Health Policy Proposal

7/30/2019 Health Policy Proposal

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Running head: UNIT 10 ASSIGNMENT 1 1

K. Monique Bloomfield

Unit 10 Assignment 1- Final Proposal- Healthcare Succession Planning

HS 8118

Dr. Chavez

June 17, 2011


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Table of Contents

Introduction----------------------------------------------------------------------------------- 4

Problem Statement------------------------------------------------------------------------- 4

Proposal Overview-------------------------------------------------------------------------- 4

Recommendations----------------------------------------------------------------- 6

Theoretical Support---------------------------------------------------------------- 7

Analysis and Evaluation-------------------------------------------------------------------- 9

Sociological Analysis--------------------------------------------------------------- 10

Socio-Political Analysis------------------------------------------------------------ 11

Implementation Process----------------------------------------------------------- 12

Proposed Succession Planning Scheme-------------------------------------- 13

Comparative Decision-Making--------------------------------------------------- 14

Cost-Benefit Analysis--------------------------------------------------------------- 14

Ethical Dilemmas--------------------------------------------------------------------- 17

Conclusion-------------------------------------------------------------------------------------- 18

References-------------------------------------------------------------------------------------- 22


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Abstract

This course project will introduce a new health policy proposal that the senior

policy analyst at the American Society for Healthcare Human Resources Administration

(ASHHRA) of the American Hospital Association will be advocating implementation for.

This policy will be regulatory in design in that it will be used to influence the actions,

behaviors, and decisions of those in leadership roles at mid-size to large healthcare

facilities. (Longest, 2010) Additionally, this policy is intended to maintain conditions that

permit markets to work well and fairly; it is a regulatory policy that will present rules

which will implement market-preserving controls within our seriously depleted U.S.

healthcare human resources industry. Succession planning is a strategic management

tool that is severely underutilized in the healthcare industry. It must become more

commonly used in this industry in order to assist with the issues of low retention, high

attrition, and lack of interest in the health care professions, especially the allied health

professions. This project component represents the draft of this essential policy

proposal.


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Unit 8 Assignment 1- Project Draft- Healthcare Succession Planning

Succession planning is one of the most utilized proactive business strategies in

all U.S. industries, except healthcare. According to a study conducted by the American

College of Healthcare Executives (2004) only 21% of 722 hospitals routinely engaged in

leadership-succession planning compared with two out of three for-profit companies in

other industries. Due to the catastrophic shortages that are occurring in healthcare

professions, especially nursing, succession planning has become more recognized as a

needed device for recruiting, retention, mentoring, administration activities, and

continuous forecasted succession planning frameworks. Comprehensive and effective

succession planning requires human resources to be deeply involved with the strategic

initiatives of the healthcare organization. Succession planning is a strategy or plan

which ensures that internal, qualified candidates are continuously identified and

available to take up leadership positions when vacancies occur. (Bonczek & Woodward,

2006; Schmalzried & Fallon, 2007)

Problem statement

Succession planning is a strategic management tool that is severely underutilized

in the healthcare industry. It must become more commonly used in this industry, for

technical as well as managerial positions, in order to assist with the issues of low

retention, high attrition, and the lack of interest in the health care professions, especially

the allied health professions. This policy will focus on creating an agenda for both

technical and managerial succession planning in healthcare.

I. Proposal overview


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Succession planning is an essential process that allows knowledge, intellect,

and skills to remain in an organization; the human capital is retained in organizations

that freely and purposely utilize this tool; it keeps the organization viable in the market.

More importantly, this practice sustains the quality of care healthcare consumers are

receiving. Most succession plans deal with executive leadership. This is a proposal that

extends to lower-level leadership throughout U.S. healthcare organizations as a way of

implementing a necessary retention and acquisition of healthcare workers strategy on a

national level. This proposal is also about developing talent and building sufficient

bench strength; technical succession planning. Without technical, as opposed to just

managerial, succession organizations place themselves in a greater capacity for losing

the essential knowledge base that is needed in order to develop strategically,

technically, continually, and in unison with the changes that occur in the organizational

and industrial environment of the times. Essentially, the proverbial knowledge pool has

to be maintained and filled.

