Nurse manager succession planning: synthesis of the evidence

Succession Planning and Leadership Development in Nursing: A Bibliometric Analysis (2000-2023)

Succession planning is a commonly employed term in business strategy, referring to the systematic process of transferring leadership responsibilities to another employee to ensure the seamless continuity of an organization's operations. Today, this concept has acquired importance in various industries, including healthcare, with a specific focus on nursing. Several factors led nurse managers to consider preparing potential leaders for primary leadership roles due to the shortage of nurses, significantly impacting healthcare services and patient safety. Because of the importance of this topic, this present bibliometric analysis aims to analyze research studies conducted on succession planning and leadership development in nursing from 2000 to 2023 to identify research trends, key themes, and the evolution of research during this period. The Elsevier Scopus database was utilized for this analysis. This methodology identified (n = 326) journal studies based on the predefined keywords and timeframe. The data derived from this bibliometric analysis offers a robust foundation for conducting a systematic review, enabling a comprehensive synthesis and evaluation of the evidence in this significant field of study.

The relationship between succession and intellectual capital with entrepreneurship in hospitals

BACKGROUND

The hospital environment is very dynamic and faces many internal and external changes. Healthcare knowledge and technology are developing at a swift pace. This study investigated the relationship between succession and intellectual capital with entrepreneurship at the Qazvin University of Medical Sciences hospital, Iran.

METHODS

The number of employees working in six hospitals was 2256, and according to Morgan's table, the required number of samples was 331. We distributed three hundred sixty-five questionnaires considering 10% of sample loss. We used a multi-stage stratified sampling method. In the first stage, each hospital was considered a stratum. After that, occupational groups were considered the next stratum within each hospital, and based on the ratio, the required number of samples for each occupational group was randomly selected. We used the Sobel test to investigate the mediating role of intellectual capital and the structural equation model to fit the research model.

RESULTS

Succession aspects, including culturalization, meritocracy, job promotion path, and the role of senior managers, have a positive and significant effect on intellectual capital. Succession is only effective on intellectual capital and does not affect the personnel's entrepreneurship directly or through intellectual capital.

CONCLUSION

Conducting training classes and intervention programs and using localized succession models can create a suitable platform for increasing organizational creativity and entrepreneurship, motivating the hospitals' personnel, and increasing intellectual capital.

Succession Planning Leadership Model for Nurse Managers in Hospitals: A Narrative Review

The high number of nursing staff in Indonesia requires optimal management skills, one of which comes from the leadership domain. The succession planning program can be an option to prepare nurses who have leadership potential to carry out a management function. This study aims to identify the nurse succession planning model and its application in clinical practice. This study uses a narrative review of the literature approach. Article searches were carried out using electronic databases (PubMed and Science Direct). Researchers obtained 18 articles. Three main themes emerged: (1) the factors that influence the efficient implementation of succession planning, (2) the benefits of succession planning, and (3) the implementation of succession planning in clinical practice. Training and mentoring related to leadership, support from human resources, and adequate funding are the main factors in implementing effective succession planning. Succession planning also can help nurses find competent leaders. However, in its application in clinical practice, the process of recruitment and planning for nurse managers that occurs in the field is not optimal so that succession planning must exist and be integrated with organizational needs and provide guidance and assistance for the younger generation who will become leaders in the future.

Reaching a tipping point: Perioperative nurse managers' narratives about reasons for leaving their employment-A qualitative study

Aim

To describe reasons why nurse managers in perioperative settings decide to leave their employment.

Background

Current literature has shown that perioperative nurse managers’ reasons to leave their positions are formed through an interaction of factors.

Methods

Individual in‐depth interviews were performed with seven nurse managers, all women, in perioperative settings in Sweden. Data were analysed using systematic text condensation.

Results

Five key themes were identified: (a) to end where I started, as a frontline nurse; (b) I wanted to develop further to the next level in my career; (c) I ran out of ideas; (d) I lost trust in my head manager and did not believe in the new organisation and (e) I had had enough of being offended by my superior manager and my employees.

Conclusion

Nurse managers experienced feeling forced into a decision to leave because of being offended by their superiors or their employees. Furthermore, the findings indicate that nurse managers should be offered support from superior managers and the organisation together with time for discussions.

Implications in Nursing Management

The most essential element should be the influence of caritative leadership and the obvious expectation of being treated with dignity, respect and appreciation.

Common components of nurse manager development programmes: A literature review

AIMS

To critically appraise contemporary literature and synthesize common components of nurse manager development programmes.

BACKGROUND

Although the need for nurse manager development programmes has been well documented, minimal recent research exists which identifies and evaluates the common components in these programmes. Furthermore, nurse managers continue to be poorly prepared and supported in role transition, contributing to poor organisational and role performance and decreased retention.

