About Hospital Safety Center  
Career Center  
Contact Us
       Free Resources
Hospital Safety Insider

Mac's Safety Space  
        News & Analysis
Healthcare Safety Leader  
Environment of Care Leader  
Forms and Checklists Library  




Succession planning: A long-term safety essential for facility managers


December 1, 2017

Don't let the most knowledgeable person on your team become a single point of failure

For three days after Hurricane Katrina made landfall in 2005, Children's Hospital New Orleans stayed open, providing continuous care for its tiny patients, with about half its normal staff. The call to evacuate came only after breached levees unleashed flooding and chaos in much of the city, prompting hospital personnel to evacuate 103 children to nine different destinations.

"With no city, state, or federal assistance, we did it in under 22 hours—and I had to know that that building was going to perform," says Cindy Nuesslein, RN, MBA, FACHE, an independent consultant who was vice president of hospital operations at the time. "It's a remarkable experience to have been through, but it also gives you a very different level of appreciation for what a solid facility manager and a great facility team can do."

Had it not been for the well-prepared and highly qualified facility team, the mid-crisis evacuation could have been far less successful, with real and immediate consequences for the safety of patients and staff. That's why it's absolutely vital that healthcare organizations think about who will manage a facility not just in the day-to-day but over the long term as well. A commitment to succession planning will help ensure that your team can keep up with the complexities of modern facilities management and respond appropriately, even when one disaster cascades into the next.

“Healthcare facilities are very complicated. Most people don’t even begin to scratch the surface in their understanding of what that really means," Nuesslein says. "Trying to shelter in place or be resilient after some significant insult takes a good deal of foresight and somebody that really knows what they’re doing."
Considering the increasing number of regulations and technical elements that must be managed to operate a hospital these days, it should come as no surprise that facility managers have had to keep pace with job descriptions that are constantly evolving.

“Their level of sophistication and their knowledge basis is very different today than it was when I started some 35 years ago," Nuesslein says. "These are guys who grew up in the ranks through trades—and now we want to put them in public. We need them talking with all the leadership of the organization. They need to participate on these environment of care committees and quality assurance committees and patient satisfaction committees, and it’s a different mindset than it was 35 years ago."

Nuesslein, who spent three decades working for Children's, says she had a total of three facility directors on her team in that timespan—all of whom rose through the ranks.

"I was very spoiled," Nuesslein says.

But that luxury of a career ladder developing spontaneously within an organization isn't guaranteed; the current workforce is older and approaching retirement, and the field of future candidates for top facility management positions looks increasingly sparse. A survey by Health Facilities Management magazine and the American Society for Healthcare Engineering (ASHE) found that the number of facility managers who were older than 55 rose from 35% in 2009 to 40% in 2012. Meanwhile, there simply aren't as many educational paths to healthcare facility management positions as there are to certain other technical fields—which means your organization needs to actively recruit its future leaders, whether from the outside or within. 

“Were we talking about this 10 years ago? I wasn’t. I was just glad to have somebody really talented on my staff. I wasn’t worried about who was coming up behind him necessarily," Nuesslein says. "But the evolution of things has changed and changed dramatically. That’s why we’re here.”'

ASHE: Make this a priority

ASHE acknowledged the importance of succession planning for healthcare facility managers this year by publishing a collection of tools online to help leadership teams plan and recruit for their future members. The tools include links to websites related to hiring military veterans, sample job descriptions, succession planning worksheets, and even PowerPoint slides for making presentations during career fairs for high school students: www.ashe.org/successionplanning.

The centerpiece of ASHE's succession planning tools is a 48-page monograph written by Ed Avis, who interviewed a number of facility experts on the topic.

"Succession planning is more than a document to dust off when someone retires," Avis wrote. "Proper succession planning continually identifies the right people for future jobs and can help employees reach their career goals."

The fact that this is one of ASHE's three strategic initiatives in response to the aging workforce demonstrates that succession planning is "a pretty widespread concern," says George Mills, MBA, FASHE, CEM, CHFM, CHSP, who recently resigned from his job as director of engineering for The Joint Commission, after 14 years with the organization, to take a new post as director of healthcare technical operations with JLL's healthcare group.

"Coming from my position and moving on, I see how it would be easy not to have done the succession planning," Mills says. "But I think good management makes you want to make sure that somebody’s behind you [and] is ready to step into your shoes."

The monograph, which is available to ASHE members as a free PDF download, addresses six how-to categories:

  1. Figuring out which positions need a succession plan
  2. Using position summaries to clearly define the competencies required for each position identified
  3. Assessing the existing competencies of your current employees
  4. Developing and utilizing internal resources to fill education and experience gaps
  5. Building external relationships to fill positions when needed
  6. Planning for personal career growth

However your organization decides to go about its succession planning, the method should be well-documented and adjustable so that the plan can be changed over the years without losing its utility.

"Some organizations create databases of employees and positions with each employee's qualifications spelled out," the monograph states. "The databases match the employees to likely higher-up positions, and they can be easily edited when employees gain more experience or education, or when positions change."

By providing on-the-job training and other professional development opportunities, your team can help shepherd lower-ranking facility workers up the ranks. By identifying which competencies are mandatory for key positions, you can avoid making your facility manager a single point of failure. If he or she falls ill or leaves the organization, you'll be prepared to either fill the vacancy promptly from within or turn immediately to external recruitment, if necessary, with a specific list of qualifications in mind.

Where to begin

Your organization will be better off if it can hire its next facility director from within, Nuesslein says.
"Not only is it less expensive, but you have people who already understand the culture of the organization and the dynamics of the organization, and they’re typically more committed to its success, especially if they’ve been there for some time," she says.

To hire from within while still ensuring that the candidate you select is qualified, there are a few simple steps to follow, Nuesslein adds. They are:

Step 1. Determine which qualifications and characteristics your new director will need.

Step 2. Conduct an asset inventory of your current employees, checking their existing competencies. Try to identify two or three people, if possible, who could step into the director position.

Step 3. Develop a training guide that stretches each identified employee, pushing them to make progress toward those qualifications.

(For more detail on Nuesslein's advice, see the article she wrote on the topic last year while a principal with Mazzetti+GBA: www.mazzetti.com/succession-planning-facility-director-start/.)

“You’ve identified these individuals, identified what skills they do have, you look at where their gaps are, and then you put a plan together and you execute that plan—and it’s not a six-month ordeal here," Nuesslein says. "I mean, we’re talking about a few years, at least, depending on what level of asset inventory they have already as opposed to what you need to develop in them.”

If, at some point in this process, you recognize that the leader you need won't come from within the organization, then you will have to rely on external recruitment. Even so, you should plan on developing any new hire into the leader you want him or her to be.

“Don’t go out and look for the perfect facility director," Nuesslein warns. "Decide what the key characteristics are that you need for your organization. Pick five; don’t pick 35. Find somebody with those five; gap-train the rest. Get them in, get them acclimated to your culture. Set them up on a training program."

Subscribe Now!
Sign up for our free e-newsletter
About Us | Terms of Use | Privacy Statement | Contact Us
Copyright © 2019. Hospital Safety Center.