Succession planning can mean, any effort designed to ensure the continued

effective performance of an organization, division, department, or work group by making

provision for the development, replacement and strategic application of key people over

time. (Rothwell, 2000b,p.47 ) Most succession planning within organizations is focused

on preparing for the departure of upper-level management, those who are in top

positions that give them the authority to make decisions, mobilize resources, and direct

others to take action. However, this policy proposal recommends that healthcare

organizations focus on more than just the succession of management. This proposal

recommends the succession planning of technical positions as well, in order to preserve


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and enhance specialized knowledge, learned from experience, across the horizontal

chart of the organization chart. According to Rothwell and Poduch (2004) technical

succession planning means, any effort designed to ensure the continued effective

performance of an organization, division, department, or work group by making

provision for distilling, preserving, maintaining, and communicating the fruits of the

organizations institutional memory and unique experiences over time. (p. 407)

Consequently, technical succession planning is a form of knowledge management

(Smeltzer & Bonello, 2004) the theory of which will bring more light and emphasis to the

proposal, in conjunction with the Human Capital and Organizational Development

theories, later on.

Recommendations

This health policy proposal is a declaration for a national mandate that will cause

the implementation of structured succession plans in all healthcare organizations which

employees 50 or more personnel. The plans must include an emergency plan, standard

plan, and anticipatory plan. The emergency plan will be referred to should unforeseen

circumstances such as death of a leader occur within the organization. The standard

plan will be utilized when leadership takes a different position that is either internal or

external to the organization. The anticipatory plan is used when an organization is privy

to the retirement date of a healthcare leader. This plan will also be initiated when the

evaluation of the internal and external organizational environment deems it necessary to

prepare for changes.


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Additionally, it is recommended that the succession planning process begin with

the development of preliminary replacement charts (Flynn, Mathis, Jackson, & Langan,

2007). These charts will: 1) ensure that the right individuals with sufficient capabilities

and experience to perform the targeted jobs are available at the right time; 2) show the

backup players for each position; 3) identify positions without a current qualified

backup and; 4) identify who could take over key jobs if someone leaves, retires, dies

unexpectedly, or otherwise creates a vacancy.

Finally, it is suggested that the organization makes successorship, the process of

selecting those interested in and qualified for the possibility of being trained as a

successor, open and known throughout the organization. Having the process of training

for potentially obtaining advanced positions, shows that the organization encourages

self-development of its employees and is will to encourage and provide employees with

the resources and encouragement that is often times needed in order for them to

pursue self-development as stated in The Receivables Reportin 2005 and as is

recommended by many other research sources that are too numerous to name in this

proposal. However, in referring to any paper written about human capital development

succession planning and encouragement of employees are on top of every

organizations list that has a vested interest in the subject matter.

Theoretical support

The expected objectives for this new policy are:

to make healthcare organizations more accountable for the level of staffing that

they require in order to keep the quality of healthcare provisions optimal.


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to enforce proactivity and forward-thinking

to provide the necessary funding for job retention, recruitment, mentoring,

administrative duties, and continuous forecasted succession planning

frameworks.

to revitalize the healthcare industry and make it more appealing to current-day

generations.

Another essential and to many organizations, the primary reason for having a

succession plan is for the development of knowledge management. There have been

fundamental changes in the structure of organizations which have led to massive

increases in productivity. Along with the need to continue production has been the

desire of organizations to improve upon and maintain the companys knowledge base.

The tenets of Knowledge Management are to (KPMG, 1999):

1. support innovation, the generation of new ideas and the exploitation of the

organizations thinking power

2. capture insight and experience to make them available and usable when, where,

and by whom required

3. make it easy to find and reuse source of know-ho and expertise, whether they

are recorded in a physical form or held in someones mind

4. foster collaboration, knowledge sharing, continual learning and improvement

5. improve the quality of decision making and other intelligent tasks

6. Understand the value and contribution of intellectual assets and increasing their

worth, effectiveness and exploitation


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Knowledge management can contribute to organizational goals for reducing

process/service development time, employee satisfaction, profitability, cost reduction,

waste reduction, consistency, and organizational branding (Smeltzer & Bonello, 2004).

According to Davenport, DeLong, and Beers (1998), knowledge management and

related strategy concepts are promoted as important and necessary components for

organizations to survive and maintain their competitive keenness. It has become

necessary for managers and executives to address Knowledge Management (Goodman

& Chinowsky, 1997) seeing that is it now seen as a prerequisite for higher productivity

and flexibility in both the private and the public sectors (Martensson, 2000)

II. Analysis and Evaluation

There are many perspectives from which an analysis of succession planning can

be derived and defined. The definition mentioned previously in this policy reflects a

perspective that is focused on filling lateral or technical positions, which is the premise

of this policy proposal. However, what if succession planning was looked at from a

depleted leadership pipeline perspective as is exemplified by Charan, Drotter, and Noel

