An Ongoing Succession Plan is Crucial for the Role of the Board Chair

In the healthcare industry, staff vacancies at any level can be difficult, but operating without a board chair can be particularly troublesome. After all, a healthy functioning board of trustees is often accountable for the financial stability of the organization and the quality of patient care and the board chair leads those efforts. A vacancy in this role, or a less than stellar replacement, can have almost instant negative impact in the day-to-day running of the organization, and the bottom line. Here we discuss how to handle replacing a board chair.


Whenever leadership roles are about to change hands, there is an opportunity to look critically at the job description to make sure the role is clearly defined and in line with the mission/vision of the organization. The role of the board chair must have a key leadership focus. Traditionally, a board chair is responsible for setting goals, ensuring the integrity and effectiveness of the board’s governance, and presiding at board and executive committee meetings. The chair is the voice (and face) of the board to staff, stakeholder groups, and community. As such he/she must have excellent leadership skills, integrity, approachability and dedication to the organization, while maintaining effective professional relationships with board members, management and stakeholders.


A thoroughly considered, well-conceived succession plan for such a change in leadership is a necessity, and should ideally be an ongoing process rather than something put in place when the current chair is about to roll off. The governance committee should provide continuous leadership training opportunities for board members with the goal of creating a pool of leadership candidates prepared to move up when a new election approaches.


The full board must be involved in the leadership succession process in order to avoid concentrating power in the hands of a few. Once the role and qualifications have been clearly defined, the governance committee should consult with each board member to solicit nominations of other members who have demonstrated leadership qualities. These nominations should be sifted through to identify a single candidate to be brought before the board for election. This strategy allows all board members to play a decision-making role and creates a feeling of consensus amongst the members.


James E. Orlikoff, a healthcare governance consultant, recommends succession plans include the opportunity to vote in a chair-elect, who can work alongside the current chair. The chair-elect can gradually take on specific responsibilities, allowing the board to assess his/her skills in real time (including areas that need improving), and prior to taking on the role of board chair. However, this role is not a guarantee of the chair position in the future. If the chair-elect proves inadequate, another candidate can be chosen.

Given that the board and board chair represent the organization to the public, having a solid leadership development and board chair succession plan is a must because it maximizes quality of care and organizational accountability.

Contact Us

LeaderStat specializes in direct care staff, interim leadership, executive recruitment, travel nursing and consulting for healthcare organizations nationwide.