enforced, but leaders had their approach for

evaluating talent through strong mentorship programs that facilitated career growth and

leadership development to avoid a vacuum in executive-level leaders that could affect the

financial stability of the organization. NYC hospitals could use the findings of this study

to develop a more robust succession planning strategy that applies to all NYC tri-state

hospitals to ensure proper training, mentoring, and knowledge sharing to prepare the next

generation of healthcare executive-level leaders adequately. Leadership development and

succession planning mitigate the challenges associated with the transfer of power and

organizational success (Kim, 2012; Shaari, Areni, Grant, & Miller, 2014). All

participants alluded to the fact that applying successful succession planning strategies in

healthcare organizations may increase the visibility of potential talent that has the

tenacity to occupy the incumbents’ position upon a planned or unplanned departure of a

key leader.
 75
Top executives were responsible for ensuring leadership stability at the executive-

level by aligning mentorship programs with leadership development to promote

organizational stability and commitment in the absence of formal succession planning.

Patidar et al. (2016) proffered that organizational succession planning is informal and an

unstructured process that is determined by top-executives and shareholders. Aligning

organizational strategies with leadership development in the absence of formal corporate

succession planning strategies may lead to barriers that hinder the facilitation of

healthcare succession planning at the executive-level. However, the findings of this study

might assist in the development and execution of corporate strategies used to facilitate

leadership development of talented employees to promote the transparency of succession

planning within their organization.

Implications for Social Change

Exploring the strategies used by hospital executive-level leaders for succession

planning could assist other healthcare leaders in developing strategies to improve the

growth and visibility of future leaders across the organization for executive-level

positions. Hopkins, O’Neil, and Stoller (2014) claimed that healthcare leadership

readiness and long-term organizational viability requires the grooming and nurturing of

future leaders. Integrating business performance with leadership development could

motivate talented lower-level leaders to improve organization productivity to achieve an

executive-level leadership position (Caplan, 2014). Schuller, Kash, and Gamm (2015)

stated that leadership training and development programs maintained a continuum of

leadership, organizational stability, and performance. Empowering potential leaders

 76
benefit the organization, employees, and the community served. Booker, Turbutt, & Fox

(2016) concluded that leadership development in healthcare facilities contributes to

positive social change. Therefore, integrating effective business strategies with executive-

level leadership succession planning strategies could contribute to career development

opportunities, retention, new mentoring techniques, increased productivity and increased

morale amongst employees.

Organizations with an ingrained culture of leadership development and employee

engagement promote talent retention to ensure corporate productivity (Quintana, Ruiz, &

Vila, 2014). Increased employee engagement at the executive-level could improve

performance; identify strategies executives could use to develop the skills of future

executive-level leaders to contribute to the achievement of positive social change.

Executive-level mentorship programs create a work-related environment that embraces

knowledge sharing and leadership development that positively contributes to the

healthcare of patient and community served and also the sustainability of the

organization.

Recommendations for Action

The transitioning from one executive-level leader to another can affect the

confidence of shareholders, employees, and leaders within the organization in the

absence of formal corporate succession planning policies. Organizations that lack a

structured leadership succession planning policy will fail to identify and align talented

employees with successful business strategies to promote leadership continuity (Bowen,

2014). Therefore, NYC hospitals need to develop a clear pathway for executive-level
 77
leadership succession planning within their organization. Recommended actions

include the implementation of a robust mentoring program to provide incumbents with

executive-level leadership development skills to improve the corporate relationship with

employees, shareholders, and the community they serve. Developing high potential

employees could empower future leaders to align their vision with the mission and

strategic needs of the organization. For healthcare leaders to succeed they need to be able

to identify and groom future leaders for executive-level positions (Kaplan & Gingrass,

2017). Healthcare leaders should establish an integrated approach to succession planning

management that involves knowledge management, development of a leadership

pipeline, and retention practices to avoid a knowledge and skill gap in leadership.

Since some leaders are resistant to sharing critical components of corporate

knowledge with lower-level leaders to maintain job security, healthcare organizations

should develop strict written procedural policies that mandate the importance of

knowledge transfer because leadership development benefits the sustainability of the

organization. To prepare skilled workers for future leadership positions tacit knowledge

transfer is an essential tool used by leaders to maintain knowledge capital and facilitate

succession planning (Donate & Sánchez de Pablo, 2015). Therefore, healthcare leaders

must invest in executive-level leadership mentoring, formal leadership training, and

knowledge transfer to provide a framework that drives leadership development to

facilitate executive-level succession planning within their hospitals. I will disseminate the

results of this study by sharing the findings with the participants, healthcare

organizations, executive-level leaders, and through journal publications.

