Welcome to ACNL in Action, brought to you by the Association of California Nurse Leaders. I'm your host, Charlene Platon. Our guest today is Dr. Molly Rodriguez, DNP, RN, CNS, and Senior Program Manager at Stanford Healthcare. In her role, Molly manages the succession planning process for nurse leaders at Stanford. Molly recently presented at the ACNL annual conference in February on a succession planning tool that she and her team developed to identify future leaders. The assessment tool was designed to be able to be completed in just 10 minutes and could serve as a model for other organizations looking to improve their own succession planning process. Thank you so much, Molly, for being here. It's great to have you on the podcast.

Hi, it's nice to be here. Thank you for inviting me.

Yeah, very exciting topic today. And I know we're going to get into everything about succession planning. So I wanted to first start with you know, what do we mean when we actually talk about succession planning and nursing and why is that so important right now?

Yeah. Yeah. So succession planning is a talent management strategy. It's been used across many industries for years, and it's really aimed at developing and retaining talent. So talent could be knowledge, skills, and abilities of employees within the organization. And it's retaining that in the organization to achieve organizational deliverables, to maintain the mission and vision, and to remain competitive or leading edge. So it's really a way, a huge asset of the organization is the talent within the organization. And so it's managing that talent. As far as why succession planning is important for nursing and why at this time, I don't, I think there's a couple of different factors. If you read some of the literature, some of the stuff that professional organizations are putting out as to why this is a priority. One of them is that there's the shifts in the nursing workforce with like the current or anticipated nursing shortages. I think as nurses, we feel the impact of that like on a daily basis right now. But you know, over the next decade, there is predicted and anticipated to be even more expansion for need for nurses and then nurses leaving the workforce. Uh, that is anticipated to be anywhere even close to like 200K a year over the next decade as nurses exit the workforce and retire for various either retire or exit the workforce for various reasons. So there's the shifting of the nursing workforce, which is really putting an emphasis on what kind of succession plan are we going to have in place, especially for our nursing leaders who may be shifting out of the organization. And then I think another really important thing to think about is just the importance of the emerging emphasis that our profession has on opportunity for career progression for nurses, where we really have a need and a goal to work at the highest levels of the organization across healthcare industries. And then that's really uh supported across like all of our professional organizations, ACNL, AONL, and it's even embedded in the Magnet document that you have to have an exemplar and show succession planning practices within your organization. So it's definitely a professional um goal and aspiration to ensure that nurse leaders are at the highest levels of uh the healthcare industry, which is important. So those are a couple of things I can think of, why succession planning for nursing and why now. But succession planning has been a practice that industries have used for a long time.

Yeah, thank you so much for that summary, Molly. It sounds like succession planning really is an important topic, um, particularly for nursing, because of the different impacts that you described just now. And it sounds like there is quite a bit of risk if organizations do not have a succession plan in place and if they don't really have a meaningful strategy for having nurses successfully transition into the workforce as we're facing shortages and other challenges in the profession. And I want to talk about that a little bit because, you know, from your perspective, what risks do organizations really face when they don't have this clear succession plan for nurse leadership?

Yeah, when we're looking at nurse leadership in particular, nursing uh the turnover and loss of nursing leadership can have multiple different impacts that can place an organization at risk. Um, for instance, the fall 2024 report that AONL and LATION Insights put out regarding the trends and innovations of nurse manager retention actually showed that annual retention just for RNs drops 2% to 4% on average when a nurse manager transitions, regardless of what kind of transition that is. So we know that the impact of turnover at the nursing leadership level just impacts nursing retention in general. So thinking through our strategy of how we're going to navigate that. Um, nursing leadership turnover also impacts patient safety and clinical outcomes due to the disruption in continuity of care and of leadership. Um consider as we have nurses retiring is losing that experiential knowledge that has been gathered over years within an organization. What is our plan to transfer that knowledge to new nursing leaders who are coming in? And then, of course, just the financial impact due to the cost of recruiting and onboarding new leaders and new nurses. Succession planning can really help to understand and be able to utilize the internal talent within an organization and leverage that as a talent management process where we're not necessarily having to maybe bring as much talent from the outside and saving some of that financial impact. So those are some of the summary of some of the risks, particularly for nurse leaders when we're looking at not having a succession strategy in place.

