By Matt Skoufalos
For all the complexities associated with working in the radiology space, the business of administrative duties can often be a secondary consideration to operational needs. In the January 2017 issue of the Journal of the American College of Radiology E. Michael Donner, III, et al, describe these challenges in “Succession Planning and Management: The Backbone of the Radiology Group’s Future.”
“All too frequently, leadership in radiology groups defaults to those willing to do it,” the authors note. “Leadership vacuums commonly exist, and a specific focus on leadership identification and development is not emphasized because clinical work drives the group.”
Part of that is attributable to the notion that, “when entering medicine, most future physicians do not anticipate that they must be adept at business leadership activities,” they write. But compounding the issue are their observations that “most radiology practices do not have comprehensive succession plans,” and that “the current replacement process for a radiology practice leader is all too often an individual reluctantly agreeing to accept the responsibility.”
Rather than letting these considerations fall by the wayside until they necessitate an emergent response, the authors note that the American College of Radiology (ACR) Commission on Human Resources recommends succession planning as a necessity for all practices and offer some guidance on how to follow through with it in a formal, transparent way.
Michelle Nocera, director of radiology academic market at University Hospitals of Cleveland Ohio, said that succession planning became a topic of conversation one day when she realized that, if there were some circumstance by which she were unable to report for work, she’d have no idea who would be called upon to take her place.
“You never want to get in a situation where nobody knows what’s going on to the point that the company is suffering because you’re stuck,” Nocera said. “In my own training in leadership, as a manager and as a director, I have always been one to teach at least a couple people, if not everyone on my team, how and why I’m doing certain things.”
Beyond identifying for a long-term or permanent replacement, succession planning pays dividends in a variety of temporary circumstances as well. Nocera spoke plainly about the need for employees to be able to take paid time off (PTO) without worrying or wondering whether their absence for any length would cause problems for their colleagues, or delay projects.
The best way to achieve this, she said, is for organizations to commit to a process of continuous improvement, both institutionally and interpersonally. In her current position, Nocera said every employee both evaluates and is evaluated by their managers and direct supervisors in a 360-degree process to identify whether they would be capable of advancement, and if not, how they might improve their performance to better ready them for subsequent opportunities.
“I evaluate all the people who report to me,” Nocera said. “I can review those people every year and say, ‘Are they ready for the next step in their career? If they’re not ready, what can I do to help make them successful and get them ready?’ That then becomes a topic of conversation at our reviews.”
Even for institutional “lifers,” as Nocera describes her own perspective on her current place of employment, there’s always an opportunity to continue to develop professionally and learn new skills and techniques. Advancement isn’t mandatory – plenty of people are happy in their current roles in addition to being well-suited to them – but committing to a process of continuous professional development affords every employee the opportunity to be supported in their own individual growth.
“Sometimes it’s hard for some people to stay in a role and not continue to advance,” Nocera said. “Some of those roles aren’t out there, and workers have to go somewhere else. But I also have a number of people who like where they’re at and what they do, and we just continue growing them. To come to work every day knowing that you love your job – that is the plan.”
A key component of helping employees continue to grow professionally involves developing clearly defined roles, responsibilities and expectations. Nocera spoke about the need “to map everything out, be very detailed, and share what I’m doing” with the employees to whom she reports and those who report to her. By way of example, she meets with a department manager to keep them in the know about director-level conversations that would affect the way that manager might work or might lead their employees.
“A lot of times, you might hear in your employee engagement series that staff don’t feel like they’re considered in decisions made higher up, so I try to have that dialogue to bring them in and fold them into that.”
“In radiology, we’re hands-on,” Nocera said. “That’s how our brains work. We have to be doing things to interact and remember. It is a continuous process developing an employee.”
In settings where there’s no structured process in place for employee development or for succession planning, Nocera recommends striking up a conversation with human resources or with institutional leadership to ask them whether there are any plans to create such channels, or opportunities to build them within the organization.
“Start with human resources and see whether they have any type of organizational development and management leadership programs,” Nocera said, “and if not, work with them to create leadership programs.”
Once such programs have been created, there’s additional work to be done to spread the word about them within the organization, she said. Peer evaluation systems, co-mentorship programs, team-building efforts, and comparable processes help identify opportunities to develop leaders as well as areas of shortfall among other skilled employees. Cross-discipline training is another way for skill-building and talent evaluation to support institutional resilience and identify chances for streamlining workflow where possible.
“When you review your talent, you can see what knowledge and experiences are needed for professional development,” Nocera said. “I went through and talked to other leaders in different disciplines – people in the cancer center, people in respiratory therapy – because they have the same kind of information that we have.”
Nocera also recommended undergoing the process with the help of systems analysts or data teams that will be able to help develop and quantify their understanding of employee skill sets and opportunities to improve patient volumes, engagement scores, gaps in quality assurance, or any other key performance indicator that can help an organization and its members thrive.
“If your area doesn’t have the metrics to be able to see that, see if there’s somebody within that team that can help get you that data so that you can look at it daily or weekly,” Nocera said.
“The big thing out there right now is diversity, equity and inclusion (DEI) strategies; making sure that you’re broad in opportunity and access, and that the makeup of your leadership reflects the makeup of your workforce.”
Once that process is underway, the work of identifying which employees will make the best new leaders for an institution can begin. Strong leadership qualities can include things like effective communication strategies, shrewd resource management, innovative approaches to job-related tasks, thoughtful conflict resolution, and the ability to translate a broad variety of employee perspectives into supportive actions that benefit the group as a whole.
