What to do when a hospital leader resigns: A checklist

Hospital and health system leaders resign for various reasons. Sometimes the resignation is involuntary and other times the executive steps down to take another job. A departure may also come without a stated reason.

In the last year, these scenarios have played out at organizations across the U.S. Daniel McKinney is resigning from his post as CEO of South Baldwin Regional Medical Center in Foley, Ala., to become CEO of Grandview Medical Center in Birmingham, Ala., effective Jan. 1. Greg Neal told the Bristol Herald Courier that he was asked to resign as CEO of Bristol (Tenn.) Regional Medical Center in August after accepting a cardiothoracic surgeon's invitation to participate in a surgical procedure even though he has no medical license. And Steve Handy is resigning as CEO of Uniontown (Pa.) Hospital, effective Dec. 31, as part of the facility's transition to Morgantown-based West Virginia University Health System.

No matter the circumstances surrounding a resignation, there are steps hospitals and health systems can take when they occur. Below are six.

Rely on a succession plan 

Christine Mackey-Ross, executive lead partner with AMN Leadership Solutions, recommends organizations have succession plans for key executives in which they have thought through potential resignation scenarios. A succession plan may identify an internal employee as a permanent or interim replacement for an executive who resigns.

"Let's hope all organizations are that prepared. Many are, but not all," said Ms. Mackey-Ross. "And I don't think there's a rhyme or reason to that. Some small organizations are very prepared, and some large organizations have a succession plan, and they stick it in the drawer; it's not utilized as well as it could be. So there's variation with succession planning. We encourage succession planning, particularly for the top five executives."

She recommends that the succession plan be formally updated annually but also "be a living document with milestones in it for each person that's identified in there." 

"If you want the COO to be the next CEO, then have milestones in place for them, making sure they have board exposure and gain visibility in the community," she said. 

Examine implications of the resignation

When a resignation occurs, Ms. Mackey-Ross recommends hospitals and health systems pause to examine the implications of the resignation, both public and internal, on the organization's operations. 

"There won't be public implications for all positions, but certainly for a major C-suite role, you're going to want to think about what those implications are in the public eye," she said.

Ms. Mackey-Ross said hospitals and health systems should also think through how they will announce the resignation, to whom and in what order. 

Other questions to ask: How serious is this resignation going to be? How is this resignation going to trickle down in the organization? 

Evaluate the position

Although many organizations automatically seek to replace the person who is resigning, there are also times when a resignation gives the hospital or health system a chance to evaluate the position, whether it's needed, and whether a restructuring of the position might be a good option, said Ms. Mackey-Ross. In other words, could other leaders who are willing to grow take on responsibilities previously held by the person who resigned? 

Ms. Mackey-Ross said she has observed situations during the pandemic in which a hospital executive left or the organization restructured to reduce costs, and that executive's responsibilities were moved to another role.

At Chapel Hill, N.C.-based UNC Health, Steve Burriss was promoted to COO of the academic medical system, but still will oversee UNC Medical Center, UNC Rex Healthcare and the ambulatory division, as he did as president of UNC Health's Triangle Region. UNC Health said it does not intend to hire a new Triangle Region president. 

Conduct an exit interview

Micha'le Simmons, a managing director at Advisory Board, recommends hospitals and health systems have at least one conversation with the person resigning, including an exit interview. 

"If it is a surprise, you want to talk about what caused the person to want to leave the organization, because that's going to be important for the person who will step into that role in the future," she said.

She said these conversations also can shed light on what an organization may have missed in terms of resources that person needed, or other barriers the person faced.  

Ms. Simmons said it can also be beneficial for the hospital or health system to discuss experiences the person resigning had that contributed to their success and what skills the person feels they didn't have that would be useful for someone in that same role.

"You want to use that to help guide your evaluation criteria for the next person you evaluate for the role," she said.

Consider options for the successor

Ms. Simmons advises organizations to resist automatically hiring a successor who is exactly like the person resigning. 

When a leader resigns, there is an opportunity for organizations to bring more diversity to the executive team, whatever that looks like for the organization, she said. 

Ms. Mackey-Ross said she has seen more hospitals and health systems start to bring their social consciousness/social justice agendas to the foreground of a lot of their operations, particularly around executive hires.

Set the successor up for success

Hospitals and health systems should put significant thought into an onboarding plan for whoever replaces the person who resigned, Ms. Simmons said. 

This means ensuring the person coming into the role knows the goals for the position and the challenges associated with it. 

"Those first few months [of onboarding] are really critical, and you want to personalize an onboarding plan that includes early performance objectives, a list of individuals who can provide support and guidance and formal mechanisms for providing feedback," said Ms. Simmons. "Investing in a detailed onboarding plan is crucial."


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