Yes, thank you. And it really sounds like there's multiple layers, right, when we do see these risks and when it comes to organizations and and the way that they manage succession planning. And when it comes to nursing leadership, it sounds like these impacts could be pretty dire. You know, they could impact us financially, it could impact the staff even from a recognition standpoint and how they feel valued, right? Because like you mentioned in terms of having the the talent in the organization sustained from within, it is different than seeking external leaders and seeking external leaders to be in these succession planning types of you know situations. So lots of potential things that uh that can happen when we do have a very meaningful succession plan. And I did want to ask, too, because on that note, can you share how succession planning is different from general leadership development or mentoring in general, since people might have some confusion about that?

Yeah, that's a great question. There's a lot of literature exploring kind of the concepts of succession planning specifically for nursing and healthcare, um, and what the differences may be between a succession planning program and the concepts of just leadership development, professional development. Um, so professional development programs are essential, you know, for strategies to improve retention and to improve organizational outcomes. Um, succession planning models in general usually include a whole component that focuses on professional development, knowing that to prepare leaders to fill organizational talent needs, there needs to be talent and development that's occurring. I think a unique um kind of aspect of formal succession planning as a talent management strategy is that, first of all, it's conducted from the perspective of meeting an organization's need for talent and then understanding what needs to occur at individual and group levels to um develop and uh to develop talent, but it's really done from the perspective of what will the organization need as far as leadership talent goes, and then how can we ensure we're building that up in our employees? So that's one perspective that can be different from other leadership development programs and maybe prioritizing professional development in a different context or for a different goal. And then also formal succession planning typically has a component where you have a formal talent review. Um, so there's it usually happens on a particular cadence, a regular cadence, where you review the talent in your organization for the goal of identifying high potential employees and potential successor candidates, where you're really putting in a plan in place of who are internal, possible internal job candidates as positions become open and having a good pulse check on what exists in the organization. And so succession planning really delivers on that component of putting a plan in place.

Got it. Thank you so much for sharing that. And I think it, you know, it can be confusing, right? Because there's different benefits that you can see in both succession planning and with mentorship and with just general leadership development. You know, it's kind of like the difference between having this formal succession plan process versus having like a clinical ladder, right, for nursing or a pro promotional ladder, which, you know, has a different means of growth.

Yeah, and they can and they can have very similar, they can have a um different uh outcomes that are the same as far as retention and professional development, but some of them I think are built for different purposes. And succession planning really often it utilizes just the existing development programs that are there, but it you it gives you a little bit of a pulse check and a plan. And then it's like, okay, how can we leverage existing development programs that are there now to build up the talent within the organization to meet those organizational needs? So it's definitely a hand in hand piece. You can't have a talent review process that then does nothing with the information we just got.

Right, right, exactly. They go hand in hand, and not all not all organizations may have both, but you know, I'm really excited to hear about the tool that you developed and how that's really um coming into play because I think that could be really helpful for organizations that may be considering, you know, having something like that in place.

Absolutely.

And so with that um said, I'm curious if you could tell us more about the tool and the process that you've developed for Stanford Healthcare and you know, just walking us through some of those qualities and competencies that are included or that are being measured, you know, even for things that may not be typically considered in a program like this, like someone's ambition or someone's passion, and using that to measure in a way that's statistically valid, you know. Tell us more about that.

