(July 2024) – Hospital and health system boards are responsible for steering their organizations through the challenges of health care transformation, medical and technological advancements, regulatory changes and shifting patient needs. Because the board sets the tone that impacts the community for years to come, future trustee leadership should not be left to chance.

Strategic Continuity and Resilience – One of the primary goals of succession planning is to maintain strategic continuity and build resilience within the organization. Effective succession planning ensures the board remains equipped with the skills, knowledge and perspectives necessary to navigate the unique challenges hospitals and health systems face. By anticipating and preparing for board member transitions, hospitals can avoid governance gaps that might impede their strategic operations or dilute their vision.

Enhancing Board Diversity – A diverse board of trustees is a strong catalyst for innovation, strategic dialogue and decision-making. For hospital boards, diversity should span expertise, gender, race, age, background and community representation. Part of trustee succession planning includes comparing the board’s composition to the community-at-large and identifying gaps that may be missing on the board.

Cultivating Leadership and Expertise – The process of trustee succession planning is tied to the cultivation of leadership within the hospital’s broader community. By identifying and nurturing potential trustees, the board invests in the development of future leaders who are aligned with the hospital's mission and values. This approach enriches the pool of candidates ready to step into governance roles and strengthens the hospital's ties to its community. In addition, the connection between seasoned hospital leaders and emerging community leaders allows outgoing members to pass on valuable insights and experiences to future successors.

Practical ways boards may build future leaders include:

• Seek out existing hospital volunteers.
• Reach out to individuals in the community with experience in governance or leadership through local community and business organizations.
• Offer opportunities for potential leaders to serve in other capacities, such as on the hospital's foundation board or in ad hoc committees or task forces.

Defining Trustee Roles – Too often, boards fill vacancies through an informal process of candidate suggestions from other trustees. Existing board members may have connections to individuals who make excellent board members. Still, internal recommendations may also result in the recruitment of friends and acquaintances that mirror existing board members rather than bringing in varied perspectives and backgrounds. Potential candidates should be selected based on the individual's fit with the organization's mission, the current board team and the unique skills and perspectives the candidate brings to the board.

Before identifying specific candidates, boards should create:

1. An up-to-date trustee job description defining typical trustee responsibilities and expectations.
2. A "candidate profile" that articulates the qualities, skills and characteristics the board seeks in a new trustee.

The criteria for board membership should focus on the best thinkers and leaders rather than filling a requirement for a specific constituency or occupation. An exception is if the board needs expertise in a specific area that is lacking.

Assessing Current Board Traits and Identifying Gaps – Hospital and health systems can determine "gaps" in current governance expertise and perspectives by comparing current board composition to the skills and perspectives the board believes will be most important to ensure future success. Some gaps can be addressed through board education, while others must be filled through future board succession planning. Areas boards may consider when conducting a gap analysis include experience or expertise in the following areas:

• Quality and patient safety
• Clinical expertise
• Technology (medical, information and artificial intelligence)
• Community building and community connections
• Collaboration with stakeholders and organizations committed to building a healthier community
• Health equity and social determinants of health and its implications for building healthier communities
• Population health
• Diversity, equity and inclusion
• Advocacy
• Strategic planning
• Governance or leadership experience
• Innovative thinking
• Finance
• Legal
• Philanthropy
• Passion for health care and serving the community

Special thanks to The Walker Company and governWell™ for the use of Navigating the Future: The Imperative of Effective Trustee Succession Planning. Additional trustee resources are available in Kansas governWell and the Trustee section of the KHA website.