METHOD

A structured literature review saw 14 original research publications appraised for quality, analysed and included in the review.

RESULTS

The common components identified in nurse manager development programmes include curriculum, method of delivery, support, and funding components. Various subthemes were also identified.

CONCLUSION

The components identified within existing nurse manager development programmes are varied. Although there are common components within nurse manager development programmes, these individual components have not been evaluated for effectiveness. There is a clear need for further development of nurse manager development programmes and evaluation of the specific components within.

IMPLICATIONS FOR NURSING MANAGEMENT

An understanding of the common components in NM development programmes is useful for designing and implementing robust evidence-based programmes. Inclusion of these components may facilitate a smoother role transition, enhance performance and improve recruitment and retention of nurse managers.

Succession planning in nursing education

BACKGROUND

Succession planning in nursing is a new concept with limited evidence found in nursing education.

PURPOSE

The purpose of this study was to provide a comprehensive summary of the descriptions of succession planning, as self-reported by administrators over an academic nursing division.

METHODS

A qualitative descriptive methodology was utilized to obtain descriptions of succession planning from participants having personal experience with succession planning.

FINDINGS

The categories discovered in the data included strategies for succession planning implementation, advantages of succession planning, and obstacles to succession planning.

DISCUSSION

Succession planning can provide growth plans, leadership development, and mentoring programs allowing for positive relationships that cultivate, inspire, and assist faculty to develop the necessary skills to be successful in a leadership role. Succession planning requires adequate financial and human resources to develop potential leaders to meet the future needs of an organization, and ultimately, nursing education.

Concept analysis: Succession planning

The aim is to understand the concept of succession planning and its application to initiate successful succession planning in nursing education. In nursing education, there is a lack of qualified academic nursing administrators associated with a national nursing faculty shortage. Succession planning is often confused with other leadership management techniques. An understanding of the concept and its application is required to initiate successful succession planning in nursing education. Walker and Avant's methodological approach was followed for this concept analysis. The electronic databases searched included CINAHL, Medline, Google Scholar, PROQUEST, ERIC, PsycINFO, along with reference and bibliographic lists, relevant books, and public domain websites. The initial search terms included: succession planning, academic deans/directors, and nursing education. A pattern of five attributes emerged related to the characteristics of the concept of succession planning: organizational support and culture, attitude, commitment, and resources. Antecedents included strategic planning, identification of potential individuals, leadership development, mentoring programs, and identification of leadership competencies. Consequences of succession planning appeared to be related to retention, recruitment, improved leadership competencies, decreased role transition stress, and a healthier work environment. Succession planning has been defined as the proactive strategy involving the purposeful identification, assessment, and development of individuals through the processes of educating and mentoring for future leadership positions and establishing leadership continuity within an institution. Succession planning is needed for the continued growth and development academic nursing leaders.

Development and Evaluation of a Nurse Leadership Succession Planning Strategy in an Academic Medical Center

Absence of nurse manager succession planning in an academic medical center necessitated a quality improvement project to identify, select, and enroll emerging leaders into a development program. The authors used organizational competencies and an evidence-based approach to effectively identify barriers, select future nurse leaders, and discover opportunities for process improvement.

Chief Nurse Executives involuntary turnover in times of health care reforms: Findings from an interpretative phenomenology study

In recent years, due to several health care system reforms in different countries, an increased involuntary turnover rate of Chief Nurse Executives has been reported around the World. However, no data on their perceived experience of their dismissal have been documented up to now in the European context. Describing the experience of involuntarily dismissed Chief Nurse Executives was the main aim of this interpretative phenomenological study. Data were collected through face-to-face audiotaped interviews performed by involving a purposeful sample of 13 Chief Nurse Executives; data analysis was performed by using the QSR NVIVO 11 software. The Chief Nurse Executives’ experience of Being fired is characterized by three main themes: (1) “Health Care Institutions are places influenced by political turbulences”; (2) “My competence and presence in the arena is despised by a range of strategies”; and (3) “Transiting from darkness to light”. According to their experience, the reason for dismissal was due to changes in the political climate and the introduction of a new chief executive officer; moreover, Being fired caused a deep pain similar to that experienced during bereavement. In some socio-political contexts, the political climate can influence the role of a Chief Nurse Executive: political membership, whether implicit or explicit, is considered of great value. In other contexts, the Chief Nurse Executives’ value is based on professional competences and achieved outcomes. At times of changes in the political climate, the peculiarities of the specific socio-political context should be evaluated as to whether one should anticipate his/her resignation or not.

Succession Planning in Nursing Academia: A Scoping Review

Purpose

The purpose of this scoping review was to examine the range of literature about succession planning in nursing education.

Background

Succession planning establishes leadership continuity and inherent knowledge within an institution and nursing education. Most of the literature on succession in nursing is focused in the healthcare setting with limited information of succession planning in nursing education discovered.