Yeah, so um our aim for our succession planning program, which is for mostly for nursing leaders. We have a few other healthcare leaders that are in our program, but we our goal was to create an assessment tool that measures the concepts of leadership potential and leadership performance. Um, and then having that those measurements of leadership potential and performance, we use that information to help identify high potential employees and then potential successors for either groups of roles or individual roles. Um, when we looked at the literature, we didn't really find a tool that did this, a valid or reliable process for doing this. Um, it's worth noting too that this assessment is really designed to be used in collaboration. It's not necessarily used to in isolation. We've embedded it into our program where it's designed to be completed as an informative uh piece of work, where it's a it's a pre-work done by a supervisor who then takes that information that they receive from the assessment, uh, the understanding, the measurement of potential and performance, and they attend a talent review session with peer leaders facilitated by human resource resources to have a robust and contextualized conversation about their employees' leadership potential and their potential as a successor. So the assessment itself shouldn't really be used in isolation, but enhances our succession planning process and the conversation around leadership potential and provides a reliable and valid and data-driven piece of information because oftentimes these conversations can be um can be lacking reliable or scientific approaches. So it's it's the goal is to bring an element of that in as well. Uh so we what we did to develop the assessments, we we did a we conducted a multi-phase and mixed method approach to develop, validate, and pilot the tool. So for the tool development, we did a literature review, we connected with content experts to clarify our concepts and identify the leadership frameworks that we wanted to incorporate into the assessment questions. Um, once the tool is constructed, we conducted our content validity through a stakeholder and expert panel review and ultimately arrived at like 100% agreement on the content of the questions and the content of the assessment. And then finally, we piloted the tool. And so we ended up piloting the tool with the process that we were able to facilitate the assessment of 240 individuals by 87 different leaders. Um, and so with that, with that data, then we conducted our reliability testing and also conducted exploratory factor analysis. So a little bit more information about the assessment. The internal, the frameworks that we, the leadership frameworks we incorporated into our assessment, we did two leadership frameworks. One of them is internal to Stanford, and the other one is the ANO AO AONL NERSE Leader Core Competencies. Um, so we have, so you know, the the AONL core competencies are content validated also by a panel of experts. The um internal Stanford leadership uh competency framework is um validated through content uh validity as well. So we're able to incorporate both of those in to make sure we're aligning with competencies in our profession that have been identified by our profession, but also with our organization. So it was important to us to make sure that we aligned with both so that we could uh make sure we are capturing and measuring and even defining leadership potential performance based on what is important to our organization. As far as the reliability of the two concepts, so we did the the reliability testing was then to test the reliability of the assessment to measure leadership potential and leadership performance. And the reliability testing was excellent, so that's great. And then our exploratory factor analysis really helped us refine the tool. We were able to decrease the number of questions, and it really helped us understand which competencies fell into potential or performance. So we were able to shift those based on the indications from the exploratory factor analysis of which factors loaded stronger to which concept. Um, so really refining the definitions and the concepts of leadership potential and performance. Um, so that kind of explains how we created the tool. So looking at someone who, when we look at the assessment, then now it's a Likert scale scoring. And so as far as the overall score, we look at the the um we total, we take the sum and we average it. And so it's out of a one to five score. And so it tells us leadership potential out of one to five and performance out of one to five. And it gives us an indicator based on the content of each of these concepts that are filled with different leadership competencies of um someone's potential and performance. And then we can take that and we use it with different tools like the nine box tool and peer review conversations to really have a contextualized conversation about this um individual's potential and performance and readiness for advancement or ability, you know, or readiness for being a potential uh internal job candidate for a role. So what questions do you have about?

That was kind of detailed. No, I appreciate the detail and I really appreciate the amount of thoroughness and how mindful you and your team have been into really developing a succession planning tool that was very well thought out and also incorporates our own, you know, of course, our own internal resources, but also external um competencies like the AONL competencies. And that's really great to see because then as a result, um the tool that you've created has a really nice blend of what, you know, what is out there as, you know, as what we can see through established models. Yeah. And then being able to customize that through what is most important for Stanford and what we look for in our leaders. Uh, and then as a result, we could plug in the best, you know, the best candidates or the best um staff members into the best roles and aligning that with what the role needs, right?

