wileyonlinelibrary.com/journal/jonm J Nurs Manag. 2018;26:238–243.
© 2017 John Wiley & Sons Ltd
Accepted: 20 May 2017
Nurse manager succession planning: A cost–benefit analysis
Tracy Phillips DNP, RN, NE-BC, Nurse Researcher , Adjunct Faculty
| Jennifer L. Evans
DNP, RN, Assistant Professor
| Stephanie Tooley DNP, RN, NE-BC, CPHQ, Executive
Director of Quality
| Maria R. Shirey PhD, MBA, RN, NEA-BC, ANEF, FACHE, FAAN,
Professor and Chair
Baptist Health Paducah, Paducah, KY, USA
School of Nursing, University of Southern
Indiana, Evansville, IN, USA
St Vincent Hospital and Health Services,
Indianapolis, IN, USA
University of Alabama of Birmingham,
Birmingham, AL, USA
Tracy Phillips, Baptist Health Paducah,
Paducah, KY, USA.
Aim: This commentary presents a cost–benefit analysis to advocate for the use of suc-
cession planning to mitigate the problems ensuing from nurse manager turnover.
Background: An estimated 75% of nurse managers will leave the workforce by 2020.
Many benefits are associated with proactively identifying and developing internal can-
didates. Fewer than 7% of health care organisations have implemented formal leader-
ship succession planning programmes.
Evaluation: A cost–benefit analysis of a formal succession- planning programme from
one hospital illustrates the benefits of the programme in their organisation and can be
Key Issues: Assumptions of nursing manager succession planning cost–benefit analy-
sis are identified and discussed. The succession planning exemplar demonstrates the
integration of cost–benefit analysis principles.
Conclusion: Comparing the costs of a formal nurse manager succession planning strat-
egy with the status quo results in a positive cost–benefit ratio.
Implications for Nursing Management: The implementation of a formal nurse man-
ager succession planning programme effectively reduces replacement costs and time
to transition into the new role. This programme provides an internal pipeline of future
leaders who will be more successful than external candidates. Using an actual cost–
benefit analysis equips nurse managers with valuable evidence depicting succession
planning as a viable business strategy.
cost benefit analysis, nurse leader, nurse manager, succession planning
1 | INTRODUCTION
Nurse managers are nursing leaders who often assume round the clock
responsibility for one or more nursing units in acute care hospitals. The
scope of responsibility for nurse managers varies greatly among hos-
pitals across the United States (USA). Effective nurse managers cre-
ate healthy work environments that increase nurse morale, improve
retention and decrease turnover (Duffield, 2011; Sikora, Ferris, &
Van Iddekinge, 2015; Stichler, 2008; Swearingen, 2009). Nurse man-
agers and the turnover of nurse managers influence patient safety,
satisfaction and clinical outcomes (Warshawsky, Rayens, Stefaniak,
& Rahman, 2013; Wong & Cummings, 2007). Despite these findings,
studies show that many organisations are not investing resources in
the development of current and future nurse managers (Sherman &
Pross, 2010). When deliberate, proactive leader development is ab-
sent, leadership stability, service continuity and job satisfaction are
compromised (McCallin, Bamford- Wade, & Frankson, 2009).
Nurse executives are senior leaders who supervise nurse man-
agers and act as advocates and strategic thinkers. These nurse ex-
ecutives should support succession- planning efforts from an ethical