Method

Arksey and O’Malley’s (2005) framework was used to guide this review.

Results

Emergent categories in the charted literature representing succession planning in nursing education included discouraging factors to assuming a leadership role, encouraging factors to assuming a leadership role, and strategies for successful succession planning.

Conclusion

There are many factors that discourage and encourage a faculty member when pursuing a leadership position. Developing and implementing a successful succession plan that includes the development of leadership abilities and traits could foster the development of future leaders in nursing education.

Nurses' expectations about the succession of leaders in the hospital context

Objective:

to analyze the expectation of nurses about the succession of leaders in the hospital context.

Method:

a descriptive and exploratory study of a qualitative approach carried out with 36 nurses from a public university hospital selected using the snowball technique. The data collection was done through semi-structured interviews that were recorded and analyzed based on the assumptions of the Content Analysis technique, Thematic modality. Ethical criteria were adequately met.

Results:

the reports comprised two central categories, “Who Will Take My Place?” and “Potential and Openness to Plan the Succession of Leadership in Nursing,” the latter being divided into two subcategories: “Nursing leadership in the hospital five years from now” and “Strengths for the implementation of a leadership succession plan”.

Conclusion:

from the results, positive aspects of the diagnosis of the leadership profile in the institution that favor the development of succession planning were verified. In addition, it was possible to perceive the necessity of the development of this planning in the hospital and its importance for the succession of leadership in Nursing. In this context, this study presents itself with an innovative character for exposing a theme that aims to potentiate the future of Nursing.

Manager, clinician or both? Nurse managers' engagement in clinical care activities

AIM

To explore the extent of Australian nurse managers' engagement in clinical care activities.

BACKGROUND

Hybrid nurse manager roles lack clarity in the optimal balance between the clinical and other activities, resulting in stress and challenges in recruiting and retaining nurse managers.

METHODS

In a national survey using the Advanced Practice Role Delineation tool, Australian nurses self-assessed their level of engagement in activities across five domains of nursing practice. The subset sample analysed comprised 2,758 registered nurses, 390 clinical (front-line) nurse managers and 43 organisational (middle) nurse managers. Median domain scores were compared with non-parametric tests of difference.

RESULTS

Clinical nurse managers were in a hybrid role, reporting high levels of engagement across the domains. Lower scores observed for organisational nurse managers highlight the shift to strategy-focussed activities that occurs as nurses up the management hierarchy.

CONCLUSIONS

By indicating their engagement in the clinical care domain, respondents demonstrated that clinically focused activities were not entirely lost from either front-line or middle-management roles.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers equipped with clinical and management skills, and allowed time to remain engage in clinical care activities are critical for patient-centred and cost-effective care in today's complex health care environments.

Future of Specialist Practice Qualifications in district nursing for band 6 leadership roles

District nurse numbers in the UK are rapidly declining. To overcome this severe staff shortage, one community trust in a rural county appointed 'case managers' (nurses without Specialist Practice Qualifications in district nursing [SPQDN]) in band 6 leadership roles that were traditionally held by district nurses. Here, we aimed to establish the value of the SPQDN to determine if there is a future for the conventionally accepted DN role, instead of case managers. The study used an exploratory mixed-methods design. Using the classic e-Delphi technique, data were collected over 5 months from 10 purposively sampled senior nurse managers employed by the community trust who formed an expert panel. In round one, the panellists provided three responses each to the question 'what is the future for district nurse specialist practitioner qualifications in [the trust] for band 6 leadership roles?' In rounds two and three, they answered a close-ended questionnaire using a 3-point Likert scale. The core findings suggest that SPQDN and the district nurse role are considered extremely valuable (both achieving 100% consensus). Additional findings are linked to four core themes, namely, (1) SPQDN, (2) clinical practice educators, (3) workforce and (4) leadership. This study recommends continued investment in SPQDN and the district nurse role with the use of succession planning for workforce management.

Developing nursing leadership talent-Views from the NHS nursing leadership for south-east England

AIM

This article explores the views of current nursing leaders in the National Health Service on the actions and resources that are required to develop and maintain nursing leadership talent.

BACKGROUND

Although there is considerable talent and expertise within the nursing leadership community, numerous unfilled vacancies and gaps have been identified in competence and capability, with a national analysis indicating that nearly a third of National Health Service director posts are filled by interim appointments or are vacant. Nursing director posts are amongst those vacant for the longest periods.

METHOD

Semi-structured interviews were conducted with NHS directors of nursing, chief nurses, directors of quality and their deputies in south-east England to explore the characteristics of their roles, development needs, barriers to applying for posts or staying in their posts, future talent identification, and support networks.