Right. Absolutely, yeah. And that's why it's really, it's a really great piece of data-driven insight that helps kind of standard set of how we're defining potential and performance um as a as an organization and as nurse leaders. And then it has to be combined with that contextualized conversation and um the peer review piece as well, because that's a really um good, good partnership with it, the data-driven insights with the contextual conversation. So um that piece is something that I feel like is really important to succession planning that sometimes as nurses and as um people in healthcare, we're very data-driven sometimes, and we would just like the data to completely capture the question at hand and give us an answer. And sometimes that's not how it is. Sometimes it has to be contextualized, there has to be conversation around it. And so that's been a process for me to learn of like, where does the data-driven insight help? And where are there, uh, where does there need to be discussion and reflection and thoughtfulness about how you approach um talent development and how to um really strategically and thoughtfully help people in your organization move into where they need to be.

Yeah, and I I really like how you framed it because you know, you're right, as nurses, we do want all the data that we can have presented to us so we can make really informed decisions about different things. It's um no surprise that we want this to be applicable to leadership transitions, right? And to um changes in, you know, throughout the organization when it comes to those types of roles. And I'm curious because, you know, there might be cases where you're doing a succession planning tool and someone meets the criteria from an objective standpoint to be in a maybe in a promotion or a different position, but then maybe that person doesn't want to like emotionally be in that position. So Which is a huge piece of it.

Yeah. People's, you know, career context is so influential to these conversations. And and even in our leadership potential assessment, we do have a question in there that actually is addressing aspiration. Um, but yes, those contextualized conversations reveal a lot more of that, of what someone's asked actual aspiration is, and then what and then not just aspiration, but career context of everything that's going on in someone's life. And so uh that's why I think also succession planning can be is so is so far removed from like pre-selection, because it's impossible to do that. Not only is it unethical, it's impossible to do that because you have no idea where someone is going to be and what an organization is going to need when a role opens up. Um, so this is just really helpful insight into the state of the organization, the state of the talent at a given point in time, and also why you need to continue to do it on a regular cadence so you can stay in touch with that because so much shifts so quickly for individuals and for organizations.

Yeah, exactly. I I agree with that, and I I think that's a wonderful assessment because you know, you're right, things can shift within the organization, outside of the organization, and that could really influence the context of the leaders and the roles that they want to be in, or that they are the appropriate fit for. And yeah, for sure. And and I'm curious if there were maybe any surprising findings that you saw just as you've been working on this, or or just anything that you didn't expect.

Um yeah, I I think just in general, the succession planning journey has been very interesting. You know, I'm a nurse by training and uh transitioned into this role um as a program manager and have gotten to partner with HR and just learn this whole new world of talent management. Um and so yeah, I think that I think that kind of re kind of going back to what we had said, that data-driven insights are important and it's really helpful to have a level setting. It's helpful to have definitions and structures to understand our framework and how we are all perceiving the language that we use to talk about people and the language that we use to understand competency and to understand leadership competency. And so that has really stuck out to me as uh really important in what this assessment helps achieve. And then I've also under Become be gotten to a place that I value so much than this opportunity where leaders actually get to come together and they get to talk about what are the actual action items that we would use to help develop these people? What are the resources in the organization that we can take and strategically offer or encourage our teams to use? So that talent review conversation in uh in connection with the assessment is really powerful to actually give leaders the information that they need to develop and foster a culture of talent development, which is really hard to do on an individual level. When you're a leader who has all of your own deliverables, all of all your packed schedule to then think about developing the people in your team, that can be really, really difficult. So having these periods, we can come together and talk and have information to really fuel that um those conversations is what has been the most impactful and exciting to see.

Yeah, that is such a good point because these programs and processes can really impact the culture of how these conversations happen. And it could really increase the visibility of these um plans, it could really increase the transparency of these conversations and put less pressure right on leaders to always have to kind of think of the right way to do these things. But if it's uh structured already within the leadership team, it's a nice kind of universal language that everyone can speak.

Yes, exactly.