(2011) who explicitly state that, the demand for leadership has risen while the supply of

leaders has not kept pace. (p. 2) They emphasize how the requirements for leadership

have changed dramatically and most organizational development strategies are not

equipped for the dynamics of change and the chaos that may accompany it. Examples

of chaotic changes include: mergers, acquisitions, downsizing, delayering, globalization,

and the Internet, which all are causing a substantial change in organizations by

invalidating the importance of some job positions that may be considered crucial in an

organization. Essentially, from the pipeline perspective it is important for organizational


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strategic business plans such as succession planning to include provisions for future

possibilities. This alternative definition for succession planning considers future

possibilities (Charan, Drotter & Noel, 2011):

Succession planning is perpetuating the enterprise by filling the pipeline with

high-performing people to ensure that every leadership level has an abundance

of these performers to draw from, both now and in the future. (p. 207)

This policy will focus on creating an agenda for both technical and managerial

succession planning in healthcare. In keeping in line with the dynamics of the

healthcare industry this policy will also focus on making it a point that organizations

create their plans by first thoroughly evaluating their unique environments.

Sociological analysis

Organizations need realistic and accurate information on the capabilities and

talents of their current staff in order to know the striking force of their human capital. If

the talent, skills, and knowledge pool is weak then an organizations ability to withstand

a drastic change such as retirements, job cuts, job layoffs, military conflicts, and loss of

personnel due to competition, will falter. (Pynes, 2004) According to Pynes (2004), To

be competitive, organizations must be able to anticipate, influence, and manage the

forces that impact their ability to remain effective. In the service sector, this means they

must be able to manage their human resource capabilities. (p. 390) Forty-two percent

of the 15.7 million individuals working for state and local government in 1999 were

between the ages of 45 and 64 years old.( Carroll & Moss, 2002)Two-fifths of state and

local government employees will be eligible to retire in the next 15 years. (Ehrenhalt,


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public attitudes, concerns, and opinions; the preferences and relative ability to

influence political decisions of various groups interested in the problem of the

way it is addressed; and the positions of involved key policymakers in the

executive and legislative branches of government. Each of these factors can

influence whether a problem is addressed through policy and the shape and

scope of any policy developed to address the problem. (p. 67 )

Implementation process

strategies. Like with any policy: federal, organizational, international or likewise,

continuous monitoring and updating must occur depending on the external and internal

environmental changes that occur. The formulation of the policy is just the first step of

many. After formulation is the implementation stages which is a huge determinant for

whether or not the policy fits into the environment of the organization or nation that it

was intended to serve. Therefore, it is imperative that top leaders of healthcare

organizations get to present their opinions about what would be needed in order for this

initiative to be successful. Essentially, the first strategy would be a reemphasis on the

problems in the current healthcare industry. The second strategy would be to present to

top healthcare leaders the importance of this new policy and how it would address the

problems the industry is facing. Next a presentation of data that argues for the

implementation of this policy and that is supported by policy development theory will be

analyzed and synthesized. Finally, an implementation strategy will be suggested to

healthcare leaders on a local and national level. The further the research progresses for

this new policy implementation the more strategic the organization will become thus

leading to the development of a calculated policy development


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Proposed Succession Planning Scheme

Figure 1. Succession Planning Scheme adapted from Succession Planning:

An Idea Whose Time Has Come, by P. Ibarra, 2005, Public Management,

87(1), p. 20. Copyright 2005 by ICMA.

Determine or

Forecast Future

Service Needs

Develop Action

Plan for

ImplementingHuman Resources

Strategies

Identify Critical

Positions and High

Potential

Employees

Identify the

Competencies That

Will Move the FirmForward

Conduct a

Complete Gap

Analysis

Select training and

Development

Activities: Based onFinancial Resources

Assessment

Select EmployeeEvaluation

Methods:Determine

continued Interest

in Program

Executive

Leadership or

Management

Involvement

Continuous Quality

Improvement:

Monitor and

Evaluate Each

Component of the

Plan Strategically


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Comparative decision-making

According to several resources, strategies and tactics that promote effective

succession planning for healthcare management positions are: 1) early and frequent

identification of successor candidates; 2) demand for forecasting and gap analysis for

future role and key position needs; 3) intentional formal and informal mentoring and

coaching; 4) exposure to career broadening future role development competency

opportunities; 5) resource dedication for leadership development, including formal

education for new competency development; and 6) serious evaluation when desirable

successor candidates who are high performers leave the organization. (Roddy, 2004;

Charan, 2005; Blouin, et al., 2006; Flynn, et al., 2007; Kappia, Dainty, & Price, 2007)

In understanding the different strategies that are or should be utilized in a

succession planning program it is essential for organizations to understand that this kind

of business strategy cannot be limited to only top-level management. These tactics

must also be implemented throughout all positions that require the need to fill key

positions.

