Date of Award



© 2019 Michael J. Smith

Document Type


Degree Name

Doctor of Education (EdD)



First Advisor

Michelle Collay

Second Advisor

Ashwini Wagle

Third Advisor

Heather Rakestraw


Healthcare organizations have been shown to operate as big business, except for one area. Research has shown that healthcare organizations do not implement succession plans for leadership turnover, director level and above. There is a need for successful healthcare systems to implement a succession plan for these leadership roles. Without a leadership succession plan, a healthcare organization can be caught in a bind and short-staffed. A system without a succession plan can also experience severe turbulence, which can lead to lost revenue and a decrease in customer and employee satisfaction. Nursing has had a successful succession plan in place for years and healthcare organizations can benefit by following the successful path of the nursing leadership succession plan.

The purpose of this qualitative, case-study was to investigate how healthcare systems are planning for vacancies of senior level leadership in their organizations. The case-study addressed the two research questions, and they were: How do hospital directors at three mid-size hospitals describe their succession planning? and What approaches, strategies, and tools do hospital directors describe using in their planning efforts? Research has shown that succession planning in healthcare is not happening at a high rate, even though healthcare is operating as big business (Trepanier & Crenshaw, 2013). A lack of succession plan can be costly and can increase hospital costs as healthcare systems recruit for leadership roles (Titzer & Shirey, 2013). One area of healthcare that succession planning is happening, nursing (Waxman & Delucas, 2014). Nursing leaders are critical in healthcare organizations, as they are the liaison between leadership and nurses (Jones, 2019).

The researcher recommends the following, based upon the findings of the study:

  • Healthcare organizations should utilize the current nursing succession plan, as this has shown to be successful and in place for many years.
  • Healthcare should implement an administrative fellowship program to train future leaders of the system and to help introduce those future leaders to the system and how the system works.


Ed.D. Dissertation