And something that actually surprised me about this tool is that the fact that it could really be a 10-minute time to complete it. And I was curious if you could share, you know, why is it important to have this tool be limited to something like maybe 10 minutes? And how has that impacted or affected the adoption of the tool?

Yeah. Yeah, that was that that was one thing that we were really struggling with is how do you really help people have an informative assessment that's completed in a quick quick amount of time? They're wonderful assessments, the full AONL core, you know, core competencies that are listed, you know, that you could dig into and that you could use, but a lot of them take a lot of time or it could be 80 to 100 questions. And so we were thinking about how do we contextualize this in our program and what our leaders are capable of doing on an annual basis. And um also in the context of just succession planning in general is a time investment. It takes time to go to a session and have a conversation, it it takes thoughtfulness and being engaged and being reflective on um your on your team and what your team needs to develop. So um we were really focusing on creating something that was easy and quick to complete. Um so with that, we ended up um uh that was that was one of our main aims was creating a succinct assessment and something that we really incorporated into the methodology of how we built it to make sure it could be completed in a short amount of time. And so far we've had no issues with adoption. Um I think the first time we piloted it, it was slightly longer, and there were a few groans and grunts, and then this this the the we refined it even a little bit more, and I've gotten no negative feedback, which has been really great to hear. And we've had every, you know, every leader who participates in succession planning does use the tool to assess their employees. So we've been able to get like a hundred percent, you know, um, compliance rate with the use of it as far as the program goes.

Yeah, that's amazing to hear. And and it sounds like the you know, the the thoughtfulness and um even down to the amount of time that's needed to implement and complete has really impacted the success of it. Um and it sounds like overall it's been really successful.

Yeah, I think it's been great. I you know, I look forward to um learning how to leverage the tool and the information more. You know, right now we um use the tool as it measures potential and performance. They use that to help inform um our identification of high potential employees and who could be the potential successors. We use it in collaboration with the nine box tool and with peer discussion. So we're really exploring now this year how we can utilize the assessment to develop individual and aggregate reports on even the competencies that are being assessed in each of those concepts and um what resources may be available to help develop those competencies if they score lower, or to acknowledge it it could be a strength that a leader could push into if they if they rate are rated really high on it. So we're kind of exploring some of those pieces of how we can leverage the information to its fullest extent.

That's great. And and what I really appreciate about this tool too is that it really incorporates different elements that people may be using already, right? For different things like the competencies might be used for other things, like these development programs. Um, they might already be using some of these measures for like, you know, retention and things. It really is a nice kind of way to tie that ribbon on this nice package of leadership development in a way.

Yeah, yeah, absolutely. For anyone who, you know, for other development programs looking to understand potential and performance, I think it could it could be appropriate definitely to utilize the assessment in those contexts. So it'd be interesting to explore that too.

Yeah, for sure. And I want to know, you know, for our listeners who may be hearing this right now and who may be interested in something like this for their own organizations, you know, I I know that you worked closely with human resources to look at the criteria to fit the needs of Stanford and, you know, the organization. And I wonder what advice you would give to leaders at other organizations who are really looking to create their own tool or maybe some sort of, you know, similar um process.

Yeah, that's a great question. You know, I think that in general, I would first recommend just really having a clear understanding of the succession planning needs and priorities within your organization. Um, if you don't know those already. So identifying, you know, stakeholders who within your organization who can probably help define this would be human resources, executive leadership, nurse leaders, um, uh educators, getting a really clear needs assessment of what the organization hopes to achieve through a succession planning program, and then what components of that program you feel are most important to invest your time and energy into developing. Um, and so I would clarify that and make sure you feel really comfortable with that. I think the next piece would be what is it that you really would like to measure and assess? If you're thinking about building your own tool, are you trying to measure the concept of potential and performance? Or are you looking to measure and assess different specific leadership competencies? Um, so really understanding what it is in the tool that you hope to measure and then how you would like to use that information to inform your succession planning conversations. And then finally, building a tool, really, you have to have a skill set to do that. So I really encourage you, encourage people to partner with like a nursing scientist or a psychometrician to be able to tackle tool development in a method, you know, methodological and scientific way that can achieve validity and reliability. So tool development, I was both surprised that I was able to engage in this process and understand that there's a clear way to move through it and it is achievable to create a tool, but it also would not have been achievable without the partnership of a nurse scientist and a psychometrician. So make sure you're partnering with those people who have those skill sets to guide you through that process.

