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The importance of governance succession planning is growing as health care organizations and their boards face increased pressure for high performance, transparency and accountability. Unlike traditional board member recruitment, where seats are filled by tapping local leaders and friends and associates of current trustees, governance succession planning seeks to find highly qualified board members who are experts in the areas of governance in which the board needs the most help, free of potential conflicts of interest and able to meet time commitments.

Governance succession planning is the key to improving board and organizational performance. By regularly assessing the board's leadership strengths and weaknesses, and using the hospital's strategic plan to define critical future leadership requirements, the board can identify governance gaps that can be closed through targeted trustee recruitment.

These gaps will be different for each board and organization; while one board may need to increase its diversity, another may seek greater financial expertise or an improved balance between visionary, big-picture, long-range thinkers and those who are more practical and want to know what they need to do now to get there.

Securing the Right Trustees

Successfully identifying, assessing and bringing a new trustee on board involves several critical steps. Boards should begin by conducting a comprehensive governance practices and performance self-assessment to determine where they may have potential leadership gaps, either now or in the future. Once strengths, weaknesses, leadership challenges and future leadership needs have been identified, the board then can develop a list of specific skills, attributes and characteristics that are important for new trustees to possess. The specifications should complement existing board members' skills and competencies, and assist the organization in furthering its ability to provide thoughtful, diligent leadership.

Next, the board should seek and engage a variety of potential candidates who may meet its leadership requirements. Once a new trustee is selected, orientation and ongoing education are critical to ensure success in providing strong and effective governing leadership.

When interviewing potential trustees, don't sugarcoat the job. Be honest about board members' roles and responsibilities, legal liabilities and the time commitment required. The last thing a board needs is a new trustee who does not understand the scope of the commitment and who then is unable to fulfill his or her duties effectively.

Questions to include in an interview with a prospective trustee should include:

  • Approximately how much time, in addition to board meetings, can you contribute to your governance responsibilities?
  • Are you aware of any conflicts of interest that may prevent you from serving as a trustee?
  • What other boards have you served on, and how will those experiences contribute to your service as a trustee for the hospital?
  • What experience do you have in envisioning and planning for the future? How do you believe that your experiences might contribute to the board's strategic development work?
  • What experience do you have in dealing with complex, fast-paced business environments?
  • Would you be willing and able to represent the hospital as a speaker at civic groups and other venues?
  • What experiences have you had leading process improvement efforts?
  • How would you characterize your knowledge of or literacy in health care issues? How do you envision putting your knowledge of hospital and health care issues to use as a trustee?

Once a potential trustee has been identified, several additional steps should be taken before extending an offer to serve on the board:

  • Assess potential conflicts of interest;
  • Invite the prospective board member to meet with the board chair and the CEO for a detailed overview of the organization as well as relevant organizational materials and a board member job description;
  • Provide the candidate with names and contact information of board members he or she may contact with questions;
  • Invite the prospective new member to observe a board meeting, and follow up with the candidate after the meeting to discuss his or her continuing interest.

Larry Walker ( is the president of The Walker Company Healthcare Consulting LLC, Lake Oswego, Ore. He is also a member of Speakers Express.

Sidebar - Key Steps in Succession Planning