 78
Recommendations for Further Research

The objective of this qualitative single case study was to explore the strategies

executives use to facilitate executive-level succession planning within their hospital.

Although this study provided rich and thick qualitative data regarding the importance of

hospital executive-level succession planning practices, a couple of limitations existed that

future researchers could explore to advance the findings of this study. First, the sample

size of the targeted population was limited to 3 executive-level hospital participants.

Secondly, I conducted a single site case study based on the organization’s demonstrated

excellence in executive-level succession planning but the overall results obtained might

not be indicative of other NYC hospitals. Parker and Northcott (2016) noted that

limitations in a study preclude researchers from generalizing the results of their findings.

Therefore, I would recommend that future researchers use a larger sample size involving

multiple healthcare facilities to improve the reliability and replicability of the results.

Other recommendations for future research involve the investigation of the best hospital

practices for leadership development and talent management to improve hospital

executive-level succession planning. Applying the recommended executive-level

succession planning strategies within healthcare organizations could improve the

effectiveness of leadership development practices through programmatic changes to

improve talent management.

Reflections

My experience and perspective of the doctoral process changed as this study

evolved and I amassed a wealth of knowledge on the topic of hospital executive-level

 79
succession planning. Before conducting this study, the only preconceived notion I had

was that the study site had a robust succession planning policy enforced based on a

pattern of smooth executive-level leadership transitioning. I eluded from making known

my personal belief to participants to remain objective and unbiased, and also to preserve

the integrity of the data collection to address the research question.

The participants who volunteered for this study were enthusiastic to share their

succession planning strategies although they had no formal policy in place, which made

the interview process a bit more intriguing to learn more about how they evaluated

potential talent. The findings of this study were enlightening and edifying to me as a new

scholar investigating the importance of implementing succession planning at the

executive-level in healthcare institutions. The results of the data presented themes that

effectively addressed the overarching research question. Therefore, I am optimistic that

the recommendations from this study will assist top-level executives with addressing the

importance of implementing formal succession planning within their healthcare facilities.

Conclusion

Succession planning at the executive-level continues to be an area that lacks clear

contingency planning to facilitate the unexpected departure of key healthcare leaders

within their organization (Patidar et al., 2016). Santora et al. (2015) stated that

approximately 50% of hospitals surveyed lack succession planning. NYC hospital

executives are realizing the benefits of succession planning to prevent a vacuum in

leadership at the executive-level. Healthcare executives can learn to adopt the successful

use of succession planning from other healthcare executives by developing policies and
 80
strategies to identify and groom talented leaders for future executive-level positions. The

findings from this study support the overarching research question and may be of benefit

to the hospital, potential executive-level leaders, and the community they serve by

reducing a vacuum in leadership to maintain organizational stability. The overall research

findings were consistent with the purpose of the study and correlated with

transformational leadership, the conceptual framework of this study.

 81
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Appendix A: Interview Protocol

Interview Protocol
What you will do What you will say—script
Introduce the interview My name is Janet Tingling; I am a Walden University
and set the stage—often Healthcare Management doctoral student with an interest in
over a meal or coffee hospital executive-level succession planning.
The purpose of this interview is to obtain strategies executive-
level leaders use to facilitate succession planning. You are
being asked to participate based on your record of maintaining
continuous executive-level leadership despite the departure of
key leaders within your organization.
Thank you for agreeing to participant. Once you have read and
understand the nature of this study, please consent via email by
replying, “I consent”. This interview will take 30-40 minutes
and audio recorded.

• Interview Questions 1. What strategies do you use to facilitate executive-level

succession planning within your hospital?
2. What strategies did you find worked best to facilitate
executive-level succession planning within your healthcare
facilities?
3. How did your executives respond to your various
executive-level succession planning techniques?
4. How do you assess the effectiveness of your organization’s
executive succession planning strategies?
5. What, if any, method of organizational preparedness is in
place to facilitate executive-level succession planning?
6. What has been your experience with organizational barriers
in the selection of a potential successor?
7. How did your organization address the key barriers to
implementing your succession planning strategies?
8. What, if any, executive-level succession planning strategies
are in place to prepare for a demographic shift in the
workforce as senior employees approach retirement age?
9. How, if at all, did your organization address the
demographic shift in the workforce to facilitate succession
planning?
10. What additional successful strategies do you have to
facilitate succession planning at the executive-level in
• Wrap-up Question larger NYC hospitals?