Yes, thank you so much for that insight. And and I do think it speaks to the importance of really the collaboration piece for something as big as this process because it's really meant to be um a larger program, something that people can really adopt um across nursing leadership, and and that's no small task, right? So so that that's really good insight. And I do want to ask too, because um I think sustainability and keeping a program like this afloat and really meaningful for a long period of time can be a challenge too. So, you know, with the constant change of healthcare and with, you know, maybe the challenges of succession planning for sustainability for a year now or for longer, what what recommendations do you have in terms of keeping your succession plan sustainable and you know, especially when competencies today might be different from what they were yesterday? Yeah, that's a really good question.

I think in general, um it's re it is really important to um have frequent and regular succession planning conversations. So a succession planning is definitely not a one and done. And like you're saying, uh a succession planning talent review and considering a talent, you know, uh potential successors or a talent pool could shift so quickly within a year, within 18 months, within less time than that. So, our program, we conduct our talent review process on an annual basis. Um, and that's what a lot of the literature shows too. So definitely performing regular touch points with succession planning and then making sure that any sort of assessment process that you use or the competency frameworks that you're using are definitely contextualized in the specific role that you may be looking at or the specific um uh individual, and then also in the context of current organizational needs in the leadership environment. Um, so definitely using assessments in isolation may not be as effective as having the whole process put together with a robust conversation.

That sounds great. I I think that having it, having something like this as a regular agenda item, a regular touch base and um check-in is speaks volumes to keeping such a powerful program in place in the organization. Yeah, yep, definitely. And I feel like there's so much more to unpack, but I know that we have to wrap up. And I just want to give you the opportunity to share any final words of wisdom that you'd like to provide for those who want to implement succession planning.

No, I think again, um, as you'd mentioned, it really is a multidisciplinary process. So we've we've partnered heavily with human resources, even just to make sure that our processes and the frameworks that we're using are appropriate and uh ensuring that we're striving for a non-biased and avoiding discrimination. So those are all things to consider when you're talking about talent management. Um, so partnering with human resources and making sure that those appropriate ground rules are set in place is really important. Um, but yeah, just uh set something in place that you can have touch points with. And as far as exploring your assessments and your tools, it's possible to build something. Um, it just takes some thoughtfulness and the right people in the room too.

That sounds great. And and for those who are listening who might want to learn more about your work, uh, where can they find you or where can they kind of learn more about what you've developed?

Yes, so I am on LinkedIn. Um if you look me up, I'm Molly Rodriguez. I'm not super active on LinkedIn. I need to get better at that.

No, we'll we'll get you right on there.

Don't worry. Uh but I will, if you message me, I will respond. Um, you can also always email me, so I'm happy to hand my email over, get that disseminated out too if anybody needs anything. But yes, I'm on LinkedIn or email is a great way to sounds great.

Well, thank you so much, Molly, for being with us here today and for sharing all of your insights. It was a wonderful conversation, and we look forward to we look forward to sharing more about your work. It was great to be here. Thank you. Thank you. Our guest today was Dr. Molly Rodriguez, Senior Program Manager at Stanford Healthcare. We would love to hear your feedback. Email us at socialmedia at acnl.org and connect with us on LinkedIn and Facebook at ACNLNurse. And as always, if you like the show, please remember to rate, review, and share. ACNL in Action is presented by the Association of California Nurse Leaders with new episodes on the first Friday of every month. To learn more about the show or ACNL in general, visit us at acnl.org. Thank you for listening.