Cost-benefit analysis

The costs and benefits of the proposal will be specific, they affect a single group,

which alone bears the projects favorable or harmful outcome. (Gupta, 2011, p.86)

According to Gupta (2011) the easiest projects for lawmakers to accept are those that

benefit specific groups of people while distributing costs over a large, diffuse population.

This is referenced as pork-barrel legislation, where appropriations of public funds by

Congress (or other legislative assemblies) for projects that do not serve the interests of


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any large portion of the country's citizenry but are nevertheless vigorously promoted by

a small group of legislators because they will pump outside taxpayers' money and

resources into the local districts these legislators represent. (Johnson, 2005, p.1)

Examples of this kind of legislation include: appropriations bills for dams, bridge and

highway construction and job-training centers.

This proposal can be judged synonymously with a job-training center; more

specifically as an, at-the-job-training center. With succession planning being a business

strategy it provides benefits that are essential for any organization upon implementation.

These benefits do not come without costs to the organization. The following is a listing

of potential benefits and costs of succession planning in healthcare organizations.

(Bolton & Roy, 2004, p. 589-590; Blouin, McDonagh, Neistadt,& Helfand, 2006)

benefits.

Provides good return on investment by decreasing recruitment and orientation

costs and minimizing time-to-fill for vacancies

It enhances the ability to achieve orderly transitions (Redman, 2003) and

maintain productivity levels

Provides for the systematic development of new and emerging leadership

competencies called for by technological and cultural changes

As an open process, it promotes the continual development of the leadership

potential in rank and file, and encourages staff ownership of their own

professional growth


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Recruitment and retention are enhanced because it identifies opportunities for

growth and establishes a policy of promoting from within

It creates a culture that supports career advancement and instills worker loyalty

It demonstrates a commitment to career development and professional

advancement and is a powerful employee retention strategy

It ensures continuity of services, helps the bottom line, and gives a competitive

edge in the market place

It provides intentional formal and informal mentoring and coaching

Ensures resource dedication for leadership development, including formal

education

costs.

Time and resource commitment for the ongoing growth and development of staff

Funding continuing education (internal and external)

Funding matriculation in degree granting programs

Funding leadership advancement programs

Recognizing and rewarding competency achievement

Essentially the argument for mandate of the implementation of a sound business

strategy such as succession planning is simple. Based on the return in investment of

having readily available successors in a tight labor market, eliminating recruitment and

orientation expenses, maintaining productivity at times of turnover, and responding

quickly to market demands adds up to significant dollars being saved. According to NAS

Recruitment Communications (2010) healthcare management is the FTE (full-time


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employee) occupation with the longest average time-to-fill of 78.9 days in 2009. The

average recruitment expense per hire includes the total fixed and variable recruiting

costs divided by the number of positions filled. Recruiting costs include advertising,

employment and advertising agency fees, travel, office rental, equipment, staff salaries

and benefits, relocation costs, and other costs associated with a new hire (NAS, 2010).

The average recruitment expense per FTE hire in 2009 was $2,302 (2010).

Ethical dilemmas

Healthcare organization leaders must make themselves willing and able to step

aside and allow new leaders to emerge. If an organization is one for accepting the

challenge of implementing a succession plan into its organization then there has to be

open communication about the process. An organization cannot say that they believe in

and is in support of a succession plan if they feel it necessary to keep the ideas,

structure, organization and the potential successors out of the communication loop.

(Levett & Guenov, 2000)

Additionally, the assessment of potential successors must be fair; the standards

for judging potential must be consistent across the board of potentials. According to

Charan, Drotter, and Noel (2011) standards for judging potential can rest on the

employees:

Exhibits operating, technical, and professional skills that are extremely required

Exhibits managerial skills that are expected at the next highest organizational

level


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Demonstrates leadership skills that are expected at the next highest

organizational level

Regularly works a building new skills and abilities

Demonstrates fire in the belly

Is oriented towards total business results, not just focused on the success of own

area (p. 212)

These standards must be addressed for all potentials for succession within the

organization. This standard process could be by way of utilizing a tool called combined

potential-performance matrix. According to Charan et al. (2011), this tool is useful for

gaining snapshots of a leadership layer. Companies can determine, for instance, that

their functional managers do not have many highly promotable people at this level and

they had better remedy the situation. (p. 216) Whatever process is decided upon,

leaders must make sure that all candidates are tested, evaluated, and compared in the

exact same manner. As with any other function in healthcare, it is a professional and

ethical duty to behave in a manner that is respectable and admirable. Tomorrows

leaders are looking at the examples made by today s.