RESULTS

Nursing leadership roles are perceived as demanding, poorly remunerated, isolating, and representing a major increase in responsibility and career risk. Too much development is currently informal.

CONCLUSIONS

Talent identification and support need to be timely, structured, experientially based, and focused on building resilience and confidence. Coaching, mentoring, and support networks are considered crucial.

IMPLICATIONS

Nursing leadership talent needs to be formally identified, developed and supported within organisations and networks should be maintained to reduce professional isolation and counter negative perceptions.

Leadership development practices and hospital financial outcomes

Affordable Care Act legislation is requiring leaders in US health systems to adapt to new and very different approaches to improving operating performance. Research from other industries suggests leadership development can be a helpful component of organizational change strategies; however, there is currently very little healthcare-specific research available to guide design and deployment. The goal of this exploratory study is to examine potential relationships between specific leadership development practices and health system financial outcomes. Results from the National Center for Healthcare Leadership survey of leadership development practices were correlated with hospital and health system financial performance data from the 2013 Medicare Cost Reports. A general linear regression model, controlling for payer mix, case-mix index, and bed size, was used to assess possible relationships between leadership practices and three financial performance metrics: operating margin, days cash on hand, and debt to capitalization. Statistically significant associations were found between hospital-level operating margins and 5 of the 11 leadership practices as well as the composite score. Relationships at the health system level, however, were not statistically significant. Results provide preliminary evidence of an association between hospital financial performance and investments made in developing their leaders.

Why is organizing human resource development so problematic?

Purpose

Human resource development (HRD) is an important field within management. Developing employees is often regarded as an instrument to improve the internal labor market and support organizational change. Organizing HRD to these ends, however, is frequently a problematic affair, in terms of training effectiveness, participant motivation and added value. This study, which consists of two parts, aims to investigate the question of why this is the case. In this first part, the problem is stated and the backgrounds and basic tenets of learning-network theory are addressed.

Design/methodology/approach

The paper first describes three approaches to organizing HRD, namely, as a training issue: customization by HRD practitioners; as a learning issue: didactic self-direction by employees; and as a strategic issue for employees and managers: micro-politics. The learning-network theory is then introduced as an integration of these three approaches. It presents a number of key organizational actors that organize four HRD processes, each operating strategically in their own way.

Findings

Organizing HRD is mostly viewed as designing training courses and instruction sessions for employees; it is also predominantly understood as a tool of management. A network perspective on organizing HRD is better able to guide organizational actors than other approaches can.

Originality/value

The study argues that organizing HRD needs to take into account learning experiences that employees can gain from participating in work and career development as well (besides formal training); moreover, that employees’ HRD strategies are at least as important as those used by line managers and HR practitioners.

Growing Clinical and Academic Nursing Leaders: Building the Pipeline

Nursing faces a crisis because there exists a dearth of qualified nurse academicians and administrators willing to step up to high-level leadership positions such as deanships and chief nursing operators. This article critically appraises the available literature regarding succession planning in the nursing profession and offers pragmatic suggestions to the profession to engage in succession planning in a deliberate and thoughtful manner.

Nurse managers' insights regarding their role highlight the need for practice changes

AIM

The purpose of this study was to understand the insights of nurse managers regarding the nurse manager role.

BACKGROUND

Nurse managers are vital to the success of healthcare organizations. Vacancy rates of nurse manager positions are on the rise. Recruiting and retaining qualified individuals for these positions requires an understanding of the perceptions of nurse managers regarding the role and the issues embedded in the role.

METHODS

A descriptive, qualitative investigation was conducted. Data were analyzed using content analysis.

FINDINGS

Although desired, role orientation, mentorship, and a strong foundational knowledge, were often lacking. Personal attributes viewed as important for success in the role included seeking opportunities and intentional self-growth. Lessons learned while in the role included the art of managing role demands and that comfort comes with time.

CONCLUSION

Concerns regarding the preparation for, introduction to, and support in the nurse manager role highlight the need for practice changes.

Professional development needs of nurse managers

BACKGROUND

Nurse managers have a key role in creating positive work environments where safe, high-quality care is consistently provided. This requires a broad range of skills to be successful within today's complex health care environment; however, managers are frequently selected based on their clinical expertise and are offered little formal preparation for this leadership role.

METHOD

We conducted three focus groups with 20 nurse managers to understand their professional development needs. Transcripts were analyzed using conventional content analysis.

RESULTS

Three themes emerged: Managing Versus Leading, Gaining a Voice, and Garnering Support. Managers focused on daily tasks, such as matching staffing to patient needs. However, the data suggested gaps in foundational management skills, such as understanding organizational behavior, use of data to make decisions, and refined problem-solving skills.

CONCLUSION

Professional development activities focusing on higher level leadership competencies could assist managers to be more successful in this challenging, but critical, role.