“We want to make sure that we are always looking for different types of leadership,” Nocera said. “I want other people’s ideas and their types of leadership styles in the mix.”
When succession plans aren’t in place, sudden employee departures can be challenging to navigate. Nocera said she’s had the experience of joining a team whose leader retired without leaving any trace of their workflow behind. That loss of insight into daily processes is just one example of the withering of institutional memory that can occur when employees leave, and its effect can be cumulative across the workplace.
“In preserving institutional memory, I really like having that document that explains standard work,” Nocera said. “Document those things that we do every day, week, month, and keep it available. Write down the things that you have to do so that one, you don’t forget anything, and two, if it changes, it’s documented somewhere.”
Operating in the age of cloud-based storage offers an even easier opportunity for management teams to catalogue and share their work with anyone else in their organization for ease of access.
“If I left tomorrow, they could go on my OneDrive and see pretty much everything that’s happening,” Nocera said. “Building that institutional memory means really figuring out what’s going on every day instead of relying on individuals; creating resilient teams, so that if one person went away, that team still knows what’s going on.”
The value in that process extends beyond employee departure or illness, as well. Nocera knows she’s years away from her own retirement, but nonetheless doesn’t want to leave her coworkers in the lurch when she is ready to move on.
“I want to make sure that I leave my coworkers the ability to be successful,” she said, “ensuring that leadership remains headed in the right direction, and able to navigate change. Our industry is constantly changing, and we need to always be adaptable and creative to continue to live our mission, vision and values. We won’t be successful if the next generation of leaders aren’t able to understand what our organizational goals are.”
Nocera said the best way to certify that institutional priorities are met by various generations of leadership is to hard-wire it into institutional culture from the beginning. Succession planning involves consistent reinforcement of operational and long-term goals so that any time change occurs, everyone can remain in alignment with them.
Katherine A. Mohr, DBA, a consultant, speaker and educator, stresses the vital need for succession planning. She believes it should always be a priority – kept “on a gentle simmer” – to ensure smooth transitions and prevent unexpected challenges. Continuous attention to this process prepares organizations for future changes.
“A great example of a successful succession plan occurred when I was transitioning out of one of my previous management roles,” Mohr said. “I had a specific person in mind to take my place; someone I had been closely monitoring and who stood out to me. It was one of my lead technologists, who consistently demonstrated exceptional skills and leadership potential.”
“During one of our casual check-ins, I decided to bring it up. As we chatted, and I asked her, ‘Are you ready for the next step in your leadership journey?’ she smiled and said, ‘Maybe in three to five years.’ I replied, ‘That’s perfect! I’m working towards a directorship, and if everything goes as planned, I’d love to mentor you into this role.’ ”
Mohr initiated a year-long process to enhance the technologist’s leadership skills, preparing her for the possibility of stepping into the leadership role. This process included tailored managerial training sessions, practical examples of daily departmental challenges, and ongoing support to build her confidence and expertise. After Mohr transitioned to a higher-level position at another institution, she committed to coaching the tech for an additional six weeks. This ensured a smoother transfer of knowledge and insights, allowing the department to thrive under its new leader.
“When I left my institution for a directorship, I ensured that I left a highly capable person in place, equipped with all the necessary tools for the job,” Mohr said. “I told my boss, ‘Give her a chance.’”
“It’s important to assess your team to identify individuals who are both interested and capable of taking on new responsibilities,” Mohr said. “You should start looking for these qualities in your team as soon as you assume a leadership role, regardless of where you are.”
“As a manager, I enjoy sharing my knowledge with my team,” she said. “I would never want to leave my department in a pickle where crucial information isn’t shared. Some people tend to hoard information because they believe it makes them more valuable; however, sharing our knowledge fosters a stronger team dynamic and helps everyone feel more confident in making autonomous decisions, even in the absence of a leader.”
As a consultant, Mohr has the opportunity to visit various institutions and identify potential leadership candidates based on their level of interest and current activities.
“You need to understand your staff and build from there,” she said. “Involve potential leaders in meetings, share departmental information with them, and watch how their leadership skills develop over time.”
“I strongly believe that implementing a clinical ladder process within a larger organization enhances employee engagement and fosters a sense of connection with leadership,” Mohr said. “In leadership roles, being open and sharing information can cultivate a positive atmosphere, which can help mitigate negative feedback.”
By holding one-on-one meetings to discuss career goals, employees who may excel in leadership positions can be more easily identified. Understanding their aspirations, both professional and personal, enables leaders to assign tasks to their employees that support their growth into leadership roles.
“Giving employees a clearer understanding of the budget, the process for ordering supplies, and the locations to find new or replacement items when necessary encourages them to think more broadly and explore different options,” Mohr said. “A good leader consistently follows up after introducing these ideas; many leaders neglect this because they become too busy with other tasks, which undermines the example they are trying to set.”
Safeguarding institutional priorities begins with “hiring from within and mentoring upwards,” Mohr said. Organizations that practice this approach foster departmental and interdisciplinary cohesion and enhance record-keeping, which helps preserve institutional memory.
“I believe that when hiring someone for a leadership position, organizations should discuss succession planning on day one,” she said. “We need to share information continuously and document it so that it remains on everyone’s radar. Ultimately, this ensures the longevity of the institution.”
For more information on this and more important topics, check out the upcoming educational sessions at the Imaging Conference & Expo at AttendICE.com/education.