III. Conclusion

This project will represent the creation of a new health policy that will focus on

mandating the implementation of succession planning within healthcare organizations

which employ 50 or more personnel. All required organizations must have emergency,

standard, and anticipatory planning strategies in the overall policy. This policy will be

advocated for through the eyes of a senior policy analyst at the American Society for

Healthcare Human Resources Administration of the American Hospital Association.


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In our increasingly competitive business climate, where consumers are

being more informed, becoming more involved with the decision making process of their

care, and therefore, are expecting the knowledge of their healthcare providers and care

management teams (providers, nurses, radiologists, phlebotomists, laboratory

technologists, physical therapists, etc.) to be top-notch and on top of their game.

Todays healthcare consumers are demanding high quality in all respects from their

chosen healthcare entity. In knowing this, it would be in the best interest of healthcare

organization management to have an implemented plan for the retention of the

knowledge that is incorporated and has added to the reputation of its health care

dynamic. According to a federally funded coalition entitled Building Engineering and

Science Talent (BEST), we are entering a quiet crisis based on the fact that American

colleges and universities are not graduating enough scientific and technical talent to

step into research labs, software centers, science policies offices, and high tech start

upsthere is going to be a shrinking workforce, and an unprecedented labor shortage.

(Roddy, 2004, p. 487)

The limitation of this proposal is essentially the scope at which succession

planning is viewed. There are organizations that feel succession planning is just the

process of selecting the next chief. They are eluded to the fact that succession

planning, if done thorough and as a component of the organizations strategic pl an,

extends in to areas as leadership development programs, mentoring networks,

performance assessment, governance theory, aligning organizational goals with human

capital, and overall building the internal leadership pipeline. (Blouin, et al., 2006;

Charan et al, 2011). When the pipeline is nonexistent it cause the organization to shift


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their sole focus to external sources of candidates and bypassing the internal

prospective, which is a process that has been shown to lower success rates.(Charan,

2005; Byham & Nelson, 1999).

Additionally, this limitation extends into what an organization is financially

capable or able to do. In thinking about succession implementations that could be made

at the a large, multi-faceted, metropolitan hospital in comparison to a 150-bed suburban

community hospital the scale is slammed in the direction of the large metropolitan

hospital. There are going to be differences amongst hospitals as to what is needed,

required, and works with the cultural environment of that organization. This allocation of

funds would have to take into account these essential limitations of this proposal.

The strength of this proposal comes from the literature that is in support of

succession planning. This business plan has traveled across several different paths;

that of family-owned businesses right into large healthcare systems. This is a business

strategy that is highly recognized and recommended in the field, especially with the

bleak outlook that has been forecasted in the healthcare industry regarding the loss of

the essential knowledge pool of the organization.

A subsequent strength is the blatantly overt support that the cost-benefit analysis

put forth; the benefits significantly outweigh the costs of what it would take for an

organization to step up and put more manpower into developing a succession plan that

would be incorporated into the strategic plan of the organization. Pork-barrel legislation

shows that legislators are already more apt at passing this kind of law because it allows

for funding to go into the areas that they represent. In classifying it as an at -the-job-

training center this should be considered more favorable because the needed


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resources at already within the healthcare facility. There would be no need to pay rent

for a building space, the hospital would be it. There would be no need to pay additional

salary dollars, the succession plan would be implemented right into the strategic goals

of the facility; therefore, the additional activities and duties could be considered lateral

duties. The primary need for funds would be contingent upon the succession plan

design that is utilized. If training is to occur externally instead of internally costs will rise.

If external trainers were utilized instead of the internal knowledge pool costs would rise.

If the organization decides that training should take place before or after work hours

instead of incorporating the training on the job then costs will rise.

Essentially, organizations have to thoroughly review, analyze, and map-out their

financial responsibilities and be creative and open-minded to the idea of planning for the

foreseeable and unforeseeable future. The support shows that legislation is for the

development of human capital (with ulterior motives of course, but nonetheless

supportive) with regards to accepting proposals for job training centers. This proposal is

exactly for a program like that. The only difference is it will be within an organization,

that would have to decide on their own if they are willing to take the time to develop an

on-the-job-training plan.


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Smeltzer, J. & Bonello, D. (2004). Building the foundation for knowledge management.

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