Succession Planning Activities at a Rural Public Health Department

This qualitative case study utilized interviews and evaluation of publically-available documents to investigate the process of succession planning in a moderately-sized public health office located in a metropolitan community in a frontier-rural state. Following analysis of the data, the results were compared to literature findings. Four public health directors, the County Health Officer and the Board of Health chairperson participated in the private, face-to-face interviews. These individuals were asked to participate because they have the ability to direct staff leadership development activities. A formal succession planning program did not exist at this agency; however, on an informal basis, leadership development was evident. Successes in promotion of leadership development included establishment of a cooperative and collegial work atmosphere. Barriers to the process of succession planning included a lack of stable funding, lack of understanding about the role of public health by the public, erosion of public health authority, inability to recruit trained personnel, low pay scales, and aging of the current workforce. The results of this study indicate that although formal succession planning programs may not exist within an agency, leadership development is still possible through proven adult education methods. Keywords: Succession Planning, Rural Public Health, Leadership Development, Case Study, Qualitative ResearchSuccession planning for key leadership positions is a dynamic activity that should be undertaken by all agencies and organizations to assure seamless functioning of vital programs in the event of planned or unplanned vacancies of those positions (Rothwell, 2005). Succession planning is important for public health agencies in general, but particularly important for rural agencies as they provide a critical link to healthcare for people who live in isolated areas of the country (Glasgow, Morton, & Johnson, 2004) and face unique challenges with smaller, minimally staffed health services (Rosenblatt, Casey, & Richardson, 2002). In these rural applications, effective succession planning is paramount as flat organizations and recruiting challenges constrain unplanned reorganization and may cause gaps in service. Rosenblatt, Casey, and Richardson (2002) reported that "two-thirds of the nation's 2,832 local health departments serve populations smaller than 50,000 people" (p. 1102). Rosenblatt et al. continued that three states (Alaska, Wyoming, and Montana) had a combined total of 99 local health departments serving nearly 2 million residents, over half of those individuals residing in rural areas. Each local health department in these states had fewer than ten employees. These numbers underscore the facts that the public health service must be effective and transitions of leadership seamless in order for optimal healthcare provision to the populations they serve. The intended audience for this study is comprised of public health managers who have leadership responsibility and should be made aware of or reminded of another perspective on succession planning activities.According to a review of the literature, only limited succession planning has been done in public health agencies in some of the larger states such as Washington and Ohio (Heishman, 2007; Schmalzried & Fallon, 2007), and historical studies are absent concerning succession planning at rural public health agencies. This article reports observations and results from a qualitative case study undertaken to explore the succession planning efforts of a rural local health department. The research questions that guided this research were as follows: does a formal succession-planning program exist at this agency? How is it accomplished? What successes have been achieved? What barriers exist that impede implementation?The local health department selected for this study was a stand-alone county health department situated in a community of approximately 70,000 residents in a frontier-rural western state. …